Ear Infection and Eustachian Tube Dysfunction VA Rating

Ear disease ratings look small. The schedule pays 10 percent for a draining middle ear, 10 percent for a chronic outer ear infection, and nothing for a hole in the eardrum. Veterans who stop reading there miss the point of these codes. The ear disease rating is often the doorway to separate ratings for the hearing loss, tinnitus, dizziness and facial nerve damage it causes, and those can be worth far more.

This page covers each ear disease code word for word, how VA handles eustachian tube dysfunction, which the schedule never names, the pressure injuries behind most of these claims, the hearing exam, and why claims are denied. The Board section further down shows how ear disease appeals have ended.

Ear disease VA rating criteria

38 CFR § 4.87 rates diseases of the ear. Here are the codes this page covers:

The note to DC 6200 (it applies to the whole ear disease group in practice) is the most important line in this section:

Note: Evaluate hearing impairment, and complications such as labyrinthitis, tinnitus, facial nerve paralysis, or bone loss of skull, separately.

So a chronic draining ear rated at 10 percent can sit beside a separate hearing loss rating, a 10 percent tinnitus rating, a vertigo rating under DC 6204 and a facial nerve rating, all combined under § 4.25. The hearing loss, tinnitus and vertigo pages cover those codes.

Eustachian tube dysfunction: rated by analogy

Eustachian tube dysfunction is the most searched ear condition on this page, and the schedule never mentions it. The tube connects the middle ear to the back of the nose and equalizes pressure. When it fails, you get fullness, muffled hearing, popping, pain and fluid behind the eardrum.

When a condition is not listed, 38 CFR § 4.20 lets VA "rate under a closely related disease or injury in which not only the functions affected, but the anatomical localization and symptomatology are closely analogous." For eustachian tube dysfunction the closest listed codes are the otitis media codes. If it causes fluid behind the eardrum, DC 6201 rates it through the hearing loss it causes. If it leads to chronic infection with drainage, DC 6200 applies. Either way, the hearing test is what drives the number.

A review of the research describes eustachian tube dysfunction as presenting "with symptoms of aural fullness and pressure, muffled hearing, tinnitus, and otalgia," and notes that when severe it can lead to fluid in the middle ear, eardrum retraction or perforation, and cholesteatoma (Juszczak and Loftus, 2020). Those complications are what move a eustachian tube claim from 0 percent to something.

How much VA pays for ear disease

At VA's rates effective December 1, 2025, a veteran alone receives $180.42 a month at 10 percent. Because the complications are rated separately and combined, the total for a damaged ear depends on the hearing test, tinnitus and any balance or nerve problems. The combined rating calculator shows how separate ear ratings combine.

How to prove ear disease is service connected

Pressure injuries from diving, flying and blasts

Rapid pressure changes injure the middle ear when the eustachian tube cannot keep up. In a survey of 1,881 Finnish professional and recreational divers, 81 percent had had middle ear barotrauma while diving, and people who could only sometimes clear their ears with the Valsalva maneuver had far higher odds of it (odds ratio 11.56) (Lindfors and colleagues, 2021). Divers, aircrew, paratroopers and anyone exposed to blasts in service have the in-service event these claims need. A blast can also rupture the eardrum outright.

Service treatment records showing ear pain after a flight or dive, a ruptured eardrum, ear infections or tubes placed in service are the strongest evidence. Your own account of repeated ear blocks, pain on descent, or a blast that left your ear ringing and leaking is competent evidence of what you experienced.

Chronic ear infections that began in service

Ear infections during training or deployment, from swimming, water survival training or field conditions, can become chronic. A record of repeated otitis media or otitis externa in service, followed by continued treatment after, supports a direct claim.

Secondary to sinus or allergy conditions

Eustachian tube problems are often tied to inflammation in the nose. The same review notes that chronic eustachian tube dysfunction is thought to be associated with nasal allergens such as allergic rhinitis, although it rates the evidence linking the two as mixed: a 2018 consensus called it low quality, and a later large adult study supported an association without finding that all cases are allergy related (Juszczak and Loftus, 2020). If your allergic rhinitis or sinusitis is service connected, a secondary claim under 38 CFR § 3.310 is possible with a medical opinion that addresses your history. The opinion should cover aggravation as well as cause, meaning the ear condition would be less severe but for the sinus condition; an opinion that skips aggravation is inadequate under El-Amin v. Shinseki, 26 Vet. App. 136 (2013).

The C&P exam and the Ear Conditions DBQ

VA examines these conditions with the Ear Conditions DBQ, along with a hearing test when hearing loss is claimed. Before the exam:

• Claim every piece. List the ear disease, hearing loss, tinnitus and any dizziness separately. VA rates what you claim and what the exam finds; a claim for "ear problems" can leave pieces out.
• Bring the ENT records. Exams showing drainage, polyps, perforation, fluid or tubes, and any tympanometry results.
• Describe flares. How often the ear drains or blocks, how long it lasts, what treatment you need. Chronic otitis externa's 10 percent turns on "frequent and prolonged treatment."
• Mention balance problems. Vertigo from ear disease can be rated on its own.

Raven Scan reads your medical records and pulls out the ear findings, hearing test results and treatment dates so you can bring a complete list.

Why VA denies ear disease claims

The Board section below shows what the Board found missing in denied ear disease appeals and why it sent others back. These are the patterns behind those numbers.

No current disability. Most denied ear disease claims fail on the current condition. Infections clear and eardrums heal, so an ear that looks normal on exam day can sink the claim. Records from active periods matter: under McClain v. Nicholson, 21 Vet. App. 319 (2007), a condition present at any time during the claim counts.

No in-service event. Ear blocks after flights and dives were rarely charted. Your statement and statements from people who served with you help.

No link to service. An examiner may blame childhood ear infections, allergies or civilian exposures. A favorable opinion has to address your service history and timeline.

Complications left unclaimed. A 0 or 10 percent ear rating with no separate hearing loss, tinnitus or vertigo rating often means those pieces were never claimed or tested.

An inadequate exam. An inadequate VA exam is the most common reason the Board sends these claims back; the remand reasons below show how often.

Questions veterans ask about ear disease

What is the VA rating for eustachian tube dysfunction?

The schedule does not name it, so VA rates it by analogy under 38 CFR § 4.20, and the closest listed codes are the otitis media codes. If it causes fluid in the middle ear, the rating comes from the hearing loss; if it leads to a chronically draining ear, DC 6200 gives 10 percent. Hearing loss, tinnitus and vertigo are rated separately.

What is the VA rating for chronic ear infections?

A chronic middle ear infection with drainage or polyps rates 10 percent under DC 6200, and a chronic outer ear infection that needs frequent and prolonged treatment rates 10 percent under DC 6210. Hearing loss and other complications are rated separately.

Is a perforated eardrum rated separately from hearing loss?

Yes. The perforation itself rates 0 percent under DC 6211, and any hearing loss is rated on its own under the hearing loss rules. A 0 percent rating still service connects the perforation.

Can ear problems from flying or diving in service be service connected?

Yes. Pressure injury to the middle ear is common in diving and flying. Records of ear pain, blocks, a ruptured eardrum or infections in service, plus a medical opinion, support a direct claim.

Is otosclerosis a VA disability?

It can be service connected, and VA rates it on the hearing loss it causes under DC 6202. The claim turns on whether it began in service or, if it was noted when you entered, whether service made it worse.

Can tinnitus be rated along with an ear infection?

Yes. The note to DC 6200 tells VA to rate tinnitus, hearing loss, labyrinthitis, facial nerve paralysis and bone loss of the skull separately from the ear disease itself.

Sources

• 38 CFR § 4.87, ear ratings, DCs 6200 to 6211 (opens in a new tab), eCFR text as of October 2, 2026
• 38 CFR § 4.20, analogous ratings (opens in a new tab)
• 38 CFR § 3.310, secondary service connection (opens in a new tab)
• El-Amin v. Shinseki, 26 Vet. App. 136 (2013); McClain v. Nicholson, 21 Vet. App. 319 (2007)
• Juszczak HM, Loftus PA. Role of allergy in eustachian tube dysfunction. Curr Allergy Asthma Rep. 2020;20(10):54. doi:10.1007/s11882-020-00951-3 (opens in a new tab)
• Lindfors OH, Räisänen-Sokolowski AK, Suvilehto J, and colleagues. Middle ear barotrauma in diving. Diving Hyperb Med. 2021;51(1):44-52. doi:10.28920/dhm51.1.44-52 (opens in a new tab)
• VA disability compensation rates (opens in a new tab), effective December 1, 2025
• Ear Conditions DBQ guide