A hearing loss VA rating works differently from almost every other condition — it’s decided almost entirely by two specific tests, not by how much your hearing loss affects your daily life. That surprises a lot of veterans, who feel their hearing is genuinely bad but come away with a 0% or 10% rating. Understanding exactly how the VA measures hearing loss is the key to knowing what to expect and how it fits into your larger claim.
Quick disclaimer: This is general educational information, not legal advice. Talk to an accredited Veterans Service Officer (VSO) or attorney about your specific case.
How Hearing Loss Is Rated: Diagnostic Code 6100
Hearing loss is rated under 38 CFR 4.85, Diagnostic Code 6100, and ratings can technically range from 0% all the way to 100%. In practice, though, most veterans land at 0% or 10% — the formula is built so that only significant impairment in both ears produces a higher rating. Both ears are rated together as a single rating; you don’t get a separate rating per ear.
The Two Tests That Decide Everything
This is the part to understand. Your rating is determined by a C&P exam that must, by regulation, be conducted by a state-licensed audiologist and must include two specific tests — performed without hearing aids:
- Puretone audiometry test. Measures how loud a sound must be before you can hear it, at four frequencies: 1000, 2000, 3000, and 4000 Hertz. These are averaged into your “puretone threshold average.”
- Maryland CNC speech discrimination test. Measures what percentage of spoken words you can correctly recognize. The audiologist reads a list of words and you repeat them back.
Think of it this way: the puretone test is the volume knob (how loud before you hear it), and the speech test is how much of the message actually gets through. Many veterans hear tones fine in a quiet booth but still miss words in real conversation — and the VA’s formula captures that gap.
The VA plugs both numbers into Table VI to get a Roman numeral (I through XI) for each ear, then cross-references both ears on Table VII to produce your final percentage. The key takeaway: your subjective frustration with your hearing doesn’t move the number — only the test results do. That’s why this is one of the few conditions where you genuinely can’t “describe your worst day” your way to a higher rating; it’s the numbers from an approved exam that count.
Why a Private Hearing Test Usually Won’t Control Your Rating
If you’ve had your hearing tested at a private clinic, that’s useful for treatment — but it may not control your VA rating unless it meets the VA’s strict requirements: a state-licensed audiologist, the Maryland CNC test specifically, and all four required frequencies, done without hearing aids. A private test that skips the Maryland CNC score or uses a different word list may be given little weight. This is why the VA’s own C&P exam is the one that matters for rating purposes.
That said, a private audiologist’s opinion can be valuable for one thing: rebutting a negative nexus opinion. If the VA examiner says your hearing loss isn’t service-connected, a private audiologist’s nexus letter can help establish the connection.
The “Exceptional Pattern” Exception
There’s a wrinkle worth knowing under 38 CFR 4.86. Certain unusual audiogram patterns — such as a puretone threshold of 55 decibels or more at all four frequencies — trigger an alternative calculation that can produce a higher rating. If your hearing loss follows one of these “exceptional patterns,” the VA uses whichever table gives you the better result. You don’t have to request this; the rater is supposed to apply it. But it’s worth knowing it exists if your numbers are severe.
Hearing Loss, Tinnitus, and Your Combined Rating
Hearing loss and tinnitus very often go together — same noise exposure, same root cause — but they’re rated separately. Tinnitus is a flat 10%; hearing loss is its own rating. Filing both (when both are present) is common and appropriate. Each then combines with your other conditions through VA math, so even a modest hearing loss rating adds to your overall picture.
The Bottom Line
Your hearing loss VA rating is decided by the numbers — the puretone average and the Maryland CNC speech score — not by how much your hearing loss frustrates you day to day. Most ratings come out at 0% or 10%, the exam must be done by a licensed audiologist without hearing aids, and severe patterns can trigger a higher alternative calculation. Pair it with tinnitus where appropriate, and remember it all combines through VA math. For the full picture, start with our walkthrough of how VA disability claims work. You can review the rating rules on VA.gov.