VA Hearing Loss Ratings in 2026: Audiograms and CNC Scores
A hearing test can feel personal, but VA hearing loss ratings come from a fixed calculation. The VA does not assign a percentage based only on how difficult conversations feel or how loud your military service was.
Instead, the rating usually depends on four puretone thresholds in each ear and a Maryland CNC speech discrimination score. Those results become Roman numerals under VA tables, which then produce a percentage under Diagnostic Code 6100. Understanding the numbers can help you spot an incomplete exam, an incorrect calculation, or a rating that deserves review.
Key Takeaways
- The VA uses puretone averages at 1,000, 2,000, 3,000, and 4,000 Hertz.
- Maryland CNC speech discrimination scores are part of the standard rating formula.
- Table VI assigns a Roman numeral for each ear, and Table VII combines both ears.
- A measurable hearing loss can receive a 0% rating, which still establishes service connection.
- Exceptional patterns, one-sided service connection, and an inadequate examination can change the analysis.
How the VA Rates Hearing Loss in 2026
As of July 2026, the VA continues to rate hearing impairment under 38 C.F.R. § 4.85 and Diagnostic Code 6100. The regulation uses a mechanical formula. That means the adjudicator generally applies the test results to the rating tables rather than assigning a percentage based on personal judgment.
The process has three main stages:
- The VA calculates a puretone average for each ear.
- Table VI converts the puretone average and Maryland CNC score into a Roman numeral.
- Table VII combines the two Roman numerals into a disability percentage.
The Roman numerals run from Level I through Level XI. Level I indicates the least severe impairment under the table. Level XI indicates the most severe hearing impairment.
The final rating can be 0%, 10%, 20%, 30%, or a higher percentage, including 100% in the most serious cases. Many veterans with documented hearing loss receive 0% or 10%, even when the condition affects work, family conversations, television use, and safety.
That result can seem inconsistent with daily experience. However, the rating schedule measures hearing through defined thresholds and speech scores. The VA’s formula does not directly measure frustration, embarrassment, social isolation, or the volume setting on a television.
A veteran must also prove service connection before the VA assigns compensation for hearing loss. A current diagnosis and qualifying hearing impairment are not enough by themselves. The evidence must connect the disability to an in-service event, injury, disease, or noise exposure.
Service connection and the percentage rating are separate questions. A veteran may win service connection at 0%, then seek a higher rating if later testing shows greater impairment.
What the Audiogram Measures
A puretone audiogram measures the softest sounds a person can hear at different frequencies. The results appear in decibels hearing level, usually written as dB HL. A higher threshold means the person needs a louder sound to hear it.
For the standard VA calculation, the relevant frequencies are:
- 1,000 Hertz
- 2,000 Hertz
- 3,000 Hertz
- 4,000 Hertz
The VA uses those four readings for the right ear and repeats the calculation for the left ear. It does not use a simple average of every number appearing on a private audiogram.
The puretone average, or PTA, is calculated as follows:
PTA = (1,000 Hz threshold + 2,000 Hz threshold + 3,000 Hz threshold + 4,000 Hz threshold) / 4
For example, thresholds of 25, 30, 40, and 50 dB produce this result:
(25 + 30 + 40 + 50) / 4 = 36.25 dB
The VA then places that average into Table VI alongside the Maryland CNC score. Veterans should avoid rounding the average before reviewing the table. A result such as 36.25 dB remains the calculated average used for the table range.
A private hearing evaluation may contain several other measurements, including speech reception threshold, bone conduction, tympanometry, and hearing aid recommendations. Those details can help diagnose the condition, but they don’t all control the schedular percentage.
Older military records also require careful review. Some historical audiograms used the ASA standard instead of the ISO-ANSI standard used today. Comparing the numbers without identifying the testing standard can make old hearing appear better or worse than it was.
A useful explanation of the relationship between threshold results and the rating schedule appears in this VA hearing-loss rating formula guide. The important point is that the four frequencies must be read correctly before anyone calculates a percentage.
Why the Maryland CNC Speech Score Matters
The second major input is the Maryland CNC speech discrimination test. This test measures how accurately a person recognizes spoken words at a controlled volume. The result appears as a percentage for each ear.
A score of 92% means the veteran correctly recognized 92% of the test words. It does not mean the veteran has a 92% disability rating. The VA places the score into Table VI with the puretone average.
For example, a veteran with a moderate puretone average and a low word-recognition score may receive a higher Roman numeral than a veteran with the same puretone average and a strong speech score. The two ears can also receive different numerals.
The Maryland CNC test is not the same as:
- A speech reception threshold
- A casual conversation test
- A test using a different word list
- A veteran’s description of difficulty understanding speech
- A hearing aid demonstration
The standard VA examination must use the Maryland CNC word list unless the examiner finds that speech discrimination testing is inappropriate. A private audiologist who uses another word-recognition test may provide useful medical evidence, but the result may not fit directly into the standard VA rating table.
The examiner must be a state-licensed audiologist. Testing is conducted without hearing aids. If the veteran’s language background, cognitive condition, inconsistent responses, or another factor makes the speech score unsuitable, the VA may use Table VIa instead. Table VIa relies on the puretone average without the speech discrimination percentage.
A low speech score can therefore matter substantially. Still, the score must be valid and the report must identify the test used. A report that lists only “word recognition: 80%” without identifying Maryland CNC may raise a question about whether the VA can use it for the regular formula.
How Tables VI and VII Produce a VA Rating
Table VI combines two measurements for each ear:
- The puretone average
- The Maryland CNC speech discrimination percentage
The intersection produces a Roman numeral from I through XI. The higher the numeral, the more serious the hearing impairment under the schedule.
The VA then uses Table VII. The better ear appears on one axis, and the poorer ear appears on the other. Their intersection creates the final percentage.
| Better ear level | Poorer ear level | Typical Table VII result |
|---|---|---|
| I | I | 0% |
| II | VI | 10% |
| III | VII | 20% |
| V | VIII | 30% |
| VIII | X | 70% |
| XI | XI | 100% |
The table is not a general percentage average. A veteran cannot add the two ear percentages together or divide them by two. The VA must apply the specific combination shown in Table VII.
For example, suppose Table VI assigns Level II to one ear and Level VI to the other. Table VII produces a 10% hearing loss rating. If the better ear remains at Level II but the poorer ear reaches Level IX, the combined result becomes 20%.
That difference may come from a lower speech discrimination score, a higher puretone average, or both. A small change in one test result can move an ear into a different table range, but the change must cross the applicable boundary.
A hearing-loss rating guide can help veterans organize their audiogram information before reviewing the official rating decision. Online calculators are estimates, however. They don’t replace the regulation, the actual examination report, or a review of whether the exam followed VA requirements.
The mechanical formula also explains why everyday symptoms don’t always match the percentage. A veteran may struggle in restaurants and receive 0%, while another veteran with a similar complaint receives 10% because the test scores fall into a different table combination.
Exceptional Patterns and One-Ear Hearing Loss
Some audiograms qualify for special treatment under 38 C.F.R. § 4.86. These rules apply when the pattern of puretone thresholds shows unusually severe impairment at the tested frequencies.
The first exceptional pattern applies when thresholds at all four frequencies, 1,000 through 4,000 Hertz, are 55 dB or higher in one ear. In that situation, the VA compares the Roman numeral under Table VI with the numeral under Table VIa and uses the higher result.
The second pattern applies when the threshold is 30 dB or less at 1,000 Hertz and 70 dB or more at 2,000 Hertz. The VA again compares Table VI and Table VIa. Under this pattern, the VA uses the higher numeral and then elevates it to the next higher numeral.
These rules apply separately to each ear. The examiner and adjudicator must review every frequency, not only the puretone average.
One-sided service connection also creates a separate issue. When hearing loss is service-connected in only one ear, the VA generally assigns Level I to the non-service-connected ear when applying Table VII. Exceptions can apply when the non-service-connected ear has total deafness or when another provision allows consideration of both ears.
That rule can limit the percentage even when the non-service-connected ear has measurable hearing loss. The veteran may need to establish service connection for the other ear before the VA can use its actual test results in the combined calculation.
The decision should state which ear is service-connected and show how the VA treated the other ear. If that information is missing or appears inconsistent with the evidence, the calculation deserves review.
What a 0% Rating Means
A 0% rating is not the same as a denial. It means the VA recognizes a service-connected hearing disability but finds that the test results do not meet the threshold for monthly compensation under the schedule.
The rating can still matter. It creates an official service-connected condition, which may support access to VA treatment and provide a record for a future increased-rating claim. The veteran may also receive other benefits depending on the complete disability picture.
A 0% rating does not automatically become 10% because hearing gets worse with age. The veteran needs new medical evidence showing that the current impairment meets the rating criteria and remains connected to service.
Tinnitus is rated separately under Diagnostic Code 6260. The maximum schedular tinnitus rating is generally 10%, regardless of whether the ringing affects one ear or both. Hearing loss and tinnitus often arise from the same military noise exposure, but they use different diagnostic codes.
The VA combines service-connected disabilities under its combined ratings table. It does not add individual percentages in the ordinary way. A 10% hearing loss rating and a 10% tinnitus rating usually do not equal a straight 20% combined rating.
Veterans can review VA disability benefits for hearing loss to understand how hearing impairment may fit within a broader benefits claim. The complete record matters because the rating for one condition may affect other benefits.
Reviewing a C&P Hearing Examination
The Compensation and Pension examination is often the central evidence in a hearing loss rating decision. The veteran should obtain a copy of the report and check whether it includes the information needed for the calculation.
Look for the following details:
- The examiner’s name and state license information
- Puretone thresholds at all four required frequencies
- A separate result for each ear
- The Maryland CNC word list and speech score
- Confirmation that the testing occurred without hearing aids
- Notes about inconsistent responses or communication barriers
- A description of the hearing loss’s functional effects
Functional effects matter even though they don’t replace the numeric formula. The examiner should record how hearing loss affects conversations, employment, alarms, telephones, meetings, and other daily activities. An incomplete description may support an argument that the examination was inadequate.
Bring a complete history to the examination. Describe noise exposure involving aircraft, engines, weapons, machinery, communications equipment, or other service duties. Also explain when symptoms began and how they continued after service.
Private medical evidence can help when it follows VA standards. A private audiologist should identify the test method, provide the actual thresholds, state the speech test used, and explain the medical relationship between the current condition and service. A bare statement that a veteran has “severe hearing loss” gives the VA less usable information than a complete audiological report.
The rating percentage is only one part of the claim. Evidence may also need to address:
- An in-service event or hazardous noise exposure
- A current hearing loss disability under VA standards
- A nexus between service and the current condition
- Continuity of symptoms when medical records are limited
- Whether both ears should be service-connected
A normal hearing test at separation does not automatically resolve every service-connection question. The VA must consider the full record, including threshold shifts, military duties, credible reports, and post-service medical evidence.
Challenging an Incorrect Hearing Loss Rating
A veteran who disagrees with a decision generally has one year from the date VA mailed the decision to choose a review option. The right option depends on the error and the evidence available.
A Supplemental Claim allows the veteran to submit new and relevant evidence. This route may fit a claim supported by a new audiogram, a medical nexus opinion, corrected service records, or evidence showing that the C&P examiner used the wrong test.
A Higher-Level Review asks a senior VA reviewer to examine the existing record. New evidence cannot be submitted through this option. It may fit a clear error in applying Table VI, Table VII, or the exceptional-pattern rules.
A Board Appeal sends the dispute to the Board of Veterans’ Appeals. The veteran can choose a record review, submit additional evidence, or request a hearing, depending on the selected docket.
Common issues include a missing frequency, an incorrect puretone average, use of a non-Maryland speech test, failure to apply 38 C.F.R. § 4.86, or treating the non-service-connected ear incorrectly. A decision can also overlook evidence connecting hearing loss to military noise exposure.
Veterans seeking help in Florida can review how VA disability ratings work before deciding whether to request review. An accredited representative or attorney can compare the examination report with the rating tables and identify the evidence needed for the next filing.
Conclusion
VA hearing loss ratings in 2026 depend mainly on four puretone thresholds, a Maryland CNC speech score, and the required VA tables. The final percentage comes from the combination of both ears, not from a simple average or a description of how frustrating hearing loss feels.
A 0% rating can still establish service connection, while an incorrect test method or missed exceptional pattern can affect the result. When the numbers, examination report, or service-connection analysis don’t match the evidence, the veteran has a reason to seek a careful review.