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VA Hearing Loss Claims: How the VA Rates It and What You'll Actually Get Paid

Hearing loss is the #2 most-claimed VA disability — 1.3 million veterans currently rated under 38 CFR 4.85 and 4.86. The rating system is not intuitive: your audiogram doesn't directly produce a percentage. Two tables convert it, and most veterans get 0% even with real damage. This guide breaks down the math, the exceptional patterns rule that rescues zero-rated claims, and how to file hearing loss alongside tinnitus for maximum combined value. Veteran-to-veteran, no paywalls.

Calculate Your Combined Rating → Get Claims Alerts
1.3M+ #2 most-claimed VA disability
38 CFR 4.85 The rating regulation — DC 6100
4.86 Exceptional patterns rule — Table VIa
Maryland CNC Required word recognition test — no aids allowed
38 CFR 4.85 — Diagnostic Code 6100

The brutal math: why most hearing loss claims come back at 0% even when you clearly have damage.

The VA does not rate hearing loss by asking "how bad is it?" and assigning a percentage. Instead, it runs a two-step conversion process using two tables: Table VI converts your audiometric test results into a Roman numeral (I through XI). Table VII maps the Roman numerals for each ear together to produce the final percentage rating.

The reason most veterans get 0% is structural: Table VI assigns Roman numeral I or II to mild-to-moderate hearing loss — and Table VII assigns 0% to any combination that includes a Roman numeral I or II in the better ear. Veterans with genuine noise-induced hearing loss at the mild-to-moderate level (the most common audiometric profile from military service) are rated service-connected but non-compensable. The condition counts as part of your record and enables secondary conditions, but it pays nothing at 0%.

How Table VI works — puretone average + speech discrimination = Roman numeral

Step 1 — Puretone average (PTA): The VA averages four frequencies: 1000 Hz, 2000 Hz, 3000 Hz, and 4000 Hz. This produces a single number in decibels (dB). The higher the dB, the worse the hearing.

Step 2 — Maryland CNC word recognition: The examiner plays recorded words in a sound booth (no hearing aids). You repeat each word. Your score is a percentage of words you got correct. Higher percentage = better speech discrimination.

Step 3 — Table VI lookup: Find your puretone average on the left axis and your speech discrimination score on the top axis. The cell where they intersect gives you a Roman numeral from I (best) to XI (worst).

Step 4 — Table VII lookup: Use the Roman numeral for your worse ear (vertical axis) and better ear (horizontal axis). The intersecting cell gives your final rating percentage. If the better ear lands at Roman numeral I or II, the rating is almost always 0%.

Simplified Table VI — Puretone average to Roman numeral (selected rows):

PTA (dB) Speech Disc. 92–100% Speech Disc. 84–90% Speech Disc. 72–82% Speech Disc. 60–70% Speech Disc. ≤58%
≤ 41 dB I II III IV V
42–48 dB II III IV V VI
49–55 dB III IV V VI VII
56–62 dB IV V VI VII VIII
63–70 dB V VI VII VIII IX
71–77 dB VI VII VIII IX X
≥ 78 dB VII VIII IX X XI
Worked example — 55 dB average + 84% speech discrimination

PTA: 1000 Hz = 50, 2000 Hz = 55, 3000 Hz = 60, 4000 Hz = 55 → Average = 55 dB

Speech discrimination: Maryland CNC test = 84%

Table VI lookup: 49–55 dB row + 84–90% column = Roman numeral IV

If this is the right ear (worse ear) and left ear is Roman numeral III: Table VII maps IV/III = 10% rating

If both ears are IV/IV: Table VII maps IV/IV = 10% rating

If one ear is IV and the better ear is I or II: Table VII maps to 0% — the better ear's strong result cancels the worse ear's damage in the table.

Final Rating % What it means in 2025 Path to get there
0%
MOST COMMON RESULT
Service-connected, non-compensable. No monthly pay from hearing loss alone, but the service connection is on record. Enables secondary claims and a future increase when hearing worsens. VA also provides hearing aids and batteries at 0%.
Better ear at Roman numeral I or II in Table VII calculation. Very common for veterans with mild-to-moderate noise-induced hearing loss.
10%
$175.51/mo (2025)
Compensable. First level of pay. Most common compensable hearing loss rating.
Typically requires both ears at Roman numeral III or IV in Table VII, or worse ear V/VI with better ear at II/III. PTA around 50–62 dB with speech discrimination around 80–90%.
20%
$345.00/mo (2025)
Significant impairment in both ears. Moderately severe hearing loss range.
Requires higher Roman numerals in both ears — typically V/V or V/VI in Table VII. PTA above 63 dB with speech discrimination below 80%.
30–100%
$508–$3,737+/mo (2025)
Severe to profound hearing loss. Requires significantly elevated Roman numerals (VII–XI) in Table VII calculations.
Table VII maps to 30%, 40%, 50%, 60%, 70%, 80%, 90%, or 100% for the most severe audiometric profiles — PTA above 78 dB, speech discrimination below 60%.
38 CFR 4.86 — The rule most veterans never hear about

The exceptional patterns rule — how to rescue a claim that Table VI alone would have lost.

Most rating decisions apply only Table VI. But 38 CFR 4.86 requires the VA to use a different table — Table VIa — in specific audiometric situations. Table VIa produces higher Roman numerals for the same puretone results, which means higher final ratings from Table VII. This rule exists because certain audiogram patterns indicate more functional impairment than Table VI's conversion formula captures.

The two exceptional pattern triggers under 38 CFR 4.86

Trigger 1 — High-frequency four-frequency rule: When the puretone thresholds at all four frequencies (1000 Hz, 2000 Hz, 3000 Hz, and 4000 Hz) are 55 dB or higher for the same ear. When this applies, the VA must use the higher Roman numeral produced by either Table VI or Table VIa — whichever benefits the veteran.

Trigger 2 — Significant 1000 Hz / 2000 Hz jump: When the puretone threshold at 1000 Hz is 30 dB or lower AND the threshold at 2000 Hz is 70 dB or higher for the same ear. This pattern indicates a steep, sudden drop from low-frequency hearing (relatively preserved) to high-frequency hearing (severely impaired), which is the classic audiometric signature of noise-induced cochlear damage concentrated in the 2000–4000 Hz range.

Why this matters: Table VIa assigns higher Roman numerals to the same puretone average than Table VI does for these specific patterns. A veteran whose Table VI result was Roman numeral II (mapping to 0%) may get Roman numeral IV from Table VIa — which can produce a 10% compensable rating in Table VII. The VA is required to compare both tables and use the higher result when 38 CFR 4.86 applies. If the rating decision did not do this and your audiogram meets either trigger, this is a Clear and Unmistakable Error (CUE) — the strongest basis for a CUE claim or Higher Level Review.

Check your audiogram — the examiner may not have applied 4.86

Pull your VA audiogram records. Look at the threshold values for 1000 Hz, 2000 Hz, 3000 Hz, and 4000 Hz for each ear. If all four are 55 dB or higher, or if 1000 Hz is ≤ 30 dB and 2000 Hz is ≥ 70 dB, 38 CFR 4.86 must apply to that ear. If your rating decision used only Table VI without mentioning 4.86 or Table VIa, you likely have a viable Higher Level Review argument based on examiner error. File the HLR and cite the specific regulation the decision failed to apply. See VA Claim Denied Guide →

38 CFR 4.26 — the bilateral factor myth for hearing loss

The § 4.26 bilateral factor does not stack on a hearing loss rating.

You will sometimes hear veterans or advocates suggest adding the 38 CFR 4.26 bilateral factor (a 10% multiplier applied when a veteran has paired extremities or paired sensory organs rated under separate diagnostic codes) on top of a hearing-loss rating to make it higher. It does not work here. The hearing-loss schedule under DC 6100 is already a pair-of-organs rating: Table VII scores both ears together by design, and the schedule already contemplates bilateral involvement in every cell. Where a condition is rated under a code that already accounts for the pair, § 4.26 cannot be stacked on top — the rating is the rating.

The same logic closed the door on "bilateral tinnitus" claims: DC 6260 caps at 10% whether the ringing is one ear or both, per the 2003 regulatory revision and the Federal Circuit's holding in Mayer v. Shinseki, 676 F.3d 1349 (Fed. Cir. 2011). Both the tinnitus cap and the § 4.26 hearing-loss myth trace to the same underlying principle: when the rating schedule already prices both ears, you do not get a second bump.

What veterans sometimes mistake for a § 4.26 effect in hearing-loss ratings is just the natural Table VII asymmetry — a worse-ear IV paired with a better-ear IV lands at 10%, and a worse-ear IV paired with a better-ear II lands at 0%. That difference is the schedule working as designed, not a § 4.26 application. If a rating decision letter cites § 4.26 explicitly on a hearing-loss rating, that's actually a CUE argument worth challenging — the rating should not have factored it.

C&P exam — what can go wrong and how to catch it

The C&P exam trap: the Maryland CNC word recognition test must be done without hearing aids in a sound booth.

The hearing loss C&P exam is an audiological examination. What makes it unique is that the VA's own regulations specify the exact test protocol: word recognition must be tested using the Maryland CNC word list, in a sound booth, without hearing aids. This is not optional — it is the required protocol under 38 CFR 4.85.

The three protocol requirements — and what to do if they're violated

Requirement 1 — Maryland CNC word list. The examiner must use the Maryland CNC (consonant-nucleus-consonant) word list — not a substitute list, not an abbreviated version. If the examiner uses a different word recognition test (NU-6, W-22, etc.), the result is not computed per 38 CFR 4.85. Demand a supplemental exam using the correct test list and file a request for examination via VA Form 21-4142a or a statement to the file. A rating based on the wrong word list is ratable error.

Requirement 2 — Sound booth. The test must be administered in an audiometric booth that eliminates ambient noise. Testing in an open office, hallway, or clinical room without acoustic isolation distorts the results — ambient noise can artificially improve speech discrimination scores by masking the test signal. If your C&P exam was not conducted in a sound booth, this is a procedural defect that can be raised in a Higher Level Review.

Requirement 3 — No hearing aids. The word recognition test evaluates your unaided hearing — the level of impairment your cochlea actually has. Testing with hearing aids on measures aided performance, not the disability itself. Aided scores will produce a better (higher) speech discrimination result, which maps to a lower (worse for the veteran) Roman numeral in Table VI and ultimately a lower rating. If you were wearing hearing aids during the word recognition portion of your C&P exam, the entire speech discrimination component is invalid. Request a corrected exam and note in writing that the protocol violated 38 CFR 4.85.

SRT and the single best-ear strategy — how the audiologist scores you

SRT (Speech Recognition Threshold): The lowest decibel level at which you can correctly repeat familiar two-syllable spondee words ("baseball," "hotdog," "stairway") roughly half the time. SRT is a separate measurement from Maryland CNC — the CNC test gives you the speech-discrimination percentage used in Table VI, while SRT confirms the puretone thresholds are reliable. If SRT disagrees sharply with your puretone average, the examiner should re-test; inconsistent results are a flag that the rating was based on bad data.

Best-ear strategy (what the audiologist actually scores): Each ear is tested independently and scored independently. There is no combined-ear score and no way to "transfer" a strong result from one ear to the other. Veterans sometimes give a half-hearted response on what they perceive as their worse ear — that is the wrong move. The VA scores each ear on its own audiogram; underperforming on one ear only hurts that ear's Roman numeral and ultimately your Table VII result. Listen carefully to every word and respond to every item on each ear's test.

Preparing for the C&P exam: arrive without wearing hearing aids. Bring documentation of any prior audiology records — from service, VA audiology appointments, or private audiologists. Tell the examiner your complete noise exposure history: your MOS or rate, specific weapons or equipment you worked around, and approximate years of exposure. If you have tinnitus, mention it — the examiner will typically evaluate both conditions at the same appointment.

Full C&P preparation guide: C&P Exam Guide — what to expect and how to prepare →

The most valuable paired claim in the VA system

Tinnitus + hearing loss: file them together, rate them separately, and let the combined math work.

Tinnitus and hearing loss are the #1 and #2 most-claimed VA disabilities — and they almost always come from the same source: noise-induced cochlear damage from military service. They share the same C&P exam, the same noise exposure nexus, and the same audiologist examiner. Filing them separately is inefficient. Filing them together is the standard approach.

How the combined rating math works — 10% tinnitus + 10% hearing loss

VA combined ratings use the "whole person" method — each condition takes a percentage of what's left, not a straight addition. But the practical outcome of adding tinnitus and hearing loss together is almost always higher than either alone:

Example: Veteran has 30% PTSD as their only current rating. Stand-alone: 30% = $508/mo.

+ 10% tinnitus: Combined = 37% → rounds to 40% = $621/mo. Gain: $113/mo.

+ 10% hearing loss added after tinnitus: Combined = 43% → rounds to 40%. No additional bracket jump yet.

But: if the hearing loss rates at 20% instead of 10%: 30% PTSD + 10% tinnitus + 20% hearing loss = 49% → rounds to 50% = $1,075/mo. Total gain from both auditory claims: $454/mo, $5,448/year, tax-free, for life.

Use the Combined Rating Calculator to run your own numbers — the bracket effect is what makes these claims worth pursuing even when individual percentages seem low.

Cross-filing options — which to file first

Option A — File both simultaneously on VA Form 21-526EZ. This is the cleanest approach. One C&P exam, one decision. Use this when neither condition is currently service-connected.

Option B — Hearing loss already service-connected. File tinnitus as secondary to hearing loss. The cochlear damage mechanism from the already-established hearing loss directly causes tinnitus — this is a well-accepted secondary pathway. Or file it directly as a separate claim from the same noise exposure.

Option C — Tinnitus already service-connected. File hearing loss as secondary to the service-connected tinnitus. The same cochlear damage that causes tinnitus causes hearing loss — the VA accepts this pathway. An audiologist nexus letter connecting the two makes the claim cleaner.

Full tinnitus guide: VA Tinnitus Claims Guide — 38 CFR 4.87 DC 6260, rating math, C&P prep, and denial rebuttals →

Service connection — the three-element test

How to service-connect hearing loss: MOS noise exposure, Hickson elements, and the nexus letter.

Service connection for hearing loss requires the same three elements as any VA claim: (1) a current diagnosis of hearing loss (audiogram showing measurable impairment), (2) an in-service event — virtually always noise exposure, and (3) a nexus connecting the in-service event to the current hearing loss. For most noise-exposed veterans, element (2) is the strongest: the MOS, AFSC, or naval rate documents the noise environment without requiring a separate letter.

MOS noise exposure — the most common in-service noise hazard billets

Army: Infantry (11 series), Field Artillery (13 series), Cavalry (19 series), Special Forces (18 series), Aviation (15 series), Combat Engineers (12 series), Armor (19K/E). Crew-served weapons (M2HB, M240, M249), howitzers, main battle tanks, and mortar systems produce sustained noise levels above 140 dB — far above safe exposure thresholds.

Navy / Marine Corps: Engineering ratings (EN, MM, BT, EM), aviation ratings (AD, AE, AM, AO, AV), gunner's mates, flight deck crew, submarine machinery spaces, shipboard combat systems, Marine Corps infantry and weapons MOSs (0311, 0331, 0341, 0351), and any billet requiring regular flight deck or flight line work.

Air Force: Aircraft maintenance (2A-series), airfield and flight line specialties, munitions (21M), security forces in flight-line environments, crew chiefs, aircraft loadmasters, and explosive ordnance disposal (EOD).

Coast Guard: Machinery technicians (MK), maritime enforcement, flight mechanics on rotary wing aircraft, and any billet near marine diesel engines.

The Hickson elements for noise-induced hearing loss service connection: (1) history of occupational or recreational noise exposure, (2) audiometric pattern consistent with noise-induced hearing loss (4000 Hz notch on audiogram is the classic fingerprint), and (3) exclusion of non-noise causes. Your MOS documentation, personnel record, and any fitness reports mentioning duty assignments establish elements 1 and 2. A private audiologist can attest to element 3 in a nexus letter.

Buddy statements — the underused evidence for noise exposure claims

Service members almost never reported hearing problems during service — it was normalized and reporting it meant being removed from duty. The absence of medical records documenting hearing complaints does not mean the exposure didn't happen. VA Form 21-10210 buddy statements from fellow veterans who served in the same unit, operated the same equipment, or worked in the same noise-hazardous environment can directly corroborate your exposure history. A buddy statement doesn't need to say your hearing is damaged — it only needs to corroborate the noise exposure ("We fired the M198 howitzer multiple times per week at [training site] from [year] to [year] and hearing protection was not always available or consistently used").

Buddy statements are especially valuable when your service record lists a billet or MOS that is not on the obvious noise-hazard list but where the actual working environment was loud — motor pool, vehicle maintenance, shipboard spaces. The buddy statement describes the actual working conditions, not just the job title.

If you need stronger nexus evidence — especially if you've already been denied — a private audiologist's independent medical opinion (IMO) is the cleanest path. The letter should: (1) review your audiogram and note the noise-induced pattern (high-frequency loss at 4000 Hz), (2) identify your MOS/service history as noise exposure documentation, and (3) state that your hearing loss is "at least as likely as not" related to in-service noise exposure. The 50% standard — "at least as likely as not" — is the legal threshold. The opinion doesn't need certainty.

Secondary conditions — 38 CFR 3.310

Secondary conditions to claim from service-connected hearing loss: tinnitus, vertigo, migraines, and depression.

Once hearing loss is service-connected, it becomes the anchor for secondary claims. Secondary conditions are rated separately under their own diagnostic codes and add independently to your combined rating. Full secondary conditions guide: Secondary Conditions →

Tinnitus
38 CFR 4.87 DC 6260 — Most common paired claim
  • Tinnitus and hearing loss share the same cochlear damage mechanism — noise-induced or ototoxic damage to the hair cells of the cochlea produces both conditions simultaneously
  • If hearing loss is already service-connected, tinnitus can be filed as secondary to the same cochlear damage that caused the hearing loss — or filed directly from the same in-service noise exposure
  • Tinnitus is rated at a flat 10% under DC 6260 — no severity scaling. 10% = $175.51/mo in 2025
  • Even a 0% hearing loss rating enables tinnitus as a secondary claim — the service connection is what matters, not the compensable percentage
  • Full tinnitus guide: Tinnitus VA Claims Guide →
Vertigo / Meniere's Disease
38 CFR 4.87 DC 6204/6205 — Vestibular system damage
  • The cochlea and the vestibular system (balance organs) share the same inner ear space. Noise trauma or ototoxic damage that impairs cochlear function can also affect the vestibular system, producing balance disorders, vertigo, and dizziness
  • Vestibular dysfunction (DC 6204) is rated 0–30% based on frequency and severity of dizziness and its effect on daily function. Meniere's disease (DC 6205) includes hearing fluctuation, tinnitus, and vertigo and rates 0–100%
  • An ENT or neurotologist nexus letter connecting vestibular symptoms to the same cochlear damage mechanism as the service-connected hearing loss is the key evidence item
  • Vertigo secondary to hearing loss is a legitimate, well-accepted pathway that many veterans overlook — if you have balance problems or dizziness, ask your VA audiologist to order a vestibular function test
Migraines
38 CFR 4.124a DC 8100 — Sound sensitivity pathway
  • Hearing loss and tinnitus both produce auditory hypersensitivity (hyperacusis) in many veterans — sudden loud sounds cause disproportionate pain or startle responses that can trigger migraines
  • The sleep disruption from tinnitus, combined with auditory processing stress from communication difficulty (constantly straining to hear), are well-documented migraine precipitants
  • Migraines rate under DC 8100: 0–50% based on frequency and severity of prostrating attacks. A 30% or 50% migraine rating from a tinnitus/hearing loss secondary pathway is achievable with strong documentation
  • Frequency documentation is critical — keep a headache diary with dates, duration, prostration (inability to function), and any missed work or medical treatment
Anxiety / Depression
38 CFR 4.130 DC 9400/9434 — Significant rating potential
  • Chronic hearing loss produces documented psychological sequelae: social isolation from communication difficulty, anxiety from inability to hear safety cues, depression from loss of occupational capacity and social connections, and withdrawal from activities previously enjoyed
  • Anxiety secondary to hearing loss is rated under DC 9400 (generalized anxiety disorder) and depression under DC 9434 (major depressive disorder) — using the General Rating Formula for Mental Disorders (0%, 10%, 30%, 50%, 70%, 100%)
  • A psychiatrist's or psychologist's nexus letter connecting the psychological symptoms causally to the veteran's service-connected hearing impairment is the required evidence
  • Mental health ratings at 50% or 70% represent far higher compensation than the hearing loss rating itself — this secondary pathway often has the highest per-claim value in the hearing loss cluster
Denied? One year to act.

Common hearing loss denial reasons and how to fight back.

Most hearing loss denials trace to one of three issues. All are fixable. You have one year from the denial date to select an AMA appeal lane. Don't let the clock run.

Denial reason #1 — "No in-service noise exposure documented"

The VA's argument: Service treatment records don't mention hearing complaints or audiometric testing. The examiner finds no formal documentation of noise hazard in the file.

The rebuttal: Hearing problems were almost never documented during service — reporting hearing problems led to removal from duty or medical hold, so service members didn't report them. The absence of a medical record is not evidence the exposure didn't happen. Respond with: (1) A detailed personal statement describing your MOS, the specific noise-producing equipment or environments, and approximate years of exposure. (2) Buddy statements from veterans who served alongside you — VA Form 21-10210. (3) An audiologist's nexus letter noting that your MOS constitutes documented noise hazard and that your audiogram shows the 4000 Hz notch pattern consistent with noise-induced hearing loss. File a Supplemental Claim with these items as new and relevant evidence.

Denial reason #2 — "Negative nexus / not related to service"

The VA's argument: The C&P examiner stated that the hearing loss is "less likely than not" related to military service — possibly attributing it to age-related hearing loss (presbycusis) or other non-service causes.

The rebuttal: Presbycusis is flat and symmetric across all frequencies. Noise-induced hearing loss shows a characteristic 4000 Hz notch — a specific dip at 4000 Hz with recovery at higher frequencies. If your audiogram shows a 4000 Hz notch pattern, a private audiologist can document that the pattern is inconsistent with presbycusis and consistent with noise-induced cochlear damage. Obtain an independent medical opinion (IMO) from a private audiologist who will review your service records and provide the "at least as likely as not" standard opinion, citing the specific audiometric pattern. File a Supplemental Claim with the private IMO as new evidence. The VA must weigh the private opinion against the C&P examiner's opinion — a well-supported private IMO typically prevails.

Denial reason #3 — "Audiometric results too mild / 0% non-compensable"

The VA's argument: Service connection is granted (you won this part) but the VA assigned 0% because the Table VI/VII conversion produced a non-compensable Roman numeral combination.

The rebuttal: First check whether 38 CFR 4.86 exceptional patterns applied and was applied. Pull your audiogram: if all four frequencies (1000, 2000, 3000, 4000 Hz) are 55 dB or higher in either ear, or if 1000 Hz is ≤ 30 dB and 2000 Hz is ≥ 70 dB, Table VIa is mandatory. If the decision used only Table VI without comparing Table VIa, file a Higher Level Review citing failure to apply 38 CFR 4.86. Second, a 0% rating is not permanent — file for increase whenever your hearing worsens. There is no time limit on increase claims for service-connected conditions. Finally, file tinnitus as secondary to the 0% hearing loss service connection — tinnitus pays 10% ($175.51/mo) and does not require the hearing loss to be compensable, only service-connected.

Start here VA Claim Denied Guide What the denial letter means, what the VA must explain, and your first move in the one-year window. Pick your lane VA Appeals Guide Higher Level Review, Supplemental Claim, or BVA? When to use each and what evidence works in each lane. File the pair Tinnitus VA Claims Guide Even a 0% hearing loss rating enables tinnitus as a secondary claim. 10% tinnitus + hearing loss = the most common and valuable paired claim. Open more claims Secondary Conditions Guide Hearing loss is service-connected? File vertigo, migraines, anxiety, and depression as secondaries to stack the combined rating. Bad exam C&P Exam Guide If the exam used the wrong word list, tested with aids on, or was not in a sound booth — this guide explains how to challenge the exam. Run the math Combined Rating Calculator Model exactly how hearing loss + tinnitus ratings affect your combined percentage. The bracket effect can be worth hundreds per month.
Ask on the HadIt Forum — 26,000 veterans who've fought the same fight →
Frequently asked questions

VA Hearing Loss Claim FAQ — 7 questions veterans ask most.

What percentage does the VA give for hearing loss?
Hearing loss is rated under 38 CFR 4.85, Diagnostic Code 6100, using a two-table conversion process. Your puretone average (1000/2000/3000/4000 Hz) and speech discrimination score (Maryland CNC word test) are converted to a Roman numeral (I–XI) by Table VI, then both ears' Roman numerals are mapped together in Table VII to produce a percentage from 0% to 100%. Most veterans with mild-to-moderate noise-induced loss receive 0% (service-connected but non-compensable). Compensable ratings start at 10% and require meaningful Roman numeral values in both ears.
Why do most hearing loss claims come back at 0%?
Because Table VI maps mild-to-moderate audiometric results to Roman numeral I or II, and Table VII assigns 0% to most combinations where the better ear lands at Roman numeral I or II. Veterans with real, documentable noise-induced damage often still land at 0% because the impairment, while genuine, doesn't cross the table thresholds. The exceptional patterns rule under 38 CFR 4.86 is the key exception — if your audiogram meets either exceptional pattern trigger, the VA must compare Tables VI and VIa and use whichever produces the higher Roman numeral.
Can I appeal a 0% hearing loss rating?
Yes — and first check whether 38 CFR 4.86 was applied. If all four audiogram frequencies (1000, 2000, 3000, 4000 Hz) tested at 55 dB+ in either ear, or if 1000 Hz was ≤ 30 dB and 2000 Hz was ≥ 70 dB, the exceptional patterns rule applies. If the decision ignored it, file a Higher Level Review citing failure to apply 38 CFR 4.86. You can also file for increase any time your hearing worsens — there's no time limit on increase claims. And even at 0%, the service connection enables tinnitus as a secondary claim paying 10%. See VA Appeals Guide →
Does wearing hearing aids affect my VA hearing loss rating?
No — the rating is based on unaided hearing. The Maryland CNC word recognition test must be administered without hearing aids, in a sound booth. If you were wearing aids during the test, the result overstates your speech discrimination ability and likely understated your impairment. Request a corrected exam noting that the 38 CFR 4.85 protocol was not followed. The VA also provides hearing aids and batteries to veterans with any service-connected hearing loss rating, including 0%.
Should I file hearing loss and tinnitus together?
Yes. They share the same C&P exam, the same noise exposure nexus, and the same audiologist. Filing both on VA Form 21-526EZ is the cleanest approach — one exam, one decision. The combined value of 10% tinnitus + even a 10% hearing loss is substantially higher than either alone due to combined ratings math. Use the Combined Rating Calculator to model the exact impact on your total combined percentage and monthly pay. Full tinnitus guide: VA Tinnitus Claims Guide →
What are the most common reasons a hearing loss VA claim is denied?
Three main reasons: (1) "No in-service noise exposure documented" — respond with buddy statements, a personal statement about your MOS and noise environments, and a private audiologist nexus letter. File a Supplemental Claim. (2) "Negative nexus from C&P examiner" — obtain a private audiologist IMO establishing the 4000 Hz notch pattern as noise-induced and stating "at least as likely as not." File a Supplemental Claim. (3) "Audiometric results too mild / 0% non-compensable" — this isn't a true denial but check the 38 CFR 4.86 exceptional patterns rule first. File a Higher Level Review if the exceptional patterns rule was not applied. See VA Claim Denied Guide →
What secondary conditions can I claim from service-connected hearing loss?
Tinnitus (38 CFR 4.87 DC 6260, 10%), vertigo and Meniere's disease (38 CFR 4.87 DC 6204/6205, 0–100%), migraines triggered by auditory hypersensitivity or tinnitus-related sleep disruption (38 CFR 4.124a DC 8100, 0–50%), anxiety and depression secondary to chronic hearing impairment (38 CFR 4.130 DC 9400/9434, 0–100%). Each secondary rates separately under its own diagnostic code and adds independently to the combined rating. Full guide: Secondary Conditions →

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