Few ratings frustrate veterans more than hearing loss. You know your hearing is worse — yet the VA hands you 0%. That's because hearing loss is rated by a strict formula based on test numbers, not by how much it bothers you. Understanding the formula tells you what a rating decision actually means — and what's worth doing about it.
How it's rated (DC 6100)
Hearing loss is rated under 38 CFR §4.85, Diagnostic Code 6100, using results from a specific audiology exam. Two measurements drive everything:
- Puretone threshold average — how loud a tone must be before you hear it, averaged across four frequencies: 1000, 2000, 3000, and 4000 Hz.
- Speech discrimination score — the percentage of words you correctly repeat on the Maryland CNC word-recognition test.
From there the process is a pure lookup, ear by ear:
- Step 1: For each ear, the puretone average and Maryland CNC score go into Table VI, which assigns that ear a Roman numeral from I (essentially normal for rating purposes) to XI (the worst).
- Step 2: The two numerals — one per ear — are cross-referenced in Table VII. The cell where they intersect is your rating, from 0% to 100%.
That's the whole system. The examiner's opinion of severity doesn't change the result, and neither does your testimony about missed conversations or the TV volume. It's mechanical by design — which cuts both ways: sympathetic facts can't raise a rating, but a correct set of test numbers can't be argued down either.
What a 0% rating is still worth
Even at 0%, getting hearing loss service-connected is valuable:
- The connection is locked in. If your hearing worsens later, you file for an increase and only current severity is at issue — you never have to re-prove that the loss came from service.
- Hearing care and hearing aids. Service connection supports eligibility for VA audiology care and hearing aids — a benefit whose real-world value can easily exceed a small monthly payment.
- A foundation for related claims. A service-connected hearing condition supports related claims, and the documented noise-exposure history behind it supports a tinnitus claim if you haven't filed one.
Exceptional patterns of hearing loss (§4.86)
The standard tables assume word recognition tracks real-world function. For some hearing-loss patterns it doesn't, so 38 CFR §4.86 provides two exceptions. If either applies, the rating specialist may use Table VIA — which assigns the Roman numeral from puretone thresholds alone, ignoring the word-recognition score — and use whichever numeral is higher:
- Pattern (a): puretone thresholds of 55 dB or more at all four measured frequencies (1000–4000 Hz).
- Pattern (b): a threshold of 30 dB or less at 1000 Hz combined with 70 dB or more at 2000 Hz — the steep drop-off pattern.
If your audiogram fits one of these shapes and your decision doesn't mention §4.86, that's worth raising with a representative — applying the wrong table is a concrete, checkable error.
The exam: what makes it valid
Because the rating is only as good as the test, the VA requires the exam to be performed by a state-licensed audiologist and to include both the puretone audiometry test and the Maryland CNC word test. An exam missing either piece — or using a different word list — can't support a rating. Practical points for exam day:
- Don't downplay. The numbers speak for themselves, but describe your real-world difficulty anyway — it belongs in the record and matters for related claims.
- Mention ringing in your ears. Tinnitus is evaluated at the same kind of exam, and it's a separate 10% rating.
- Flag bad test conditions. Background noise, equipment trouble, or a rushed word test are legitimate grounds to challenge the exam's adequacy later.
Hearing loss vs. tinnitus — they're separate
This is the key thing to know: hearing loss and tinnitus are different conditions with different codes. Tinnitus (DC 6260) is a flat 10% on its own; hearing loss (DC 6100) is rated by the tables above. Many veterans qualify for both from the same noise exposure — and the combination is where the money usually is:
| Ratings | Combined | 2026 monthly pay |
|---|---|---|
| Hearing loss 0% + tinnitus 10% | 10% | $180.42 |
| Hearing loss 10% + tinnitus 10% | 10 + 10 = 19 → 20% | $356.66 |
That second row is $4,279.92 a year, tax-free — from two ratings that individually look small. And through VA math, both keep contributing when other conditions are added on top.
If you think your rating is too low
- Check the exam. Was the Maryland CNC word test used? Was the audiologist state-licensed? Was the environment proper? Testing errors are a common appeal ground precisely because the rating is mechanical.
- Check for §4.86. If your thresholds fit an exceptional pattern, confirm Table VIA was considered.
- File for an increase if your hearing has measurably worsened since the last exam — new numbers mean a new lookup.
- Don't forget tinnitus — if you have ringing in the ears, that's a separate 10% claim.
- Consider related effects — significant hearing loss can contribute to mental-health or balance claims, which are rated separately.
Frequently asked questions
Why did I get 0% when my hearing is clearly bad?
Because the rating comes from Table VI and Table VII, not from your experience. A good Maryland CNC score in particular pulls the Roman numerals down even when the puretone loss is real. The result is a rating that's service-connected but non-compensable — frustrating, but still worth holding (see below).
Is a 0% rating actually worth keeping?
Yes. It establishes service connection permanently, supports VA hearing care and hearing-aid eligibility, and means any future worsening only requires proof of current severity, not a new fight over origin.
Can I get hearing loss and tinnitus at the same time?
Yes — separate codes, separate ratings, commonly awarded together from the same noise exposure. Hearing loss 10% plus tinnitus 10% combines to a 20% rating: $356.66 a month in 2026.
What makes a hearing exam invalid?
The exam must be done by a state-licensed audiologist and include both puretone audiometry and the Maryland CNC test. A missing test, the wrong word list, or poor test conditions are all grounds to challenge the exam.
What if my hearing keeps getting worse?
File for an increase with a current audiogram. Because the system is mechanical, worse numbers translate directly into a higher rating — and if your combined conditions ever keep you from working, TDIU is worth understanding too.