38 CFR Part 4 — 38 CFR § 4.85
Hearing impairment — VA Diagnostic Code 6100
Auditory / ENT
Diagnostic code
6100
38 CFR § 4.85 evaluates impairment of auditory acuity under Diagnostic Code 6100, in the schedule of ratings for the ear. The percentage comes from Table VII. Each ear first receives a Roman numeral from Table VI, or from Table VIa when § 4.85(c) or § 4.86 applies. Section 3.385 states when impaired hearing is a disability.
Reviewed 2026-09-28. Diffed against the eCFR versioner full-text XML for 2026-09-24 on 2026-09-28. Title 38 was up to date as of 2026-09-24; latest amended on 2026-08-27. Sections 4.85(a) through (h) and 4.86(a) and (b) were copied from that XML. Tables VI, VIa, and VII are images in § 4.85(h) and are not transcribed on this page.
The rating criteria at each level
Diagnostic Code 6100 — the percentage is the Table VII intersection
Rating %: —
Criteria (verbatim). Table VII, “Percentage Evaluations for Hearing Impairment,” is used to determine the percentage evaluation by combining the Roman numeral designations for hearing impairment of each ear. The horizontal rows represent the ear having the better hearing and the vertical columns the ear having the poorer hearing. The percentage evaluation is located at the point where the row and column intersect.
| Rating % | Criteria (verbatim) |
|---|---|
| — | Table VII, “Percentage Evaluations for Hearing Impairment,” is used to determine the percentage evaluation by combining the Roman numeral designations for hearing impairment of each ear. The horizontal rows represent the ear having the better hearing and the vertical columns the ear having the poorer hearing. The percentage evaluation is located at the point where the row and column intersect. |
(a) 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.
(b) Table VI, “Numeric Designation of Hearing Impairment Based on Puretone Threshold Average and Speech Discrimination,” is used to determine a Roman numeral designation (I through XI) for hearing impairment based on a combination of the percent of speech discrimination (horizontal rows) and the puretone threshold average (vertical columns). The Roman numeral designation is located at the point where the percentage of speech discrimination and puretone threshold average intersect.
(c) Table VIa, “Numeric Designation of Hearing Impairment Based Only on Puretone Threshold Average,” is used to determine a Roman numeral designation (I through XI) for hearing impairment based only on the puretone threshold average. Table VIa will be used when the examiner certifies that use of the speech discrimination test is not appropriate because of language difficulties, inconsistent speech discrimination scores, etc., or when indicated under the provisions of § 4.86.
(d) “Puretone threshold average,” as used in Tables VI and VIa, is the sum of the puretone thresholds at 1000, 2000, 3000 and 4000 Hertz, divided by four. This average is used in all cases (including those in § 4.86) to determine the Roman numeral designation for hearing impairment from Table VI or VIa.
(f) If impaired hearing is service-connected in only one ear, in order to determine the percentage evaluation from Table VII, the non-service-connected ear will be assigned a Roman Numeral designation for hearing impairment of I, subject to the provisions of § 3.383 of this chapter.
(g) When evaluating any claim for impaired hearing, refer to § 3.350 of this chapter to determine whether the veteran may be entitled to special monthly compensation due either to deafness, or to deafness in combination with other specified disabilities.
(h) Numeric tables VI, VIA*, and VII.
§ 4.86(a): When the puretone threshold at each of the four specified frequencies (1000, 2000, 3000, and 4000 Hertz) is 55 decibels or more, the rating specialist will determine the Roman numeral designation for hearing impairment from either Table VI or Table VIa, whichever results in the higher numeral. Each ear will be evaluated separately.
§ 4.86(b): When the puretone threshold is 30 decibels or less at 1000 Hertz, and 70 decibels or more at 2000 Hertz, the rating specialist will determine the Roman numeral designation for hearing impairment from either Table VI or Table VIa, whichever results in the higher numeral. That numeral will then be elevated to the next higher Roman numeral. Each ear will be evaluated separately.
Paragraph (e) is the only percentage rule printed in the text of § 4.85. The percentage is the cell where the better-ear row and the poorer-ear column meet on Table VII. This page does not state a percentage that is not printed in that text.
Source: 38 CFR § 4.85 (Evaluation of hearing impairment), Diagnostic Code 6100, and 38 CFR § 4.86 (Exceptional patterns of hearing impairment), eCFR, up to date as of 2026-09-24.
What the words mean in your records
Puretone threshold average
Section 4.85(d) defines it as the sum of the puretone thresholds at 1000, 2000, 3000, and 4000 Hertz, divided by four. The same average is used for Table VI and Table VIa, including the § 4.86 cases. A threshold at 500 Hertz is not part of that average.
Maryland CNC and Table VIa
The examination must include a controlled speech discrimination test (Maryland CNC). Table VIa, which uses only the puretone average, applies when the examiner certifies that the speech test is not appropriate because of language difficulties, inconsistent speech discrimination scores, etc., or when § 4.86 indicates it.
The two exceptional patterns
Section 4.86 is only those two puretone patterns. It is not a separate rating for functional impact. Pattern (a): 55 decibels or more at each of 1000, 2000, 3000, and 4000 Hertz. The rating specialist uses Table VI or Table VIa, whichever numeral is higher, and evaluates each ear separately. Pattern (b): 30 decibels or less at 1000 Hertz and 70 decibels or more at 2000 Hertz. The specialist again takes the higher numeral from Table VI or Table VIa, then elevates that numeral to the next higher Roman numeral. Each ear is evaluated separately.
One service-connected ear
If impaired hearing is service-connected in only one ear, § 4.85(f) assigns the non-service-connected ear a Roman numeral of I for Table VII, subject to § 3.383. That Roman numeral I is a table instruction. It is not a finding that the other ear hears normally.
When impaired hearing is a disability
38 CFR § 3.385 (Disability due to impaired hearing) says impaired hearing will be considered to be a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, 4000 Hertz is 40 decibels or greater; or when the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz are 26 decibels or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. Meeting § 3.385 does not itself assign the Table VII percentage.
Evidence that speaks to each level
The examination § 4.85(a) requires
What the rater needs to see. A state-licensed audiologist, a Maryland CNC score, and a puretone audiometry test, conducted without hearing aids.
Where that usually lives. The audiology report from the VA examination or a VA contractor examination.
The numeral for each ear
What the rater needs to see. The puretone threshold average at 1000, 2000, 3000, and 4000 Hertz, and the speech-discrimination percent, unless Table VIa applies.
Where that usually lives. The same audiogram. Entry and separation audiograms in the service treatment record are separate records; they do not replace the current test.
§ 4.86(a) or (b)
What the rater needs to see. Thresholds showing 55 decibels or more at each of the four frequencies, or 30 decibels or less at 1000 Hertz with 70 decibels or more at 2000 Hertz.
Where that usually lives. The puretone audiogram for that ear. Each ear is evaluated separately.
One ear only
What the rater needs to see. Which ear is service-connected, and whether the other ear meets § 3.385 for the paired-organ rule in § 3.383(a)(3).
Where that usually lives. The rating decision and the audiogram for each ear.
You can describe noise exposure, when the trouble started, and what ordinary activity is affected. Those facts do not replace the Maryland CNC score or the puretone average. 38 CFR § 4.10 (Functional impairment) requires the examiner to furnish a full description of the effects of disability upon the person's ordinary activity. That description is not a § 4.86 rating. Section 4.86 is the two puretone patterns quoted above.
The exam form
VA’s public DBQ list, checked September 28, 2026, places “Hearing Loss and Tinnitus” on the list of DBQs not available for public use. A private clinician does not complete that form for you. The examination is done through VA or its contract examiners. See the hearing-loss DBQ guide and contractor exams.
What the regulation requires the examination to include is § 4.85(a): a state-licensed audiologist, Maryland CNC, puretone audiometry, and no hearing aids during the test. This page does not publish a form number or form section numbers.
Related codes and how they interact
Tinnitus, rated under its own code
DC 6260 is “Tinnitus, recurrent,” at 10 percent. Note (1): “A separate evaluation for tinnitus may be combined with an evaluation under diagnostic codes 6100, 6200, 6204, or other diagnostic code, except when tinnitus supports an evaluation under one of those diagnostic codes.” The public page is tinnitus. See tinnitus claims and hearing loss and tinnitus.
Ear codes that point at hearing impairment
DC 6205, Meniere's syndrome, lists 100, 60, and 30 percent for hearing impairment with vertigo and cerebellar gait at the frequencies the code prints. Its note: evaluate either under those criteria or by separately evaluating vertigo, 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.”
DC 6200, chronic suppurative otitis media, mastoiditis, or cholesteatoma, is 10 percent “During suppuration, or with aural polyps.” Its note: “Evaluate hearing impairment, and complications such as labyrinthitis, tinnitus, facial nerve paralysis, or bone loss of skull, separately.”
DC 6201, chronic nonsuppurative otitis media with effusion, says “Rate hearing impairment.” DC 6202, otosclerosis, says “Rate hearing impairment.”
DC 6204, peripheral vestibular disorders, lists 30 percent for “Dizziness and occasional staggering” and 10 percent for “Occasional dizziness.” Its note requires objective findings before a compensable evaluation, and says “Hearing impairment or suppuration shall be separately rated and combined.”
38 CFR § 4.14 (Avoidance of pyramiding) says the evaluation of the same disability under various diagnoses is to be avoided. The ear schedule is 38 CFR § 4.87 (Schedule of ratings—ear).
Secondary conditions and presumptions
Reg: 38 CFR § 3.383(a)(3) (Special consideration for paired organs and extremities). Compensation is payable as if both disabilities were service-connected when there is hearing impairment in one ear compensable to a degree of 10 percent or more as a result of service-connected disability, and hearing impairment as a result of nonservice-connected disability that meets § 3.385 in the other ear. The nonservice-connected disability must not be the result of willful misconduct.
Reg: § 4.85(g) and 38 CFR § 3.350 (Special monthly compensation ratings). Paragraph (g) tells the rater to refer to § 3.350 for special monthly compensation due to deafness, or to deafness in combination with other specified disabilities. Section 3.350(a)(5) says deafness of both ears, having absence of air and bone conduction, will be held to exist where examination in a VA-authorized audiology clinic under current testing criteria shows bilateral hearing loss is equal to or greater than the minimum bilateral hearing loss required for a maximum rating evaluation under the rating schedule. This page does not state a dollar amount.
No secondary condition is named in DC 6100. Any secondary claim needs a medical opinion on the facts under 38 CFR § 3.310 (Disabilities that are proximately due to, or aggravated by, service-connected disease or injury).
Short answers
How does VA calculate a hearing loss rating under DC 6100?
Under 38 CFR § 4.85, a state-licensed audiologist tests each ear without hearing aids using puretone audiometry and the Maryland CNC speech test. The puretone average, the sum at 1000, 2000, 3000, and 4000 Hertz divided by four, and the speech score give each ear a Roman numeral on Table VI, or on Table VIa in the cases § 4.85(c) and § 4.86 allow. Table VII then turns the better-ear and poorer-ear numerals into the percentage. The numeric tables are images at § 4.85(h). Education only.
When does hearing loss count as a disability for VA?
38 CFR § 3.385 says impaired hearing is a disability when any threshold at 500, 1000, 2000, 3000, or 4000 Hertz is 40 decibels or greater, when at least three of those frequencies are 26 decibels or greater, or when the Maryland CNC score is less than 94 percent. The Table VII percentage is a separate step under § 4.85. Education only.
FAQ
How does VA calculate a hearing loss rating under DC 6100?
Under 38 CFR § 4.85, a state-licensed audiologist tests each ear without hearing aids, using Maryland CNC and puretone audiometry. The puretone average is the sum of the thresholds at 1000, 2000, 3000, and 4000 Hertz, divided by four. That average and the speech score produce a Roman numeral on Table VI, or on Table VIa when § 4.85(c) or § 4.86 applies. Table VII combines the better-ear and poorer-ear numerals into the percentage. Those grids are images on eCFR and are not reprinted here.
When does hearing loss count as a disability for VA?
38 CFR § 3.385 treats impaired hearing as a disability when any threshold at 500, 1000, 2000, 3000, or 4000 Hertz is 40 decibels or greater; or when at least three of those frequencies are 26 decibels or greater; or when the Maryland CNC score is less than 94 percent. That section decides whether there is a hearing disability for VA purposes. The percentage, if service connection is granted, still comes from Table VII.
What must the hearing exam include?
Section 4.85(a) requires a state-licensed audiologist, a controlled speech discrimination test (Maryland CNC), and a puretone audiometry test. Examinations are conducted without hearing aids. The Hearing Loss and Tinnitus DBQ is on VA’s list of forms not available for public use, so this examination is through VA or a VA contractor.
What are the § 4.86 exceptional patterns?
There are two, and both are puretone patterns. If each of 1000, 2000, 3000, and 4000 Hertz is 55 decibels or more, the rating specialist uses Table VI or Table VIa, whichever numeral is higher. If 1000 Hertz is 30 decibels or less and 2000 Hertz is 70 decibels or more, the specialist takes that higher numeral and elevates it to the next higher Roman numeral. Each ear is evaluated separately. Section 4.86 does not rate functional impact.
Can tinnitus be rated separately from hearing loss?
DC 6260 Note (1) says a separate evaluation for tinnitus may be combined with an evaluation under diagnostic codes 6100, 6200, 6204, or another diagnostic code, except when tinnitus supports an evaluation under one of those codes. DC 6260 itself lists one level, 10 percent, for recurrent tinnitus. The note is the combining rule. It is not a second percentage under DC 6100.
What if only one ear is service-connected?
Section 4.85(f) assigns the non-service-connected ear a Roman numeral of I on Table VII, subject to § 3.383. Section 3.383(a)(3) addresses the paired-organ case: one ear compensable to 10 percent or more from service-connected disability, and the other ear nonservice-connected but meeting § 3.385. This page does not add a percentage on top of the Table VII cell.
Next steps
- Get the rating decision and the audiology report. Compare the puretone averages, the Maryland CNC scores, and any § 4.86 pattern with Table VI, Table VIa, and Table VII on eCFR § 4.85.
- Use C&P prep (Founding Pass) to organize what you will tell the examiner. Then take the file to an accredited representative through find a VSO.
- Other ear codes are on the auditory diagnostic-code index. The catalog home is the diagnostic code index. A separate discussion of combat lay evidence is 38 U.S.C. 1154(b).
Education only. Not legal or medical advice. My Claim Packet is not a VA-accredited representative and does not file claims. VA decides every claim on its own evidence.
Other codes in this body system
Nearby catalog entries in Auditory / ENT, ordered by diagnostic code number. All Auditory / ENT codes
- DC 6200Chronic suppurative otitis media
- DC 6201Chronic nonsuppurative otitis media
- DC 6202Otosclerosis
- DC 6204Peripheral vestibular disorders
- DC 6205Meniere's syndrome
- DC 6207Loss of auricle
- DC 6208Malignant neoplasm
- DC 6209Benign neoplasm
- DC 6210Chronic otitis externa
- DC 6211Tympanic membrane, perforation
- DC 6260Tinnitus, recurrent
- DC 6275Smell, complete loss
- DC 6276Taste, complete loss
Also: DC code lookup (tools) lists the same index in a compact layout.
Source: 38 CFR Part 4, Diagnostic Code 6100 • va.gov
⚠️ Important Disclaimer
This page provides general educational information based on public VA regulations and VA.gov resources. It is not legal or medical advice, and My Claim Packet is not a VA-accredited representative. Any worksheets or draft documents produced by the tools must be reviewed for accuracy and are not filed with VA for you. Ratings and service connection are decided case-by-case from the individual record. Consult a VA-accredited VSO, claims agent, attorney, or qualified clinician for help with your situation, and verify current rules using the linked official source.