Hearing · 38 CFR 4.85-4.87
Hearing Conditions and VA Disability
Tinnitus and hearing loss are the two most claimed VA disabilities of all. Years around weapons, aircraft, and heavy machinery damage hearing in ways that often do not show up until long after service. The VA rates these conditions under 38 CFR 4.85 through 4.87.
Patriot Path writes the medical piece of these claims. Our physicians write nexus letters and independent medical opinions that connect your hearing condition to your service. One flat fee of $1,500, and the first consultation is free.
Medically reviewed by the Patriot Path Medical Team
Licensed MD reviewers • Last updated: June 2026
Conditions in this system
These are the two hearing conditions veterans claim most. Each one has a full guide with how the VA rates it, the ways to connect it to your service, and an evidence checklist.
How the VA rates hearing conditions
Tinnitus is simple: one flat rating of 10% under DC 6260, whether you hear it in one ear, both ears, or in your head. There is no higher rating for the ringing itself. Its real value is as an anchor for secondary claims, since constant ringing drives migraines, depression, and anxiety.
Hearing loss works the opposite way. It is figured from your audiogram under DC 6100. An audiologist runs a word test and a puretone test. The VA averages your hearing thresholds, and two tables turn that into a rating from 0% to 100%. Because the math leans on word recognition, a 0% rating is common, even with real loss.
Tinnitus and hearing loss normally carry separate evaluations that combine, so most veterans claim both. Our guide to claiming tinnitus alongside service-connected hearing loss works through the arithmetic and the theory to plead.
Connecting a hearing condition to service
- Direct. Loud noise in service damaged your hearing. Weapons, artillery, aircraft, armor, and engine rooms are common causes, usually without steady hearing protection.
- Secondary. Another service-connected condition caused it (38 CFR 3.310). A head injury, ear disease, or an ototoxic medication can cause tinnitus or hearing loss.
- Aggravation. You had some hearing damage before service, and service made it permanently worse.
Neither condition is presumptive in the way Agent Orange or PACT Act conditions are, and both can show up years after the noise. For most claims the VA needs a current diagnosis, in-service noise exposure, and a medical opinion linking them (38 CFR 3.303). That opinion has to clear the “at least as likely as not” standard, a 50% or better chance. That standard is the benefit-of-the-doubt rule under 38 U.S.C. 5107(b), carried out in 38 CFR 3.102. A nexus letter is that linking opinion.
Frequently asked questions
How does the VA rate hearing conditions?
Two very different ways. Tinnitus has one flat rating of 10% under DC 6260. It does not matter how loud it is, or whether it is in one ear or both. Hearing loss is different. It is figured from your audiogram under DC 6100, using two hearing tests and two tables, and can run from 0% to 100%.
Why is tinnitus only 10%?
The rule allows just one 10% rating for recurrent tinnitus. A federal court upheld that limit. To raise your award, you claim the conditions tinnitus causes, such as migraines, depression, or anxiety, as secondary. Insomnia is the exception, because VA folds sleep symptoms into the primary disability rather than rating them separately.
Can I claim tinnitus and hearing loss together?
Usually yes, and the order you file them in affects your effective date. Our guide to a nexus letter for tinnitus secondary to hearing loss covers that, what the two ratings combine to, and the one situation where a separate tinnitus evaluation cannot be combined with another ear code.
Why did my hearing loss come back at 0%?
The formula leans heavily on word recognition. So a 0% rating is common, even with real, documented loss. A 0% rating still makes the condition service-connected. That protects you if it worsens, and it lets the condition pair with a 10% tinnitus rating.
Do I need a nexus letter?
Often, yes, though not always. Sensorineural hearing loss and tinnitus are both treated as organic diseases of the nervous system, which puts them inside the chronic-disease list at 38 CFR 3.309(a) per VA's manual at M21-1 V.iii.12.A.1.d. That opens two narrow routes. Under 38 CFR 3.303(b) you may be able to establish the claim by showing the condition began in service and has continued since, without a medical opinion bridging the gap. Under 38 CFR 3.307 there is a one-year presumption if you served 90 days or more during a war period or after December 31, 1946 and the condition was 10 percent disabling within a year of separation. Neither is anything like an Agent Orange or PACT Act presumptive, and conductive and mixed hearing losses are not in that category at all. Outside those routes, a nexus letter supplies the medical opinion linking your hearing condition to your service.
Still hearing the ringing?
Tell us what you are dealing with. The first consultation is free, and we will tell you straight whether a nexus letter can strengthen your claim.
Sources & regulatory references
- VA disability compensation (VA.gov) https://www.va.gov/disability/
- 38 CFR 4.85, Evaluation of hearing impairment (eCFR) https://www.ecfr.gov/current/title-38/section-4.85
- 38 CFR 4.86, Exceptional patterns of hearing impairment (eCFR) https://www.ecfr.gov/current/title-38/section-4.86
- 38 CFR 4.87, Schedule of ratings, ear, including DC 6260 tinnitus (eCFR) https://www.ecfr.gov/current/title-38/section-4.87
- 38 CFR 3.385, Disability due to impaired hearing (eCFR) https://www.ecfr.gov/current/title-38/section-3.385
- 38 U.S.C. 5107, Benefit of the doubt (Cornell LII) https://www.law.cornell.edu/uscode/text/38/5107