Hearing Loss VA Rating: From Audiogram to Percentage

Before the VA rates anything, your audiogram has to cross the line the VA uses to define hearing loss for benefits. That happens when any one of these is true:

• You need 40 decibels or more to hear at least one of the tones at 500, 1000, 2000, 3000 or 4000 Hz
• Three or more of those five tones need 26 decibels or more
• Your Maryland CNC word recognition score is below 94%

Clear that bar and the next question is service. Weapons qualification, artillery, flight lines, generators and ship engine spaces are the usual sources, and the VA concedes noise exposure for many military jobs. A normal hearing test when you got out doesn't end the claim. Hearing loss can still be connected to service when a medical opinion ties today's loss to the noise you were around.

The rating exam has to be done by a state-licensed audiologist, without hearing aids, and it has to include two specific tests.

Puretone audiometry

You wear headphones and signal each time you hear a tone. The VA takes your thresholds at 1000, 2000, 3000 and 4000 Hz and averages them. That figure, the puretone threshold average, is the first number that goes into the rating tables. The 500 Hz tone helps decide whether you have hearing loss at all, but it stays out of the average.

Maryland CNC speech recognition

You listen to a recorded list of short words and repeat each one. Your score is the percentage you get right, and a lower score pushes the numeral for that ear higher.

A screening from a retail hearing center or a workplace program often can't be used for a rating, because it may skip the Maryland CNC test. A private audiologist's exam can count when it meets every requirement above.

The steps are mechanical, which is why the quality of the exam matters so much:

1. Each ear gets a numeral. Table VI crosses your puretone average with your word score and returns a Roman numeral from I (close to normal) to XI (profound loss).
2. Sometimes the word score is set aside. If the audiologist certifies that the speech test isn't appropriate, for example because of language barriers or inconsistent scores, Table VIA assigns the numeral from the puretone average alone.
3. The two numerals meet in Table VII. The better ear's numeral and the worse ear's numeral point to a percentage from 0% to 100%.

That last table explains the flood of 0% decisions. When only one ear is service connected, the VA sets the other ear at level I, and with level I on one side, the connected ear has to reach level X or XI before the result rises to 10%. Real, documented hearing loss can still land at 0%.

There is one exception worth knowing. Under 38 CFR 3.383, if the service-connected ear rates 10% or more and the other ear also meets the VA's hearing loss definition, both ears are rated as if both were service connected.

Some patterns of loss get scored more favorably, one ear at a time:

• Severe across the board: when every one of the four tones from 1000 to 4000 Hz is at 55 decibels or worse, the rater uses whichever of Table VI or VIA gives the higher numeral.
• A steep drop: when 1000 Hz is at 30 decibels or better but 2000 Hz is at 70 or worse, the rater takes the higher of the two tables and then moves up one more numeral.

Ask for a copy of your audiogram and compare it against these two shapes yourself. If your thresholds fit one and the decision doesn't mention 38 CFR 4.86, raise it. The decision review options exist for errors like that.

• It settles the service question. Hearing tends to decline with age. Once your loss is service connected, a later increase claim only needs a new audiogram showing it's worse.
• It can add up with other zeros. Under 38 CFR 3.324, two or more permanent service-connected conditions rated 0% that clearly interfere with normal employment can support a single 10% rating, as long as you hold no other compensable rating.
• It travels with tinnitus. The same noise history usually supports both claims, and tinnitus is rated separately at 10%.