How does the VA calculate hearing loss percentage?

The VA converts each ear's audiogram into a Roman numeral I through XI using two inputs: (1) the puretone threshold average across 1000/2000/3000/4000 Hz (Table VI), and (2) the Maryland CNC speech-discrimination score (also Table VI). The two Roman numerals — one per ear — feed into Table VII, which outputs the final percentage rating from 0% to 100%.

Why is my hearing loss rated 0% when I clearly can't hear?

Most service-connected hearing loss rates 0%. The VA tables are calibrated so that mild-to-moderate hearing loss often produces a Roman numeral I or II in each ear, which intersects to 0% on Table VII. This does not mean the VA disputes your hearing loss — it means the disability is service-connected (which preserves future rate-increase claims and dependents benefits) but currently non-compensable. Pair with tinnitus (DC 6260, flat 10%) and the cluster becomes compensable.

What is the exceptional-pattern rule under 38 CFR 4.86?

Under 4.86, when an ear has puretone thresholds of 55 dB or more at all four frequencies (1000/2000/3000/4000 Hz), OR thresholds of 30 dB or less at 1000 Hz AND 70 dB or more at 2000 Hz, the rater uses Table VIa instead of Table VI. Table VIa uses puretone-only (ignores speech discrimination) and often produces a higher Roman numeral, raising the rating.

Can hearing aids reduce my rating?

No. Hearing aids do NOT reduce the rating. 38 CFR 4.85 specifies that ratings are based on the audiogram and speech discrimination results — both measured without hearing aids. Wearing aids does not reduce future ratings.

How do I prove service-connection for hearing loss?

Two elements: (1) in-service noise exposure (combat arms MOS, aviation, motor pool, artillery — usually documented via DD-214 MOS code or award documentation), and (2) a current diagnosis via audiogram. The 2007 IOM (now NAM) noise-induced hearing loss study supports nexus opinions for delayed-onset hearing loss in noise-exposed veterans, helping cases where hearing was normal at separation but degraded later.

Hearing · 38 CFR 4.85 & 4.86 · Diagnostic Code 6100

Hearing Loss VA Disability Rating

By Shirley Chia · Last updated 2026-05-22 · Source: 38 CFR 4.85 · Exceptional patterns: 38 CFR 4.86

TL;DR. Hearing loss is rated via two tables: Table VI converts an ear's audiogram (puretone-threshold average + Maryland CNC speech-discrimination score) into a Roman numeral I–XI; Table VII intersects the two ears' Roman numerals into a 0–100% rating. Most veterans with documented service-related hearing loss rate 0% — it's the structure of the tables, not skepticism about the loss. Pair with tinnitus (flat 10% under DC 6260) and you get a compensable cluster. Under 38 CFR 4.86, exceptional puretone patterns trigger Table VIa, which often produces a higher Roman numeral. Hearing aids do NOT reduce the rating.

What hearing loss means in VA disability terms

VA hearing-loss ratings are pure numeric outputs of an audiogram + a word-recognition test. There is no severity descriptor (mild/moderate/severe), no subjective measure, no functional-impact evaluation as in musculoskeletal exams. Two inputs go in; one number comes out.

The two inputs:

Puretone threshold average (PTA) — the average of the four puretone thresholds at 1000, 2000, 3000, and 4000 Hz, measured in decibels (dB). Higher = worse.
Maryland CNC speech-discrimination score — the percentage of single-syllable words from the Maryland CNC list the veteran correctly repeats when presented at a comfortable volume. Lower = worse.

The Maryland CNC word list is a specific standardized list. Speech-discrimination scores from other word lists are not used. C&P examiners are required to use Maryland CNC.

How the tables work

Table VI — Roman numeral per ear (puretone + speech)

For each ear, you read down the table by PTA (left axis) and across by speech-discrimination percentage (top axis). The intersection is a Roman numeral I through XI. I = essentially normal; XI = profound loss.

Approximate (consult the regulation for the official table): an ear with PTA 50 dB and speech-discrimination 84% rates Roman numeral III. An ear with PTA 70 dB and speech-discrimination 60% rates VI. An ear with PTA 100 dB and 0% discrimination rates XI.

Table VII — final rating from two Roman numerals

The better ear's Roman numeral is on one axis, the poorer ear's on the other. The intersection is the final percentage. Examples:

Both ears Roman numeral I → 0%.
Better ear II, poorer ear III → 0%.
Better ear IV, poorer ear V → 10%.
Better ear VI, poorer ear VI → 20%.
Better ear VIII, poorer ear IX → 50%.
Both ears XI → 100%.

The asymmetry matters: an ear that is much worse than the other doesn't drive the rating up as fast as bilaterally moderate loss does. The tables reward symmetric severity over asymmetric severity.

The exceptional-pattern rule (38 CFR 4.86)

4.86 provides two trigger patterns. When an ear matches either pattern, the rater uses Table VIa instead of Table VI for that ear. Table VIa uses PTA alone (no speech-discrimination input).

Pattern 1. Puretone thresholds of 55 dB or more at all four frequencies (1000, 2000, 3000, 4000 Hz). The "all-frequencies-affected" profile.
Pattern 2. Puretone threshold of 30 dB or less at 1000 Hz AND 70 dB or more at 2000 Hz. The "ski-slope" high-frequency loss profile.

When the trigger applies, the rater uses whichever table (VI or VIa) produces the higher Roman numeral. This is a one-way ratchet — 4.86 cannot lower a rating, only raise it.

Service-connection paths

Direct in-service onset

The simplest case: an audiogram during service shows a shift from entry. The Hickson v. West (1996) framework requires (1) current diagnosis, (2) in-service event/injury/disease, (3) nexus between the two. In-service noise exposure (MOS, awards, range-time documentation) usually satisfies (2).

Delayed-onset hearing loss

The 2007 Institute of Medicine study (now National Academy of Medicine) on noise-induced hearing loss concluded that delayed-onset hearing loss from in-service noise exposure is medically plausible. The Federal Circuit's Hensley v. Brown (1993) decision predates this and is sometimes misread to require continuity of symptoms — in fact, Hensley requires only that the hearing loss is etiologically related to service, which the 2007 IOM study supports for noise-exposed veterans.

Practical effect: an audiogram showing normal hearing at separation does NOT defeat a hearing-loss claim filed decades later by a veteran with documented in-service noise exposure. A nexus letter from a private audiologist or ENT citing the 2007 IOM study supports delayed-onset claims.

Secondary service connection

Hearing loss is uncommonly the secondary condition (it's usually primary). The most viable secondary path is hearing loss secondary to a service-connected condition causing ototoxicity (e.g., long-term loop diuretic use for service-connected hypertension, or ototoxic antibiotics during service).

Evidence the VA looks for

DD-214 and MOS. Combat-arms MOS (11B/11C, 0311, 31B, 13B, 13F) and aviation/motor pool/artillery codes establish noise exposure on the face of the record.
Award documentation. Combat Infantryman Badge, Combat Action Ribbon, Combat Action Badge — all establish exposure to weapons noise.
Service treatment records. Entrance and separation audiograms. Even when both are normal, the comparison plus current loss is informative.
Current audiogram. From a private audiologist or the C&P exam. Must include both PTA and Maryland CNC speech-discrimination.
Nexus letter for delayed-onset. Private audiologist or ENT citing the 2007 NAM/IOM study, linking current loss to in-service noise exposure.
Hearing aid records. Document treatment without changing the rating.

Pairing hearing loss with tinnitus

Tinnitus (DC 6260) rates a flat 10%. Hearing loss often rates 0% on its own. The combination — 0% hearing loss + 10% tinnitus — is the most-common rated configuration for noise-exposed veterans and is fully compensable at 10%. Both should be claimed together for any veteran with documented in-service noise exposure.

Use the Hearing Disability Calculator (4.85/4.86 + tinnitus) →

Common rating pitfalls

Not claiming both hearing loss and tinnitus. File together. The 10% tinnitus rating is essentially automatic for veterans with documented noise exposure.
Accepting a 0% rating without considering 4.86. If your audiogram shows the ski-slope or all-frequencies-affected pattern, 4.86 may raise the rating. Have an audiologist review.
Using a speech-discrimination score from a non-Maryland CNC list. Only Maryland CNC counts. Word-recognition scores from other lists must be redone.
Filing without an audiogram on file. The VA cannot rate hearing loss without an audiogram. If your claim is denied for lack of audiogram, get one and refile or appeal.
Not pursuing increase claims after progression. Hearing loss is progressive. Veterans rated 0% who later show progression should refile for a higher rating using the current audiogram.

Worked example

Veteran: Marine Corps, 0311 infantry, 4 deployments. Service exit audiogram normal. 2024 audiogram: right ear PTA 55 dB / speech 76%; left ear PTA 60 dB / speech 72%. Tinnitus claimed concurrently.

Right ear Table VI: PTA 55 / speech 76% → Roman numeral IV.
Left ear Table VI: PTA 60 / speech 72% → Roman numeral V.
Table VII (better IV, poorer V): 10%.
Tinnitus DC 6260: 10%.
Combined: 10 + 10 → 1 − 0.9 × 0.9 = 0.19 → 20%.
2026 monthly compensation (single veteran, 20%): $356.66.

Hearing loss alone produced 10%; tinnitus added 10%; combined to 20% via VA math. Many noise-exposed Marines and infantry land at exactly this configuration.

Common secondary conditions

Tinnitus. Almost always accompanies noise-induced hearing loss.
Meniere's disease. Endolymphatic hydrops — rated under DC 6205 separately.
Vestibular dysfunction. Balance disorders.
Anxiety or depression secondary to communication impairment. Recognized secondary mental-health pathway in severe cases.

Sources cited in this article

38 CFR 4.85 — Evaluation of hearing impairment
38 CFR 4.86 — Exceptional patterns of hearing impairment
38 CFR 4.87 — Schedule of ratings: ear (includes DC 6260 tinnitus)
Institute of Medicine (2007). Noise and Military Service: Implications for Hearing Loss and Tinnitus.

VetDisabilityCalc is an independent reference site. We are not VA-accredited and we do not prepare or present VA claims.