Diagnostic Code 6201 · 38 CFR §4.87
Chronic nonsuppurative otitis media with effusion (also called serous otitis media) is a condition where fluid accumulates behind the eardrum without active infection. Unlike suppurative otitis media (which involves pus and active infection under DC 6200), this form involves serous or mucoid fluid that persists in the middle ear space. The fluid impairs hearing by preventing the eardrum and ossicles from vibrating normally. Veterans may develop this condition from repeated pressure changes during military aviation, diving, blast exposure, or as a complication of upper respiratory infections common in close-quarters military living. The condition can cause fluctuating hearing loss, a sensation of ear fullness, and balance problems.
| Rating | Criteria |
|---|---|
| 0% | This condition does not have its own fixed rating levels. Under 38 CFR 4.87, DC 6201 instructs the VA to rate hearing impairment. Your rating is determined by your audiometric test results using the standard hearing loss formula in 38 CFR 4.85 (Tables VI and VII). If your hearing test results place both ears at Level I, you will receive a 0% rating. Higher ratings (10% through 100%) are possible depending on the severity of hearing loss documented by audiometry. See the hearing loss article (DC 6100) for the full breakdown of how hearing ratings are calculated. |
An audiological evaluation documenting hearing loss associated with the effusion is critical because the VA rates this condition entirely based on the degree of hearing impairment. ENT records showing the diagnosis through otoscopic examination or tympanometry are needed to establish the underlying condition. Service treatment records showing ear problems during military service help establish nexus. If the condition required myringotomy (ear tube placement) or other procedures, those surgical records are valuable.
No. The regulation simply says to rate hearing impairment. This means the VA evaluates the hearing loss caused by the effusion using the standard audiometric formula under DC 6100 (Tables VI and VII in 38 CFR 4.85). Your rating depends on your puretone threshold averages and speech recognition scores.
Suppurative means there is active infection with pus drainage, rated under DC 6200 at a flat 10%. Nonsuppurative means there is fluid without active infection, rated under DC 6201 based on the degree of hearing loss it causes. The rating approaches are completely different.
Yes. If nonsuppurative otitis media has caused tinnitus, that can be rated separately under DC 6260 at 10%. The tinnitus rating is in addition to whatever hearing impairment rating you receive.