How the VA rates tinnitus and hearing loss

Tinnitus is the most-claimed condition in the VA system, and it pays exactly one number. Hearing loss is claimed almost as often and, to most veterans' surprise, usually pays nothing at all. Both outcomes are built into the schedule, and knowing why changes how you file.

Last reviewed August 2026 · Not legal advice, VA.gov always controls

Tinnitus: one rating, 10%, and that is the ceiling

Tinnitus, ringing, buzzing, or hissing in the ears, is rated under diagnostic code 6260 in 38 CFR § 4.87. The schedule has one line: recurrent tinnitus, 10%. Note (2) to the code makes it explicit that a single 10% is assigned whether the sound is in one ear, both ears, or perceived in the head. There is no higher tier, no bilateral rating, and no increase to file for. The Federal Circuit confirmed this in Smith v. Nicholson (2006).

What makes tinnitus worth claiming anyway is that it is almost entirely subjective. No test can disprove it. The VA's own guidance treats a veteran's statement that they experience ringing as competent evidence of the symptom, because it is the kind of thing a layperson can observe in themselves. Service connection then turns on noise exposure, and noise exposure is where the presumption does the work.

Noise exposure by job

The VA maintains a Duty MOS Noise Exposure Listing that rates each military occupation as having a high, moderate, or low probability of hazardous noise exposure. If your MOS or rating is on the high-probability list (infantry, artillery, aviation, engineering, many maintenance fields), the VA concedes in-service noise exposure without further proof. Moderate-probability jobs get the benefit of the doubt when the rest of the record is consistent. Low-probability jobs need something more: a specific event, a deployment, weapons qualification records, a statement from someone who was there.

Conceding exposure is not the same as conceding service connection. The examiner still has to opine that the tinnitus is at least as likely as not related to that exposure, and the most common denial is an audiologist who writes that it is "less likely than not" because your separation audiogram was normal or because the tinnitus started years later. Two answers to that: tinnitus does not require measurable hearing loss to be service connected, and a credible statement that the ringing started in service or soon after is evidence of onset the examiner has to address.

Hearing loss: what counts as a disability at all

Before the VA rates hearing loss, it has to be bad enough to count. 38 CFR § 3.385 sets the threshold. Hearing loss is a disability for VA purposes when, in either ear:

• the threshold at any of 500, 1000, 2000, 3000, or 4000 Hz is 40 decibels or greater; or
• the thresholds at at least three of those frequencies are 26 decibels or greater; or
• speech recognition using the Maryland CNC test is less than 94 percent.

Below those numbers, you may have a hearing problem in real life, but you do not have a hearing loss disability, and the claim is denied before rating ever comes up. This is a common and confusing outcome: the audiologist confirms loss, the VA denies anyway, and the decision letter is citing § 3.385.

How the rating is calculated

Hearing loss is rated under DC 6100 in § 4.85, and it is the most mechanical rating in the schedule. There is no examiner judgment and no symptom description. Two numbers from the audiogram go into a table:

1. The puretone threshold average for each ear: the average of your thresholds at 1000, 2000, 3000, and 4000 Hz.
2. The speech discrimination score for each ear, from the Maryland CNC word list.

Table VI converts those two numbers into a Roman numeral from I (best) to XI (worst) for each ear. Table VII then takes the two Roman numerals, one per ear, and reads off the percentage. A veteran at Level I in both ears is 0%. A veteran at Level III in one ear and Level II in the other is also 0%. The percentages climb slowly; a 10% rating requires something like Level IV in one ear and Level II in the other, and getting to 30% or more means significant loss in both ears.

There is one variation. § 4.86 handles "exceptional patterns": when all four thresholds are 55 dB or more, or when the 1000 Hz threshold is 30 or less and the 2000 Hz threshold is 70 or more, the examiner uses Table VIa, which rates on puretone average alone, and takes whichever result is higher. That pattern, decent low-frequency hearing with a steep high-frequency drop, is classic noise damage, and it is worth checking whether your audiogram qualifies.

The exam

Hearing loss and tinnitus exams are done by a VA or contract audiologist, usually in one visit. The examiner runs the audiogram and the Maryland CNC test, reviews your file, and writes a nexus opinion for each condition. Because the rating is arithmetic, there is little to say during the test itself. The conversation that matters is the history: your MOS, specific noise events, hearing protection use, post-service occupational noise (be honest; the examiner will look for it), and when you first noticed each problem.

Bring your separation audiogram if you have it. Even a "normal" separation test can show a threshold shift compared with your entrance exam, and a documented shift in service is strong evidence of noise damage even if it did not yet meet § 3.385. Hensley v. Brown (1993) held that a normal separation audiogram does not by itself bar service connection.

Hearing loss, tinnitus, and what comes after

Tinnitus and hearing loss are rated separately and both combine into the total. Tinnitus is also a frequent primary for secondary claims: sleep disturbance, and in some cases anxiety or depression, are claimed as secondary to chronic tinnitus with supporting medical opinions. Migraines are sometimes claimed on the same basis. See the secondary conditions guide for what those opinions need.

If a hearing loss rating is denied under § 3.385, the answer is usually time rather than appeal: hearing loss from noise exposure tends to progress. Get a private audiogram every couple of years and file for an increase when the numbers cross a line. See filing for an increase.

The checklist

1. Entrance and separation audiograms from your STRs, and any in-service hearing conservation records.
2. Your MOS and the noise sources that came with it, in your own statement.
3. A specific account of when tinnitus started, with any in-service mention or a buddy statement.
4. A current audiogram with Maryland CNC scores, VA or private.
5. Honest detail on post-service noise exposure, so the examiner does not discover it and discount you.