Vertigo and Meniere's Claims Guide

Vertigo, dizziness, and the balance problems that come from inner-ear damage are common after acoustic trauma, blasts, head injuries, and ear infections, yet they are among the most under-claimed conditions veterans carry. The VA rates them in two places: peripheral vestibular disorders under DC 6204, and Meniere's syndrome under DC 6205. Both turn on one thing most veterans miss: objective test findings, not just how you feel. This guide explains how each code works, the either-or rule that decides Meniere's, and the evidence that wins.

What Peripheral Vestibular Disorders and Meniere's Are

Peripheral vestibular disorders are problems in the inner-ear balance system that cause vertigo (a spinning sensation), dizziness, and disequilibrium (a feeling of being off balance, sometimes with staggering). This bucket includes labyrinthitis, vestibular neuritis, and the lasting residuals of positional vertigo. They are rated under diagnostic code 6204. Meniere's syndrome (endolymphatic hydrops) is a specific inner-ear disorder that brings attacks of vertigo together with fluctuating hearing loss, tinnitus, and a feeling of fullness in the ear. It is rated under diagnostic code 6205. Both sit in the ear schedule (see 38 CFR § 4.87).

The rating needs objective proof. Under the Note to DC 6204, the VA cannot assign a compensable (10 percent or higher) rating for vestibular disequilibrium unless objective findings support the diagnosis. Balance testing, not just your description of the dizziness, is what unlocks the rating.

How Vertigo Gets Service Connected

Direct. An inner-ear injury or illness that began in service: acoustic trauma or blast exposure, a head injury, barotrauma from diving or flight, an ototoxic medication, or labyrinthitis and ear infections documented at the time, with a current diagnosis and a nexus.
Secondary. Vertigo caused or worsened by another service-connected condition. The common paths are a traumatic brain injury, migraine (vestibular migraine), chronic ear disease, or a neck injury driving cervicogenic dizziness. See secondary conditions.
Increased rating. An already service-connected vestibular condition that has gotten worse, more frequent attacks or new staggering, can be re-rated higher.

Across published DC 6204 decisions, here is how often the Board granted by the legal theory the claim was argued on:

Vertigo is not a presumptive. There is no exposure list that connects dizziness automatically, and claims argued on a presumptive or exposure theory grant at the lowest rate above. Vertigo is won on a direct in-service event or a secondary link to a condition like TBI or migraine, backed by objective testing.

Common Secondary Conditions

Inner-ear balance problems connect to other claims in both directions, usually through a shared injury or the ear itself. Each bar below is the Board's grant rate for DC 6204 in that pairing, with the number of decisions under it. They describe the published record across many veterans, not a prediction about any one claim.

Conditions linked as causing vertigo (vertigo as the secondary)

Claims where a vestibular disorder was argued as secondary to an already service-connected condition, hearing loss, tinnitus, TBI, migraine, ear disease, and more:

Conditions vertigo is linked to causing (vertigo as the primary)

Conditions veterans have claimed as caused or aggravated by a service-connected vestibular disorder:

How the VA Rates Vertigo (DC 6204): Dizziness and Staggering

Peripheral vestibular disorders are rated on two findings: how often you are dizzy, and whether the dizziness is bad enough to make you stagger.

Rating	What it takes
30%	Dizziness and occasional staggering
10%	Occasional dizziness

Two rules in the Note to DC 6204 decide most of these claims. First, objective findings supporting a diagnosis of vestibular disequilibrium are required before any compensable rating can be assigned, self-reported dizziness alone is not enough. Second, hearing impairment and ear suppuration are rated separately and combined, so a vestibular rating does not absorb your hearing loss.

Objective findings means testing. The findings that support a vestibular diagnosis come from balance studies: electronystagmography or videonystagmography (ENG or VNG), rotary-chair testing, caloric testing, posturography, or a documented positive Romberg or Dix-Hallpike on exam. If the file has only your account of the dizziness, the rating usually comes in at zero.

How the VA Rates Meniere's Syndrome (DC 6205): Attack Frequency

Meniere's is rated on how often the vertigo attacks strike and whether they come with cerebellar gait (a wide, unsteady, staggering walk), plus hearing impairment.

Rating	What it takes
100%	Hearing impairment with attacks of vertigo and cerebellar gait more than once a week, with or without tinnitus
60%	Hearing impairment with attacks of vertigo and cerebellar gait one to four times a month, with or without tinnitus
30%	Hearing impairment with vertigo less than once a month, with or without tinnitus

The either-or election. The Note to DC 6205 lets the VA rate Meniere's one of two ways, whichever gives you the higher overall evaluation: as a single rating under 6205, or by separately rating the vertigo (as a peripheral vestibular disorder), the hearing loss, and the tinnitus and combining them. It cannot do both, you do not stack a 6205 rating on top of separate vertigo, hearing, and tinnitus ratings. For veterans with strong hearing loss but infrequent attacks, the separate-and-combine method sometimes wins a higher number; for veterans with frequent, disabling attacks, the single 6205 rating usually does.

Go deeper: open the full vestibular breakdown

What the VA measures at your C&P exam
Evidence that has won at the Board
Inside the rater's playbook: grant, denial, and remand rates
Secondary condition map

See the full DC 6204 breakdown →

Evidence That Wins

Objective balance testing, ENG or VNG, rotary-chair, caloric, or posturography results. This is the finding the compensable rating is built on, and its absence is the single most common reason these claims fail.
An attack diary, dated, with the frequency and duration of each vertigo spell, whether you staggered or fell, and any hearing change or tinnitus at the time. Frequency is what drives both the 6204 staggering row and every Meniere's row.
An audiogram, especially one showing fluctuating low-frequency hearing loss, which supports a Meniere's diagnosis and feeds the separate-and-combine election.
A nexus opinion. The bars above show the lift: files with a private medical opinion, or both a private and VA opinion, granted at roughly twice the rate of files with no opinion at all.
The Ear Conditions DBQ, which captures the vestibular findings, attack frequency, and gait the ratings depend on. See the DBQ guide.

Common Mistakes

The same handful of missteps account for most lost or under-rated vertigo claims. Among the Board's classified service-connection denials for DC 6204, here is what claims most often fell short on:

No objective testing. A compensable vestibular rating requires objective findings. Self-reported dizziness with nothing in the file to support it, no ENG or VNG, no documented positive exam, usually rates at zero.
Filing vertigo as a presumptive. Dizziness is not on any exposure list. Claims argued on a presumptive theory grant at the lowest rate; the direct or secondary path with a nexus is the one that works.
Double-dipping Meniere's. You cannot carry a 6205 rating and separate vertigo, hearing, and tinnitus ratings at the same time. Pick the method that combines higher, not both.
No attack diary. Meniere's rows and the 6204 staggering row all turn on frequency. A vague "I get dizzy sometimes" undercounts what a dated log of weekly attacks would have shown.
Missing the secondary link. Dizziness that started after a head injury, or that travels with migraine, is often ratable as secondary to TBI or migraine. Filing it as an unconnected new problem throws that link away.

Frequently Asked Questions

How does the VA rate vertigo and dizziness?

Under diagnostic code 6204, peripheral vestibular disorders are rated 30 percent for dizziness with occasional staggering, or 10 percent for occasional dizziness. A key rule applies: the VA cannot assign any compensable rating unless objective findings, such as ENG or VNG balance testing, support the diagnosis. Self-reported dizziness alone rates at zero.

What is the difference between DC 6204 and DC 6205?

DC 6204 covers peripheral vestibular disorders in general, vertigo, dizziness, and disequilibrium from inner-ear problems like labyrinthitis. DC 6205 covers Meniere's syndrome specifically, where attacks of vertigo come together with fluctuating hearing loss and tinnitus. Meniere's carries higher possible ratings (up to 100 percent) because it bundles the vertigo, hearing loss, and gait problems.

Can I get 100 percent for Meniere's syndrome?

Yes. The top rating under DC 6205 is 100 percent, for hearing impairment with attacks of vertigo and cerebellar gait occurring more than once a week. It requires documented, frequent, disabling attacks, which is why an attack diary and balance testing matter so much.

Should Meniere's be rated under 6205 or as separate conditions?

Whichever gives you the higher overall rating. The Note to DC 6205 lets the VA rate it either as a single 6205 evaluation, or by separately rating the vertigo, hearing loss, and tinnitus and combining them, but not both. Frequent, severe attacks usually favor the single 6205 rating; strong hearing loss with infrequent attacks sometimes favors the separate-and-combine method.

Is vertigo covered by the PACT Act or any presumptive?

No. Vertigo and vestibular disorders are not on any presumptive or PACT Act exposure list. They are service connected on a direct basis (an in-service injury or illness) or as secondary to another condition such as a traumatic brain injury or migraine, with a medical nexus.

What testing proves a vestibular disorder?

Objective balance studies: electronystagmography or videonystagmography (ENG or VNG), rotary-chair testing, caloric testing, and posturography, along with a documented positive Romberg or Dix-Hallpike on exam. These are the objective findings DC 6204 requires before a compensable rating can be assigned.

Related Tools and Guides

DC 6204, peripheral vestibular disorders

The code page with rating levels and BVA data.

DC 6205, Meniere's syndrome

The Meniere's code page with rating levels and BVA data.

Hearing Loss and Tinnitus Guide

The two conditions that most often travel with vertigo.

TBI Claims Guide

The head-injury path that vertigo is often secondary to.

Migraine Claims Guide

Vestibular migraine and the dizziness that comes with it.

Nexus Letters

The medical link a direct or secondary claim turns on.

Sources: 38 CFR 4.87, schedule of ratings for the ear · VA, disability eligibility. Educational only, not legal advice, and not a prediction of any individual claim. Rating criteria change; confirm current details in 38 CFR 4.87. For help with your claim, find a VA-accredited representative.