The VA rates hearing loss using a mechanical, formula-based system that is unlike any other VA rating process. The system uses three tables in 38 CFR 4.85 and 4.86 to convert audiometric test results into a disability percentage.
Step 1 — Table VI converts each ear's test results into a Roman numeral level (I through XI). The two inputs are: the puretone threshold average (the average of hearing thresholds at 1000, 2000, 3000, and 4000 Hz) and the speech discrimination score from the Maryland CNC word recognition test. Table VI cross-references these two numbers to produce a Roman numeral for each ear. Level I represents the best hearing, Level XI represents the worst.
Step 2 — Table VII takes the Roman numeral levels for both ears and cross-references them to produce a percentage rating (0% through 100%). The less-impaired ear determines the column, the more-impaired ear determines the row.
Step 3 (when applicable) — Table VIA is an alternative to Table VI that uses only puretone averages, without speech discrimination scores. It applies when there is an exceptional pattern of hearing loss under 38 CFR 4.86: either all four puretone thresholds (1000-4000 Hz) are 55 dB or higher, or the 1000 Hz threshold is 30 dB or less and the 2000 Hz threshold is 70 dB or more. When Table VIA applies, the VA uses whichever table (VI or VIA) produces the more favorable result for the veteran.
This mechanical system means the rating depends entirely on the audiometric numbers. Many veterans with real-world hearing difficulty still receive a 0% rating because their numbers fall at Level I on the tables. A 0% service-connected rating still qualifies the veteran for free hearing aids and audiology care through the VA, which represents significant ongoing value.