Noise-Induced Cochlear Synaptopathy (Hidden Hearing Loss)

DC 6100Organs of Sense38 CFR 4.85, DC 6100

A type of hearing damage where you have difficulty understanding speech in noisy environments even though your standard hearing test (audiogram) shows normal results. The damage is at the connection between hair cells and nerve fibers in the cochlea. The VA rates this condition based on word recognition scores using the Maryland CNC test.

How the VA rates this condition

The VA rates this condition based on objective clinical measurements and test results. The examiner will use standardized tests or lab values to determine the severity of your condition rather than relying primarily on subjective symptom reports.

Diagnostic code

DC 6100

Rating range

0% – 10%

Rating levels

Rating criteria are defined in 38 CFR 4.85, DC 6100. This guide presents a plain-language summary and is not a substitute for the full regulatory text. Always consult a VSO or VA-accredited attorney for case-specific advice.

Rating Levels

Your word recognition scores on the Maryland CNC test show a deficit even though your standard hearing thresholds are normal or near-normal. The combination of your puretone average and speech discrimination score results in a compensable rating under the VA hearing loss tables.

What the VA looks for

Maryland CNC word recognition score between 84-92%
Pure-tone audiometry at or near normal limits
Documented military noise exposure (weapons, engines, aircraft, explosions)
Audiologist statement noting disproportionate speech discrimination deficit
Functional impact on communication in noisy environments documented

Common Pitfalls

⚠Not requesting the Maryland CNC word recognition test specifically — the standard audiogram may show normal hearing, but the word recognition test can reveal the hidden damage. Make sure the C&P examiner administers this test.
⚠Not documenting your specific military noise exposure in detail — include weapon systems, vehicles, aircraft, generators, and any blast exposures. Your MOS and duty stations can corroborate noise exposure.
⚠Assuming you cannot file because your audiogram is normal — the VA rates hearing loss using both puretone thresholds AND speech discrimination scores. A low word recognition score can qualify you for a rating even with a normal audiogram.
⚠Not filing for tinnitus as a separate claim — hidden hearing loss and tinnitus frequently co-occur from the same noise exposure, and tinnitus has its own diagnostic code (DC 6260) with a 10% rating.
⚠Not getting a nexus letter from an audiologist who understands cochlear synaptopathy — this is a relatively new area of audiology research, and a specialist opinion explaining how noise exposure damages cochlear synapses strengthens the claim.

Related DBQ Forms

DBQ Hearing Loss and Tinnitus

View evidence checklist →See secondary conditions →

Condition Rating Guides

Understand what the VA looks for at each rating level — loading conditions…

Noise-Induced Cochlear Synaptopathy (Hidden Hearing Loss)

How the VA rates this condition

Diagnostic code

DC 6100

Rating range

0% – 10%

Rating levels

Rating Levels

What the VA looks for

Maryland CNC word recognition score between 84-92%
Pure-tone audiometry at or near normal limits
Documented military noise exposure (weapons, engines, aircraft, explosions)
Audiologist statement noting disproportionate speech discrimination deficit
Functional impact on communication in noisy environments documented

Common Pitfalls

⚠Not requesting the Maryland CNC word recognition test specifically — the standard audiogram may show normal hearing, but the word recognition test can reveal the hidden damage. Make sure the C&P examiner administers this test.

⚠Not documenting your specific military noise exposure in detail — include weapon systems, vehicles, aircraft, generators, and any blast exposures. Your MOS and duty stations can corroborate noise exposure.

⚠Assuming you cannot file because your audiogram is normal — the VA rates hearing loss using both puretone thresholds AND speech discrimination scores. A low word recognition score can qualify you for a rating even with a normal audiogram.

⚠Not filing for tinnitus as a separate claim — hidden hearing loss and tinnitus frequently co-occur from the same noise exposure, and tinnitus has its own diagnostic code (DC 6260) with a 10% rating.

⚠Not getting a nexus letter from an audiologist who understands cochlear synaptopathy — this is a relatively new area of audiology research, and a specialist opinion explaining how noise exposure damages cochlear synapses strengthens the claim.