Tinnitus is one of the most prevalent conditions among veterans’ post-service.
In fact, tinnitus is the #1 most common service-connected disability recognized by the VA, with 2,944,093 veterans currently receiving benefits for it.
While tinnitus has a maximum VA rating of 10%, did you know a service-connected rating for tinnitus might be worth a 100% combined VA disability rating?
That’s right—by filing secondary claims for conditions linked to your service-connected tinnitus, you might significantly increase your combined VA rating.
In this blog post, we’ll dive into the key aspects of secondary claims, the evidence you’ll need, a detailed list of conditions commonly secondary to tinnitus, and some expert tips and strategies to help you secure the VA disability benefits you’re entitled to.
Pro Tip: The VA has proposed changes that will eliminate the standalone 10% rating for subjective tinnitus. Under the new rules, tinnitus would only be rated as part of an underlying condition, like hearing loss. If your hearing loss is rated at 10% or higher, there would be no separate rating for tinnitus. However, if hearing loss is rated at 0%, a 10% tinnitus rating could still be assigned if it’s linked to the hearing loss. Click here to learn more about the VA rating changes for tinnitus.
Table of Contents
Summary of Key Points
- Tinnitus is the #1 most common service-connected disability among veterans, with nearly 3 million veterans currently receiving benefits for it. While the maximum VA rating for tinnitus is 10%, it can contribute to a much higher combined VA disability rating when linked to secondary conditions.
- Filing high-value secondary claims for conditions related to tinnitus—such as anxiety, depression, or Meniere’s disease—can significantly increase your overall VA disability rating, potentially helping you reach a 100% combined rating.
- Establishing secondary service connection requires meeting specific criteria, including a medical diagnosis of the secondary condition, evidence of a service-connected primary disability, and a nexus letter linking the secondary condition to tinnitus.
- The VA has proposed changes that may eliminate the standalone 10% tinnitus rating, meaning tinnitus could only be rated as part of an underlying condition, like hearing loss. If the hearing loss is rated at 10% or higher, no separate tinnitus rating would be provided.
How to Prove Secondary Service Connection
In accordance with 38 CFR § 3.310 disabilities that are proximately due to or aggravated by or the result of a service-connected disease or injury shall be service connected.
Secondary conditions require a “showing of causation.”
A showing of causation requires that the secondary VA claim is “proximately due to” or “aggravated by” another service-connected disability.
There are three evidentiary elements that must be satisfied to prove VA secondary service connection under the law:
- A medical diagnosis of the secondary VA disability you’re attempting to link to the current service-connected disability (must be documented in a medical record) and
- A current service-connected primary disability (e.g., your current list of service-connected disabilities from your VA.gov account) and
- Medical nexus evidence establishing a connection between the service-connected primary condition and the current disability (e.g., headaches secondary to tinnitus)
Click here for a list of the top 100 secondary claims for secondary service connection.
What Do I Need to Prove for VA Secondary Service Connection?
- The first pillar can be satisfied with any existing medical evidence in service treatment records, VA medical records, or any private medical records that show a diagnosis of the condition you’re going to connect secondary to tinnitus.
- The second pillar can be satisfied with a veteran’s existing service-connected disability rated at 0% or higher, which is the tinnitus rated at 10%.
- The third pillar, and often the missing link needed to establish secondary service connection, can be satisfied with a nexus letter from a private healthcare provider that shows the connection between the new condition and tinnitus.
Click here to learn how to find doctors who write VA nexus letters for veterans.
How a 10% VA Rating for Tinnitus Could Result in a 100% Combined VA Disability Rating
Here’s a step-by-step process that explains how secondary claims to service-connected tinnitus could get you a 100 percent VA rating combined:
Step #1: Confirm Your Service-Connected Tinnitus Rating
Before you can pursue additional disability benefits, you must already have a service-connected VA rating for tinnitus at 10%. This is the baseline requirement because any secondary conditions you claim must be linked to this already established primary condition. If you don’t have this rating yet, you’ll need to secure it before moving forward with secondary claims.
Step #2: Obtain a Medical Diagnosis for a Secondary Condition
You need a current medical diagnosis for any secondary condition you plan to link to your tinnitus, such as anxiety, depression, headaches, Meniere’s disease, TMJ disorders, high blood pressure, or insomnia. This diagnosis should be well-documented in your medical records, as it forms the foundation of your secondary claim. Without a clear diagnosis, your secondary claim will lack the necessary support.
Step #3: Secure a Nexus Letter Linking the Conditions
A nexus letter is a crucial document that establishes a connection between your service-connected tinnitus and the secondary condition(s) you’re claiming. This letter should be written by a qualified healthcare provider who can clearly explain how your tinnitus has either caused or aggravated your secondary condition. The nexus letter provides the necessary medical rationale that ties everything together for the VA’s review.
Step #4: File a New Claim for Secondary Conditions
Once you have your nexus letter and supporting medical records, it’s time to file a new claim on VA.gov. When doing so, make sure to list the secondary conditions and specify that they are related to your service-connected tinnitus. Upload all relevant documents, including your medical records and nexus letter(s), to provide comprehensive evidence supporting your claim.
Step #5: Consider Filing Multiple Secondary Claims to Maximize Your Rating
Don’t limit yourself to a single secondary condition. Veterans are encouraged to file multiple secondary claims if they have more than one condition linked to tinnitus. For example, you could claim anxiety, depression, and headaches as separate secondary conditions. Each condition requires its own medical diagnosis and nexus letter, but together, they can significantly boost your combined VA rating. For instance, you could receive a 70% VA rating for anxiety secondary to tinnitus and a 50% rating for headaches secondary to tinnitus. Depending on the number and severity of secondary conditions connected to your tinnitus, it’s entirely possible to achieve a 100% combined VA disability rating based on secondary claims related to your 10% tinnitus rating alone.
Step #6: Prepare for the Compensation & Pension (C&P) Exam
After filing your claim, you’ll likely be scheduled for a C&P exam. This exam is crucial, as a VA examiner will assess the severity of your secondary conditions and their connection to your tinnitus. Here’s some C&P exam tips to educate yourself on the process and be ready to explain how each condition affects your daily life, providing specific examples to help the examiner understand the impact on your overall health and well-being.
Step #7: Stay Organized and Persistent Throughout the Process
The VA claims process can be challenging, with potential delays and complications. It’s important to keep all your documentation organized and to stay on top of your claim’s progress. Follow up regularly to ensure that your claim is being processed, and don’t hesitate to seek assistance from a VA-accredited representative. Your persistence can make a significant difference in the outcome of your claim. Don’t ever quit or give up on the fight!
List of Secondary Conditions to Tinnitus for VA Disability
Here’s a comprehensive list of secondary conditions that can be associated with tinnitus:
1. Hearing Loss
Explanation: Hearing loss is often closely linked with tinnitus, as both conditions can result from damage to the auditory system. Veterans exposed to loud noises during service, such as gunfire, explosions, or machinery, often experience both hearing loss and tinnitus.
VA Ratings: Hearing loss is rated based on the severity and impact on daily life. Ratings can range from 0% to 100%, but most veterans receive a rating between 0% and 10%. Higher ratings are assigned if the hearing loss significantly impairs communication and daily activities.
2. Traumatic Brain Injury (TBI)
Explanation: Traumatic Brain Injury (TBI) can result from a blow or jolt to the head and is common among veterans who have experienced combat or accidents. TBI can exacerbate or even cause tinnitus, along with cognitive, emotional, and physical impairments.
VA Ratings: TBI is rated based on the severity of residuals, which can include cognitive impairment, physical limitations, and emotional disturbances. Ratings range from 0% to 100%, depending on the severity and impact on daily life.
3. Meniere’s Disease
Explanation: Meniere’s disease is an inner ear disorder that causes episodes of vertigo, hearing loss, and tinnitus. It can severely impact balance and hearing, making daily activities challenging.
VA Ratings: Meniere’s Disease is rated under Diagnostic Code 6205. The ratings are 30% for less frequent vertigo, 60% for moderate vertigo, and 100% for severe and frequent episodes that significantly impact life.
4. Anxiety
Explanation: Anxiety is a mental health condition that can be worsened by the persistent noise of tinnitus. The constant ringing or buzzing can lead to heightened anxiety, stress, and other mental health challenges.
VA Ratings: Anxiety is rated under the General Rating Formula for Mental Disorders, with ratings ranging from 0% to 100%. The rating depends on the severity of symptoms and how much they interfere with daily life.
5. Depression
Explanation: Depression can be exacerbated by chronic tinnitus, as the constant noise can interfere with sleep, concentration, and overall quality of life, leading to feelings of hopelessness and sadness.
VA Ratings: Depression is also rated under the General Rating Formula for Mental Disorders, with ratings from 0% to 100%, depending on the impact on occupational and social functioning.
6. Post-Traumatic Stress Disorder (PTSD)
Explanation: PTSD is a mental health condition that occurs after experiencing or witnessing a traumatic event. Veterans with PTSD often report tinnitus, with each condition potentially aggravating the other.
VA Ratings: PTSD is rated under the General Rating Formula for Mental Disorders, with ratings ranging from 0% to 100%. The severity of symptoms and their impact on daily life determines the rating.
7. TMJ Disorders (Temporomandibular Joint Disorders)
Explanation: TMJ disorders affect the jaw joint and muscles, and can contribute to or worsen tinnitus symptoms. Veterans with TMJ may experience jaw pain, headaches, and ringing in the ears.
VA Ratings: TMJ Disorders are rated under Diagnostic Code 9905, with ratings ranging from 10% to 50% based on the degree of limited motion of the jaw and associated symptoms.
8. Hypertension (High Blood Pressure)
Explanation: Hypertension can increase the severity of tinnitus by affecting blood flow to the inner ear. Veterans with high blood pressure may experience more pronounced tinnitus symptoms.
VA Ratings: Hypertension is rated under Diagnostic Code 7101, with ratings ranging from 10% to 40%, depending on the severity of the condition and blood pressure readings.
9. Sleep Disorders
Explanation: Tinnitus can lead to sleep disorders such as insomnia, making it difficult to fall or stay asleep. Conversely, sleep disorders can also exacerbate tinnitus symptoms.
VA Ratings: Sleep disorders are rated under different Diagnostic Codes depending on the condition. For example, Sleep Apnea is rated from 0% to 100%, with a 50% rating if a CPAP machine is required.
10. Migraine Headaches
Explanation: Migraines are severe headaches often accompanied by nausea, sensitivity to light and sound, and in some cases, tinnitus. Veterans with migraines may find that their tinnitus worsens during an episode.
VA Ratings: Migraines are rated under Diagnostic Code 8100, with ratings ranging from 0% to 50%, based on the frequency and severity of the attacks.
11. Fibromyalgia
Explanation: Fibromyalgia is a chronic condition characterized by widespread pain and tenderness, and it can be associated with tinnitus. Veterans with fibromyalgia often experience fatigue, sleep disturbances, and cognitive issues.
VA Ratings: Fibromyalgia is rated under Diagnostic Code 5025, with ratings ranging from 10% to 40%, depending on the severity and frequency of symptoms.
12. Thyroid Disorders (Hypothyroidism or Hyperthyroidism)
Explanation: Thyroid disorders can cause or worsen tinnitus by affecting the body’s metabolism and overall health. Both hypothyroidism and hyperthyroidism can lead to changes in hearing and increase tinnitus symptoms.
VA Ratings: Hypothyroidism is rated under Diagnostic Code 7903, with ratings from 10% to 100%. Hyperthyroidism is rated under Diagnostic Code 7900, with ratings depending on the severity and impact on health.
13. Atherosclerosis
Explanation: Atherosclerosis is the hardening of the arteries, which can lead to pulsatile tinnitus, where the ringing in the ears matches the heartbeat. This condition can significantly impact hearing and health.
VA Ratings: Atherosclerosis is rated under various Diagnostic Codes depending on the affected area, with ratings ranging from 20% to 100% based on severity.
14. Lyme Disease
Explanation: Lyme disease is a tick-borne illness that can affect the nervous system, potentially leading to tinnitus as one of the symptoms. Veterans exposed to ticks during service may develop this condition.
VA Ratings: Lyme Disease is rated under Diagnostic Code 6319, with ratings from 10% to 100% based on the severity of symptoms and residual effects.
15. Otosclerosis
Explanation: Otosclerosis is the abnormal bone growth in the middle ear that can lead to hearing loss and tinnitus. It is a progressive condition that can significantly affect hearing.
VA Ratings: Otosclerosis is rated under the same codes as hearing loss, typically ranging from 0% to 100% based on the level of hearing impairment.
16. Diabetes
Explanation: Diabetes can cause nerve damage (neuropathy), which may contribute to tinnitus. Poor blood sugar control can lead to complications that affect hearing and overall health.
VA Ratings: Diabetes Mellitus is rated under Diagnostic Code 7913, with ratings ranging from 10% to 100% depending on the severity and management of the disease.
17. Multiple Sclerosis (MS)
Explanation: Multiple Sclerosis is a neurological condition that can damage the nerves involved in hearing, potentially leading to tinnitus. Veterans with MS may experience a range of symptoms, including tinnitus.
VA Ratings: MS is rated under Diagnostic Code 8018, with ratings from 30% to 100% based on the severity and progression of the disease.
18. Head and Neck Injuries
Explanation: Injuries to the head and neck can impact the auditory system and result in tinnitus. Veterans who have experienced trauma in these areas may develop tinnitus as a secondary condition.
VA Ratings: Head and neck injuries are rated under various codes depending on the specific injury and its residual effects, with ratings ranging widely based on the severity.
19. Autoimmune Inner Ear Disease (AIED)
Explanation: AIED is a condition where the immune system attacks the inner ear, leading to hearing loss, vertigo, and tinnitus. It can be a progressive and debilitating condition.
VA Ratings: AIED may be rated similarly to Meniere’s Disease or hearing loss, with ratings depending on the specific symptoms and severity.
20. Eustachian Tube Dysfunction
Explanation: Eustachian Tube Dysfunction can lead to pressure problems in the ear, contributing to tinnitus symptoms. This condition affects the ear’s ability to regulate pressure, leading to discomfort and hearing issues.
VA Ratings: Eustachian Tube Dysfunction can be rated analogously to chronic otitis media or hearing loss, typically ranging from 0% to 10%.
21. Acoustic Neuroma
Explanation: Acoustic Neuroma is a benign tumor on the nerve that connects the ear to the brain, leading to tinnitus, hearing loss, and balance issues. It is a rare but serious condition that can significantly impact quality of life.
VA Ratings: Acoustic Neuroma is often rated under Diagnostic Code 6208, with malignant growths warranting a 100% rating, and residuals rated according to the specific symptoms, such as hearing loss or balance problems.
22. Barotrauma
Explanation: Barotrauma refers to ear damage caused by changes in pressure, such as during air travel or diving. This condition can result in tinnitus, hearing loss, and ear pain.
VA Ratings: Barotrauma-related tinnitus or hearing loss is typically rated under the same codes as hearing loss or tinnitus.
23. Side Effects of Medications
Explanation: Certain medications, particularly ototoxic drugs, can cause or worsen tinnitus. These include some antibiotics, diuretics, and chemotherapy drugs, which can damage the inner ear or auditory nerves, leading to tinnitus.
VA Ratings: The VA does not rate tinnitus caused by medication under a separate Diagnostic Code. Instead, the rating would depend on the underlying condition or the extent of the hearing damage caused by the medication. Tinnitus caused by medication is typically rated at 10% under Diagnostic Code 6260, the standard rating for tinnitus.
Connecting tinnitus with these secondary conditions can potentially increase your overall VA disability rating, as each of these conditions may qualify for additional compensation.
What is the Highest VA Rating for Tinnitus?
The maximum schedular VA rating for tinnitus is 10%.
However, it’s possible to receive additional compensation through an extraschedular rating, such as Total Disability based on Individual Unemployability (TDIU), which can allow you to be paid at the 100% disability rate even if your overall combined rating isn’t 100%.
Additionally, tinnitus can be linked to several high-value secondary conditions, potentially leading to a higher overall VA disability rating when these connections are established.
Can I Have More Than One Condition Connected Secondary to Tinnitus?
Yes, you can have multiple conditions connected secondary to tinnitus.
For example, you could get approved for secondary service connection for anxiety secondary to tinnitus, headaches secondary to tinnitus, and Meniere’s disease secondary to tinnitus, and so on.
There is no limit to the number of conditions that can be connected on a secondary basis.
You can also connect secondary conditions to secondary conditions.
For example, you might be able to service connect headaches secondary to tinnitus, and vertigo secondary to headaches.
What Is the Process for Filing a Secondary Claim?
Filing a secondary claim involves several steps.
First, ensure that you have a medical diagnosis for the secondary condition you wish to connect to your primary service-connected disability, such as tinnitus.
Next, gather evidence, including medical records and a nexus letter from a healthcare provider that establishes the connection between the two conditions.
After that, file a claim through VA.gov, providing all necessary documentation.
Lastly, prepare for a possible C&P exam, where a VA examiner will assess your conditions.
Do I Need a Nexus Letter for Each Secondary Condition?
Yes, a nexus letter is a good idea for each secondary condition you are claiming.
This letter should clearly explain how your primary service-connected disability (e.g., tinnitus) has caused or aggravated the secondary condition.
Without this evidence, the VA may deny the connection between the two conditions.
What If My Secondary Condition Is Aggravated by Tinnitus, But Not Directly Caused by It?
Even if a condition is not directly caused by tinnitus but is aggravated by it, you can still file a secondary claim.
The VA allows for conditions to be service-connected on an aggravation basis, which means that if your tinnitus worsens another condition, you could be eligible for additional benefits.
Can I Receive TDIU Based on Secondary Conditions Connected to Tinnitus?
Possibly, if your secondary conditions connected to tinnitus prevent you from maintaining substantial gainful employment.
You might qualify for Total Disability based on Individual Unemployability (TDIU).
TDIU allows you to receive compensation at the 100% disability rate, even if your combined disability rating is less than 100%.
Watch: How a 10% VA Rating for Tinnitus Could Be Worth 100% Combined!
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About the Author
Brian Reese
Brian Reese is a world-renowned VA disability benefits expert and the #1 bestselling author of VA Claim Secrets and You Deserve It. Motivated by his own frustration with the VA claim process, Brian founded VA Claims Insider to help disabled veterans secure their VA disability compensation faster, regardless of their past struggles with the VA. Since 2013, he has positively impacted the lives of over 10 million military, veterans, and their families.
A former active-duty Air Force officer, Brian has extensive experience leading diverse teams in challenging international environments, including a combat tour in Afghanistan in 2011 supporting Operation ENDURING FREEDOM.
Brian is a Distinguished Graduate of Management from the United States Air Force Academy and earned his MBA from Oklahoma State University’s Spears School of Business, where he was a National Honor Scholar, ranking in the top 1% of his class.
