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June 30, 2022

Can I Get a VA Rating for Insomnia Secondary to Tinnitus? (The Insider’s Guide)

Last updated on December 5, 2022

I hope you enjoy reading this blog post.

If you want to learn how to implement these strategies to get the VA benefits you deserve, click here to speak with a VA claim expert for free.

Brian Reese here with VA Claims Insider, and in this expert-level post, I’m going to reveal and explain how to get a VA Rating for Insomnia Secondary to Tinnitus.

We’ll also explore the “3 Magic Pillars” of VA secondary service connection to include mission critical medical evidence requirements.

Finally, we’ll uncover tips, strategies, and lessons learned for getting a Nexus Letter for Insomnia Secondary to Tinnitus (with high probative value) to help you prove secondary service connection under the law and avoid a VA claim denial.

All right, let’s jump-in.

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How Common is Insomnia in Veterans?

Insomnia in Veterans

Very common!

The bottom line is veterans don’t sleep well or hardly at all.

There’s a joke in the veteran community that goes like this: “I once got 8 hours of sleep … it only took me 3 days.”


But the truth is, Insomnia is no laughing matter and can lead to all sorts of problems.

Insomnia is a sleep disorder characterized by the inability to fall asleep, stay asleep, or both.

This may cause you to still feel tired all the time.

Insomnia can drain your energy level, mood, health, work performance, and quality of life.

There are two primary types of insomnia:

  • Acute Insomnia, which lasts for days or weeks. It’s usually the result of stress or a traumatic event.
  • Chronic Insomnia, which lasts for a month or more. Insomnia may be the primary problem, or it may be associated with other medical conditions or medications.

Insomnia Secondary to Tinnitus: Is There a Connection?

Insomnia Secondary to Tinnitus

Yes, there is a significant relationship between Insomnia and Tinnitus.

One study from 2020 found that patients with Tinnitus also suffered from severe Insomnia symptoms.

A whopping 60% of those Tinnitus patients met strict diagnostic criteria of Insomnia secondary to Tinnitus.

In addition, the data suggests that Tinnitus patients with co-morbid Insomnia have a more severe form of Tinnitus, and thus, may need further care and treatment.

Another study from 2015 found that 76% of all Tinnitus patients in the sample suffer from Insomnia.

This finding emphasizes that Insomnia represents a major problem for those who have chronic Tinnitus.

VA Disability Ratings for Insomnia Explained:

How is Insomnia Rated by the VA?

Medical Research Studies:

Insomnia in Tinnitus Patients: A Prospective Study Finding a Significant Relationship

Psychophysiological Associations between Chronic Tinnitus and Sleep: A Cross Validation of Tinnitus and Insomnia Questionnaires

BVA Case History Example:

Service Connection for Insomnia Secondary to Tinnitus is Granted

Can I Service Connect VA Disability Tinnitus Secondary Insomnia and Depression?

VA Disability Tinnitus Secondary Insomnia and Depression

Yes, there is evidence to support Tinnitus Secondary to Insomnia and Depression.

The key is you’ll want to obtain a Nexus Letter from a private provider to help strengthen your argument to the VA.

If you need a Nexus Letter for a secondary claim, we can help!

What is the VA Rating for Insomnia Secondary to Tinnitus?

VA Rating for Insomnia Secondary to Tinnitus

The VA rates Insomnia secondary to Tinnitus under CFR Title 38, Part 4, Schedule for Rating Disabilities, Diagnostic Codes (DC) for Mental Disorders.

It’s important to note that Insomnia does not have its own Diagnostic Code (DC) under the general rating schedule.

Thus, because the symptoms of Insomnia are most closely related to mental disorders, Insomnia is rated “analogous” to mental disorders, which have ratings of 0%, 10%, 30%, 50%, 70%, or 100%.

For example, you could get a 70 percent VA rating for Insomnia secondary to Tinnitus.

What is the VA Disability Rating for Insomnia Secondary to Tinnitus?

VA Rating Scale for Insomnia Secondary to TinnitusVA Rating
Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name.100%
Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships.70%
Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships.50%
Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, Insomnia, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events).30%
Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by continuous medication.10%
A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication.0%

VA Insomnia Secondary to Tinnitus: What is a VA Secondary VA Claim?

VA Secondary Condition Insomnia and Tinnitus

In accordance with 38 CFR § 3.310 disabilities that are proximately due to, or aggravated by, service-connected disease or injury, a current disability condition, which is proximately due to or the result of a service-connected disease or injury shall be service connected.

VA 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 account) AND
  • Medical nexus evidence establishing a connection between the service-connected primary condition AND the current disability, which in this example is Insomnia secondary to Tinnitus

VA secondary conditions include any of the 900+ disabilities listed in CFR Title 38, Part 4, the Schedule for Rating Disabilities that can be service connected SECONDARY to a current VA disability you’re already rated for at 0% or higher.

The Caluza Triangle and VA Secondary Claims: What Do I Need to Prove Secondary Service Connection?

Caluza Triangle VA Disability

The FIRST part can be satisfied with any existing medical evidence in service treatment records, VA medical records, or any private medical records that shows a diagnosis of Insomnia.  

The SECOND part can be satisfied with a veteran’s existing service-connected disability rated at 0% or higher, which is your Tinnitus.

The THIRD part, and often the missing link needed to establish secondary service connection, can be satisfied with a credible Nexus Letter (Independent Medical Opinion) from a private healthcare provider that shows the connection between Insomnia and Tinnitus.

>> Click HERE for a list of Doctors Who Write VA Nexus Letters for Veterans!

Did you know there are HUNDREDS of common secondary VA claims that you can get service connected by law?

Here’s a truth bomb fellow veterans…

You could be missing out on thousands of dollars of tax-free disability compensation you deserve by law, and not even realize that your current VA disability might be caused or aggravated by an existing service connected disability.

Pro Tip: A Nexus Letter with “high probative value” is RECOMMENDED to help establish secondary service connection.


Because “Medical Nexus Evidence” is needed to satisfy the third evidentiary element that must be satisfied to prove your secondary VA claim on an “at least as likely as not” basis.

Need a Nexus Letter for Insomnia Secondary to Tinnitus?

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We’re a company OF veterans, BY veterans, FOR veterans and we’ve helped 15,000+ veterans increase their VA rating since 2016.

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At VA Claims Insider, we help veterans get the VA disability rating they deserve in less time, if you’ve already filed, been denied, or gave up.

About the Author

Brian Reese
Brian Reese

Brian Reese

Brian Reese is one of the top VA disability benefits experts in the world and bestselling author of You Deserve It: The Definitive Guide to Getting the Veteran Benefits You’ve Earned (Second Edition).

Brian’s frustration with the VA claim process led him to create VA Claims Insider, which provides disabled veterans with tips, strategies, and lessons learned to win their VA disability compensation claim, faster, even if they’ve already filed, been denied, gave up, or don’t know where to start. 

As the founder of VA Claims Insider and CEO of Military Disability Made Easy, he has helped serve more than 10 million military members and veterans since 2013 through free online educational resources.

He is a former active duty Air Force officer with extensive experience leading hundreds of individuals and multi-functional teams in challenging international environments, including a combat tour to Afghanistan in 2011 supporting Operation ENDURING FREEDOM.

Brian is a Distinguished Graduate of Management from the United States Air Force Academy, Colorado Springs, CO, and he holds an MBA from Oklahoma State University’s Spears School of Business, Stillwater, OK, where he was a National Honor Scholar (Top 1% of Graduate School class).

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