How VA Rates Vertigo and Meniere's Disease: DC 6204 & DC 6205 Guide

The VA rates inner ear balance conditions under two primary diagnostic codes in 38 CFR 4.87. Diagnostic Code 6204 covers peripheral vestibular disorders, including Benign Paroxysmal Positional Vertigo (BPPV), vestibular neuronitis, and labyrinthitis. Diagnostic Code 6205 specifically governs Meniere's disease (endolymphatic hydrops), which presents with a characteristic triad of episodic vertigo, fluctuating sensorineural hearing loss, and tinnitus.

Under 38 CFR 4.87, Diagnostic Code 6204 assigns either a 10% or 30% rating based on dizziness and gait stability. A 30% rating is awarded for dizziness and occasional staggering. A 10% rating is awarded for occasional dizziness. A critical schedular note mandates that objective findings supporting the diagnosis of vestibular disequilibrium are required before a compensable evaluation can be assigned under DC 6204. Subjective dizziness alone cannot support a compensable rating. Furthermore, DC 6204 does not use a generic mild, moderate, or severe rating ladder, nor is it based on a frequency-only attack ladder. Hearing impairment or suppuration shall be separately rated and combined.

Meniere's disease under DC 6205 provides three rating tiers: 30%, 60%, and 100%. A 30% rating is assigned for hearing impairment with vertigo occurring less than once a month, with or without tinnitus, without requiring cerebellar gait. A 60% rating is awarded for hearing impairment with attacks of vertigo and cerebellar gait occurring one to four times a month, with or without tinnitus. A 100% rating is assigned for hearing impairment with attacks of vertigo and cerebellar gait occurring more than once weekly, with or without tinnitus.

A critical note to DC 6205 mandates that Meniere's syndrome is evaluated either: (A) under DC 6205, or (B) by separately evaluating vertigo as a peripheral vestibular disorder under DC 6204, hearing impairment under DC 6100, and tinnitus under DC 6260, whichever method results in the higher overall evaluation. Raters must calculate both approaches and grant whichever evaluation provides the greatest benefit. However, adjudicators cannot combine a DC 6205 evaluation with separate hearing loss, tinnitus, or vertigo evaluations when those manifestations are being used to support DC 6205.

Compensation and pension examiners evaluate vestibular disorders using the official form titled "VA Ear Conditions (Including Vestibular and Infectious Conditions) Disability Benefits Questionnaire." Clinical balance conditions like Benign Paroxysmal Positional Vertigo (BPPV) are documented as clinical diagnoses on the DBQ, but BPPV does not possess its own independent schedular diagnostic code and is evaluated under DC 6204 or by analogy based on documented functional impairment. For VA rating purposes, a hearing-impairment examination must be conducted by a state-licensed audiologist and include Maryland CNC controlled speech-discrimination testing and puretone audiometry without hearing aids under 38 CFR 4.85. The specialized Hearing Loss and Tinnitus DBQ itself is not available for public use on VA's public DBQ page. Key evidence includes electronystagmography (ENG), videonystagmography (VNG), rotary chair testing, and clinical balance tests like the Romberg test.