Chronic Nonsuppurative Otitis Media — VA Disability Rating (DC 6201)
Diagnostic Code 6201 · 38 CFR §4.87
What Is It?
Chronic nonsuppurative otitis media with effusion — the schedule’s full title for DC 6201 adds "(serous otitis media)" — is persistent fluid behind an intact eardrum without active infection. It muffles sound by keeping the middle-ear bones from moving freely, and in veterans it commonly follows barotrauma from flight or diving, blast exposure, or repeated upper-respiratory illness in close quarters. What matters for a claim is that DC 6201 assigns no percentage. Its rating cell in 38 CFR 4.87 is empty and the entry says only "Rate hearing impairment," which sends the evaluation to the audiometric mechanic in 38 CFR 4.85. The whole rating is therefore decided by one document: the audiogram. A veteran whose effusion is genuinely troublesome but whose measured hearing sits at Level I in both ears will be rated 0 percent, and that is the schedule working as written rather than a mistake to appeal. The productive claims here are usually the separate ones — tinnitus, vertigo, or the underlying eustachian-tube dysfunction — and the long game is a fresh audiogram when the hearing measurably worsens.
Rating Criteria
| Rating | Criteria |
|---|---|
| See pathways | DC 6201 carries no percentage column in 38 CFR 4.87 — the rating cell beside it is empty. The entry reads "Chronic nonsuppurative otitis media with effusion (serous otitis media): Rate hearing impairment", so the evaluation comes from the hearing-impairment mechanic in 38 CFR 4.85, not from this code. That mechanic works in two steps: Table VI converts your puretone threshold average (the sum of the thresholds at 1000, 2000, 3000 and 4000 Hertz divided by four) and your Maryland CNC speech discrimination percentage into a Roman numeral from I to XI for each ear, and Table VII combines the two ears’ numerals into a percentage under DC 6100. The reachable range is 0 to 100 percent, but which figure you get is fixed by the audiogram — there are no severity tiers to argue. |
Evidence Needed
The audiogram is the claim. 38 CFR 4.85(a) requires an examination conducted by a state-licensed audiologist including a controlled speech discrimination test (Maryland CNC) and puretone audiometry, performed without hearing aids — an audiogram missing the Maryland CNC score cannot be run through Table VI. Beyond that: an ENT or audiology note documenting the effusion itself (otoscopy, tympanometry, or a tympanogram showing a flat trace), any myringotomy or tympanostomy-tube procedures, and service records showing pressure exposure, blast exposure, or repeated middle-ear infections. If the effusion has caused tinnitus or vestibular symptoms, get those documented as conditions in their own right rather than as descriptions of the ear problem.
C&P Exam Tips
This is an audiology exam and the numbers are the outcome, so make sure the testing is complete: puretone thresholds at 1000, 2000, 3000 and 4000 Hertz and a Maryland CNC speech discrimination score, in each ear, without hearing aids. Ask whether your pattern triggers 38 CFR 4.86 — if every one of those four frequencies is 55 decibels or more, or if 1000 Hertz is 30 decibels or less while 2000 Hertz is 70 decibels or more, the rating specialist must use whichever of Table VI or Table VIa yields the higher numeral, and in the second case elevate that numeral one step. Mention tinnitus and any dizziness explicitly so they are captured as separate claims. Describe functional effect for the record, but do not expect it to move the percentage — Table VII does not read narrative.
How to File
File under DC 6201 and treat the audiogram as the centre of the claim. Ask expressly for a VA audiology examination that includes Maryland CNC speech discrimination, and file separately for tinnitus (DC 6260, a flat 10 percent) and for any vestibular disorder (DC 6204, 30 or 10 percent) rather than folding them into the ear claim. If hearing is service-connected in only one ear, 38 CFR 4.85(f) assigns the non-service-connected ear Roman numeral I, subject to the paired-organ provisions of 38 CFR 3.383. And 38 CFR 4.85(g) directs that any impaired-hearing claim be checked against 38 CFR 3.350 for special monthly compensation for deafness alone or in combination with other disabilities.
Common Mistakes
The central misunderstanding is expecting DC 6201 to have levels of its own; it has none, and every figure comes from Tables VI and VII. The second is accepting an incomplete audiogram — no Maryland CNC score means no Table VI numeral. The third is treating a 0 percent decision as a denial: it establishes service connection and the effective date, and it is the platform for an increase when the audiogram changes. The fourth is leaving tinnitus and vertigo inside the ear claim instead of filing them under DC 6260 and DC 6204, where they carry their own percentages. The fifth is not asking about 38 CFR 4.86, which can raise the numeral for exceptional hearing patterns that Table VI alone understates.
Frequently Asked Questions
What percentage does DC 6201 pay?
None on its own. The rating column for DC 6201 in 38 CFR 4.87 is empty and the entry says "Rate hearing impairment." The percentage comes from 38 CFR 4.85 — Table VI converts your audiogram into a Roman numeral for each ear and Table VII converts the pair into a percentage under DC 6100.
Why did I get 0 percent when the fluid clearly bothers me?
Because the evaluation is measured, not described. If Table VI places both ears at Level I, Table VII returns 0 percent regardless of symptoms. That decision still establishes service connection and preserves your effective date for a later increase.
What has to be in the audiogram?
38 CFR 4.85(a) requires a state-licensed audiologist, a controlled speech discrimination test using the Maryland CNC word list, and puretone audiometry, all without hearing aids. The puretone threshold average is the thresholds at 1000, 2000, 3000 and 4000 Hertz divided by four.
What is 38 CFR 4.86 and does it apply to me?
It covers exceptional patterns of hearing impairment. If the threshold at each of the four frequencies is 55 decibels or more, the specialist uses whichever of Table VI or Table VIa gives the higher numeral. If 1000 Hertz is 30 decibels or less and 2000 Hertz is 70 decibels or more, the specialist takes the higher numeral and elevates it one step.
How is this different from suppurative otitis media?
DC 6200 covers chronic suppurative otitis media, mastoiditis or cholesteatoma and pays a flat 10 percent during suppuration or with aural polyps, with a note directing that hearing impairment and complications such as labyrinthitis, tinnitus, facial nerve paralysis or bone loss of the skull be evaluated separately. DC 6201 has no figure of its own at all.
Can I claim tinnitus as well?
Yes, and you should file it separately. Tinnitus is DC 6260 at a flat 10 percent whether it affects one ear or both, and it is assigned in addition to whatever hearing-impairment percentage the audiogram produces.