Hearing Loss VA Rating

Roughly 1.6 million veterans are service-connected for hearing loss. The most common rating in that group is zero percent. That isn't a fluke or a denial. It's how the rating schedule is built. 38 CFR § 4.85 (opens in a new tab) runs your audiogram through a two-axis table: puretone threshold averages on one side, Maryland CNC speech discrimination scores on the other. The table pushes mid-range hearing loss with preserved speech discrimination into Roman numeral I or II in each ear, and Roman numerals I and II combine to zero percent every time.

The math doesn't care whether you can follow your spouse at a restaurant or hear your grandkids on the phone. The Maryland CNC is a word test given in quiet, and quiet-room word scores can stay high while hearing in noise falls apart. In a VA clinic study of 3,430 veterans, half scored 90 percent or better on a standard word list in quiet, while only 7 percent performed normally on a words-in-noise test (Wilson, Journal of the American Academy of Audiology, 2011, PMID 21993048). That preserved quiet-room score is what holds most ratings at zero.

There's one significant exception, and it's the part most veterans haven't read: 38 CFR § 4.86 (opens in a new tab). When the audiogram shows puretone thresholds of 55 dB or more at all four rating frequencies, or a steep drop (30 dB or less at 1000 Hz and 70 dB or more at 2000 Hz), the rater uses Table VI or Table VIa (puretone only), whichever gives the higher Roman numeral, and for the steep drop raises it one more level. This page walks through the hearing loss rating chart, the § 4.86 exception, the Maryland CNC requirements, how noise exposure gets conceded, why VA denies hearing loss claims, and how hearing loss combines with tinnitus.

TL;DR

• Hearing loss is rated under 38 CFR § 4.85 using a two-axis table: puretone threshold averages on one axis, Maryland CNC speech discrimination scores on the other. The output is a Roman numeral I through XI per ear, then a combined rating from Table VII.
• Most veterans with documented service-connected hearing loss land at Roman numeral I or II in each ear, which combines to 0%.
• 38 CFR § 4.86 carves out an "exceptional patterns of hearing impairment" exception. When the puretone threshold is 55 dB or higher at each of the four frequencies, or when it is 30 dB or less at 1000 Hz and 70 dB or more at 2000 Hz, the rater compares Table VI with Table VIa (puretone only) and assigns whichever Roman numeral is higher, then raises it one more level for the second pattern.
• The audiogram has to come from a state-licensed audiologist, include puretone testing at 1000, 2000, 3000 and 4000 Hz and a Maryland CNC word test, and be done without hearing aids. VA C&P audiograms qualify. Some private audiograms don't.
• Hearing loss and tinnitus are rated as two separate conditions. They almost always travel together, and the 10% tinnitus rating is independent of whatever the hearing loss rating works out to.
• For combat arms, aviation, artillery, armor, and similar jobs, in-service noise exposure is generally conceded from the DD-214. When the Board denies hearing loss, it most often finds no hearing loss disability under § 3.385 at all.
• A 0% rating still counts: VA furnishes hearing aids for service-connected hearing loss rated 0% when the hearing loss affects communication (38 CFR § 17.149(c)).

Hearing loss VA rating chart (DC 6100)

The rating process for hearing loss runs through three tables. Most veterans never see it laid out this way, because the decision letter just states the percentage without showing the math.

Step one: the audiogram numbers

The audiogram produces two numbers per ear.

• The puretone threshold average. Add the dB thresholds at 1000, 2000, 3000, and 4000 Hz, divide by four.
• The Maryland CNC speech discrimination score.

Step two: Table VI turns each ear into a Roman numeral

Look up the Roman numeral in Table VI using the puretone average on one axis and the speech score on the other. The result is a Roman numeral from I to XI. Here's a partial slice of Table VI to make it concrete.

• Puretone average 0-41 dB, speech score 92-100%: Roman numeral I
• Puretone average 42-49 dB, speech score 84-90%: Roman numeral II
• Puretone average 50-57 dB, speech score 76-82%: Roman numeral IV
• Puretone average 58-65 dB, speech score 68-74%: Roman numeral V
• Puretone average 66-73 dB, speech score 60-66%: Roman numeral VII

The full table goes higher. A veteran with mid-range hearing loss who comes in with puretone averages in the 30-45 dB range and speech scores in the 88-96% range lands at Roman numeral I or II.

Step three: Table VII combines the two ears

Plug the Roman numerals for both ears into Table VII. The intersection is the rating, from 0% to 100%. It's not additive in the way veterans sometimes expect. Here's how some common pairings work out.

• Both ears at I, or I and II, or II and II, or III and III: 0%
• III and IV, IV and IV, or IV and V: 10%
• V and V, or V and VI: 20%
• VI and VI, or VI and VII: 30%
• VII and VII: 40%
• VIII and VIII: 50%

You need at least one ear at Roman numeral IV or worse before any rating above 0% shows up, and the rating climbs mostly in 10% steps as the Roman numerals climb together.

If only one ear is service connected, § 4.85(f) assigns the other ear Roman numeral I, subject to the paired-organ rule in § 3.383. In Table VII, an ear at I paired with anything up to IX still rates 0%, so a single service-connected ear has to reach X or XI before it rates 10%.

Why mid-range hearing loss lands at 0%

The schedule's logic is that the Maryland CNC score captures functional impairment. If you can still repeat most single-syllable words in a quiet booth, the schedule says your speech discrimination is preserved, even if your puretone thresholds are 35 dB elevated.

Whether that captures real-world hearing is a separate question. Real conversation happens in noisy rooms, and a word score in quiet does not predict a word score in noise, because the two tasks measure different parts of hearing (Wilson, PMID 21993048). The argument for the booth test is that it is reproducible across raters and across time. The argument against is that it produces ratings that don't reflect what the impairment does in daily life. The data can't tell me which framing is right. The schedule does what it does.

The § 4.86 exception for exceptional hearing patterns

38 CFR § 4.86 is the part most veterans haven't read. For two "exceptional patterns of hearing impairment," the rater may use Table VIa, which is puretone only, with no Maryland CNC component.

§ 4.86(a). Puretone threshold of 55 dB or more at each of the four frequencies (1000, 2000, 3000, and 4000 Hz). This is for severe hearing loss across the board. The rater uses Table VI or Table VIa, whichever gives the higher numeral, and evaluates each ear separately.

§ 4.86(b). Puretone threshold of 30 dB or less at 1000 Hz and 70 dB or more at 2000 Hz. This is for a steep drop between 1000 and 2000 Hz. The rater uses whichever of Table VI or Table VIa produces the higher Roman numeral, and then raises it to the next higher numeral.

Board decisions explain why VA wrote the rule in 1999. Citing 64 FR 25209, the Board describes the (b) pattern as "an extreme handicap in the presence of any environmental noise," and notes that a speech test "conducted in a quiet room with amplification of sound does not always reflect the extent of impairment experienced in the ordinary environment" (Citation Nr. 25000510).

The (b) pattern is narrower than many veterans assume. The classic noise pattern is a notch at higher frequencies: when VA proposed its 2022 hearing changes, it described a noise notch as normal or nearly normal hearing below 2000 Hz with the worst thresholds at 3000 to 6000 Hz and better hearing at 8000 Hz (87 FR 8474), and an occupational medicine review puts the typical early notch at 3 to 6 kHz (PMID 26563797). A notch at 4000 Hz with a fairly normal 2000 Hz threshold does not meet § 4.86(b). So check the numbers rather than assume.

Reading your own audiogram for § 4.86

Look first at 1000 Hz and 2000 Hz in each ear. If 1000 Hz is 30 dB or less and 2000 Hz is 70 dB or more, that ear may qualify under § 4.86(b). Then check whether all four rating frequencies are 55 dB or more, the § 4.86(a) path, which can move the rating when speech scores are preserved.

A veteran whose 1000 Hz threshold is 20 dB but whose 2000 Hz threshold is 75 dB falls into § 4.86(b). Under Table VI, a good speech score might keep the Roman numeral low. Under Table VIa, the puretone-only numeral might land higher, and then one more level gets added. That can shift a 0% rating to 10% or 20% with no change in the underlying audiogram. If your audiogram fits either pattern, check that the rating decision says it applied § 4.86. A gap analysis is one way to check whether VA used the right table.

The Maryland CNC test and VA audiogram rules

The Maryland CNC word list is the speech test VA uses in hearing loss exams. CNC stands for consonant-vowel nucleus-consonant, the structure of the one-syllable words on the list, and the test is routinely used in VA medical centers (Mendel and colleagues, Journal of the American Academy of Audiology, 2014, PMID 25380123). The test has ten word lists (Causey and colleagues, Audiology, 1984, PMID 6517748). In one VA medical center's C&P records, the score used was the best word score across presentation levels, and scores fell as hearing loss got worse beyond a mild level (PMID 25380123). VA kept the Maryland CNC when it last substantively revised the hearing rating rules in 1999.

The Maryland CNC also sets the threshold for whether you have a hearing loss disability at all. Under 38 CFR § 3.385 (opens in a new tab), impaired hearing counts as a disability when the threshold at any of 500, 1000, 2000, 3000, or 4000 Hz is 40 dB or greater, when at least three of those frequencies are 26 dB or greater, or when the Maryland CNC score is below 94%.

Audiogram requirements under § 4.85(a)

The regulation reads as follows.

An examination for hearing impairment for VA purposes must be conducted by a state-licensed audiologist and must include a controlled speech discrimination test (Maryland CNC) and a puretone audiometry test. Examinations will be conducted without the use of hearing aids.

The requirements that matter are these.

• A state-licensed audiologist. Hearing aid dispensers and physicians who are not audiologists do not meet this requirement.
• The Maryland CNC specifically. Not W-22, not NU-6, not "speech discrimination test" generally.
• Puretone audiometry, with the average taken at 1000, 2000, 3000, and 4000 Hz.
• Testing without hearing aids.

When a private audiogram won't count for the rating

The most frequent gap in private audiograms is the Maryland CNC piece. Many community audiologists use NU-6 or another word list. The Board treats an audiogram that does not show the Maryland CNC was used as inadequate for rating purposes (Citation Nr. 25001163 and 25002261), so the rating usually comes from the VA C&P audiogram.

That does not make the private audiogram useless. It can support continuity, diagnosis, worsening, and nexus. Before a C&P, use the C&P exam prep tool and an evidence checklist for hearing claims to make sure the file includes service noise exposure, post-service occupational exposure history, hearing-aid records, and any prior audiograms.

Is hearing loss service connected? Noise exposure and your MOS

For hearing loss to be rated, it has to be service-connected. The standard three elements apply: a current disability under § 3.385, an in-service event or exposure, and a medical nexus.

The in-service exposure piece is where your military job matters. The Board relies on the Department of Defense's Duty MOS Noise Exposure Listing, which rates each job's probability of hazardous noise. It has conceded exposure for jobs listed as high probability, such as a helicopter repairman (Citation Nr. 25006174) and a cavalry scout (Citation Nr. A25008539), and the regional office conceded it for a Military Police job listed as moderate (Citation Nr. A25001661). Combat arms, artillery, armor, aviation, flight deck and similar jobs are commonly treated as high-probability exposure. For those veterans, the in-service event is often the easiest part of the claim.

For lower-probability jobs, the file needs more context. Lay statements, deployment records, weapon qualification, aircraft or vehicle proximity, generator exposure, shipboard noise, and unit records can all matter. Buddy statements for in-service noise exposure are useful when the DD-214 job title understates the actual noise environment.

Sensorineural hearing loss also counts as a chronic disease under 38 CFR § 3.309(a), as an organic disease of the nervous system. If it reached 10 percent within one year of separation, after at least 90 days of active service, service connection is presumed (Citation Nr. 25000288 and 25000818). Continuous symptoms since service can also carry the claim (Citation Nr. 25000157, citing Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013)).

The nexus piece is the medical opinion connecting current hearing loss to in-service exposure. It gets contested in a few situations.

• Late-onset hearing loss with significant post-service occupational noise exposure (construction, manufacturing, civilian aviation).
• No in-service audiogram, or audiograms showing normal hearing at separation followed by hearing loss diagnosed decades later.
• Documented intervening medical events (head injury, ototoxic medications, ear infections).

Normal hearing at separation does not defeat the claim on its own. Service connection for hearing loss does not require hearing loss in service if there is a medically sound basis to attribute it to the in-service noise (Hensley v. Brown, 5 Vet. App. 155 (1993)), and the Board has found VA opinions that rested only on a normal separation audiogram inadequate (Citation Nr. 25000092 and 25000109).

Why VA denies hearing loss claims

Hearing loss has a higher denial rate than most conditions in the Board data. A ruling is one issue the Board decided in one decision; one decision often rules on several issues. Across 53,933 decided Board rulings on hearing loss from 2021 to 2026, 20.3% were granted, 44.2% denied and 35.6% remanded, so denial is the most common outcome. That denial rate is 14.2 points higher than the 30.0 percent denial rate across all 1,241,238 decided Board rulings. Rating appeals fare far worse than service connection appeals, which fits the table math above. When the Board denied service connection, it most often found no current hearing loss disability under § 3.385, more often than it found no link to service. The Board section below shows how often each part of the claim failed, why claims were sent back, and results by what the appeal asked for.

The denials and 0% ratings I've seen for hearing loss tend to cluster around a few patterns.

Hearing that does not meet § 3.385. VA counts impaired hearing as a disability only when the auditory threshold at any of 500, 1000, 2000, 3000 or 4000 Hz is 40 decibels or greater, when at least three of those frequencies are 26 decibels or greater, or when the Maryland CNC speech recognition score is below 94 percent (38 CFR § 3.385). A veteran can notice real trouble hearing and still test short of those numbers. Until the test results meet the definition, there is nothing to service connect.

No current audiogram. Service connection needs a current disability, and for hearing loss that means a current audiogram with puretone thresholds and a Maryland CNC score. A claim built on symptoms alone, or on an old test, is denied or sent back for an exam.

No in-service audiogram. For older veterans, entry and separation audiograms weren't always performed or preserved. The claim has to rely on post-service audiograms and the credibility of in-service exposure and continuous symptoms.

An opinion that rests on a normal separation exam. An examiner who stops at "hearing was normal at separation" has not answered the nexus question under Hensley. That opinion can be challenged as inadequate.

Audiogram doesn't include Maryland CNC. A private audiogram is in the file, but the speech test was NU-6 or W-22. The rater orders a C&P exam to redo the test or relies on the C&P audiogram alone.

Speech discrimination preserved despite significant puretone loss. This is the structural 0% pattern. A 35-45 dB puretone average with a Maryland CNC score of 94-100% puts each ear at Roman numeral I or II, and Table VII returns 0%.

Documented post-service occupational noise exposure. A veteran who spent 20 years in a noisy civilian job may face a C&P opinion that attributes the hearing loss mainly to post-service exposure. The question then is whether in-service exposure was at least as likely as not a cause, not whether it was the only cause.

§ 4.86 exception not applied. The audiogram fits one of the two exceptional patterns, but the rating decision used Table VI by default and produced a 0% or low rating.

A bare-bones "less likely than not" without rationale gets the case remanded. The Board applies the standard that comes up across most appeals.

"A medical opinion is most probative if it is factually accurate, fully articulated, and based on sound reasoning."

The Board section below also shows how hearing loss claims went when the Board relied on a favorable opinion, an opinion against the claim, or none.

Hearing loss and tinnitus: two separate ratings

Hearing loss and tinnitus are rated separately. They're clinically intertwined, almost always travel together, and often share the same in-service noise exposure as the cause. But the rating schedule treats them as two distinct diagnostic codes. Tinnitus is under 38 CFR § 4.87 DC 6260, capped at 10%. See the Tinnitus condition page for the rating and the secondary chains it opens up. Hearing loss is under DC 6100, ranging from 0% to 100%.

When a veteran files for both, each gets its own rating decision. The combined ratings table at 38 CFR § 4.25 reduces each new rating against the capacity that remains rather than adding it.

• 0% hearing loss + 10% tinnitus: 10% combined
• 10% hearing loss + 10% tinnitus: combines to 19%, rounds to 20%
• 20% hearing loss + 10% tinnitus: combines to 28%, rounds to 30%
• 30% hearing loss + 10% tinnitus: combines to 37%, rounds to 40%

Some veterans assume tinnitus and hearing loss are one claim. They're not. The audiogram is part of any tinnitus C&P exam anyway, so the data is already in the file. The veterans I've seen file for tinnitus alone and never follow up with a hearing loss claim are leaving a rating on the table. Even a zero percent hearing loss grant preserves the condition for future increase claims if the audiogram worsens.

Hearing loss can also push a veteran across a rounding threshold. A veteran whose combined value is 44%, paid at 40%, who picks up a 10% hearing loss moves to a combined value of 50%. At the 2026 rates (effective December 1, 2025), that is $795.84 versus $1,132.90 a month for a single veteran with no dependents.

In the Board's rulings, tinnitus and vertigo are the conditions most often claimed as secondary to hearing loss, and tinnitus is also claimed as a cause of it. The Board section below lists those pairs with their counts and grant rates. Secondary conditions linked to hearing loss need their own diagnosis and nexus path. If ringing, buzzing, balance symptoms, or noise-environment difficulty are part of the record, track ringing and noise-environment difficulty before the exam.

When the rating won't move, and when it will

The hardest truth about hearing loss claims is that real-world frustration does not move the schedular rating by itself. Difficulty hearing in restaurants, asking people to repeat themselves, turning up the TV, and missing conversation are real impairments. But VA's position, stated in its 2022 proposal, is that DC 6100 already accounts for the natural effects of hearing loss, such as trouble telling sounds apart or using the telephone (87 FR 8474). The Board describes hearing ratings as "a mechanical application of the rating schedule" to the audiogram numbers (Citation Nr. 25001163, citing Lendenmann v. Principi, 3 Vet. App. 345 (1992)).

The rating moves when the inputs move. That means worse puretone averages, lower Maryland CNC scores, a qualifying § 4.86 exceptional pattern, or a correctly documented change from a prior audiogram. Subjective testimony can support service connection and functional impact, but it usually cannot override correct table math.

Questions veterans ask about hearing loss

What is the VA rating for hearing loss?

Hearing loss is rated from 0 to 100 percent under DC 6100, using the Roman numeral for each ear from Table VI and the combined result from Table VII. Most service-connected hearing loss lands at 0 percent because each ear sits at Roman numeral I or II.

What is the Maryland CNC test?

It is the word recognition test VA requires for a rating exam under 38 CFR § 4.85(a). You repeat one-syllable words from a Maryland CNC list, and the percentage you get right goes into Table VI alongside your puretone average.

Do hearing aids lower my VA hearing loss rating?

No. Section 4.85(a) requires the rating exam to be done without hearing aids, so wearing them does not reduce the rating.

Can I get VA hearing aids with a 0 percent rating?

Yes, when the conditions in 38 CFR § 17.149(c) are met. VA furnishes needed hearing aids to veterans whose service-connected hearing loss is rated 0 percent when the loss contributes to a loss of communication ability, and only as needed for that service-connected condition.

Is hearing loss a presumptive condition?

Sometimes. Sensorineural hearing loss is treated as a chronic disease under 38 CFR § 3.309(a), so it is presumed service connected if it reached 10 percent within one year of separation. Outside that window, you prove it with the noise exposure, the audiogram and a nexus opinion.

Is VA changing the hearing loss rating rules?

Not yet. VA's February 2022 proposal (87 FR 8474) would mostly update the wording of the hearing tables and § 4.86, keep the Maryland CNC, add a 10 percent rating for tinnitus that comes with noncompensable hearing loss, and remove the separate tinnitus code. As of October 2026 it is not final; the September 2024 supplemental notice (89 FR 74162) only addressed constrictive bronchiolitis.

Bottom Line

Hearing loss is rated under 38 CFR § 4.85 through a two-axis table that combines puretone threshold averages with Maryland CNC speech discrimination scores, producing a Roman numeral per ear and a combined rating from Table VII. Most veterans with service-connected hearing loss land at 0%, because mid-range puretone loss with preserved speech discrimination produces Roman numerals I or II, which combine to 0%. The 38 CFR § 4.86 exception lets puretone-only ratings apply when the audiogram fits either of two exceptional patterns, but the steep-drop pattern is narrower than the usual high-frequency noise notch, so check the 1000 and 2000 Hz numbers yourself. The audiogram has to come from a state-licensed audiologist using the Maryland CNC and the four standard frequencies, without hearing aids. Service connection is generally favorable for combat arms, aviation, artillery, and similar jobs where in-service noise exposure is conceded, and a normal separation audiogram does not end the claim. Hearing loss and tinnitus are rated as two separate conditions, and the combination at 10% each produces a 20% combined rating. The structural reason most hearing loss ratings come back at 0% isn't a denial. It's the table doing what the table is built to do.

Related Conditions

Hearing loss commonly travels with tinnitus, vertigo, balance problems, and communication-related functional impacts. Veterans with a zero percent grant should keep the rating active, track worsening, and review the gap analysis if the audiogram appears to fit an exceptional pattern.

Methodology and Limitations

• Data source: Rating criteria are quoted from 38 CFR §§ 4.85 and 4.86, checked against the eCFR text current to October 2, 2026. Table VI, Table VIa, and Table VII values were checked against the printed tables in the July 1, 2024 edition of 38 CFR (64 FR 25206, May 11, 1999, unchanged since). The disability definition is 38 CFR § 3.385, the hearing aid rule is 38 CFR § 17.149(c), and the chronic disease rule is 38 CFR § 3.309(a). The 1.6 million service-connected veteran count is from VA's 2024 Annual Benefits Report. Maryland CNC and word-in-noise statements cite PubMed abstracts by PMID. Combined rating math follows 38 CFR § 4.25. 2026 compensation figures (rates effective December 1, 2025) are from the VA disability pay tables for a single veteran with no dependents. The status of the 2022 proposal (87 FR 8474) and its 2024 supplement (89 FR 74162) was checked in the Federal Register in October 2026.
• Board snapshot: Across 53,933 decided Board rulings on hearing loss from 2021 to 2026, 20.3% were granted (including partial grants and mixed outcomes), 44.2% denied and 35.6% remanded. Dismissed, withdrawn and moot rulings are excluded. These are appealed claims, not your personal odds.
• Sample size: Patterns in this post are drawn from Claim Raven's read of every Board decision from 2021 to 2026 that it holds: 511,036 decisions containing 1,378,030 rulings, including 58,787 Board rulings on hearing loss (53,933 decided). The data captures Board-level outcome rather than schedular rating tier (the I-XI Roman numeral grid feeding into Table VII), so the rating-distribution framing in this post is regulatory rather than coded tier data.
• Classification approach: Rating tier definitions and tables are drawn from the regulatory text. Board decisions cited by number are examples of reasoning. The Board section on this page breaks the overall figures down by denial reason, remand reason, appeal type, claim theory, medical opinion, era and secondary pair; those figures are computed from the data, not typed here, and they are associations, not causes.
• Limitations:
• Compensation figures use 2026 VA disability rates for a single veteran with no dependents. Family rates differ at 30% and above.
• The "MOS noise presumption" referenced is a working concession that flows from the Duty MOS Noise Exposure Listing, not a formal statutory presumption. Practice varies across regional offices.
• Table VI / Table VIa / Table VII excerpts in this post are partial illustrations. The full tables in 38 CFR § 4.85 should be consulted for the complete grid.
• Private audiograms that don't include Maryland CNC speech discrimination are still useful for service connection and continuity of symptoms even if they can't be plugged into Table VI directly.
• These observations reflect patterns from the regulatory text, the relevant audiology studies, and BVA decisions. They are not predictions of individual outcomes.