Vertigo, the sensation of spinning or whirling dizziness, is common among service members, often resulting from issues within the inner ear or the brain’s balance centers. The Department of Veterans Affairs (VA) does not rate vertigo as a standalone condition but evaluates it under specific Diagnostic Codes for vestibular disorders. The process centers on proving the condition is connected to service and documenting the functional impairment caused by the frequency and severity of the episodes. The ultimate rating reflects the condition’s impact on daily life and ability to maintain employment.
Establishing Service Connection
Before the VA can assign any disability rating for vertigo, a service connection must be formally established. This foundational step requires a veteran to demonstrate three specific elements that link the current health issue to their military service.
The first element is a current medical diagnosis of a vestibular disorder that causes vertigo symptoms, confirmed by a qualified healthcare professional. The second requirement is evidence of an in-service event, injury, or exposure that could have caused or aggravated the condition, such as documented head trauma, prolonged noise exposure, or an inner ear infection during active duty.
Finally, a medical nexus is required, which is a professional medical opinion stating that the veteran’s current diagnosis is “at least as likely as not” due to the in-service event.
Service connection can be established directly, if the condition originated during service, or secondarily, if the vertigo is caused or aggravated by an already service-connected disability, such as Tinnitus or a traumatic brain injury (TBI). Furthermore, aggravation occurs if a pre-existing condition was made permanently worse beyond its natural progression by military service.
The Rating System for Vestibular Disorders
The VA rates conditions causing vertigo under the Schedule for Rating Disabilities for Diseases of the Ear, using two primary diagnostic codes based on the underlying cause. Peripheral vestibular disorders, such as Benign Paroxysmal Positional Vertigo (BPPV) and generalized vertigo, are rated under Diagnostic Code (DC) 6204. Ratings under this code are limited to 10% for occasional dizziness or 30% for dizziness accompanied by occasional staggering.
Meniere’s Syndrome, an inner ear disorder characterized by episodes of vertigo, hearing loss, and tinnitus, is rated under DC 6205. The rating criteria are tied to the frequency and severity of prostrating attacks—episodes severe enough to require the veteran to lie down. A 30% rating is assigned for hearing impairment with vertigo occurring less than once a month.
A 60% rating is assigned if the veteran experiences hearing impairment with attacks of vertigo and cerebellar gait (a wide, staggering walk) occurring one to four times a month. The highest schedular rating of 100% is assigned for attacks occurring more than once weekly. The rating under DC 6205 is a single, comprehensive evaluation that includes the symptoms of vertigo, hearing impairment, and tinnitus.
The VA will determine the most advantageous method for the veteran, either rating Meniere’s Syndrome as a whole under DC 6205 or separately rating the individual components (vertigo under DC 6204, hearing loss, and tinnitus) and combining them. However, if the veteran is rated under DC 6205, they cannot receive additional separate ratings for the associated hearing loss or tinnitus.
Required Medical Evidence and Examinations
To support a vertigo claim, the VA requires objective medical evidence demonstrating the existence and severity of the vestibular dysfunction. Submitting continuous treatment records, including notes from neurologists or Ear, Nose, and Throat (ENT) specialists, is important for establishing the chronic nature of the condition. These records should specifically detail the frequency, severity, and duration of the vertigo episodes and the extent of functional limitations.
Objective tests are often used to measure the balance system’s function. These can include:
- Videonystagmography (VNG) or Electronystagmography (ENG), which track eye movements to assess the vestibular system.
- Caloric testing.
- Rotary chair testing.
For peripheral vestibular disorders rated under DC 6204, VA regulation requires objective findings of vestibular disequilibrium before a compensable rating can be assigned.
A Compensation and Pension (C&P) examination, conducted by a VA or contract clinician, is mandatory. During this examination, the clinician reviews the veteran’s history, conducts physical maneuvers like the Romberg or Dix-Hallpike tests, and completes a Disability Benefits Questionnaire (DBQ). The examiner’s focus is to confirm the diagnosis and determine the current severity of the symptoms, particularly the impact of prostrating attacks on the veteran’s ability to function.
Linking Vertigo to Secondary Conditions
Vertigo often co-occurs with other conditions, particularly those stemming from inner ear issues, which can be rated as secondary disabilities to increase overall compensation. The most common secondary conditions are Tinnitus, which is the perception of sound where none is present, and Hearing Loss. These are rated under their own Diagnostic Codes (DC 6260 for Tinnitus and the DC 6100 series for Hearing Loss).
The maximum rating for Tinnitus is a fixed 10%, while the rating for Hearing Loss is determined by an audiometric examination. For peripheral vestibular disorders (DC 6204), any associated hearing loss or tinnitus is rated separately and combined with the vertigo rating. This separate evaluation is often beneficial to veterans.
In contrast, under the Meniere’s Syndrome criteria (DC 6205), the symptoms of hearing impairment and tinnitus are integrated into the syndrome’s percentage rating. Therefore, a veteran rated for Meniere’s cannot receive separate compensation for related hearing loss or tinnitus. Establishing a secondary connection requires a medical nexus opinion that directly links the onset or worsening of the secondary condition to the primary service-connected disability.