§ 4.87 Schedule of Ratings - Ear

The Schedule of ratings for ear impairments

💡 A Note About Meniere's Disease: An Important Consideration in Ear Cases:

Meniere’s disease is a clinically diagnosed condition. While often diagnosed by an ENT, there is no single test used to make the diagnosis. Generally, the diagnosis requires a history of:

Two or more episodes of vertigo, lasting at least 20 minutes each;
Tinnitus;*
Hearing loss (permanent or temporary);
Sometimes a feeling of periodic fullness in the ear.

Under the Department of Veterans Affairs criteria for establishing and rating service-connected conditions, the VA, a finding of Meniere’s syndrome should be accepted whenever a veteran suffers from vertigo, tinnitus and hearing loss and a diagnosis of Meniere’s would result in a higher rating than considering each condition individually. It is not necessary that an individual have ruled out all other possible causes of the symptoms, only that the symptoms are present in aggregate and evaluation under the diagnostic code for Meniere’s is more beneficial to the veteran.

Even if there are other potential causes that would dictate a different clinical course, under VA regulations, the diagnosis, like any other question of fact in a VA matter should be resolved with the benefit of the doubt in the veteran’s favor, and a finding may be made provided the question is “at least as likely as not,” supportive. In other words, if there is a 50/50 possibility that Meniere’s disease could be an appropriate diagnosis, it may be credited.

The rating criteria for Meniere’s, which is rated either at 30, 60, or 100% are copied below. A discussion between the healthcare provider and veteran should be had to evaluate the frequency of vertigo, the presence of cerebellar gait and the frequency of those symptoms. There is no required severity of hearing loss, as you will see. Under VA rules, a veteran is considered competent to report on his or her firsthand experiences unless there is objective evidence to contradict a lay statement. Therefore, a veteran can speak to the frequency and severity of symptoms. However, a Veteran cannot make medical conclusions, or reach a diagnosis. That is the exclusive domain of medical providers:

* As you can see from the ratings, while tinnitus is relevant to the diagnosis, the experience of active tinnitus, is not required in evaluating the appropriate rating.

§ 4.87 Schedule of ratings—ear.

Diseases of the Ear

Note (3): Do not evaluate objective tinnitus (in which the sound is audible to other people and has a definable cause that may or may not be pathologic) under this diagnostic code, but evaluate it as part of any underlying condition causing it.
	Rating
6200 Chronic suppurative otitis media, mastoiditis, or cholesteatoma (or any combination):
During suppuration, or with aural polyps	10
Note: Evaluate hearing impairment, and complications such as labyrinthitis, tinnitus, facial nerve paralysis, or bone loss of skull, separately.
6201 Chronic nonsuppurative otitis media with effusion (serous otitis media):
Rate hearing impairment
6202 Otosclerosis:
Rate hearing impairment
6204 Peripheral vestibular disorders:
Dizziness and occasional staggering	30
Occasional dizziness	10
Note: Objective findings supporting the diagnosis of vestibular disequilibrium are required before a compensable evaluation can be assigned under this code. Hearing impairment or suppuration shall be separately rated and combined.
6205 Meniere's syndrome (endolymphatic hydrops):
Hearing impairment with attacks of vertigo and cerebellar gait occurring more than once weekly, with or without tinnitus	100
Hearing impairment with attacks of vertigo and cerebellar gait occurring from one to four times a month, with or without tinnitus	60
Hearing impairment with vertigo less than once a month, with or without tinnitus	30
Note: Evaluate Meniere's syndrome either under these criteria or by separately evaluating vertigo (as a peripheral vestibular disorder), 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.
6207 Loss of auricle:
Complete loss of both	50
Complete loss of one	30
Deformity of one, with loss of one-third or more of the substance	10
6208 Malignant neoplasm of the ear (other than skin only)	100
Note: A rating of 100 percent shall continue beyond the cessation of any surgical, radiation treatment, antineoplastic chemotherapy or other therapeutic procedure. Six months after discontinuance of such treatment, the appropriate disability rating shall be determined by mandatory VA examination. Any change in evaluation based on that or any subsequent examination shall be subject to the provisions of § 3.105(e) of this chapter. If there has been no local recurrence or metastasis, rate on residuals.
6209 Benign neoplasms of the ear (other than skin only):
Rate on impairment of function.
6210 Chronic otitis externa:
Swelling, dry and scaly or serous discharge, and itching requiring frequent and prolonged treatment	10
6211 Tympanic membrane, perforation of	0
6260 Tinnitus, recurrent	10
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.
Note (2): Assign only a single evaluation for recurrent tinnitus, whether the sound is perceived in one ear, both ears, or in the head.