Menieres VA Rating: Meniere's Disease (DC 6205) and Vertigo (DC 6204) Criteria

Complete Meniere’s syndrome and vertigo rating table (38 CFR 4.87)

The table below sets out the exact criteria for Diagnostic Code 6205 (Meniere’s syndrome) and Diagnostic Code 6204 (Peripheral vestibular disorders) in 38 CFR 4.87, along with veteran-alone monthly payments effective 2025-12-01.

How each Diagnostic Code 6205 tier is evaluated

Every evaluation level under Diagnostic Code 6205 in 38 CFR 4.87 shares two core elements:

• Hearing impairment is required at all three tiers (30%, 60%, and 100%): DC 6205 itself says only “hearing impairment” and does not state a Table VII threshold under 38 CFR 4.85; evidence of hearing impairment attributable to Meniere’s syndrome is what the criterion calls for.
• Tinnitus is optional (“with or without tinnitus”): All three tiers explicitly state “with or without tinnitus.” Whether a veteran has constant roaring tinnitus, intermittent ringing, or no tinnitus at all, the DC 6205 percentage does not change. Conversely, when rated under DC 6205, tinnitus is included within the 30%, 60%, or 100% rating and cannot receive an extra 10% under DC 6260.

30 percent, 60 percent, and 100 percent criteria

• 30% rating ($552.47/month alone): Assigned for hearing impairment with vertigo occurring less than once a month, with or without tinnitus. Unlike the 60% and 100% tiers, the 30% tier does not require a cerebellar gait.
• 60% rating ($1,435.02/month alone): Assigned for hearing impairment with attacks of vertigo and cerebellar gait occurring from one to four times a month, with or without tinnitus. Moving from 30% to 60% requires both an attack frequency of 1 to 4 times per month and attacks of vertigo and cerebellar gait (an unsteady, wide-based, staggering, or reeling gait).
• 100% rating ($3,938.58/month alone): Assigned for hearing impairment with attacks of vertigo and cerebellar gait occurring more than once weekly, with or without tinnitus. The schedule awards 100% directly under DC 6205 when those criteria are met.

The Note to DC 6205: Unified rating vs. separate ratings

The binding Note to Diagnostic Code 6205 in 38 CFR 4.87 states verbatim:

“Note: Evaluate Meniere’s syndrome either under these criteria or by separately evaluating vertigo (as a peripheral vestibular disorder), hearing impairment, and tinnitus, whichever method results in a higher overall evaluation. But do not combine an evaluation for hearing impairment, tinnitus, or vertigo with an evaluation under diagnostic code 6205.”

1. Prohibition against combining with DC 6205

Under the second sentence of the Note to DC 6205, the anti-pyramiding rule in 38 CFR 4.14, and Note (1) to Diagnostic Code 6260 (which permits combining tinnitus with other ear codes “except when tinnitus supports an evaluation under one of those diagnostic codes”), a veteran rated under DC 6205 at 30%, 60%, or 100% cannot combine that rating with a separate evaluation for hearing loss (DC 6100), tinnitus (DC 6260), or vertigo (DC 6204) attributable to Meniere’s syndrome.

2. When separate ratings beat DC 6205

Rating specialists must calculate both methods and award whichever yields the higher overall percentage:

• When separate ratings are higher: Suppose a veteran with Meniere’s syndrome has vertigo less than once a month (30% under DC 6205), or has frequent dizziness with occasional staggering without cerebellar gait. If the veteran also has bilateral sensorineural hearing loss rated at 40% under DC 6100, dizziness with occasional staggering rated at 30% under DC 6204, and recurrent tinnitus rated at 10% under DC 6260, combining those three separate ratings under 38 CFR 4.25 yields 40% + 30% = 58%, and 58% + 10% = 62%, rounding to 60%—exceeding the 30% DC 6205 rating. Similarly, if early-stage Meniere’s causes vertigo with occasional staggering (30% under DC 6204) and tinnitus (10% under DC 6260) without measurable hearing impairment yet, separate ratings combine to 37% (40%).
• When DC 6205 is higher: Because unilateral Meniere’s disease often leaves the better ear at Roman Numeral I on Table VI, hearing loss under DC 6100 frequently rates 0% or 10% on Table VII. Then, 0% (DC 6100) + 30% (DC 6204 maximum) + 10% (DC 6260) combines to at most 40% (37%), and 0% + 10% (DC 6204) + 10% (DC 6260) combines to 20% (19%). Thus, DC 6205 produces the higher rating whenever the veteran qualifies for 60% (1 to 4 attacks/month with cerebellar gait), 100% (more than once weekly with cerebellar gait), or 30% without staggering.

Peripheral vestibular disorders under Diagnostic Code 6204

Non-Meniere’s inner-ear balance conditions—including benign paroxysmal positional vertigo (BPPV), vestibular neuritis, labyrinthitis, and post-traumatic peripheral vestibulopathy—are rated under 38 CFR 4.87, Diagnostic Code 6204:

• 10% rating: Occasional dizziness ($180.42/month alone).
• 30% rating: Dizziness and occasional staggering ($552.47/month alone).

The Note to Diagnostic Code 6204 establishes two binding rules:

1. Objective findings are mandatory: “Objective findings supporting the diagnosis of vestibular disequilibrium are required before a compensable evaluation can be assigned under this code.” Subjective dizziness alone cannot support a 10% or 30% rating. Objective findings include nystagmus on a Dix-Hallpike maneuver, an abnormal Romberg test or unsteady gait on exam, or abnormal ENG, VNG, caloric, rotary chair, or VEMP testing.
2. Separate ratings for hearing loss, suppuration, and tinnitus are permitted: The Note to DC 6204 directs that “Hearing impairment or suppuration shall be separately rated and combined,” and Note (1) to DC 6260 allows combining a 10% tinnitus rating with DC 6204.

How the C&P exam and Ear DBQ measure Meniere’s and vertigo

During a VA Compensation and Pension (C&P) exam, the examiner completes the Ear (including Vestibular and Infectious) Disability Benefits Questionnaire (DBQ) (and a Hearing Loss and Tinnitus DBQ with state-licensed audiologist puretone and Maryland CNC testing under 38 CFR 4.85 when hearing loss or tinnitus is claimed):

1. Sections I & II (Diagnosis and History): Checkboxes for Meniere’s syndrome or endolymphatic hydrops, Peripheral vestibular disorder, and Benign Paroxysmal Positional Vertigo (BPPV), plus onset and continuous medications.
2. Section III (Meniere’s Syndrome and Vestibular Conditions — Item 3A): Records checkboxes, frequency (Less than once a month, 1–4 times a month, or More than once weekly), and duration for Hearing impairment with vertigo, Hearing impairment with attacks of vertigo and cerebellar gait, Tinnitus (unilateral or bilateral), Vertigo, and Staggering.
3. Section VI (Physical Exam — Items 6D–6G): Documents objective vestibular and cerebellar signs: 6D. Gait (Normal, Unsteady, or Other abnormality), 6E. Romberg test, 6F. Dix-Hallpike test (Nylen-Barany test) for vertigo or nystagmus, and 6G. Limb coordination test (finger-nose-finger).
4. Sections IX & X (Testing and Functional Impact): Records audiometry, ENG/VNG, ECochG, or MRI results and work limitations. Bring a 6-to-12-month vertigo attack log and private ENT/neurology records to substantiate attack frequency.

Direct, presumptive, and secondary service connection

• Direct and presumptive service connection (38 CFR 3.303 & 38 CFR 3.309(a)): Requires a current diagnosis, in-service acoustic trauma, barotrauma, head injury, inner-ear infection, or documented vertigo/hearing symptoms, and a medical nexus. Continuity of symptomatology under 38 CFR 3.303(b) can link in-service labyrinthitis or vertigo to a post-service Meniere’s diagnosis, and organic vestibulocochlear pathology manifesting to 10%+ within one year of separation may qualify under 38 CFR 3.309(a).
• Secondary service connection (38 CFR 3.310): Post-traumatic BPPV (DC 6204) and endolymphatic hydrops (DC 6205) may be claimed secondary to traumatic brain injury (TBI) (DC 8045) or chronic otitis media/cholesteatoma (DC 6200). Conversely, service-connected Meniere’s disease may support secondary claims for depression or anxiety (38 CFR 4.130) (0% to 100%), migraine headaches (DC 8100) (0% to 50%), or orthopedic injuries and scars from falls during vertigo attacks.

Status of the February 2022 proposed rule (87 FR 8474)

In February 2022 (87 FR 8474, RIN 2900-AQ72), the VA proposed revising DC 6204 to a 10%, 30%, and 100% schedule based on work and self-care limitations, revising DC 6205 to require diagnosis by an otolaryngologist or neurologist and measure vertigo frequency over a six-month average (replacing “more than once weekly” at 100% with “five or more times a month; or with persistent disequilibrium and gait instability”), and eliminating standalone tinnitus (DC 6260). This proposed rule has not been finalized. Current claims follow the existing text of 38 CFR 4.87, and established ratings remain protected under 38 CFR 3.951(a).

Combining ratings and getting accredited help

Your DC 6205 rating (or separate DC 6204, DC 6100, and DC 6260 ratings) combines with other service-connected conditions under 38 CFR 4.25, without the 38 CFR 4.26 bilateral factor. Combining 60% under DC 6205 with 30% for secondary depression adds 30% of the remaining 40% efficiency (12%), reaching 72%, which rounds to 70% ($1,808.45/month alone, effective 2025-12-01). Model both rating methods with our VA combined rating calculator and estimate past-due pay with our VA back pay calculator.

Accredited Veterans Service Organizations (VSOs) (such as the DAV, VFW, and American Legion) provide free representation, while VA-accredited claims agents and attorneys handle appeals under regulated fees. No representative can promise an outcome; verify credentials through the VA Office of the General Counsel Accreditation Search.