How the VA Rates Hearing Loss

How your audiogram becomes a percentage

The exam has to be done by a state-licensed audiologist and include two tests: a Maryland CNC speech discrimination test and puretone audiometry (38 C.F.R. § 4.85(a)). The rating uses two numbers from each ear:

• Puretone threshold average

  The thresholds at 1000, 2000, 3000 and 4000 Hertz, added up and divided by four (§ 4.85(d)). Loss at 500 Hertz or above 4000 Hertz doesn't enter this average.

• Speech discrimination score

  The percentage of words you repeat correctly on the Maryland CNC word list.

• Table VI, then Table VII

  Table VI combines each ear's two numbers into a Roman numeral from I to XI. Table VII then combines the numerals for the two ears into the percentage (§ 4.85(b) and (e)).

Why so many hearing loss ratings are 0%

The definition of a hearing disability and the rating tables measure different things. Under § 3.385, hearing counts as a disability when any threshold from 500 to 4000 Hertz is 40 decibels or more, when at least three of those thresholds are 26 decibels or more, or when the Maryland CNC score is below 94. Many veterans clear that bar and still have a puretone average and speech score that sit at low numerals on Table VI, and low numerals in both ears combine to 0% on Table VII.

Two other things keep ratings low. The test is done in a quiet booth, so trouble following speech in a noisy room may not show up in the score. And if only one ear is service-connected, the other ear is assigned numeral I, as if it were normal (§ 4.85(f)).

If you have the audiology report, look at the four thresholds and the speech score for each ear. Read My Records can pull those numbers out of your records so you can see where they land on the tables. If the report seems to understate your hearing, a VSO can help you decide whether newer testing is worth sending.

The two exceptional patterns (§ 4.86)

Some audiograms qualify for a different table. In both patterns below, the rater uses Table VI or Table VIa (which looks at the puretone average only), whichever gives the higher numeral:

• 55 decibels or more at all four frequencies

  When the threshold at each of 1000, 2000, 3000 and 4000 Hertz is 55 decibels or more in that ear (§ 4.86(a)).

• 30 or less at 1000 Hertz, 70 or more at 2000 Hertz

  When the threshold is 30 decibels or less at 1000 Hertz and 70 decibels or more at 2000 Hertz. The numeral is then raised to the next higher numeral (§ 4.86(b)).

Tinnitus is a separate rating

Ringing in the ears is rated on its own, under diagnostic code 6260 in 38 C.F.R. § 4.87, at 10% for recurrent tinnitus. It's one rating whether you hear it in one ear, both ears, or in your head, and it can be combined with your hearing loss rating. If you have tinnitus and it isn't on your decision letter, it may never have been claimed.

C&P exam tips for Hearing Loss

1. 1Request a VA audiological examination — this must include both pure tone average and Maryland CNC speech discrimination testing.
2. 2Don't try to 'pass' the hearing test. Answer honestly — guess when you think you hear something, but don't strain beyond what you actually hear.
3. 3Bring records of any service noise exposure (MOS, unit, weapons qualified, aircraft, combat).
4. 4Note functional impacts: TV volume complaints, missing alarms, difficulty at work.

Common mistakes on Hearing Loss claims

• Trying too hard on the hearing test — this reduces your score and your rating.
• Not filing tinnitus as a separate condition alongside hearing loss.
• Forgetting to request the audiological exam specifically (some examiners do only a quick tone test).