Meniere's Disease & Vertigo VA Rating

Overview

Meniere's syndrome (endolymphatic hydrops) features vertigo, fluctuating hearing loss, and tinnitus.

VA allows the veteran to choose the higher of: (a) the DC 6205 rating, or (b) separate ratings for each component.

In Depth

Ménière's syndrome (endolymphatic hydrops) is evaluated under DC 6205 in 38 CFR § 4.87. The code is structured around the combination of hearing impairment with attacks of vertigo and cerebellar gait, and the tiers turn on the frequency of those attacks — how many times per month they occur — together with whether staggering is present.

A note to DC 6205 provides that VA evaluates Ménière's syndrome either under the DC 6205 criteria or by separately evaluating vertigo (as a peripheral vestibular disorder under DC 6204), hearing impairment, and tinnitus, whichever method results in the higher evaluation — but the note prohibits combining the separate evaluations with a DC 6205 evaluation.

DC 6204 addresses peripheral vestibular disorders and is written around occasional dizziness versus dizziness with occasional staggering. A note to that code provides that objective findings supporting the diagnosis of vestibular disequilibrium are required before a compensable evaluation may be assigned, and that hearing impairment or suppuration is rated separately.

How to Establish Service Connection

• Direct: in-service onset or noise exposure with documented post-service development.
• Secondary: aggravated by service-connected hearing loss / tinnitus.

Rating Criteria

Paraphrased from 38 CFR § 4.87, Diagnostic Code 6205

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Evidence Checklist

• ENT specialist diagnosis.
• Vestibular testing (ENG/VNG).
• Documentation of attack frequency.

Evidence Templates

Common formats of evidence the VA looks for in this type of claim. These describe what the documents typically include — they are not legal forms or medical opinions, and Oakridge Claims does not draft them.

Evidence VA Commonly Cites in These Claims

Descriptive summary of evidence types frequently referenced in rating decisions for this condition. Not a checklist of actions to take — every claim is decided on its own facts.

• ★Attack frequency is the core variable in DC 6205's tiers, so contemporaneous clinical documentation of how often episodes occur is what the code is applied to.
• ★Objective vestibular testing — such as ENG/VNG or caloric testing — addresses the objective-findings requirement in the note to DC 6204.
• ★Because the DC 6205 note contemplates an alternative separate-evaluation method, having a current audiogram in the record allows both methods to be compared.
• ★Documentation of falls, staggering, or prescribed activity restrictions relates directly to the language used in the criteria.

Common pitfalls VA sees

• Expecting DC 6205 and separate vertigo, hearing, and tinnitus evaluations at the same time, which the code's note addresses.
• Claiming vertigo without objective vestibular findings, given the note to DC 6204.
• Not documenting episode frequency over time when the criteria are frequency-based.

Frequently Asked Questions