Meniere's syndrome - endolymphatic hydrops - produces episodes of vertigo together with hearing loss and tinnitus, and it can be genuinely disabling between episodes as well as during them. The VA rates it under Diagnostic Code 6205 in 38 CFR 4.87, and the structure of that code is unusual enough to be worth understanding before filing.
The three rating levels
Diagnostic Code 6205 rates the syndrome as a whole:
- 100 percent - hearing impairment with attacks of vertigo and cerebellar gait occurring more than once weekly, with or without tinnitus
- 60 percent - hearing impairment with attacks of vertigo and cerebellar gait occurring from one to four times a month, with or without tinnitus
- 30 percent - hearing impairment with vertigo less than once a month, with or without tinnitus
The choose-the-higher rule
The note to Diagnostic Code 6205 directs that Meniere's syndrome be evaluated either under these criteria or by separately evaluating vertigo (as a peripheral vestibular disorder), hearing impairment, and tinnitus - whichever method results in the higher overall evaluation - but the two approaches cannot be combined.
That is a real decision point. A veteran with frequent, severe attacks usually does better under 6205. A veteran with mild, infrequent vertigo but substantial measured hearing loss may do better with separate ratings: hearing impairment under 38 CFR 4.85, vertigo under Diagnostic Code 6204, and tinnitus under Diagnostic Code 6260, combined under 38 CFR 4.25. Our VA rating calculator shows how combined values actually work out.
Where veterans start
Every case is different, and there is no obligation at any step. When veterans want to understand what their records actually support, these are the two most common starting points:
- Medical records review
A licensed physician reviews your records for a $250 flat fee and identifies which conditions the available evidence may support. The fee is refunded in full if nothing supportable is identified.
- Nexus letter
When the records support one, a licensed provider writes the medical opinion addressing the link between your hearing condition and your service, including delayed-onset reasoning where that applies.
Frequency and cerebellar gait are the criteria
The higher levels require both vertigo attacks and cerebellar gait - an unsteady, wide-based walking pattern - at documented frequencies. The word documented matters. A veteran who rides out attacks at home, as most do, produces no contemporaneous record of the frequency the criteria measure.
An episode log kept over several months, clinical notes recording the reported frequency, and statements from people who have witnessed the attacks fill that gap. Our personal statement guide covers how to record it usefully.
Service connection
Meniere's disease is most often claimed secondary to a service-connected condition under 38 CFR 3.310 - following head trauma, barotrauma, or chronic ear disease - or directly where in-service acoustic trauma, blast exposure, or ear pathology is documented. The medical literature does not establish a single cause for Meniere's, which is precisely why a claim benefits from an opinion that engages the uncertainty honestly rather than overstating it.
Our hearing loss service connection guide covers the shared framework, and our tinnitus claim evidence guide covers the records these claims rest on.
Where veterans get stuck
Two problems recur: a diagnosis of unspecified dizziness rather than Meniere's, which sends the claim to Diagnostic Code 6204 by default, and a file with no objective vestibular or audiometric testing to support either code. Both are fixable, and both are worth addressing before filing rather than after a denial.
If you are unsure what your records currently support, a medical records review answers that question for a flat fee that is refunded if nothing supportable is identified, and a nexus letter supplies the medical opinion when the records support one.