Diagnostic Code 6211 · 38 CFR §4.87
A perforated tympanic membrane is a hole or tear in the eardrum. In veterans, this is most commonly caused by blast exposure (explosions, gunfire), barotrauma from diving or flying, direct trauma, or severe ear infections during service. The eardrum may heal on its own, require surgical repair (tympanoplasty), or remain permanently perforated. While the perforation itself receives only a 0% rating under DC 6211, it is significant as a service-connected condition because it commonly causes hearing loss, tinnitus, and recurrent ear infections — each of which can be rated separately and often at much higher percentages.
| Rating | Criteria |
|---|---|
| 0% | Perforation of the tympanic membrane. This condition receives a 0% rating regardless of symptoms. However, associated hearing loss is rated under DC 6100, tinnitus under DC 6260, and recurrent infections under DC 6200. Establishing service connection at 0% opens the door for these secondary claims. |
ENT examination documenting the perforation is needed. Service treatment records showing the injury or incident that caused the perforation establish nexus. Audiometric testing documenting associated hearing loss is important. If the perforation has caused recurrent infections, treatment records for those episodes are valuable. Surgical records if tympanoplasty was performed should be included.
A service-connected condition at 0% is still valuable. It establishes that the ear injury occurred during service, which makes it much easier to get secondary service connection for hearing loss (which can be rated 0-100%) and tinnitus (rated at 10%). The 0% rating is the gateway to higher-rated secondary conditions.
Yes. Even if the eardrum has healed, the fact that the perforation occurred during service is documentable. Scarring on the eardrum may be visible, and the residual effects (hearing loss, tinnitus) persist regardless of whether the perforation healed.
Yes. Filing for the perforated eardrum, hearing loss, and tinnitus simultaneously is recommended. This creates a clear chain of connection: the in-service blast or trauma caused the perforation, which caused hearing loss and tinnitus.