Benign Neoplasm of the Ear — VA Disability Rating Criteria (DC 6209)

Diagnostic Code 6209 · 38 CFR §4.87

What Is It?

DC 6209 covers benign neoplasms of the ear other than skin growths — glomus tympanicum and jugulare tumours, acoustic neuroma and other vestibular schwannomas, osteomas, cholesteatoma-associated masses, and similar growths in the canal, middle ear or petrous bone. Benign here means non-cancerous, not harmless: a growth in that space damages by pressure and by what the surgery to remove it costs, and the residuals can include conductive or sensorineural hearing loss, vertigo, tinnitus, facial nerve weakness, and loss of taste. DC 6209 assigns no percentage. Its rating cell in 38 CFR 4.87 is empty and the entry reads "Rate on impairment of function," which means the evaluation is assembled from the codes that govern each function the growth or its treatment actually impaired. That is the useful part of this code: rather than one number, it produces as many separate evaluations as there are impaired functions, combined under 38 CFR 4.25. Its malignant counterpart, DC 6208, is different in kind — a flat 100 percent that continues beyond the cessation of surgery, radiation or chemotherapy, with a mandatory VA examination six months after treatment ends.

Rating Criteria

Evidence Needed

Imaging that identifies the growth and its extent — CT of the temporal bone, or MRI with contrast for a vestibular schwannoma — plus the pathology report confirming it is benign. Then one document per impaired function: an audiogram meeting 38 CFR 4.85(a) with Maryland CNC speech discrimination for hearing; objective findings of vestibular disequilibrium for DC 6204, which expressly requires them before a compensable evaluation can be assigned; a facial nerve examination grading weakness for DC 8207; and documentation of any taste or smell loss. Operative reports matter twice over, because surgical access to this region is itself a common cause of the residuals being rated.

C&P Exam Tips

Come with a list of functions rather than a description of the tumour. Name each one — hearing, balance, ringing, facial weakness, taste — and ask that each be addressed in the examination, because each has its own code and its own criteria. For the vestibular component, ask that objective findings be recorded: DC 6204 requires objective findings supporting vestibular disequilibrium before any compensable evaluation, and its note directs that hearing impairment or suppuration be rated separately and combined. Make sure the audiogram is complete and unaided. If facial nerve function is affected, ask the examiner to grade it rather than note it in passing.

How to File

File under DC 6209 and then claim each residual by name in the same application — hearing loss, vertigo, tinnitus, facial nerve impairment, loss of taste — so each is developed as its own issue. Attach the imaging, the pathology report, the operative notes, and one piece of objective evidence per function. If a vestibular schwannoma was treated with radiosurgery rather than resection, include the treatment record and the follow-up imaging. Where hearing is service-connected in one ear only, 38 CFR 4.85(f) assigns the other ear Roman numeral I, subject to 38 CFR 3.383. Check 38 CFR 3.350 for special monthly compensation, particularly where deafness combines with other disabilities.

Common Mistakes

Filing one "ear tumour" claim and receiving one evaluation, when the code is designed to produce several. Expecting DC 6209 to have percentages of its own — it has none. Leaving the vestibular component undocumented: DC 6204 will not pay a compensable rating without objective findings of disequilibrium, however convincing the description of dizziness. Confusing DC 6209 with DC 6208, the malignant code, which carries a flat 100 percent that continues past the end of treatment with a mandatory examination six months afterward. And overlooking facial nerve weakness and taste loss, which are commonly caused by the surgery and just as commonly never claimed.

Frequently Asked Questions

Does DC 6209 have fixed rating percentages?

No. The rating column is empty and the entry says "Rate on impairment of function." Each function the growth or its treatment impaired is evaluated under its own code — hearing under 38 CFR 4.85, vertigo under DC 6204, tinnitus under DC 6260, facial nerve weakness under DC 8207 — and the results are combined under 38 CFR 4.25.

Can I really get more than one rating from a single tumour?

Yes, and that is the point of a function-based instruction. Distinct functions rated under distinct codes are not pyramiding. What 38 CFR 4.14 forbids is rating the same symptom twice under two codes.

How is a benign ear tumour different from a malignant one?

DC 6208 covers malignant neoplasm of the ear at a flat 100 percent, and its note continues that rating beyond the cessation of surgery, radiation or chemotherapy, with a mandatory VA examination six months after treatment ends. DC 6209 has no percentage of its own and is built entirely from residual function.

Why was my vertigo not compensated?

DC 6204 requires objective findings supporting a diagnosis of vestibular disequilibrium before a compensable evaluation can be assigned. Without vestibular testing in the file, a description of dizziness alone will not reach 10 percent.

Is an acoustic neuroma rated here?

A vestibular schwannoma is a benign neoplasm in this region, so the function-based instruction applies: hearing loss, tinnitus, vestibular impairment and facial nerve involvement are each evaluated under their own code. Where the tumour is intracranial and produces central neurological residuals, those are evaluated under the neurological schedule at 38 CFR 4.124a.

Are post-surgical residuals rated separately?

Yes. It makes no difference whether the impairment came from the growth or from the operation to remove it — hearing loss, vestibular dysfunction, tinnitus and facial nerve weakness are all rated under their own codes and combined.