Hearing Loss VA Rating: How the VA Rates Your Ears

Most veterans searching for a hearing loss rating want one answer: what does the audiogram have to show to reach the next percentage. The answer sits in 38 CFR 4.85 through 4.87, and it is the most formula-driven part of the entire rating schedule.

The schedule does not rate effort, frustration, or how many times you ask people to repeat themselves. It rates two measurements from an audiogram: pure tone thresholds and word recognition.

The two measurements

Pure tone thresholds are the softest sounds you can hear at specific frequencies - the VA evaluates 500, 1,000, 2,000, and 4,000 Hz, each ear separately. Thresholds are recorded in decibels, and higher numbers mean worse hearing.

Word recognition is measured separately: the audiologist reads a standardized list of words and records the percentage you repeat back correctly. Poor word recognition with reasonable thresholds, or the reverse, is exactly why the VA uses two tables and takes the better result.

The formula and the tables

38 CFR 4.85 includes the numeric formula - often called the Maryland Council for Audible Range calculation - that converts pure tone thresholds into a number comparable against the evaluation tables. Table VIA lists pure tone criteria from 0 to 100 percent, and Table VII lists word recognition criteria. The VA computes both and assigns the higher evaluation.

38 CFR 4.86 provides an alternative exceptional pattern for ears that do not fit the standard formula, and 38 CFR 4.87 contains Diagnostic Code 6100 itself. The percentages are earned ear by ear, then combined like any other ratings.

Why so many hearing claims land at 0 percent

The compensable lines in the tables sit at thresholds that many veterans with real hearing difficulty do not cross. Mild high-frequency loss, the most common military pattern, often produces a 0 percent rating even though it makes conversation in restaurants and on the phone genuinely difficult.

A 0 percent rating is still a grant - service connection is established. Two practical notes follow from that. First, worsening hearing over the years is the basis for increased rating claims, so keep getting tested. Second, the 0 percent still counts in the combined rating table, which matters for claims like TDIU.

What gets recorded matters

An exam report that lists thresholds without the word recognition score, or that records results without noting reliable testing, is a report that can be challenged. The audiometric data in the file is what the rater uses, and incomplete data usually defaults to the low end.

This is also why a private audiogram from an audiologist can be worth obtaining before the claim is filed. It puts complete, professional measurements in the file instead of leaving the percentage to whatever the exam produces.

Hearing aids do not change the rating

A common misconception is that wearing hearing aids lowers the rating or that refusing them protects it. Neither is true. The rating is based on your unaided audiometric findings with hearing aids in or out of the picture. Our hearing aids guide explains what hearing aids do and do not change, and our VA hearing care guide explains how treatment eligibility differs from compensation.

Where an independent medical opinion fits

The rating formula is fixed, but the service connection question underneath it is not. When the VA accepts that you have hearing loss but denies the link to service, the fix is a reasoned medical opinion that reviews the audiometric history, the exposure, and the competing causes. Our nexus letter guide explains what that contains, and a medical records review is where veterans start when they are not sure the file supports one.

Combining ratings when both ears are involved

When hearing loss is service connected in both ears, the VA does not simply add the two ear percentages together. Diagnostic Code 6100 already accounts for both ears in a single combined evaluation drawn from the tables in 38 CFR 4.85, using the poorer ear and the better ear together to reach one overall percentage for the disability.

This is different from how the VA combines separate disabilities, such as hearing loss and a knee condition, under the combined ratings table. Within hearing loss itself, the two ears are inputs to one Diagnostic Code 6100 evaluation, not two ratings that get combined afterward.

Special monthly compensation for severe hearing loss

Most hearing loss claims are rated on the standard 0 to 100 percent schedule, but severe bilateral hearing loss - particularly when combined with deafness or when it exists alongside blindness or loss of use of extremities - can potentially support special monthly compensation under 38 CFR 3.350, which pays additional amounts beyond the standard rating tables.

This applies to a relatively small number of veterans with the most severe hearing loss, often at or near total deafness in one or both ears. Veterans whose hearing loss is profound should ask their VA audiologist and claims representative whether the level of loss documented on the audiogram meets any of the special monthly compensation criteria.

Filing for an increased rating as hearing worsens

Sensorineural hearing loss from noise exposure typically does not improve, and many veterans who receive a low percentage or a 0 percent rating find their hearing measurably worse five or ten years later. Because the rating is tied directly to the current audiogram, a new audiological evaluation showing lower thresholds or reduced word recognition is the basis for an increased rating claim.

There is no limit on how many times a veteran can request reevaluation as hearing changes, and there is no requirement to show a new injury or exposure - the natural progression of the existing service-connected condition is enough. Keeping periodic audiograms in your personal records, even outside of a claim, makes it easier to document that progression when the time comes.