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Sensorineural hearing loss from noise exposure — engines, weapons, flight lines, artillery — rated strictly by audiogram tables. This guide quotes the actual rating criteria from 38 CFR Part 4 for diagnostic code 6100, explains what the C&P examiner measures, covers the presumptive and secondary routes to service connection, and lists the reasons these claims come back denied — and how each gets fixed.
How the VA rates hearing loss in 2026 — the exact criteria
These are the criteria a VA rater applies, quoted from the rating schedule (§ 4.85 – § 4.87). Your rating is the highest level whose wording your evidence meets — and evidence that never uses these words tends to be rated at the bottom.
DC 6100 — Hearing loss (rated by table, not by symptoms)
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 are conducted without hearing aids.
Table VI turns your puretone threshold average and speech-discrimination score into a Roman numeral (I–XI) for each ear; Table VII turns the two numerals into the percentage (0% to 100%). Most hearing-loss ratings land at 0% or 10% because the tables are unforgiving — tinnitus (DC 6260) is rated separately at 10%.
Table VIa (puretone average only) applies when the examiner certifies speech discrimination is not appropriate, or in the exceptional patterns of § 4.86 (all four frequencies 55 dB or more, or 30 dB or less at 1000 Hz and 70 dB or more at 2000 Hz).
Honest ceiling: most land 0–10%; higher needs severe measured loss.
What the C&P examiner measures
A state-licensed audiologist runs puretone audiometry at 1000, 2000, 3000 and 4000 Hz and the Maryland CNC word-recognition test, without hearing aids. Nothing you say changes the tables — what matters is showing up rested, without ear congestion, and reporting your real noise history.
The questions that get at the rating criteria — answer them for yourself before the exam:
- Do you find yourself asking people to repeat themselves? Does your family say the TV is too loud?
Service connection: presumptive, direct, or secondary
Same one-year chronic-disease presumption as tinnitus. In-service noise exposure is usually conceded from the MOS; the fight is almost always about whether current hearing loss is linked to it, and a normal separation audiogram is not a bar (Hensley v. Brown, 5 Vet. App. 155 (1993)).
Every service-connection claim has three legs: a current diagnosis (the C&P exam can supply it), an in-service event, injury, exposure or an already-connected condition, and a link between the two — which the VA's own examiner addresses at the exam for direct and secondary claims, and which the law supplies for presumptive ones. You do not need a private opinion to file; you need one only if the VA denies for lack of nexus, and a supplemental claim within one year keeps your effective date.
Secondary conditions veterans miss
This condition is more often the secondary in a chain than the anchor — see the secondary-claims guides for the recognized pathways.
What the medical literature says
Institute of Medicine, Noise and Military Service: Implications for Hearing Loss and Tinnitus (National Academies Press, 2006)
Hazardous military noise causes hearing loss; normal separation audiograms do not rule out later noise-related loss. Why it matters: Direct claims and delayed-onset arguments alike.
VA Duty MOS Noise Exposure Listing (adopted via VA Fast Letter 10-35)
Noise exposure conceded by MOS — the in-service event leg handled by the VA’s own table. Why it matters: Cite the MOS match in the personal statement.
Why hearing loss claims get denied — and the fix
- Current hearing loss not "disabling" under 38 CFR 3.385 (thresholds under 40 dB / 26 dB at three frequencies / speech under 94 percent).
- No link to service because separation audiogram was normal — the examiner must still address delayed-onset noise damage.
A denial is a grade on the evidence packet, not a verdict on you. Filed as a supplemental claim within one year, the fix keeps your original effective date.
Filing it right the first time
- Intent to File first. It locks your effective date for a year — back pay runs from that day, not from the day the package is ready.
- File everything at once. Every condition with a real symptom and a plausible route — direct, presumptive, secondary, increase — goes in one claim. The VA's duty to assist schedules the exam and pulls your records; a condition held back "for more evidence" only starts its clock later.
- Your statement in the criteria's words. A Statement in Support of Claim (VA Form 21-4138) that describes your worst days and your typical days using the language in the table above is the evidence the rater reads first.
- Your records. VA records through Blue Button, decision letters and code sheet from VA.gov, and private records from each doctor's office or patient portal — or a signed 21-4142 so the VA pulls them.
- Prepare for the exam. Know what the examiner measures (above) and answer honestly, including the bad days.
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See If You Qualify →Frequently asked questions
Is hearing loss a presumptive condition?
Same one-year chronic-disease presumption as tinnitus. In-service noise exposure is usually conceded from the MOS; the fight is almost always about whether current hearing loss is linked to it, and a normal separation audiogram is not a bar (Hensley v. Brown, 5 Vet. App. 155 (1993)).
Do I need a nexus letter for hearing loss?
Not to file. The VA's duty to assist schedules a C&P exam where its own examiner addresses the connection, and presumptive conditions need no opinion at all. A private opinion becomes worth buying only if the VA denies for lack of nexus — a supplemental claim within one year keeps your original effective date.
Rating criteria verified against eCFR (38 CFR Part 4) — last reviewed 2026-09-19. Regulations change; confirm anything decision-critical at ecfr.gov.