VA Hearing Loss
Disability Rating —
Complete Filing Guide
Hearing loss is the #3 most common VA service-connected disability, with over 1.3 million veterans holding a rating. But here's what most of them don't realize: the VA doesn't simply look at your audiogram and assign a number. It uses a two-table system that combines puretone hearing thresholds with speech recognition scores — and the interaction between those two numbers determines whether you get 0% or 100%.
What Is a VA Hearing Loss Rating?
Hearing loss is rated under 38 CFR § 4.85, Diagnostic Code 6100: "Hearing impairment." Unlike tinnitus, which has a flat 10% rate, hearing loss ratings range from 0% to 100% — and the percentage depends entirely on two numbers from your audiogram: your puretone threshold average and your Maryland CNC word recognition score.
The VA uses two rating tables. Table VI combines both metrics when your speech discrimination is reliable. Table VIA uses puretone averages only when speech discrimination testing is unreliable. Which table applies to you — and how your specific numbers combine within it — is what drives your rating.
Unlike tinnitus, hearing loss can reach 100%. The higher your puretone average and the worse your speech discrimination, the higher your rating. The ceiling is real — and veterans with bilateral severe hearing loss regularly qualify for 50%, 70%, or 100% combined ratings.
How the VA Measures Hearing Loss
Every VA hearing loss claim is built on an audiogram — a test performed by a licensed audiologist that measures two distinct things:
Puretone threshold averages
The audiologist plays tones at different frequencies (250 Hz through 8000 Hz) and records the softest volume at which you can hear each tone in each ear. Those thresholds are averaged across the key speech frequencies (500, 1000, 2000, and 3000 Hz) to produce a single number — your puretone average (PTA) — for each ear. A lower PTA means better hearing; a higher PTA means more hearing loss.
Maryland CNC word recognition score
While wearing headphones, you listen to a list of single-syllable words and repeat them back. The audiologist records the percentage of words you correctly identify. This is your speech discrimination score — it measures how well you understand speech in a controlled environment. A score above 82–92% (depending on the table row) signals reliable speech discrimination; below that threshold, Table VIA may apply instead.
Many veterans focus only on their audiogram tones — but the speech recognition score is equally important. A veteran with moderate hearing loss (PTA ~50 dB) and poor speech discrimination (60%) will receive a higher rating than a veteran with identical puretone thresholds but excellent word recognition (92%). Both inputs feed into the table.
Understanding Table VI and Table VIA
The actual tables are found in 38 CFR Part 4, Appendix VI. Here's how they work in plain terms:
Table VI is the standard rating path. You use it when your Maryland CNC word recognition score is high enough to be considered reliable. Your puretone average for the better ear and your word recognition percentage together determine which row and column of the table you fall into — and the intersection is your rating (0%, 10%, 20%, etc.).
Table VIA applies when speech discrimination testing is unreliable or contraindicated — for example, if language barriers, cognitive issues, or physical inability to respond make the CNC test invalid. In Table VIA, only the puretone average for each ear is used, with the average of the better ear determining the rating. Table VIA almost always produces lower ratings for mild-to-moderate hearing loss compared to Table VI.
| Puretone Average (Better Ear) | Table VIA Rating (without speech test) |
|---|---|
| 26–40 dB (or better) | 0% |
| 41–55 dB | 10% |
| 56–69 dB | 20% |
| 70–89 dB | 40% |
| 90+ dB | 50% (or higher with both ears) |
Note: Table VI produces higher ratings than Table VIA for most mild-to-moderate hearing loss patterns when speech discrimination is good. The actual Table VI rating also incorporates your speech recognition score — better discrimination can move you up within the table.
If your C&P examiner marks your speech discrimination test as unreliable, the VA will rate you under Table VIA — which almost always produces a lower number than Table VI. This is a common fight in appeals. If you scored well on the Maryland CNC test and the examiner still applied Table VIA, challenge it with a private audiologist's report confirming valid speech discrimination scores.
How to File a Hearing Loss Claim
Hearing loss claims follow the same process as any VA disability claim. Here's what you need — in order of importance:
1. A current audiogram
Get a comprehensive audiometric evaluation from a licensed audiologist — civilian or VA, either is acceptable. The test must include puretone thresholds (air and bone conduction) for both ears and Maryland CNC word recognition scores. An audiogram older than 12 months may be challenged; schedule a current one before filing.
2. In-service noise exposure evidence
You need evidence that your hearing loss is connected to your military service. This includes:
- Service Treatment Records (STRs) — any hearing test results, complaints of ear problems, or audiometric shifts documented during active duty
- DD-214 / MOS code — military occupational specialties with high noise exposure (infantry, artillery, aviation, mechanics, communications) create a presumptive link even without in-service hearing complaints
- Noise exposure documentation — records of specific noise events (explosions, aircraft, heavy equipment) that occurred during your service
- Buddy statements (VA Form 21-10210) — fellow service members who witnessed your exposure to heavy noise or noticed your hearing difficulties during service
3. A medical nexus letter
If your STRs don't clearly document hearing loss during service, a private nexus letter from your audiologist or ENT is critical. The letter must specifically connect your current hearing loss to your in-service noise exposure. For veterans whose hearing loss developed years after service, this is the most important document in the claim.
Before submitting your full claim with all your evidence, file an Intent to File (VA Form 21-0966) on VA.gov. This costs nothing and locks in today's date as your effective date — meaning your back pay, if approved, runs from today rather than from the date your complete claim is received. You then have 12 months to gather your evidence and submit the full 21-526EZ. Do not skip this step.
C&P Exam — What to Expect and How to Prepare
The Compensation & Pension exam is where your hearing loss rating is decided. The examiner evaluates two things: the puretone audiogram you take during the visit, and a functional-impact interview about how hearing loss affects your daily life. The exam report directly drives the rating decision. How you prepare and what you say in that room matters more than almost anything else in your claim.
Before the exam — bring your private audiogram + symptom log
Don't walk into the C&P exam cold. Schedule a private audiogram with a licensed audiologist 2–4 weeks before the VA exam and bring the printed report with you. Also bring a written symptom log describing how hearing loss has affected your daily life over the past several months. The goal is to make sure your worst days are on record — not just what you can recall under the stress of a short clinical appointment.
Document specific incidents: missing phone calls, turning the TV up so loud it disturbs family members, eating lunch alone because you can't follow group conversation at the office, walking away from a service-connected social event because the background noise made conversation unintelligible. Upload this log to VA.gov along with your claim and bring a printed copy to the C&P exam. A written record cannot be contradicted by the examiner's memory of your verbal answers.
During the exam — describe your worst days
The examiner needs to understand your typical functional impact, not your best-managed moments. Be specific and complete. Cover each of the following:
- Household impact — TV volume relative to others in the room, missing doorbell or phone rings, difficulty hearing smoke alarms or other safety signals
- Group conversation — restaurants, family dinners, team meetings at work; how often you ask people to repeat themselves
- Phone calls — switching ears, asking callers to speak up, avoiding calls entirely; whether you've been evaluated for or wear hearing aids
- Work impact — missed information in meetings, mistakes from misheard instructions, accommodations you've requested
- Worst days — describe a bad hearing day in specific terms — what you couldn't do, what you had to give up, what it cost you in time or money
Veterans who say "I've adapted," "I just turn the volume up," or "it's not that bad most days" signal low functional impairment to the examiner. The rating reflects impairment as documented — not how stoic you appear. Describe your actual experience, including your worst days and everything hearing loss has cost you. Coping strategies are evidence of ongoing impairment, not evidence that you're fine.
If the C&P examiner marks your Maryland CNC speech discrimination test as unreliable, you will be rated under Table VIA — which almost always produces a lower number than Table VI. If you scored well on a private Maryland CNC and the VA examiner still applied Table VIA, that is a fightable issue. After the decision, file a Supplemental Claim with your private audiogram and a signed statement from your audiologist confirming valid speech discrimination scores.
If the exam goes poorly
You have the right to request a new C&P exam if the examiner failed to review your records, was hostile or dismissive, or produced a report that contradicts your documented history. File a Supplemental Claim with a written explanation of why the exam was inadequate, attach your private audiogram, and ask your private audiologist to write a counter-statement addressing the specific points the VA examiner got wrong.
See the full step-by-step VA claim filing guideNeed a printable checklist for exam day? See our consolidated VA C&P Exam Prep Checklist — what to bring, what to describe, what NOT to say, and DBQ/nexus context.
Secondary Conditions — Hidden Angles Most Veterans Miss
Hearing loss can be filed as secondary to several service-connected conditions. This is often the winning path for veterans whose service treatment records don't contain documented in-service noise exposure — the direct claim fails, but the secondary claim succeeds because the primary service-connected condition provides the link.
Tinnitus → Hearing Loss
Tinnitus and hearing loss stem from the same inner-ear damage, and most veterans who have one also have the other. If you are already service-connected for tinnitus but haven't filed a hearing loss claim, tinnitus is the natural primary condition for a secondary hearing loss claim — a nexus letter from your audiologist can establish that the same in-service noise event that caused your tinnitus also caused the hearing loss you now experience. Better yet: file the hearing loss claim alongside the tinnitus claim from the start. They are evaluated independently and both contribute to your combined rating.
TBI → Hearing Loss
Blast-exposure traumatic brain injury is a documented cause of sensorineural hearing loss and auditory processing deficits. If you are service-connected for TBI under DC 8045, you can file hearing loss as a secondary condition. TBI residuals are rated separately (cognitive, emotional/behavioral, physical), and hearing loss can stand on its own as an additional secondary condition stemming from the same blast event. Veterans with combat or IED exposure who are already rated for TBI should file hearing loss if they haven't — it is one of the most supportable secondary claims in this category.
Ototoxic Medications → Hearing Loss
Certain medications prescribed during or after service are documented ototoxic drugs — medications that can cause sensorineural hearing loss as a side effect. These include specific chemotherapeutics (cisplatin, carboplatin), loop diuretics, aminoglycoside antibiotics, and some antimalarials. If you were prescribed any of these medications during service, or for a service-connected condition after service, the link between the medication and your hearing loss may support a secondary claim — particularly when direct-service-connection evidence is thin. Your prescribing provider can write a nexus letter identifying the medication, documenting the dosing, and connecting it to your current audiometric results.
If your STRs show any in-service noise exposure or hearing complaints, file a direct claim first. If they don't, file secondary to tinnitus, TBI, or an ototoxic medication link. You can file both paths simultaneously — the VA will grant whichever connection it can establish on the evidence. There is no penalty for filing both, and the secondary path routinely succeeds when the direct path doesn't have enough documentation.
If filing hearing loss for the first time, also file tinnitus as a companion claim in the same submission. If you're already rated for hearing loss, file any new secondary condition (TBI, medication link) and ask the VA to evaluate it as secondary to the existing service-connected condition. Hearing loss and tinnitus come from the same underlying damage — filing them together is the highest-value move in this claim type, and the VA evaluates both from the same evidence stack.
Hearing Loss + Tinnitus — Combined Ratings
Almost every veteran with service-connected hearing loss from military noise exposure also has tinnitus — the two conditions stem from the same damage to the inner ear. The VA rates them as separate conditions, and this is one of the most powerful tools in your claims strategy.
Here's why: tinnitus is always rated at a flat 10%. Hearing loss can rate anywhere from 0% to 100%. When you file both together, you're stacking a known 10% on top of whatever hearing loss rating your audiogram supports. A veteran with 30% hearing loss + 10% tinnitus doesn't get 40% — the VA uses the Combined Ratings Table (38 CFR § 4.25), but the two conditions together routinely push the combined rating meaningfully higher than either condition alone.
Most veterans who have their hearing loss claim approved automatically qualify for tinnitus. If you file hearing loss without tinnitus, you may be leaving 10% on the table — and you can add the tinnitus claim later, but it's cleaner to include it on the original claim. File both. It's one form, one upload, one C&P exam.
Use our VA Rating Calculator to see how hearing loss and tinnitus combine with your other service-connected conditions to produce your actual combined rating and monthly compensation estimate.
Most veterans with hearing loss also have tinnitus — both from the same in-service noise damage. Both conditions are rated separately, and the combination often produces a significantly higher combined rating than either alone.
Read the Tinnitus Rating GuideCommon Mistakes Veterans Make With Hearing Loss Claims
- Not filing for tinnitus alongside hearing loss. These are separate conditions, both stemming from the same inner ear damage. Filing tinnitus separately adds 10% to your combined rating — and it's free to add to the same claim.
- Accepting a Table VIA rating without challenging it. If your Maryland CNC scores were valid and the examiner used Table VIA anyway, file a supplemental claim with a private audiologist's report confirming reliable speech discrimination.
- Not getting a private audiogram before the C&P exam. A civilian audiogram done on your timeline, with your chosen provider, gives you control over documentation quality. VA C&P audiograms are variable — some are thorough, others are cursory.
- Underestimating functional impact at the C&P exam. The audiologist will ask about how hearing loss affects daily life. Don't downplay it — difficulty understanding speech in restaurants, needing to turn up the TV, asking people to repeat themselves, struggling on the phone. These are the functional limitations the rating reflects.
- Not filing an Intent to File first. Every month of delay costs you back pay. The Intent to File takes 10 minutes online and protects your effective date for 12 months.
- Not appealing within one year of a denial or low rating. If your claim was denied or rated lower than your audiogram suggests it should be, file a Supplemental Claim with new evidence (updated audiogram, new nexus letter, additional buddy statements) within one year.
- Missing the secondary-conditions angle. If your STRs don't show documented in-service noise exposure, hearing loss can still be filed as secondary to a service-connected TBI, tinnitus, or ototoxic medication side effect. Filing only the direct path leaves that angle on the table.
Related Rating Guides
Frequently Asked Questions
How does the VA rate hearing loss?
The VA uses two tables from 38 CFR § 4.85. Table VIA is used when speech discrimination (Maryland CNC) is poor enough to be unreliable — in that case, the rating is based purely on your puretone average. Table VI is used when speech discrimination is reliable — it combines your puretone average with your CNC word recognition percentage to determine your rating. The combination produces ratings from 0% to 100%.
What puretone thresholds trigger a VA hearing loss rating?
There's no single number — the rating depends on the combination of puretone average and speech discrimination across both ears. As a rough guide using Table VIA: PTA 41–55 dB (better ear) = 10%; 56–69 dB = 20%; 70–89 dB = 40%; 90+ dB = 50%+ (bilateral). But Table VI can produce higher ratings when speech discrimination scores are included in the calculation. The actual tables are in 38 CFR Part 4, Appendix VI.
What's the difference between Table VI and Table VIA?
Table VI requires both puretone averages and Maryland CNC speech discrimination scores. Table VIA uses puretone averages only and applies when speech discrimination testing is unreliable or contraindicated. Table VIA tends to produce lower ratings for mild-to-moderate hearing loss. Fighting for Table VI — with a valid, high CNC score — is often strategically important.
Should I file for hearing loss and tinnitus together?
Always file both on the same claim form. Tinnitus is almost always a companion condition to noise-induced hearing loss, and both are rated separately. Most veterans with hearing loss also have tinnitus — it's one form, one upload, one exam. Adding tinnitus is free and adds 10% to your combined rating.
Does the VA accept private audiograms?
Yes — civilian audiograms are accepted and commonly used in VA claims. The test must include puretone thresholds and Maryland CNC word recognition scores from a licensed audiologist. A private audiogram gives you control over timing and documentation quality. VA C&P audiograms are acceptable but variable in quality and scheduling speed.
What if my hearing loss is bilateral (both ears)?
The VA rates each ear independently, then uses the rating tables to combine them. Bilateral hearing loss almost always results in a higher combined rating than one-ear loss — both ears feed into the tables. Veterans with significant bilateral loss routinely receive 30%, 40%, or higher ratings.
What evidence do I need to establish service connection for hearing loss?
Three categories: (1) a current audiogram with puretone thresholds and CNC scores; (2) in-service evidence — STRs showing hearing tests or complaints, a high-noise MOS code, or documented noise events during active duty; (3) a medical nexus letter from an audiologist or ENT specifically connecting your hearing loss to in-service noise exposure.
What are the most common mistakes with hearing loss claims?
Five main mistakes: (1) Not filing an Intent to File first — every month costs back pay. (2) Accepting a Table VIA rating without challenging it if your CNC scores were valid. (3) Not filing tinnitus alongside hearing loss — leaving 10% on the table. (4) Minimizing functional impact at the C&P exam. (5) Not appealing within one year if rated lower than expected.
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