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Peripheral vestibular disorders and Meniere's syndrome — dizziness, staggering, and attacks of vertigo with hearing loss and tinnitus. This guide quotes the actual rating criteria from 38 CFR Part 4 for diagnostic code 6204 / 6205, 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 vertigo and meniere's disease in 2026 — the exact criteria
These are the criteria a VA rater applies, quoted from the rating schedule (§ 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 6204 — Peripheral vestibular disorders
| Rating | Criteria (38 CFR Part 4 wording) |
|---|---|
| 30% | Dizziness and occasional staggering |
| 10% | Occasional dizziness |
Objective findings supporting the diagnosis of vestibular disequilibrium are required before a compensable evaluation can be assigned. Hearing impairment or suppuration is separately rated and combined.
DC 6205 — Meniere's syndrome (endolymphatic hydrops)
| Rating | Criteria (38 CFR Part 4 wording) |
|---|---|
| 100% | Hearing impairment with attacks of vertigo and cerebellar gait occurring more than once weekly, with or without tinnitus |
| 60% | Hearing impairment with attacks of vertigo and cerebellar gait occurring from one to four times a month, with or without tinnitus |
| 30% | Hearing impairment with vertigo less than once a month, with or without tinnitus |
Meniere's is rated either under these criteria or by separately rating vertigo, hearing impairment and tinnitus — whichever gives the higher overall evaluation, never both.
Honest ceiling: 30% with dizziness and occasional staggering.
What the C&P examiner measures
The examiner records the frequency of dizziness, staggering and vertigo attacks, hearing and tinnitus findings, and objective vestibular testing (Dix-Hallpike, ENG/VNG). Objective findings are required for a compensable rating, so bring the ENT and audiology records.
The questions that get at the rating criteria — answer them for yourself before the exam:
- Any dizziness or balance trouble along with that ringing?
- Ever have to grab a wall, or stagger when it hits?
Service connection: presumptive, direct, or secondary
No presumption. Direct connection from an in-service head injury, ear infection or barotrauma, or secondary to TBI, hearing loss or a service-connected ear condition.
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
Hoffer M.E. et al., Otology & Neurotology 31(2) (2010) — Blast exposure: vestibular consequences and associated characteristics
Blast and head-injury exposure produce lasting vestibular dysfunction (dizziness, imbalance). Why it matters: Vertigo/vestibular secondary to concussion or blast.
Theeler B.J., Erickson J.C., Headache (2012) — chronic symptoms after concussion in soldiers
Post-concussive symptom clusters persist years after the injury. Why it matters: Backup for delayed-onset vestibular claims.
Why vertigo and meniere's disease claims get denied — and the fix
- Denied for no objective vestibular findings — ENT/VNG testing is required for a compensable rating.
- Meniere's rated under 6205 when separate vertigo + hearing + tinnitus ratings would have paid more (the note allows whichever is higher).
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
What is the VA rating for vertigo and meniere's disease?
Vertigo and Meniere's Disease is rated under diagnostic code 6204 / 6205 (§ 4.87) at 10%, 30%, 60%, 100%. The percentage depends on which criteria in the rating schedule your evidence meets — the full table is on this page.
What is the highest VA rating for vertigo and meniere's disease?
The highest schedular rating available is 100%. Typical grants land around 10%, but every case is decided on its own evidence.
Is vertigo and meniere's disease a presumptive condition?
No presumption. Direct connection from an in-service head injury, ear infection or barotrauma, or secondary to TBI, hearing loss or a service-connected ear condition.
Do I need a nexus letter for vertigo and meniere's disease?
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.