Meniere’s Disease VA Disability Ratings

What is Meniere’s Disease?

Meniere’s disease is a disorder of the inner ear that can lead to vertigo (i.e., dizzy spells) and hearing loss.  In the majority of cases, Meniere’s disease only affects one ear; however, it is possible for both ears to be affected.  While Meniere’s disease can occur at any age, its onset typically takes place in young and middle-aged adulthood.  Importantly, Meniere’s disease is considered to be a chronic condition.  Nonetheless, there are various treatments to help with symptom relief and minimizing any long-term negative impact.  Common signs and symptoms of Meniere’s disease include the following:

• Recurring episodes of vertigo (i.e., spinning sensation that starts and stops spontaneously; can cause nausea)
• Hearing loss (temporary or permanent)
• Tinnitus (i.e., ringing, buzzing, roaring, whistling, or hissing sound in the ear)
• Feeling of fullness in the affected ear (i.e., aural fullness)

The cause of Meniere’s disease is unknown, yet symptoms appear to be the result of an abnormal amount of fluid in the inner ear.  More than likely, the disease is caused by a combination of factors that affect the fluid in the inner ear, such as:

• Improper fluid drainage (caused by blockage or anatomic abnormality)
• Abnormal immune response
• Viral infection
• Genetic predisposition

Over time, the frequency of episodes may decrease, and signs and symptoms may diminish.  However, it is still important to recognize that the disease can be very debilitating and individuals coping with this condition should seek treatment when necessary.  Prior to receiving treatment, individuals should be diagnosed with Meniere’s disease.  Doctors will usually conduct an examination and take a medical history.  An official diagnosis of Meniere’s disease requires:

• Two episodes of vertigo, each lasting 20 minutes or longer but not longer than 12 hours
• Hearing loss verified by a hearing test
• Tinnitus or a feeling of fullness in the ear
• Exclusion of other known causes of these complications

Again, Meniere’s disease is a chronic condition for which there is no cure.  A number of treatments may help reduce the severity and frequency of vertigo episodes; however, there are no treatments for the hearing loss.  Most commonly, doctors will prescribe motion sickness medications and anti-nausea medications for individuals to take during vertigo episodes.  Other procedures may include:

• Rehabilitation: If experiencing balance issues between episodes of vertigo, vestibular rehabilitation therapy may improve balance.
• Hearing aids: Again, there is no treatment for hearing loss but hearing aids may help improve hearing.
• Positive pressure therapy: Involves applying pressure to the middle ear to lessen fluid buildup.
• Middle ear injections: Medications injected into the middle ear, and then absorbed into the inner ear, may improve vertigo symptoms.
• Surgery: If vertigo associated with the disease is severe and debilitating, surgery might be an option.

VA Service Connection for Meniere’s Disease

In order to receive VA disability benefits for Meniere’s disease, veterans must first prove to VA that their condition is the result of their active-duty military service.  For direct service connection, they must establish the following three elements: (1) a current, diagnosed ear condition; (2) an in-service event that may have caused or contributed to their current diagnosis; and (3) a medical opinion definitively linking the in-service event to their Meniere’s disease.  In this case, a medical opinion from an audiologist may be particularly helpful.

How VA Rates Meniere’s Disease

VA rates Meniere’s disease under 38 CFR § 4.87, Schedule of Ratings – Ear, Diagnostic Code 6205.  The rating criteria are as follows:

• 100% – hearing impairment with attacks of vertigo and cerebellar gait occurring more than once weekly, with or without tinnitus
• 60% – hearing impairment with attacks of vertigo and cerebellar gait occurring from one to four times a month, with or without tinnitus
• 30% – hearing impairment with vertigo less than once a month, with or without tinnitus

Importantly, Meniere’s disease should be evaluated according to either the criteria outlined above or by separately evaluating vertigo (i.e., as a peripheral vestibular disorder), hearing impairment, and tinnitus, whichever results in a higher overall evaluation.  However, evaluations for hearing impairment, tinnitus, or vertigo, cannot be combined with an evaluation under Diagnostic Code 6205.

Total Disability Based on Individual Unemployability (TDIU)

Total disability based on individual unemployability (TDIU) is reserved for veterans who are unable to work as a result of their service-connected condition(s).  Essentially, TDIU is an alternative path to receiving a 100 percent disability rating.  Veterans do not need to have a 100 percent combined disability rating to receive TDIU.  Rather, they must only prove that their service-connected condition(s) prevents them from working.

Importantly, working can be difficult for those who cope with Meniere’s disease due to the unpredictable vertigo attacks that may strike at any time.  Physical work can be dangerous as well, due to the risk of falling or losing balance.  Even sedentary work may become difficult, as episodes of vertigo can often cause individuals to lose their focus and concentration.  Hearing loss may also impair an individual’s ability to perform certain work-related tasks.  If you believe your Meniere’s disease is preventing you from obtaining and maintaining substantially gainful employment, you should consider applying for TDIU.