What does the examiner check at a Hearing Loss C&P exam?

Puretone thresholds (in decibels) at 500, 1000, 2000, 3000, and 4000 Hz — the 1000–4000 Hz average drives the rating The full list is on this page.

What should I bring to a Hearing Loss C&P exam?

A short written summary of your worst days: what happens, how often, how long it lasts. A symptom log or calendar if you keep one — dates beat memory. Names and doses of medications, and whether they actually help.

Hearing Loss: C&P Exam Prep

The C&P (Compensation & Pension) exam is where a hearing loss claim is usually won or lost. Here is exactly what the examiner measures, and how to describe your condition accurately and completely so the rating reflects your real life.

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Sources: 38 CFR Part 4 (rating schedule), VA DBQ 21-0960N-5

Describe your worst day and how often it happens — not your average day

C&P exams are snapshots. If you happen to feel okay that day and describe an okay day, that is what gets rated. The law (Sharp v. Shulkin) requires the examiner to account for your flare-ups and worst days, but only if you describe them. Give concrete frequency and duration: "three or four days a week I cannot…", "twice a month it lays me out for two days", not "sometimes it is bad."

The honest line: Report the full, honest picture — the bad days you tend to downplay included. Never invent or exaggerate symptoms. Overstating is both wrong and easy for an examiner to catch, and it can sink an otherwise valid claim.

What the examiner will assess

Taken from the Hearing Loss and Tinnitus DBQ (21-0960N-5) — these are the rating drivers.

1Puretone thresholds (in decibels) at 500, 1000, 2000, 3000, and 4000 Hz — the 1000–4000 Hz average drives the rating
2Maryland CNC controlled speech-recognition score (percent), required under 38 CFR 4.85
3Combining puretone average + speech score via Table VI to get a Roman-numeral designation for each ear
4Exceptional patterns (38 CFR 4.86): 55 dB+ at all four frequencies, or 30 dB or less at 1000 Hz with 70 dB+ at 2000 Hz
5Whether test results are valid and consistent with the examination

How the rating tiers work

The examiner's findings map onto these tiers under 38 CFR 4.85 and 4.86, DC 6100 (hearing impairment). Rating is determined by audiometric tables, not a fixed symptom ladder.. Know which describes your real function so you can report the details that matter.

0%The evaluation is set by mapping the puretone threshold average (1000, 2000, 3000, 4000 Hz) and the Maryland CNC speech discrimination score for each ear to a Roman numeral on Table VI or VIa, then combining both ears on Table VII. Many service-connected hearing losses evaluate at 0 percent. Intermediate evaluations between 0 and 100 percent are determined solely by the table intersection and cannot be expressed as a symptom-based ladder.

100%The maximum 100-percent evaluation requires the poorest hearing impairment (Roman numeral Level XI) in both ears under Table VII.

Symptoms to describe (if you have them)

• Difficulty understanding speech
• Need to increase TV/radio volume
• Frequently asking people to repeat
• Difficulty in noisy environments
• Tinnitus (ringing in ears)
• Feeling of fullness in ears

Functional limits that raise a rating

• Difficulty in conversations
• Problems in group settings
• Trouble on telephone
• Safety concerns (can't hear alarms/warnings)
• Social isolation
• Employment difficulties

Which exam you might get

In-person exam

A clinician examines you at a VA facility or a contractor (LHI, QTC, VES, MSLA). Bring your notes; you can hand them over.

Telehealth / video

Same questions over video. Have your notes on paper, not the same screen, and a quiet, private space.

Records-only (ACE)

No appointment — the examiner reviews your file. Everything rests on what is already documented, so your statements and medical records must carry the full picture.

Mention connected (secondary) conditions

Hearing Loss commonly leads to these. If you have any, raise them — they can each be rated on their own, and examiners will not connect the dots for you.

Tinnitus Depression Anxiety Meniere's Disease Vertigo

What to bring

✓ A short written summary of your worst days: what happens, how often, how long it lasts.
✓ A symptom log or calendar if you keep one — dates beat memory.
✓ Names and doses of medications, and whether they actually help.
✓ Any private treatment records the VA may not have.
✓ A buddy statement or family note describing what they witness, if you have one.
✓ Your list of secondary conditions you believe are connected (see below).

Terms the examiner uses, in plain English

Prostrating: So severe you have to stop what you are doing and lie down (used for migraines).

Ankylosis: A joint frozen or fused so it cannot move at all — very different from "stiff" or "limited."

Occupational and social impairment: How much the condition hurts your ability to work AND to keep up relationships — the driver for mental-health ratings.

Flare-up: A period when the condition gets temporarily worse. Frequency and duration matter as much as severity.

Functional loss: What you cannot do because of the condition — lift, walk, focus, sleep, be around people.

Range of motion (ROM): How far a joint moves, measured in degrees. Report where PAIN begins, not just where motion stops.

Painful motion: Motion that hurts counts toward a rating even if the joint still moves — say exactly where the pain starts.

Deficiencies in most areas: A higher mental-health tier: the condition damages work, school, family, mood, and judgment across the board.

Before and after the exam

Hearing Loss rating & evidence

The full 38 CFR breakdown and the peer-reviewed studies behind the claim.

Build the claim & statement

Chart your claim and draft your personal statement first.

Educational content, not professional advice

This article is published by Military Transition Toolkit for educational and planning purposes. It is not legal, medical, or financial advice. VA rating criteria, benefits, and regulations change — verify anything benefits-affecting against VA.gov, 38 CFR Part 4, or a VA-accredited representative (VSO, agent, or attorney) before filing.

MTT is a veteran-owned planning tool and is not affiliated with or endorsed by the Department of Veterans Affairs, the Department of Defense, or any military branch.

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