How is a VA Claim for Tinnitus Denied? 7 Reasons Why

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In this post, we’ll answer the question: “How is a VA Claim for Tinnitus Denied?”

Being denied the VA benefits you’re rightfully owed can feel like a stomach-punch (we know—nobody likes to feel like they’re being called a liar).

Stick with it fellow veterans—the VA claim process NEVER ends unless you quit!

In our experience, the most common reason for a tinnitus claim denial is there’s no diagnosis of the disability in a medical record.  

The second main reason for a VA tinnitus claim denial is there is no link or connection, called a “Nexus,” back to a specific in-service injury or event within a 60-day window.

Also, keep in mind that you might have done everything right, and yet, still got denied tinnitus benefits because of human error or a mistake—it happens all-the-time. 

Or maybe you got a bad C&P exam and got denied VA benefits for Tinnitus even though you had a Nexus Letter from a private healthcare provider.

Whatever the reason for your Tinnitus VA claim denial, here’s the 7 most common reasons why plus a 3-step process to fight back legally & ethically.

How is a VA Claim for Tinnitus Denied?

The 7 most common reasons why the VA denied your tinnitus claim:

• No diagnosis of tinnitus in a medical record (e.g., service treatment records, VA medical records, or private medical records).

• No evidence of hearing loss. Note: This should NOT be a factor for denying a tinnitus claim because Hearing Loss and Tinnitus are separate claims with different etiology.

• No specific event or injury during service that led to the tinnitus (e.g., no “nexus” for service-connection).

• Not specifically stating a time-frame during military service of when the tinnitus started (you should know the 60-day window of when your tinnitus symptoms began).

• Not knowing which ear(s) is affected by tinnitus (right, left, or both).

• Not have “recurrent” tinnitus.

• Not being able to describe your tinnitus symptoms and how they negatively affect your work, life, and social functioning.

VA Tinnitus Claim Denied? Next Steps

Step #1: Review Your Rating Decision Letter

Ugh … you want to know: “How is a VA claim for tinnitus denied?”

That’s probably the first thing you searched for online when you looked inside VA.gov and saw “not service-connected.”

If your VA claim for tinnitus was denied, the first thing you should do is review your VA rating decision letter, specifically, the section headers marked “evidence” and “reasons for decision.”

In the “Evidence” section, make sure ALL your submitted evidence is listed and was considered by the VA rater.

For example, it’s possible your Buddy Letter or Nexus Letter for Tinnitus wasn’t submitted or maybe it wasn’t reviewed by the VA rater prior to denying the claim.

Next, in the “Reasons for Decision” section, make sure to read in-detail the rationale and reason(s) for the denial.

Common errors include not considering some or all the evidence, discounting the probative value of the medical evidence, or making an illogical “less likely than not” argument against service connection by failing to consider all relevant facts.

For example, let’s say you were a gunner on convoys in Iraq in 2007.

There is no question you were exposed to enemy gunfire, IED explosions, or heavy equipment (noise exposure).

However, the C&P examiner might write something like this:

“It’s likely the veteran’s Tinnitus is due to his post-service career working as an electrician. He said he does not wear proper hearing protection. It’s less likely than not that his Tinnitus was due to military noise exposure.”

This is a classic logical error of a “causal link” that’s inapposite to the facts of the VA claim.

The C&P examiner did not even consider the veteran’s military MOS, the Duty MOS Noise Exposure Listing, deployment duties, and timeframe of exposure.

For example, when did the veteran’s Tinnitus symptoms begin?

Did the veteran’s symptoms begin in-service, during the deployment, or after leaving active duty?

In this example, the C&P examiner completely missed the actual link for service connection and failed to address all pertinent facts during the exam.

Finally, the VA Rater simply copy and pasted the C&P examiners notes into the rating decision letter and denied the claim for service connected Tinnitus.

This VA claim should be awarded in favor of the veteran upon a Higher Level Review (HLR) to correct the error made by both the C&P examiner and VA Rater.

Step #2: File a Higher Level Review

After having your VA tinnitus claim denied and following Step #1 (reviewing your VA Rating Decision Letter), the next step is to file a Higher Level Review online on VA.gov.

The VA Higher Level Review (HLR) is the first of three appeal options under the Appeals Modernization Act.

It allows you to “challenge” a VA rating denial WITHOUT adding new and material evidence to the claim.

This is a solid first step if your VA claim for Tinnitus was denied with a nexus letter because it allows you to ask a more senior level adjudicator to review the previous decision, and possibly overturn the denial due to an error or omission.

In addition, the Higher Level Review can be helpful following a poor C&P exam in which you received the dreaded “less likely than not” (less than 50% chance) that your disability was caused or made worse by your military service.

Why?

Because the new claims adjudicator can order a new C&P exam for Tinnitus, which gives you a fresh look from a new examiner.

With the Higher Level Review, we still recommend a veteran writes a 1-3 page Memorandum for Record detailing your position of record, making sure to address any legal facts and arguments relevant to your claim.

Step #3: File a Supplemental Claim

If your Higher Level Review gets denied, the next step is to file a Supplemental Claim using the VA Form 20-0995 and the VA Direct Upload Tool.

Unlike the Higher Level Review, the Supplemental Claim option allows you to submit “New” and “Relevant” evidence not previously considered.

• New evidence is information the VA didn’t have before the last claim decision.
• Relevant evidence is information that could prove or disprove something in your claim.

For example, maybe your Nexus Letter for Tinnitus wasn’t uploaded to your VA claim the first time.

Or maybe you want to submit a new Buddy Letter from a competent and credible first-hand witness who can describe when and how the ringing in your ears (Tinnitus) began in the military.

Using the Supplemental Claim option, you can attach documents to your Decision Review Request: Supplemental Claim (VA Form 20-0995) and submit them to the VA for consideration.

With the Supplemental Claim, we still recommend a veteran writes a 1-3 page Memorandum for Record detailing your claim position, noting any errors in the Higher Level Review denial, and making sure to address any legal facts and arguments relevant to your case.

Final Thoughts on Tinnitus VA Claims: Probative Value Matters

Not all Nexus Letters are created equally nor are they offered equal weight by the VA.

Thus, a privately prepared Nexus Letter does NOT guarantee service connection.

Veterans must ensure their Nexus Letter for Tinnitus has high probative value:

“For a Nexus Letter to have high probative value in support of a veteran’s claim for VA disability benefits, it should be thorough, factual, and include convincing, evidenced-based rationale. The letter should also include all records reviewed as well as relevant medical research reports and BVA decisions used to help support the doctor’s independent medical opinion. The strongest nexus letters include a nexus statement with the words “at least as likely as not” assuming the independent medical provider believes the veteran’s condition is due to their military service (or another service connected disability).”

– Brian Reese, VA Benefits Expert and #1 Amazon Bestselling Author of You Deserve It: The Definitive Guide to Getting the Veteran Benefits You’ve Earned & VA Claim Secrets: Expert Tips and Proven Strategies to Win Your VA Disability Claim Faster

What VA Claim Evidence Has High Probative Value?

Evidence may have more (or less) PROBATIVE VALUE. 

Medical evidence is medical evidence.

All competent and credible evidence of record must be reviewed by the VA Rater (and considered) prior to making a VA claim decision.

However, not all evidence is created or weighted equally. 

According to M21-1, Adjudication Procedures Manual, evidence has HIGH Probative Value if it:

• Makes a matter material to the determination and
• Has sufficient weight, either by itself or in combination with other evidence, to persuade the decision maker about a fact.

What Factors Determine the Probative Value of Evidence in a VA Disability Claim?

The following factors are important considerations in determining the probative value of evidence:

• Competency
• Credibility
• Thoroughness
• Precision
• Relevancy, and
• Date of the evidence

In addition, VA Raters must consider the key elements listed below when evaluating the probative value and relative weight of medical evidence such as a diagnosis/assessment, prognosis, or opinion on etiology/onset:

• Physician’s qualifications
  • Expertise/specialty, and
  • Experience
• Physician’s knowledge of the relevant history
  • The accuracy or validity of history provided by the patient or examinee
  • Review of records and other evidence, or
  • Length of time the physician has treated the Veteran
• Context in which the medical evidence was created
  • Treatment, or
  • Substantiation of a medical disability claim
• Reasoning employed by the physician
  • Theory
  • Observation
  • Practice
  • Clinical testing
  • Subjective report, and
  • Conjecture
• Degree of specificity, and
• Degree of certainty

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