Diagnostic Code 6202 · 38 CFR §4.87
Otosclerosis is a condition where abnormal bone growth in the middle ear prevents the stapes (stirrup bone) from vibrating properly, causing progressive conductive hearing loss. The condition can also involve the cochlea, leading to sensorineural hearing loss. While otosclerosis has a genetic component, noise exposure and trauma during military service can accelerate its progression or trigger symptoms. Veterans who were exposed to loud noise environments — artillery, aircraft, machinery — may develop otosclerosis earlier or more severely than they otherwise would have. The condition typically presents as gradually worsening hearing loss and may be accompanied by tinnitus.
| Rating | Criteria |
|---|---|
| 0% | This condition does not have its own fixed rating levels. Under 38 CFR 4.87, DC 6202 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 ENT evaluation diagnosing otosclerosis through clinical examination, audiometry, and potentially CT imaging is needed. Audiograms showing the characteristic conductive or mixed hearing loss pattern support the diagnosis and are essential for determining your rating, since DC 6202 is rated entirely based on hearing impairment. Service treatment records showing noise exposure or hearing changes during service help establish nexus. If surgical treatment (stapedectomy or stapedotomy) was performed, those records are important. A nexus opinion connecting the condition to military noise exposure or aggravation is needed since otosclerosis has a hereditary component.
Yes, through aggravation. Even if the underlying condition has a genetic component, if military noise exposure accelerated its progression or worsened symptoms beyond their natural course, service connection on an aggravation basis is appropriate.
No. The regulation simply instructs the VA to rate hearing impairment. This means the VA evaluates the hearing loss caused by otosclerosis using the standard audiometric formula under DC 6100. Your rating depends on your puretone threshold averages and speech recognition scores from audiometric testing.
Yes. If otosclerosis 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 for the otosclerosis.