The 38 CFR hearing loss rating is produced by a formula, not a judgment call. A VA rater takes two numbers from your audiology exam — your puretone threshold average and your Maryland CNC speech discrimination score — runs them through Table VI in 38 CFR § 4.85 to get a Roman numeral for each ear, and then reads Table VII to find the disability percentage where those two Roman numerals meet. Section 4.86 carves out an exception for two severe patterns of loss that can push the number higher. Most veterans with service-connected hearing loss end up at 0% or 10%.
The Threshold to Be Rated at All
Before any table applies, your hearing loss has to meet the definition of a disability in 38 CFR § 3.385. Your exam must show at least one of the following:
- An auditory threshold of 40 decibels or higher at any one of 500, 1000, 2000, 3000, or 4000 Hertz.
- Auditory thresholds of 26 decibels or higher at three or more of those frequencies.
- A Maryland CNC speech discrimination score below 94 percent.
If none of the three is met, the claim is denied for lack of a current disability, no matter how loud your service was.1eCFR. 38 CFR 3.385 – Disability Due to Impaired Hearing This is purely a definitional gate; it says nothing about service connection.
The Two Test Scores That Drive Everything
To be used for rating, the exam must be done by a state-licensed audiologist and must include two specific tests: puretone audiometry and the Maryland CNC controlled speech discrimination test. No other word list is accepted, and a private report using a different one cannot be used to rate you.2eCFR. 38 CFR 4.85 – Evaluation of Hearing Impairment
Puretone audiometry measures the quietest sound you can hear at 1000, 2000, 3000, and 4000 Hertz. The four decibel readings for each ear are added and divided by four. That average is one of the two inputs. The Maryland CNC test plays a phonetically balanced word list and scores what percentage you correctly repeat. That percentage is the second input. Each ear is scored independently.
How the Percentage Is Calculated
Once the exam is in hand, the math has two steps.
Step One: Table VI Assigns a Roman Numeral
Table VI is a grid. Puretone threshold averages run along one axis, speech discrimination scores along the other. Where your two scores intersect, the table gives that ear a Roman numeral between I (mildest) and XI (most severe). The other ear gets its own Roman numeral the same way.2eCFR. 38 CFR 4.85 – Evaluation of Hearing Impairment
If the examiner certifies that the speech discrimination test wasn’t appropriate — for example, because of a language barrier or wildly inconsistent scores — the rater uses Table VIa, which assigns the Roman numeral from the puretone average alone.
Step Two: Table VII Reads Out the Percentage
Table VII takes the two Roman numerals and gives a single number. The better-hearing ear runs along the rows, the poorer-hearing ear along the columns, and the intersection is your disability percentage. Percentages go from 0% to 100% in increments of ten. Two veterans with identical scores will always land on the same percentage, because the rater has no discretion to move it up or down.
Exceptional Patterns Under § 4.86
Section 4.86 is the one place the math gets more generous, and it’s the provision veterans most often miss. If your hearing loss fits either of two patterns, the rater must check both Table VI and Table VIa and use whichever gives you the higher Roman numeral for that ear.3eCFR. 38 CFR 4.86 – Exceptional Patterns of Hearing Impairment
- Pattern (a): puretone threshold of 55 decibels or more at all four tested frequencies (1000, 2000, 3000, and 4000 Hertz). The rater uses the higher Roman numeral from Table VI or Table VIa.
- Pattern (b): puretone threshold of 30 decibels or less at 1000 Hertz and 70 decibels or more at 2000 Hertz. The rater again takes the higher Roman numeral from the two tables, then bumps it up one additional level.
Each ear is evaluated separately. Pattern (b) is the one to watch if your audiogram shows relatively normal low-frequency hearing with a steep drop at higher frequencies, because the extra one-level bump can move the final percentage meaningfully.
Why Most Ratings Land Low
Most veterans with service-connected hearing loss are rated at 0% or 10%. This regularly frustrates people who genuinely struggle to follow conversations in restaurants or crowded rooms, but the rating schedule is built to reflect average loss of earning capacity, not day-to-day difficulty. Getting a higher number requires test results severe enough to place your ear high on the Roman numeral scale in both categories.
The Paired Organ Rule
38 CFR § 3.383 can raise a rating for veterans with hearing loss in both ears when only one side is service-connected. If service-connected hearing loss in one ear is rated at 10% or higher, and the other ear has non-service-connected hearing loss that meets the § 3.385 disability threshold, the VA rates both ears as if both were service-connected.4eCFR. 38 CFR 3.383 – Special Consideration for Paired Organs and Extremities Without that rule, the non-service-connected ear would be treated as Level I, which almost always drops the combined percentage on Table VII.
Tinnitus
Tinnitus is rated separately from hearing loss under diagnostic code 6260 in 38 CFR § 4.87. The maximum schedular rating is 10%, and only one 10% rating is assigned whether the ringing is in one ear, both ears, or perceived in the head.5eCFR. 38 CFR 4.87 – Schedule of Ratings, Ear Veterans whose tinnitus causes or worsens a separate condition, such as a sleep or mental health condition, can file a secondary claim for that condition, which is rated on its own scale.
What a 0% Rating Actually Gets You
A 0% rating means the VA has recognized your hearing loss as service-connected but your test scores don’t produce a compensable percentage on the tables. There’s no monthly payment, but the rating still carries no-cost VA healthcare and prescriptions for the condition, a travel allowance for VA appointments, 10-point federal hiring preference, and commissary and exchange access.6Veterans Affairs. VA Benefit Eligibility Matrix Hearing aids are provided at no cost to veterans with service-connected hearing loss regardless of percentage.
A 0% rating also keeps the file open. Hearing tends to worsen with age, and you can file for an increased rating whenever your numbers change. A new exam that pushes your scores higher on the tables produces a higher percentage from that point forward.
What the Percentages Pay
Monthly compensation for 2026, effective December 1, 2025, for a single veteran with no dependents at the ratings most common in hearing loss claims:7Veterans Affairs. Current Veterans Disability Compensation Rates
- 10%: $180.42 per month
- 20%: $356.66 per month
- 30%: $552.47 per month
- 40%: $795.84 per month
- 50%: $1,132.90 per month
Ratings of 30% and above increase with dependents. Veterans with profound bilateral hearing loss may also qualify for Special Monthly Compensation at the K level, adding $139.87 per month on top of the base payment.8Veterans Affairs. Current Special Monthly Compensation Rates
If the Rating Looks Wrong
Because the rating comes out of a formula, most disputes come down to the test numbers or how the rater read them. A Supplemental Claim lets you submit new evidence, and a fresh audiology exam showing worse hearing is usually the most direct way to move the percentage up. A Higher-Level Review keeps the same evidence but asks a senior adjudicator to check for errors, which is the right lane if you believe the rater misread Tables VI or VII, skipped § 4.86, or accepted an exam that used the wrong word list. A Board Appeal sends the case to a Veterans Law Judge.9Veterans Affairs. Higher-Level Reviews
When the evidence for and against a given rating is roughly balanced, 38 CFR § 3.102 requires the VA to resolve the doubt in your favor, including on which of two percentage levels applies.10eCFR. 38 CFR 3.102 – Reasonable Doubt If your decision reads as though the rater treated a close call as a loss for you, that rule is worth raising on review.