VA rating for hearing loss: how the tables work

The short answer

VA rates hearing loss under Diagnostic Code 6100 using a two-table system: audiometry numbers go in, a percentage comes out. There is no symptom-severity judgment. The audiologist’s puretone threshold average and Maryland CNC speech discrimination score determine a Roman numeral for each ear from Table VI; then Table VII converts the two-ear combination into a final percentage.

Because most veterans’ hearing falls in the lower ranges of those tables, most compensable hearing loss rates 0% or 10%. That is not an error in the system; it is what the tables produce for mild-to-moderate audiometric loss.

Bilateral hearing loss is rated as one rating covering both ears. The bilateral factor under §4.26 does not apply to DC 6100 — a common source of confusion on a site named bilateralfactor.com. The tables already handle both ears together.

How DC 6100 works: the table mechanics

Step 1 — Puretone threshold average

The audiologist measures your hearing thresholds at 1000, 2000, 3000, and 4000 Hz. The puretone threshold average (PTA) is the sum of those four measurements divided by 4, per 38 CFR §4.85(d).

Example: thresholds of 30, 50, 60, and 60 dB produce a PTA of (30 + 50 + 60 + 60) / 4 = 50 dB.

Step 2 — Maryland CNC speech discrimination

The Maryland CNC (California Consonant Test) measures how accurately you repeat 50 recorded words. The result is a percentage: 100% means perfect discrimination; 0% means you cannot repeat any words correctly. The test is conducted without hearing aids.

Step 3 — Table VI: assign a Roman numeral per ear

Table VI intersects PTA (vertical columns) and speech discrimination percentage (horizontal rows) to produce a Roman numeral from I (least impaired) to XI (most impaired). A low PTA and high speech discrimination score produce a low Roman numeral; high PTA and low discrimination produce a high one. Both ears are evaluated separately.

Table VIa uses only PTA (no speech discrimination result) and is used when speech discrimination testing is not appropriate due to language difficulties, inconsistent scores, or other factors documented by the examiner.

Step 4 — Table VII: convert to a rating percentage

Table VII is an 11-by-11 grid. The row represents the better ear’s Roman numeral; the column represents the worse ear’s. Their intersection is the final rating percentage, verified against 38 CFR §4.85(e).

Because the better ear is given more weight in the grid, a veteran with one severely impaired ear and one mildly impaired ear will see a lower combined rating than if both ears were severely impaired. The rating percentages in Table VII run from 0% (both ears at Roman numeral I) to 100% (both ears at Roman numeral XI).

Why most ratings land at 0–10%

Most veterans with mild-to-moderate service-connected hearing loss have PTAs in the 25–50 dB range and speech discrimination scores above 76%. Those numbers produce low Roman numerals in Table VI. When both ears receive low Roman numerals, Table VII returns 0% or 10%. The rating reflects the audiometric findings, not the subjective difficulty of following conversations.

A 0% rating is still a service-connected grant. It combines with other conditions in the §4.25 formula, and any secondary conditions such as depression or sleep disruption caused by hearing loss can be ratable separately.

§4.86 exceptional patterns: when the tables work differently

Two audiometric patterns trigger special handling under 38 CFR §4.86.

Pattern 1 — Severe threshold at all four frequencies. When the puretone threshold at each of the four specified frequencies (1000, 2000, 3000, and 4000 Hz) is 55 decibels or more, the rating specialist uses whichever of Table VI or Table VIa yields the higher Roman numeral. This prevents veterans with uniformly severe loss from being pulled to a lower numeral by speech discrimination scores that may understate their impairment.

Pattern 2 — Low-frequency/high-frequency disparity (the 30/70 pattern). When the puretone threshold is 30 dB or less at 1000 Hz and 70 dB or more at 2000 Hz, the specialist again chooses the higher Roman numeral from Table VI or VIa, then elevates that numeral by one additional step. This accounts for the unusual audiometric shape of that hearing profile. Each ear is evaluated separately under both patterns.

If either pattern applies to your audiogram and your rating decision does not mention §4.86, that is a specific legal argument for a Higher-Level Review or appeal.

Hearing aids do not change the rating basis

Testing is done without hearing aids, per §4.85(a). If you wear hearing aids and your unaided test produces a low-numeral result, the rating reflects your unaided hearing capacity. VA does provide hearing aids separately through the audiology program; that benefit is independent of the disability rating percentage.

Pairing hearing loss with tinnitus

Tinnitus under DC 6260 is a separate service-connected condition rated at a single flat 10%, whether perceived in one ear, both ears, or in the head. If you have both hearing loss and tinnitus from the same noise exposure event, both can be service-connected, and they combine through the standard §4.25 formula.

Example: hearing loss 10% + tinnitus 10%:

• Combine under §4.25: 10 + (10 × 90/100) = 10 + 9 = 19, rounds to 20% final rating.

Neither triggers the bilateral factor.

Worked combined-rating example

Scenario: hearing loss 10% (DC 6100) + tinnitus 10% (DC 6260) + back pain 20% (DC 5237).

1. Sort descending: 20, 10, 10.
2. Combine 20 and 10: 20 + (10 × 80/100) = 20 + 8 = 28.
3. Combine 28 and 10: 28 + (10 × 72/100) = 28 + 7.2 = 35.2, rounds to 35.
4. Final combined rating: 40% (35 rounds up to 40).

Use the VA Combined Ratings Calculator to model your exact numbers.

C&P exam for hearing loss

The examiner must be a state-licensed audiologist. The exam includes both the Maryland CNC and puretone audiometry. If your examiner tests you with hearing aids, notes that in the exam report, or uses a different word-recognition test, those are grounds to request a corrected examination. The testing environment must also be controlled (sound-treated booth), though the CFR does not specify this in §4.85 itself.

If you believe your audiometric results were recorded incorrectly or your §4.86 pattern was not recognized, a Supplemental Claim with a new independent audiological evaluation can produce a different outcome.

If your rating does not match the table mechanics after checking the math, see what to do after a VA claim decision.

For related conditions, see also:

• Tinnitus VA rating: the 10% cap and what pairs with it
• PTSD VA rating
• VA Combined Ratings Calculator

This page explains schedular rating math only. Individual VA decisions depend on service-connection evidence, exam findings, and claim-specific facts. See our disclaimer for the limits of this information.