Otosclerosis — VA Disability Rating Criteria (DC 6202)
Diagnostic Code 6202 · 38 CFR §4.87
What Is It?
Otosclerosis is abnormal bone remodelling in the middle ear that fixes the stapes so it can no longer transmit vibration, producing progressive conductive hearing loss; when it reaches the cochlea it adds a sensorineural component. It has a strong hereditary element, which shapes the claim: for most veterans the winning theory is aggravation — that military noise exposure, barotrauma or blast accelerated a process that would otherwise have progressed more slowly — rather than direct causation. On the rating side, DC 6202 assigns nothing. Its rating cell in 38 CFR 4.87 is empty and the entry reads only "Rate hearing impairment," so the percentage is produced entirely by the audiometric mechanic in 38 CFR 4.85. Two practical consequences follow. Successful stapedectomy or stapedotomy can restore measured hearing and therefore lower the rating, because the schedule grades the audiogram rather than the diagnosis. And the associated conditions — tinnitus and vertigo — carry their own codes and are worth claiming in their own right.
Rating Criteria
| Rating | Criteria |
|---|---|
| See pathways | DC 6202 carries no percentage column in 38 CFR 4.87 — the rating cell beside it is empty. The entry reads "Otosclerosis: 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
Two separate evidentiary jobs. For service connection: an ENT diagnosis supported by audiometry showing the characteristic conductive or mixed pattern (often with the Carhart notch), CT imaging or operative findings where available, service records establishing noise or pressure exposure, and — because of the hereditary component — a nexus opinion that addresses aggravation specifically, explaining how service exposure worsened the condition beyond its natural progression. For the rating: an audiogram that satisfies 38 CFR 4.85(a) — state-licensed audiologist, Maryland CNC speech discrimination, puretone audiometry, no hearing aids. Add operative reports for any stapedectomy or stapedotomy and the post-operative audiogram, since the current measured hearing is what gets rated.
C&P Exam Tips
The audiology testing is the rating, so confirm it is complete: puretone thresholds at 1000, 2000, 3000 and 4000 Hertz plus a Maryland CNC score, each ear, unaided. Describe the timeline of progression and when you first noticed the loss, which supports the aggravation theory even though it does not move the percentage. Ask whether 38 CFR 4.86 applies — with all four frequencies at 55 decibels or more, or with 1000 Hertz at 30 decibels or less and 2000 Hertz at 70 or more, the specialist uses whichever of Table VI or Table VIa gives the higher numeral, elevating one step in the second case. If you have had surgery, say what it achieved and what it did not. Raise tinnitus and any dizziness by name.
How to File
File under DC 6202 with the ENT records, all audiograms, and any operative reports. Because of the genetic component, make the nexus opinion do the aggravation work explicitly. File tinnitus separately under DC 6260 (flat 10 percent) and any vestibular disorder under DC 6204. Where hearing is service-connected in one ear only, 38 CFR 4.85(f) assigns the other ear Roman numeral I, subject to the paired-organ rule in 38 CFR 3.383. Check 38 CFR 3.350 for special monthly compensation, which 38 CFR 4.85(g) directs on any impaired-hearing claim. If surgery improved your hearing, expect a re-examination; a reduction still requires the due-process steps in 38 CFR 3.105(e).
Common Mistakes
Expecting DC 6202 to carry percentages of its own — it does not, and the audiogram supplies all of them. Arguing direct causation and ignoring aggravation, which is the stronger theory for a hereditary condition. Submitting an audiogram without Maryland CNC speech discrimination, which cannot be run through Table VI. Not filing separately for tinnitus under DC 6260. And overlooking 38 CFR 4.86, which exists precisely for hearing patterns that Table VI alone understates — the conductive pattern otosclerosis produces can qualify.
Frequently Asked Questions
Does DC 6202 have its own rating percentages?
No. The rating column is empty and the entry says "Rate hearing impairment." Your percentage comes from 38 CFR 4.85: Table VI turns each ear’s puretone average and Maryland CNC score into a Roman numeral, and Table VII turns the pair into a percentage under DC 6100.
Can otosclerosis be service-connected if it runs in my family?
Yes, through aggravation. If military noise exposure, barotrauma or blast accelerated the condition beyond its natural course, service connection on an aggravation basis is the appropriate theory, and the nexus opinion should say so in those terms.
Will surgery lower my rating?
It can. The schedule rates measured hearing, not the diagnosis, so a stapedectomy or stapedotomy that improves your audiogram can support a reduction. Any reduction still requires a VA examination and the due-process procedures in 38 CFR 3.105(e).
Does the exceptional-pattern rule help with conductive loss?
It can. 38 CFR 4.86 applies when the threshold at each of the four measured frequencies is 55 decibels or more, or when 1000 Hertz is 30 decibels or less and 2000 Hertz is 70 decibels or more. In both cases the specialist takes the higher of the Table VI or Table VIa numeral, and in the second also elevates it one step.
Can I be rated for tinnitus too?
Yes. Tinnitus is DC 6260, a flat 10 percent for one or both ears, assigned in addition to the hearing-impairment percentage.
What if my hearing loss is not bad enough to be compensable yet?
A 0 percent evaluation still establishes service connection and locks in the effective date. Otosclerosis is progressive, so that connection is what lets a later audiogram support an increase without starting a new claim.