Hearing Loss Claims: How VA Rates Them

If your hearing isn't what it used to be after your time in service, you're not alone. Hearing loss and tinnitus are two of the most commonly claimed conditions in the VA system — and for good reason. Between artillery, aircraft, small arms, generators, engine rooms, and MOS-specific noise exposure, most veterans left service with ears that took a beating.

But here's where a lot of veterans get frustrated: they file a hearing loss claim, get called in for a C&P exam, and walk out with a 0% rating — or a denial entirely. If that's happened to you, or you're about to file, this article walks through exactly how the VA rates hearing loss, why so many claims come back with lower ratings than veterans expect, and what you can do about it.

The Basics: How Hearing Loss Rating Actually Works

VA rates hearing loss under 38 CFR § 4.85, using a specific formula based on two pieces of data:

1. Puretone threshold average — how loud sounds have to be for you to hear them at 1000, 2000, 3000, and 4000 Hz
2. Speech discrimination score — the percentage of words you correctly identify on the Maryland CNC word list

Those two numbers are plugged into Table VI in § 4.85, which spits out a Roman numeral (I through XI) for each ear. Then Table VII combines both ears' Roman numerals into your final percentage rating.

That's it. No pain scale, no functional questionnaire, no lay statements about how you can't hear your grandkids. Just puretone thresholds and speech discrimination, run through a table.

This mechanical approach catches a lot of veterans off guard. You can genuinely struggle to follow conversations in noisy restaurants, miss your alarm clock, and blast the TV — and still end up with a 0% rating because your audiogram numbers didn't hit the thresholds.

Why So Many Hearing Loss Claims Come Back at 0%

A 0% (noncompensable) rating on hearing loss doesn't mean the VA rejected your claim. A 0% rating means service connection was GRANTED — the VA agrees your hearing loss is related to service — but the current severity doesn't meet the threshold for monthly compensation. For hearing loss that 0% comes straight out of Table VII in § 4.85, which includes a noncompensable level.

That's actually important. A 0% rating:

• Gets your hearing loss into the VA system as service-connected
• Preserves your ability to file for an increase later if it gets worse
• Can serve as the predicate condition for secondary claims
• Entitles you to VA health care for that condition

So don't panic at a 0%. But also don't leave money on the table if your hearing is genuinely worse than that rating reflects.

The reason 0% is so common comes down to how § 4.85 works. The tables are stingy at the low end. You need pretty significant loss in the tested frequencies before Table VI starts kicking out Roman numerals that produce a compensable rating. Mild-to-moderate high-frequency loss — the classic "military noise exposure" pattern — often lands right at the 0% line.

The Tinnitus Piece

Here's the good news: even if your hearing loss lands at 0%, tinnitus is rated separately. Under 38 CFR § 4.87, diagnostic code 6260, recurrent tinnitus is rated at a flat 10% — no higher, no lower. That's the entire scale.

At Augustus Miles, we see this pattern constantly: a veteran files for hearing loss, gets 0%, and doesn't realize they should also be filing for tinnitus. If you have ringing, buzzing, hissing, or roaring in your ears — even intermittently — that's a separate condition with its own rating.

One note: there's been a proposed rule floating around to change how tinnitus is rated, but as of now, the standalone 10% under DC 6260 is still in effect.

When § 4.85 Doesn't Apply: Exceptional Patterns

Some veterans have hearing loss patterns that don't fit neatly into the standard Table VI framework — and these are cases Augustus Miles sees regularly. For those situations, 38 CFR § 4.86 provides an alternative pathway called "exceptional patterns of hearing impairment."

Two scenarios trigger § 4.86:

• Puretone thresholds of 55 dB or more at all four tested frequencies (1000, 2000, 3000, 4000 Hz) in either ear
• Puretone threshold of 30 dB or less at 1000 Hz AND 70 dB or more at 2000 Hz in either ear

When either pattern shows up, the rater uses whichever table (VI or VIa) produces the higher Roman numeral for that ear. Under the second pattern, § 4.86(b) adds one more step: that numeral is then elevated to the next higher Roman numeral. Each ear is evaluated separately. This matters because § 4.86 patterns tend to produce meaningful rating bumps for veterans who'd otherwise be stuck at 0% or 10%.

If your audiogram shows either of these patterns and your rating decision doesn't reference § 4.86, that's worth a second look.

What the C&P Exam Really Measures

The C&P audio exam is where your rating gets decided. A few things worth knowing before you walk in:

Speech discrimination testing must use the Maryland CNC word list. Not any word list — the specific Maryland CNC test. Exams using a different speech discrimination test don't satisfy § 4.85(a), and a rating decision built on the wrong test is worth challenging. One exception is built into the regulation: under § 4.85(c), if the examiner certifies that speech discrimination testing isn't appropriate — language difficulties, inconsistent scores — the rating is done from Table VIa on puretone averages alone.

The audiogram measures thresholds at specific frequencies. VA cares about 1000, 2000, 3000, and 4000 Hz for the puretone average. Loss at 500 Hz or 6000 Hz isn't part of the rating math, even if it shows on your audiogram.

Exam conditions matter. Testing needs to happen in a sound-controlled environment (usually a sound booth) with calibrated equipment. If you had significant temporary threshold shift from recent noise exposure the day of the exam, mention it — you may need a rescheduled test to get an accurate baseline.

Bilateral hearing loss is rated as a single condition. Under § 4.85, both ears go into a single rating calculation. The bilateral factor under § 4.26 does NOT apply — § 4.26 covers paired extremities (arms, legs) and paired skeletal muscles, so it never reaches ears in the first place. This trips up veterans who expect a 10% bump for having both ears affected.

The Nexus Piece: Connecting Hearing Loss to Service

For service connection, VA needs three things: a current diagnosis, an in-service event or exposure, and a medical nexus tying the two together. For hearing loss, the in-service piece usually isn't hard — MOS records, deployment history, or lay statements about noise exposure typically get you there.

The tricky part is the nexus opinion. VA examiners sometimes conclude that hearing loss developed after service due to "presbycusis" (age-related loss) or occupational noise exposure post-service. If your STRs don't show a documented hearing test showing shift during service, examiners often lean on that to deny nexus.

This is where a well-supported claim matters. Augustus Miles helps veterans build the evidence file that closes that gap — buddy statements about noise exposure, private audiologist opinions addressing the pattern of loss, and documentation of the MOS-specific noise environment. When the evidence reaches the "at least as likely as not" standard for nexus, § 3.102 resolves any remaining doubt in the veteran's favor.

Filing for an Increase When Your Hearing Gets Worse

Hearing loss almost always progresses. If you were rated at 0% or 10% years ago and your hearing has clearly declined, you can file for an increased evaluation. A new audiogram — either through VA or a private audiologist — is the anchor evidence.

A few things to watch for:

• Get audiograms from before and after when possible. The comparison is what makes the case for increase.
• The Maryland CNC speech discrimination test matters as much as the puretone thresholds. Sometimes speech discrimination declines faster than thresholds and drives the rating.
• Even a modest audiogram change can move you across a Roman numeral boundary in Table VI — which can bump your rating meaningfully.

Augustus Miles handles a lot of hearing loss increase claims. Our VA-accredited attorneys look at the raw audiogram data, run the § 4.85 math, and identify whether an increase is realistically supported before filing.

What Hearing Loss Ratings Actually Pay

Hearing loss ratings can range from 0% to 100%, though ratings above 30% or 40% for hearing loss alone are uncommon and typically require exceptional patterns under § 4.86. Most compensable hearing loss ratings fall in the 10% to 30% range.

Monthly compensation (2026 rates, veteran alone): 10% is $180.42, 20% is $356.66, 30% is $552.47. Rates shown are 2026 figures — check va.gov for current amounts. Add tinnitus at 10% on top of that, and you're combining ratings under § 4.25 to get the final combined figure.

Worth noting: combined ratings don't add — they combine through Table I. A 10% hearing loss and 10% tinnitus don't equal 20%. They combine to 19, which then converts to the nearest number divisible by 10 — 20%. So the practical result there does hit 20%, but only because of how the conversion falls, not because two 10s added up to it.

Common Reasons Hearing Loss Claims Get Denied

Across the claims we see at Augustus Miles, the recurring denial patterns are:

• No documented hearing test in STRs showing shift during service. Examiners lean on this to deny nexus, even when MOS clearly involved significant noise exposure.
• Post-service occupational noise attributed as the primary cause. If you worked construction, law enforcement, or manufacturing after service, VA sometimes uses that as an alternative cause.
• Speech discrimination scores too high. Great speech discrimination combined with mild threshold loss keeps ratings at 0%.
• The audiogram doesn't meet § 3.385. Before any rating math happens, VA has to find you have a hearing loss disability at all. Under 38 CFR § 3.385 that means a threshold of 40 dB or more at any of 500, 1000, 2000, 3000, or 4000 Hz; or 26 dB or more at three or more of those frequencies; or a Maryland CNC speech recognition score under 94%. An audiogram that meets none of these three gets a denial, not a 0% — a different outcome with a different fix.
• Audiogram outside the § 4.86 exceptional patterns. Veterans whose loss curve doesn't hit the § 4.86 triggers can end up under-rated compared to their functional impairment.

Most of these are addressable — with the right nexus opinion, buddy statements, or a supplemental audiogram. Augustus Miles has seen every angle of these denials.

Closing Thoughts

Hearing loss is one of the most under-rated conditions veterans deal with, in both senses of the word. It's genuinely underdiagnosed, and when it IS diagnosed, veterans often walk away with lower ratings than the functional impact warrants. The § 4.85 tables are strict, and small differences in audiogram data can mean big differences in outcome.

If you've been denied, rated at 0%, or think your hearing has gotten meaningfully worse since your last rating, it's worth taking another look. Augustus Miles' VA-accredited attorneys handle hearing loss claims every day, and you pay nothing upfront — we only get paid if your claim succeeds, as a percentage of your past-due benefits. Our support team is made up of veterans who've been through the process themselves.

Frequently Asked Questions

Why did I only get 0% for hearing loss?

A 0% rating means the VA granted service connection but your current audiogram numbers don't meet the threshold for compensation under § 4.85 — Table VII includes a noncompensable level, so 0% is a rating on the schedule, not a denial. It's not a denial — your hearing loss is officially service-connected, and you can file for an increase later if it worsens. Most mild-to-moderate high-frequency hearing loss patterns land at 0% because the § 4.85 tables are strict at the low end.

Can I get separate ratings for hearing loss and tinnitus?

Yes. Tinnitus is rated separately under 38 CFR § 4.87, diagnostic code 6260, at a flat 10%. Hearing loss is rated under § 4.85. Even if your hearing loss comes back at 0%, tinnitus stands alone as its own 10% rating. Many veterans miss this and only file for hearing loss.

Does the bilateral factor apply to hearing loss in both ears?

No. The § 4.26 bilateral factor does NOT apply to bilateral hearing loss. Under § 4.85, both ears are already factored into a single combined rating using Table VII. Bilateral vision loss works the same way. § 4.26 is limited to paired extremities and paired skeletal muscles, so it never reaches hearing or vision in the first place.

What if my hearing has gotten worse since my original rating?

You can file for an increased evaluation. A new audiogram — either through VA or a private audiologist — is the anchor evidence. Speech discrimination scores matter as much as puretone thresholds; sometimes speech discrimination declines faster and drives the increase. Augustus Miles reviews the raw audiogram data and runs the § 4.85 math before filing to make sure an increase is realistically supported.

What is § 4.86 and when does it apply?

Section 4.86 covers exceptional patterns of hearing impairment. It kicks in when either (1) puretone thresholds are 55 dB or more at all four tested frequencies in either ear, or (2) thresholds are 30 dB or less at 1000 Hz AND 70 dB or more at 2000 Hz. In those cases, the rater uses whichever table produces the higher Roman numeral — and under the second pattern, § 4.86(b) elevates that numeral one step further, to the next higher Roman numeral. If your audiogram fits either pattern and your rating decision doesn't mention § 4.86, that's worth a second look.