Diagnostic Code 6200 · 38 CFR §4.87
Chronic suppurative otitis media is a persistent or recurring infection of the middle ear that involves active discharge (suppuration). Under DC 6200, the VA also covers mastoiditis and cholesteatoma under this same diagnostic code — any combination of these three conditions is rated together. Mastoiditis is an infection of the mastoid bone behind the ear, often a complication of untreated otitis media. A cholesteatoma is an abnormal skin growth in the middle ear that typically forms after repeated infections or a perforated eardrum. Veterans may develop these conditions from blast exposure, perforated eardrums, water exposure during training, or chronic ear problems that began during service. The VA provides a single schedular rating for the condition itself, but hearing loss, tinnitus, and other complications are rated separately.
| Rating | Criteria |
|---|---|
| 10% | During suppuration (active discharge from the ear) or with aural polyps. This is the only schedular rating available under DC 6200. The 10% rating covers the active infection, mastoiditis, or cholesteatoma itself. Hearing impairment and complications such as labyrinthitis, tinnitus, facial nerve paralysis, or bone loss of the skull are evaluated separately under their respective diagnostic codes. |
ENT treatment records showing chronic or recurrent middle ear infections, mastoiditis, or cholesteatoma are essential. Cultures of ear drainage, tympanograms, audiograms, and CT imaging of the temporal bone (especially for cholesteatoma) should all be submitted. If you have had ear tube placement, tympanoplasty, or mastoidectomy surgery, include those operative records.
DC 6200 specifically covers the chronic infection, mastoiditis, or cholesteatoma itself. However, the complications — hearing loss, tinnitus, balance problems, facial nerve paralysis, bone loss — can each be rated separately under their own diagnostic codes. The combined total from all related conditions is often significantly higher than 10%.
Yes. A perforated eardrum is a common cause of recurring middle ear infections. If your eardrum was perforated during service and you now have chronic ear infections, that is a strong basis for secondary service connection.
Chronic suppurative otitis media does not have to be constantly active. If you have a pattern of recurring infections — even with periods of remission — the condition qualifies as chronic. Document every episode with treatment records.
No. Under 38 CFR 4.87, cholesteatoma is covered under DC 6200 along with chronic suppurative otitis media and mastoiditis. Any combination of these three conditions is rated together at 10%, with complications like hearing loss and tinnitus rated separately.