Meniere's Disease VA Rating

Meniere's disease, also called endolymphatic hydrops, is rated under 38 CFR § 4.87, diagnostic code 6205. The rating turns almost entirely on one variable: how often you have attacks of vertigo combined with cerebellar gait. More than once a week pushes the rating to 100 percent. One to four times a month sits at 60 percent. Less than once a month lands at 30 percent. The hearing component runs underneath all of it, and tinnitus can be present or absent at every tier without changing the number.

The interesting part isn't the tier table. It's the Note attached to DC 6205, which sets up a choice the rating decision has to make and can easily get wrong. Meniere's can be rated one of two ways. Either you take the single combined evaluation under DC 6205, or you rate vertigo, hearing impairment, and tinnitus separately under their own diagnostic codes and combine them. The regulation requires VA to use whichever method produces the higher overall evaluation. The two approaches are not added together. This election is the single biggest swing in Meniere's claims, and it is easy to miss.

That matters because the math doesn't always favor DC 6205. A veteran whose attacks come less than once a month, or whose attacks lack documented cerebellar gait, might be rated 30 percent under DC 6205, while separate ratings for a peripheral vestibular disorder, a measurable hearing loss, and tinnitus could combine higher. This page walks through DC 6205 and what each tier pays, the election rule and how to work the comparison, why a documented attack log is the evidence that decides the whole case, how to prove service connection, the C&P exam, the secondary considerations around falls and the interaction with service-connected tinnitus and hearing loss, and why VA denies these claims.

TL;DR

• Meniere's disease (endolymphatic hydrops) is rated under 38 CFR § 4.87, DC 6205. The rating is driven by the frequency of attacks of vertigo combined with cerebellar gait.
• The tiers: 100% for hearing impairment with attacks of vertigo and cerebellar gait more than once weekly, with or without tinnitus; 60% for hearing impairment with such attacks one to four times a month, with or without tinnitus; 30% for hearing impairment with vertigo less than once a month, with or without tinnitus.
• The critical election (Note to DC 6205): Meniere's is rated either under DC 6205 or by separately rating vertigo as a peripheral vestibular disorder under DC 6204, plus hearing impairment, plus tinnitus, whichever method yields the higher overall evaluation. The two methods are not combined.
• Because the rating hinges on attack frequency, a contemporaneous attack log (dates, duration, gait disturbance, falls) is the most decisive piece of evidence in the file.
• Service connection needs a confirmed diagnosis first. Claims argued secondary to tinnitus or hearing loss face a hard medical question, because both are part of Meniere's disease itself.
• Secondary considerations include falls and injuries driven by vertigo, and the interaction with service-connected tinnitus and hearing loss already in the record.
• A ruling is one issue the Board decided in one decision; one decision often rules on several issues. Across 971 decided Board rulings on Meniere's disease from 2021 to 2026, 33.2% were granted, 21.3% denied and 45.5% remanded. The data codes overall outcome, not which rating method the Board ultimately applied, so I can't read the DC 6205 versus separate-rating split directly from it.
• Remand is the most common outcome, and the grant rate is 8.5 points above the Board-wide 24.7 percent. Appeals for a higher rating were granted more often than service connection appeals; the Board section below breaks the results down by what the appeal asked for.

Meniere's disease VA rating criteria (DC 6205)

Meniere's syndrome sits in the ear section of 38 CFR § 4.87 at diagnostic code 6205. The rating criteria read as follows.

Meniere's syndrome (endolymphatic hydrops): Hearing impairment with attacks of vertigo and cerebellar gait occurring more than once weekly, with or without tinnitus, 100% Hearing impairment with attacks of vertigo and cerebellar gait occurring from one to four times a month, with or without tinnitus, 60% Hearing impairment with vertigo less than once a month, with or without tinnitus, 30%

Three things stand out in that text.

First, every tier requires hearing impairment as a baseline. Meniere's disease is defined by episodes of vertigo together with hearing loss in the affected ear and fluctuating ear symptoms such as tinnitus or a feeling of fullness. The rating presumes hearing loss is part of the picture and does not award additional points for it under DC 6205. That is the seed of the election problem discussed below.

Second, the two higher tiers require both vertigo and cerebellar gait. Cerebellar gait is a wide-based, unsteady walk. The 100 percent and 60 percent tiers are not satisfied by vertigo alone. They require the gait disturbance documented alongside the vertigo attacks. The 30 percent tier drops the cerebellar gait requirement and asks only for vertigo less than once a month. That gap between the 30 percent and 60 percent criteria is where claims can stall, because the gait finding can be missing from the record.

Third, the phrase "with or without tinnitus" appears at every tier. Tinnitus does not move the DC 6205 rating up or down. It is folded into the single evaluation. This is the rule that the separate-rating election is designed to test against, because a separately rated tinnitus carries its own 10 percent under DC 6260.

How much VA pays for Meniere's disease

VA pays by your combined rating, not condition by condition. Using VA's rates effective December 1, 2025 (the 2026 rates) for a veteran with no dependents, a Meniere's rating alone pays $552.47 a month at 30 percent, $1,435.02 at 60 percent, and $3,938.58 at 100 percent. A spouse, children or dependent parents add to each of those amounts. On the separate-rating path, a 30 percent vertigo rating and a 10 percent tinnitus rating combine to 37, which rounds to 40 percent, $795.84 a month before any hearing loss rating is added.

Rating vertigo, hearing loss and tinnitus separately: the DC 6205 election

The Note attached to DC 6205 is the most important sentence on this page.

"Evaluate Meniere's syndrome either under these criteria or by separately evaluating vertigo (as a peripheral vestibular disorder), hearing impairment, and tinnitus, whichever method results in a higher overall evaluation. But do not combine an evaluation for hearing impairment, tinnitus, or vertigo with an evaluation under diagnostic code 6205."

Read carefully, that creates a binary choice and a comparison obligation. VA has to compute the rating both ways and assign whichever is higher. It cannot combine them. You do not get DC 6205 plus separate tinnitus plus separate hearing loss. You get one path or the other.

Path one is DC 6205 as written: a single evaluation of 30, 60, or 100 percent driven by attack frequency.

Path two breaks Meniere's into its component disabilities and rates each under its own code, then combines them under 38 CFR § 4.25.

• Vertigo rated as peripheral vestibular disorder under DC 6204. That code pays 10 percent for occasional dizziness and 30 percent for dizziness and occasional staggering, which is its maximum. A compensable rating under it requires objective findings supporting the diagnosis of vestibular disequilibrium.
• Hearing impairment rated under DC 6100 using the audiometric tables in 38 CFR § 4.85, based on measured puretone thresholds and speech discrimination.
• Tinnitus rated under DC 6260 at 10 percent, which the tinnitus note allows to be combined with a DC 6100 or DC 6204 rating.

When you work the comparison, the path that wins depends on the facts. If the attacks are frequent and accompanied by cerebellar gait, DC 6205 at 60 or 100 percent almost always wins outright, because DC 6204 caps at 30 percent and the combined separate path rarely beats a single 60 or 100 percent evaluation. But when the attacks are less frequent or the gait finding is thin, DC 6205 may be stuck at 30 percent while the separate path can combine higher. A 30 percent vertigo rating and a 10 percent tinnitus rating alone combine to 37, which rounds to 40, before any hearing loss rating is added. That is the scenario the election rule exists to catch.

The reason it gets missed is structural. A rating decision that lands on DC 6205 at 30 percent can stop there without running the separate-rating math, because DC 6205 is the obvious "Meniere's code" and applying it feels complete. The Note requires the comparison, but nothing in the workflow forces it. When a veteran or representative shows that the separate path computes higher, a supplemental claim or appeal can pick up the difference.

Why the attack log decides a Meniere's rating

Every tier of DC 6205 turns on a frequency count: more than once weekly, one to four times a month, or less than once a month. Frequency is not something a single C&P exam can measure. The examiner sees one day. The rating depends on a pattern over weeks and months. That mismatch is the central evidentiary problem in Meniere's claims.

The evidence that resolves it is a contemporaneous attack log kept by the veteran. A useful log records, for each attack: the date, the duration, whether the room was spinning (true rotational vertigo versus lightheadedness), whether you had to stop and hold onto something or sit down, whether your gait was unsteady or staggering afterward, whether you fell or nearly fell, how long the symptoms lasted, and whether nausea or vomiting accompanied it. That last cluster, the unsteady or staggering gait, is what speaks to the cerebellar gait requirement for the 60 and 100 percent tiers.

A log matters for three reasons. It establishes frequency, which the tiers require and which no clinical snapshot can supply. It documents the cerebellar gait component, which is the difference between the 30 percent tier and the 60 percent tier. And it gives the C&P examiner a factual basis to characterize the disability accurately rather than recording only what is observable in the exam room on a day you happen not to be having an attack.

Without the log, the typical pattern is a rating built on whatever attack frequency the veteran recalls verbally at the exam, often understated, and a gait described as normal because no attack occurred during the appointment. That produces a 30 percent rating where a documented pattern might have supported 60.

Lay evidence carries real weight here. You are competent to report your own dizziness, the frequency of attacks, and observable unsteadiness, and in Meniere's rulings where the Board found the veteran's lay statements credible and decided the claim, it almost always granted it. Statements from a spouse, coworker, or anyone who has witnessed an attack and your gait during or after it add corroboration the rater can rely on. The symptom tracker can hold the attack log, and buddy letters can capture what witnesses saw.

How to prove Meniere's disease is service connected

Every claim needs a confirmed diagnosis first. Under the international diagnostic criteria, definite Meniere's disease means episodes of vertigo lasting 20 minutes to 12 hours, with low- to medium-frequency sensorineural hearing loss and fluctuating ear symptoms (hearing changes, tinnitus or fullness) in the affected ear. A record that says only "dizziness" will not carry a Meniere's claim.

Direct service connection

Direct service connection needs the diagnosis, something in service, and a medical link between them. Service treatment records showing episodes of vertigo, hearing changes, ear fullness or ringing, and your own account of when the attacks began, cover the in-service part. The medical opinion then has to explain why the Meniere's disease you have now began in service or was caused by it. Meniere's disease is not named on VA's chronic disease list in § 3.309(a). Direct claims fared better at the Board than secondary claims, and claims argued on a presumption fared worst; the Board section below shows all three.

Meniere's disease secondary to tinnitus or hearing loss

Under 38 CFR § 3.310, Meniere's disease can be service connected if a service-connected condition caused it, or aggravated it, meaning it would be less severe but for that condition. Veterans often claim Meniere's secondary to service-connected tinnitus or hearing loss. Those claims face a medical problem: hearing loss and tinnitus are features of Meniere's disease itself, so an opinion has to explain why the tinnitus or hearing loss led to the Meniere's rather than the other way around. It also has to address aggravation, not only causation; an opinion that skips aggravation is inadequate (El-Amin v. Shinseki, 26 Vet. App. 136 (2013)).

The Meniere's C&P exam (Ear Conditions DBQ)

VA examines Meniere's disease with the Ear Conditions (including Vestibular and Infectious) DBQ, and the hearing component needs its own audiology exam. Under § 4.85(a), a hearing exam for VA must be done by a state-licensed audiologist, with a Maryland CNC speech discrimination test and puretone audiometry, without hearing aids. The examiner is expected to address the points below.

• A confirmed diagnosis of Meniere's syndrome or endolymphatic hydrops, distinguished from other causes of dizziness.
• The frequency of vertigo attacks, drawn from history and any contemporaneous records.
• Whether cerebellar gait is present, which is the finding that separates the higher tiers.
• Audiometric results: puretone thresholds and speech discrimination scores for the hearing component.
• The presence and character of tinnitus.
• Any associated symptoms such as aural fullness, nausea, or falls.

The recurring failure is the frequency and gait piece. An examiner who records "veteran reports occasional dizziness" without quantifying attacks per week or per month, and who notes a normal gait observed in the office without addressing the gait during attacks, leaves the rater unable to apply anything above the 30 percent tier. That is the kind of gap that sends a case back on remand.

When the exam is sparse on frequency and gait, the case stalls. The rater defaults to the lowest tier the record clearly supports, the veteran appeals, and the Board remands for an adequate exam that actually addresses how often the attacks occur and what the gait looks like during them. When the Board sends a Meniere's claim back, the most common reason is an inadequate VA exam or opinion; the Board section below shows the remand reasons.

Falls, tinnitus and hearing loss: how Meniere's interacts with other ratings

Meniere's interacts with the rest of the rating picture in a few ways worth tracking.

Falls and fall injuries. Vertigo attacks with cerebellar gait carry a real risk of falling, and some people with Meniere's also have sudden drop attacks. A 2022 review of hospital-based studies put the share of patients whose drop attacks led to a fall to the ground at about 8 percent. Injuries sustained in a documented Meniere's-driven fall, a fractured wrist, a head injury, a shoulder injury, can be considered for secondary service connection under 38 CFR § 3.310 when a medical opinion connects the fall to the service-connected vertigo. The same documentation that supports the rating tier, the attack log noting near-falls and falls, also builds the secondary-connection record.

Already service-connected tinnitus and hearing loss. Many veterans with Meniere's already carry a separate service connection for tinnitus at 10 percent or a hearing loss rating from noise exposure in service. This is where the election rule gets technically tricky and where the comparison has to be done carefully. If the hearing loss and tinnitus are already separately rated for a distinct cause, the analysis of whether to fold them into a single DC 6205 evaluation or keep them separate has to avoid pyramiding under 38 CFR § 4.14, which bars rating the same disability twice. The practical point: make sure the rating decision actually ran the DC 6205-versus-separate comparison rather than defaulting to one path, and that pre-existing tinnitus and hearing loss ratings are accounted for in whichever path is chosen.

Vertigo as a standalone disorder. Where Meniere's is not the cause, vertigo can be a separate condition in its own right. A general vertigo claim under DC 6204, the peripheral vestibular code, follows different mechanics and caps at 30 percent. The line between a peripheral vestibular disorder and full Meniere's syndrome with hearing involvement is a diagnostic question the C&P exam should resolve, because it determines which rating framework applies.

Why VA denies Meniere's disease claims

Meniere's claims do better at the Board than the average claim. Across 971 decided Board rulings on Meniere's disease from 2021 to 2026, 33.2% were granted, 21.3% denied and 45.5% remanded, so remand is the most common outcome. That grant rate is 8.5 points above the Board-wide 24.7 percent.

When the Board denied Meniere's service connection, a missing link to service and a missing current diagnosis came up about equally often, well ahead of no in-service event. The patterns behind those denials, and behind the low ratings, repeat.

Diagnosis not pinned down. Dizziness has many causes. When the record does not firmly establish Meniere's syndrome or endolymphatic hydrops as opposed to benign positional vertigo, vestibular neuritis, or vestibular migraine, the claim can stall on the diagnostic question before the rating tiers are even reached.

No medical link to service. The diagnosis is clear, but no opinion explains how service caused it, or a secondary opinion names tinnitus or hearing loss as the cause without explaining why the relationship does not run the other way.

No attack log, so frequency is unproven. This is the central rating gap. The tiers require a frequency count, and without a contemporaneous log the record carries only vague verbal estimates given at the exam. The rater cannot reliably distinguish "more than once weekly" from "less than once a month," so the rating defaults low.

Cerebellar gait never documented. The 60 and 100 percent tiers require both vertigo and cerebellar gait. When the only gait finding is "normal gait" observed in clinic on a non-attack day, the higher tiers are out of reach on the face of the record, even when the veteran's lived experience would support them. The gait during attacks has to be captured, by the veteran's log, a witness statement, or an examiner who asks the right questions.

The election comparison was never run. A decision that applies DC 6205 at 30 percent and stops, without computing the separate-rating path under DC 6204 plus DC 6100 plus DC 6260, has not satisfied the Note. In the cases where this comes up, the corrective claim that forces the comparison can produce a higher overall evaluation.

Inadequate C&P exam. The recurring deficiencies are unquantified attack frequency, no assessment of gait during attacks, and a diagnosis that does not clearly separate Meniere's from other vestibular causes. An exam with those gaps is the kind the Board sends back.

When the Board sends a Meniere's claim back instead of deciding it, the most common reason by far is an inadequate VA exam or opinion, followed by records VA still had to get. Appeals for a higher rating were granted more often than service connection appeals. The Board section below shows how often each denial and remand reason came up, the results by what the appeal asked for, and how direct, secondary and presumptive claims have fared.

Questions veterans ask about Meniere's disease

What is the highest VA rating for Meniere's disease?

100 percent under DC 6205, for hearing impairment with attacks of vertigo and cerebellar gait more than once a week. Attacks with cerebellar gait one to four times a month rate 60 percent, and vertigo less than once a month rates 30 percent.

Can Meniere's disease be rated separately from tinnitus and hearing loss?

Yes, but only instead of DC 6205, not on top of it. The Note to DC 6205 requires VA to rate Meniere's either under DC 6205 or by separately rating vertigo, hearing loss and tinnitus, whichever gives the higher overall rating, and it bars combining a DC 6205 rating with separate ratings for those same symptoms.

Is Meniere's disease rated the same as vertigo?

No. Vertigo from an inner ear disorder without Meniere's is rated under DC 6204, which tops out at 30 percent and needs objective findings of vestibular disequilibrium for any compensable rating. DC 6205 is for Meniere's syndrome and requires hearing impairment at every level, up to 100 percent.

Can Meniere's disease be secondary to tinnitus or hearing loss?

It can be claimed that way, but the medical case is hard. Hearing loss and tinnitus are part of Meniere's disease itself, so a medical opinion has to explain why the service-connected tinnitus or hearing loss caused or worsened the Meniere's, not the reverse. At the Board, secondary Meniere's claims were granted less often than direct ones.

What should a Meniere's attack log include?

For each attack, write down the date, how long it lasted, whether the room was spinning, whether you had to stop, hold on or sit down, whether your walking was unsteady afterward, any fall or near fall, and any nausea or vomiting. The log proves how often attacks happen and documents the gait problem the 60 and 100 percent ratings require.

Bottom Line

Meniere's disease is rated under DC 6205, and the number you get is driven by how often you have vertigo attacks with cerebellar gait: more than once weekly is 100 percent, one to four times a month is 60 percent, and less than monthly is 30 percent. But the rating method is itself a choice. The Note to DC 6205 requires VA to compare the single Meniere's evaluation against separately rating vertigo (DC 6204), hearing loss (DC 6100), and tinnitus (DC 6260), and to assign whichever is higher, never both. That comparison is easy to miss. Underneath the method question, everything depends on a confirmed diagnosis, proving attack frequency and documenting cerebellar gait, which a single C&P exam cannot do on its own. The cases that succeed pair a confirmed diagnosis with a contemporaneous attack log and witness statements that establish how often the attacks happen and what the gait looks like during them. Same condition, different paper trail, different outcome.

Related Conditions

Meniere's claims sit alongside the other inner-ear and balance pages, most directly tinnitus and hearing loss, because the election rule forces a comparison against exactly those separately rated codes, and vertigo, which under DC 6204 is both the standalone peripheral vestibular framework and the component code in the separate-rating path. Veterans weighing which rating method produces the higher evaluation should review the secondary conditions tool, run both paths through the combined rating calculator, and confirm the comparison was actually run before assuming a single DC 6205 rating tells the whole story.

Methodology and Limitations

• Data source: Rating criteria quoted from 38 CFR § 4.87, DC 6205, including the Note that governs the election between a single evaluation and separate ratings. Peripheral vestibular disorder criteria from DC 6204. Hearing impairment tables and exam requirements from § 4.85, DC 6100. Tinnitus from DC 6260. Combined ratings math from § 4.25. Pyramiding from § 4.14. The chronic disease list from § 3.309(a) and secondary service connection from § 3.310. Pay amounts from VA's compensation rates effective December 1, 2025.
• Medical sources: Diagnostic criteria from Lopez-Escamez, "Diagnostic criteria for Menière's disease," Journal of Vestibular Research (2015). Cerebellar gait from Manto, "Neurophysiology of cerebellar ataxias and gait disorders," Clinical Neurophysiology Practice (2023). Drop attacks and falls from Kutlubaev, "Vestibular drop attacks in Ménière's disease: A systematic review and meta-analysis," Journal of Vestibular Research (2022). Other vestibular disorders from Strupp, "Peripheral vestibular disorders: an update," Current Opinion in Neurology (2019), and Dlugaiczyk, Frontiers in Neurology (2021).
• Board snapshot: Across 971 decided Board rulings on Meniere's disease from 2021 to 2026, 33.2% were granted (including partial grants and mixed outcomes), 21.3% denied and 45.5% 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 1,040 Board rulings on Meniere's disease (971 decided). Among the decided rulings, outcomes ran 45.5% remanded, 33.2% granted, and 21.3% denied. The read records the reasons the Board gave for denials and remands, including an inadequate exam, which the Board section below shows. It captures overall outcome rather than which rating method (DC 6205 versus separate ratings) the Board ultimately applied.
• Classification approach: Diagnostic code definitions drawn from the regulatory text. The election analysis follows the Note to DC 6205. Compensation comparisons use the VA combined ratings table and 2026 rate tables.
• Limitations:
• Compensation figures are based on VA rates effective December 1, 2025. They change each year with the cost-of-living adjustment.
• The election rule is mandatory, but its application varies. Some decisions apply DC 6205 without documenting the separate-rating comparison the Note requires.
• Whether the separate-rating path actually computes higher than DC 6205 depends entirely on the individual facts, particularly attack frequency, the measured hearing loss, and whether tinnitus and hearing loss are already separately service-connected.
• Selection bias: BVA-level patterns reflect cases that appealed. Most Meniere's claims resolve at the RO level and are not in any BVA dataset.
• Remands most often cite an inadequate exam, which is consistent with how hard attack frequency and gait are to capture in one visit.
• These observations reflect patterns from the regulatory text and BVA decisions. They are not predictions of individual outcomes.