Ear conditions: vertigo, infection and the exam

Peripheral vestibular disorders

38 CFR 4.87, DC 6204

• 30%: dizziness and occasional staggering.
• 10%: occasional dizziness.

The note says objective findings supporting vestibular disequilibrium are required before any compensable rating. Hearing impairment or suppuration is rated separately and combined.

VA’s ear exam form includes a gait check, a Romberg test, a Dix-Hallpike test and a finger-nose-finger test.

Ménière’s syndrome

38 CFR 4.87, DC 6205

• 100%: hearing impairment with vertigo attacks and cerebellar gait more than once a week, with or without tinnitus.
• 60%: the same, one to four times a month.
• 30%: hearing impairment with vertigo less than once a month, with or without tinnitus.

The note lets VA rate Ménière’s either under these levels or by rating vertigo (as a vestibular disorder), hearing impairment and tinnitus separately, whichever gives the higher overall rating. It says not to combine a hearing, tinnitus or vertigo rating with a DC 6205 rating.

Chronic ear infections

38 CFR 4.87, DC 6200 to 6202 and 6210

• DC 6200 (chronic suppurative otitis media, mastoiditis or cholesteatoma): 10% during suppuration or with aural polyps. That is the only level. The note says to rate hearing impairment, labyrinthitis, tinnitus, facial nerve paralysis and bone loss of the skull separately.
• DC 6201 (chronic nonsuppurative otitis media with effusion) and DC 6202 (otosclerosis): no percentage of their own. Rate the hearing impairment.
• DC 6210 (chronic otitis externa): 10% for swelling, dry and scaly or serous discharge, and itching requiring frequent and prolonged treatment.

The schedule does not list labyrinthitis as its own code. It appears only in the DC 6200 note, as a complication to rate separately.

Perforation, the outer ear and tumors

38 CFR 4.87, DC 6207 to 6211

• DC 6211, perforated eardrum: 0%. That is the only level in the schedule.
• DC 6207, loss of the outer ear (auricle): both lost 50%; one lost 30%; deformity of one with a third or more of the substance lost 10%.
• DC 6208, malignant tumor of the ear (other than skin only): 100%, continuing after treatment ends, then a mandatory exam six months later.
• DC 6209, benign tumor: rate on impairment of function.

When hearing or tinnitus goes with an ear condition

38 CFR 4.85, 4.86; DC 6260

Hearing loss is rated from the audiology exam by a state-licensed audiologist, not by the ear exam. The exam uses the Maryland CNC speech test and pure-tone testing without hearing aids. See Hearing loss: the VA rating and the audiology exam.

Tinnitus is 10%, and only one rating applies whether it is in one ear, both ears or the head. Note 1 allows a separate tinnitus rating to be combined with ratings under DC 6100, 6200, 6204 or others, except when tinnitus is what supports the rating under that code. See tinnitus and the VA rating.

Getting an ear condition connected

38 CFR 3.303, 3.307, 3.309, 3.385

• Direct: the condition began in service or was caused by an event in service. Noise, blast, infection, pressure changes and chemical exposure are common causes.
• One-year rule: 38 CFR 3.309(a) lists “other organic diseases of the nervous system.” Hearing loss and tinnitus are not named in 3.309. The Board has described sensorineural hearing loss and tinnitus as falling under that line, citing Fountain v. McDonald, 27 Vet. App. 258 (2015), for tinnitus where there is acoustic trauma. If it shows up to a compensable degree within one year of leaving service (after at least 90 days of active service), it can be presumed.
• Continuity: under Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013), continuity of symptoms can establish service connection only for conditions listed in 3.309(a).
• No hearing loss at separation: Hensley v. Brown, 5 Vet. App. 155 (1993), as the Board describes it, means hearing loss first meeting VA’s definition after service can still be connected. Section 3.385 defines hearing disability as 40 decibels or more at one of 500, 1000, 2000, 3000 or 4000 Hz; 26 or more at three of them; or a Maryland CNC score under 94%.

Ratings for conditions often claimed alongside

38 CFR 4.150, 4.97, 4.124a, 4.104, 4.71a, 4.130

• TMJ (DC 9905): 10% to 50%, by how far the mouth opens and diet limits. See TMJ and VA dental care.
• Chronic sinusitis (DC 6510 to 6514): 0% to 50%. See sinusitis.
• Migraine (DC 8100): 0% to 50%.
• Hypertension (DC 7101): 10% to 60%, with 0% where 10% is not met.
• Neck (cervical spine): up to 40% on its own. 100% is for the entire spine. See cervical spine exam.
• Mental health: 0% to 100% under 38 CFR 4.130. See mental health secondaries.

Whether any of these is connected to an ear condition is a medical question for your own records and doctor. I only checked the rating levels.

What VA’s ear exam form covers

VA Ear (Including Vestibular and Infectious) DBQ

• Diagnosis, onset, treatment and whether you take continuous medication.
• Vestibular: whether you have vertigo, staggering or tinnitus, how often episodes occur (less than monthly, one to four times a month, more than weekly) and how long they last.
• Infection: canal swelling, discharge, itching, suppuration, polyps, facial nerve paralysis, bone loss.
• Physical exam: the outer ear, ear canal, eardrum, gait, Romberg, Dix-Hallpike and finger-nose-finger tests.
• Tests: MRI, CT, ENG, audiogram. Functional impact on work.

If you report hearing loss or tinnitus from an ear condition, the form says a separate Hearing Loss and Tinnitus questionnaire must also be completed. For otosclerosis, that questionnaire is used in place of the ear form. VA lists the Hearing Loss and Tinnitus questionnaire as not available for public use.

See Preparing for Your C&P Exam.

How the ratings add up

38 CFR 4.25

Separate ear ratings are combined, not added. For example, 30% and 10% combine to 37%, and the final combined number is rounded to the nearest 10, here 40%. See Why 50% + 50% Is Not 100%.

If an ear condition rates 100% under DC 6205, the 6205 note says not to also combine hearing, tinnitus or vertigo ratings with it.

What I could not verify

• The ear, TMJ, sinus, migraine, hypertension and spine levels come from eCFR (current as of October 16, 2026) and Cornell’s copy. Both are unofficial, and the official text wins over me. The ear schedule was last amended in 2003.
• Hearing loss Tables VI, VIA and VII are images that I could not read. I confirmed that level I in both ears is 0% from Board decisions, and I did not see the top value on the table.
• The one-year rule for hearing loss and tinnitus and the three cases are as described by Board decisions. I did not read the court opinions themselves.
• I did not check PACT Act or Gulf War presumptive lists for ear conditions.
• I did not verify medical links between ear conditions and other conditions.