Hearing Loss VA Ratings: How the Tables Actually Work

Hearing loss is one of the few conditions the VA rates almost entirely by formula. Two numbers from an audiological examination are run through fixed tables, and the result is the percentage. Understanding the mechanism explains why so many veterans with real hearing difficulty receive a 0 percent evaluation. For how a hearing claim gets service connected in the first place, start with our tinnitus and hearing overview.

What counts as hearing loss for VA purposes

Under 38 CFR 3.385, impaired hearing is considered a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, or 4000 Hz is 40 decibels or greater; or when thresholds for at least three of those frequencies are 26 decibels or greater; or when speech recognition scores using the Maryland CNC test are less than 94 percent.

A veteran whose results fall short of all three definitions does not have a ratable hearing loss under VA rules, even where daily difficulty is genuine.

The two measurements that drive the rating

Under 38 CFR 4.85, the examination must be conducted by a state-licensed audiologist and must include both a controlled speech discrimination test using the Maryland CNC word list and a puretone audiometry test. The rating uses:

• The puretone threshold average - the average of the thresholds at 1000, 2000, 3000, and 4000 Hz for each ear
• The speech discrimination percentage for each ear

From numbers to a percentage

Table VI combines each ear's puretone average and speech discrimination score into a Roman numeral designation from I to XI. Table VII then cross-references the numeral for the better ear against the numeral for the poorer ear to produce the evaluation.

Because the poorer ear's contribution is limited when the better ear hears well, asymmetric hearing loss frequently yields a lower percentage than veterans expect. The formula leaves the rater no discretion - it produces one answer from the test results.

The exceptional patterns in 38 CFR 4.86

Two patterns are treated differently because the standard tables understate them:

• Thresholds of 55 decibels or more at each of 1000, 2000, 3000, and 4000 Hz - the numeral may be taken from either Table VI or Table VIA, whichever gives the higher result
• A threshold of 30 decibels or less at 1000 Hz together with 70 decibels or more at 2000 Hz - the higher numeral is used and then elevated one step

Why the examination itself matters so much

Because the rating is arithmetic, everything depends on the examination that produces the numbers. An examination that omits the Maryland CNC test, or that is not performed by a state-licensed audiologist, does not meet the requirements of 38 CFR 4.85. Where results are inconsistent with the rest of the record, that discrepancy is worth identifying before a decision issues.

Service connection is a separate question from the rating, and it is where most hearing claims are actually won or lost. Our guide to the evidence that supports a hearing claim covers what strengthens that side of the file.

Where to start

A paid medical records review is $250 and identifies what your audiograms, service records, and treatment history actually support. Where the records support a medical opinion, a nexus letter supplies it. Talking through your situation by phone is always free, with no obligation.

Patriot NEXUS Letters provides independent medical evidence, not legal representation or claim filing. We do not guarantee that a medical professional will reach a favorable conclusion or that the VA will approve any claim.

Testing outside the VA system

A private audiogram performed by a state-licensed audiologist can be submitted as evidence, but it must include both the puretone thresholds and the Maryland CNC speech discrimination score to be usable under 38 CFR 4.85. Audiograms from hearing aid retailers or screenings that only report a general summary graph without both numeric components typically cannot be used to support a rating.

Where a private test and a VA compensation and pension examination produce meaningfully different results, both should be part of the file so the discrepancy can be addressed rather than left unexplained.

How ratings change over time

Hearing loss is a condition the VA expects can worsen, and many veterans return years after their original grant with declining thresholds. A new claim for an increased evaluation goes through the same Table VI and Table VII process using a new audiogram, not the original one.

Because the tables are unforgiving at the margins, even a modest additional loss at 3000 or 4000 Hz can shift a numeral designation and change the percentage, particularly if it moves the case into or out of the exceptional patterns described in 38 CFR 4.86.