Top 10 VA Secondary Conditions to Tinnitus for Disability Benefits

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Did you know tinnitus is the #1 most common service-connected VA disability overall?

Yep, it’s true.

The constant ringing, buzzing, or hissing is an all-too-common issue among veterans due to noise exposure during service.

But what many don’t realize is that tinnitus is often just the beginning—this condition frequently leads to a range of other serious health issues.

Many of these secondary conditions can be connected to your service-connected tinnitus and may be eligible for additional VA disability benefits.

Establishing these secondary conditions can increase your overall VA disability rating and, consequently, the compensation you rightfully deserve for serving our country.

In this high-value blog post from VA disability expert Brian Reese, we’ll break down the Top 10 Secondary Conditions to Tinnitus and Their VA Ratings, supported by current medical research.

Pro Tip: The VA is updating its rating criteria for tinnitus in 2025, but don’t let that stop you from filing secondary claims related to this condition. Even with these changes, you’re still eligible to seek compensation for conditions like migraines, anxiety, or depression caused or worsened by tinnitus. Rest assured, your right to claim these secondary conditions remain intact and unaffected by upcoming changes.

Summary of Key Points

• Tinnitus as a Gateway Condition: Tinnitus, the #1 most common service-connected VA disability, often leads to more serious secondary health conditions due to the physical and psychological toll of the constant ringing or buzzing veterans experience. Many veterans don’t realize these secondary conditions may be eligible for VA disability compensation.

• Top 10 Secondary Conditions to Tinnitus: In this blog post by VA disability expert Brian Reese, veterans can explore the top 10 secondary conditions linked to tinnitus, with details on the VA disability ratings for each. Conditions like anxiety, depression, and Meniere’s Syndrome often co-occur and are supported by medical research as likely linked to tinnitus.

• Filing Secondary VA Claims: Establishing secondary conditions to tinnitus can increase a veteran’s overall VA disability rating. Filing claims for these related conditions with proper evidence, such as a nexus letter from a healthcare provider, can boost the compensation veterans are rightfully owed.

• Pro Tip on Tinnitus Rating Changes: Despite the VA’s upcoming 2025 changes to tinnitus rating criteria, veterans are still eligible to file secondary claims. Conditions like migraines, anxiety, and depression stemming from tinnitus will remain eligible for secondary compensation, unaffected by these rating updates.

What is Tinnitus for VA Disability?

Tinnitus, often referred to as “ringing in the ears,” is the perception of sound without an external source.

This condition commonly arises from exposure to loud noises, explosions, gunfire, or machinery during military service.

It’s the most claimed VA disability, with a maximum disability rating of 10% under 38 CFR § 4.87, Diagnostic Code 6260.

This rating cap of 10% applies regardless of whether tinnitus affects one or both ears (there is no bilateral factor for tinnitus), as the VA considers it a subjective condition that cannot be measured objectively beyond a veteran’s own report.

Establishing Secondary Service Connection for Tinnitus-Related Conditions

Under 38 CFR § 3.310, secondary service connection can be granted for disabilities that are proximately due to, caused, or aggravated by an existing service-connected condition.

To establish secondary service connection to tinnitus for VA disability benefits, three key elements are necessary:

• Current Diagnosis of the Secondary Condition: You must have a current diagnosis of the secondary condition in a medical record (e.g., anxiety, depression, Meniere’s syndrome, sleep apnea). Documentation from VA or private healthcare providers is crucial.

• Service-Connected Primary Condition (Tinnitus): Tinnitus must already be recognized as service-connected by the VA rated at 10%.

• Medical Nexus Evidence: A detailed explanation of the connection between tinnitus and the secondary condition is essential. A qualified private medical professional should provide a nexus letter for a secondary claim, explaining that the secondary condition is “at least as likely as not” caused or aggravated by tinnitus.

Remember this fellow veterans: MEDICAL EVIDENCE WINS VA DISABILITY CLAIMS!

A nexus letter for your secondary condition to tinnitus is often the linchpin between a VA claim approval and a denial.

10 Most Common Secondary Claims to Tinnitus for VA Disability

Below are the 10 most common conditions that may be claimed as secondary to tinnitus, listed alphabetically.

Anxiety Secondary to Tinnitus

The constant, uncontrollable noise of tinnitus can create severe mental strain, making veterans more susceptible to anxiety. This ongoing auditory intrusion disrupts focus and amplifies stress, often leaving veterans feeling trapped and powerless. The perpetual “ringing” or buzzing can provoke heightened anxiety, especially in otherwise quiet settings, causing veterans to experience persistent frustration, irritability, and a heightened state of nervousness. The combination of physical symptoms and the unrelenting noise can make daily life challenging and intensify mental health issues.

VA Disability Ratings for Anxiety Secondary to Tinnitus

The VA evaluates anxiety secondary to tinnitus under the General Rating Formula for Mental Disorders, assigning disability ratings from 0% to 100% based on the severity of symptoms and their impact on occupational and social functioning. The rating levels are:

• 0%: Symptoms are diagnosed but do not interfere with occupational and social functioning or require continuous medication.

• 10%: Mild or transient symptoms that decrease work efficiency only during periods of significant stress, or symptoms controlled by continuous medication.

• 30%: Occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, with generally satisfactory functioning.

• 50%: Reduced reliability and productivity due to symptoms like panic attacks more than once a week, difficulty understanding complex commands, and impaired judgment.

• 70%: Deficiencies in most areas such as work, school, family relations, judgment, thinking, or mood, with symptoms like suicidal ideation, near-continuous panic or depression, and impaired impulse control.

• 100%: Total occupational and social impairment due to symptoms like persistent delusions or hallucinations, grossly inappropriate behavior, and intermittent inability to perform activities of daily living.

Depression Secondary to Tinnitus

The chronic nature of tinnitus can take a significant psychological toll, leading to depression in many veterans. As the sound often prevents them from experiencing peace or silence, veterans can feel isolated and struggle with feelings of helplessness. The condition may restrict them from engaging fully in social activities, hobbies, and everyday pleasures, exacerbating feelings of sadness and loneliness. Over time, this diminished quality of life, combined with the persistent stress of tinnitus, can deepen into clinical depression, leaving veterans with limited emotional resilience and a sense of hopelessness.

VA Disability Ratings for Depression Secondary to Tinnitus

The VA evaluates depression secondary to tinnitus under the General Rating Formula for Mental Disorders, assigning disability ratings from 0% to 100% based on the severity of symptoms and their impact on occupational and social functioning. The rating levels are:

• 0%: Symptoms are diagnosed but do not interfere with occupational and social functioning or require continuous medication.

• 10%: Mild or transient symptoms that decrease work efficiency only during periods of significant stress, or symptoms controlled by continuous medication.

• 30%: Occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, with generally satisfactory functioning.

• 50%: Reduced reliability and productivity due to symptoms like panic attacks more than once a week, difficulty understanding complex commands, and impaired judgment.

• 70%: Deficiencies in most areas such as work, school, family relations, judgment, thinking, or mood, with symptoms like suicidal ideation, near-continuous panic or depression, and impaired impulse control.

• 100%: Total occupational and social impairment due to symptoms like persistent delusions or hallucinations, grossly inappropriate behavior, and intermittent inability to perform activities of daily living.

Hearing Loss Secondary to Tinnitus

Hearing loss and tinnitus frequently go hand-in-hand, both resulting from damage to the auditory system, often due to noise trauma during service. When hearing diminishes, the brain may try to fill in the lost sound frequencies, which can make tinnitus more noticeable and harder to ignore. This compounded effect can make communication, social interactions, and work more challenging, increasing frustration and further isolating veterans from those around them.

VA Disability Ratings for Hearing Loss Secondary to Tinnitus

The VA rates hearing loss secondary to tinnitus under CFR Title 38, Part 4, Schedule for Rating Disabilities, DC 6100, Hearing Loss, with ratings ranging from 0% to 100% depending on the frequency, severity, and duration of symptoms.

Hyperacusis Secondary to Tinnitus

Hyperacusis, an extreme sensitivity to sound, often accompanies tinnitus. Everyday noises that wouldn’t normally be bothersome can become intolerably loud or painful, making daily environments uncomfortable or even unbearable. Veterans experiencing hyperacusis may avoid social gatherings, work environments, or other places with unpredictable noise levels, leading to social withdrawal and challenges in maintaining a typical routine. This heightened sensitivity not only impacts social and work life but can contribute to ongoing psychological stress.

VA Disability Rating for Hyperacusis Secondary to Tinnitus

Hyperacusis is not a ratable VA disability on its own. However, you may be eligible for a VA rating if you develop a condition linked to your hyperacusis, such as tinnitus. This concept will become especially important when the separate, stand-alone VA rating for tinnitus goes away with the 2025 VA disability rating changes.

Insomnia Secondary to Tinnitus

The relentless noise of tinnitus becomes particularly disturbing in quiet nighttime settings, significantly disrupting sleep for many veterans. The inability to escape the sound can make falling and staying asleep difficult, leading to chronic insomnia. Over time, this lack of restorative sleep can result in exhaustion, mood swings, and cognitive issues, creating a cycle where the stress of sleeplessness exacerbates tinnitus perception, further reducing sleep quality and overall well-being.

VA Disability Ratings for Insomnia Secondary to Tinnitus

The VA evaluates insomnia secondary to tinnitus under the General Rating Formula for Mental Disorders, assigning disability ratings from 0% to 100% based on the severity of symptoms and their impact on occupational and social functioning. Oftentimes, insomnia is rated as a symptom of another ratable mental health condition. The rating levels are:

• 0%: Symptoms are diagnosed but do not interfere with occupational and social functioning or require continuous medication.

• 10%: Mild or transient symptoms that decrease work efficiency only during periods of significant stress, or symptoms controlled by continuous medication.

• 30%: Occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, with generally satisfactory functioning.

• 50%: Reduced reliability and productivity due to symptoms like panic attacks more than once a week, difficulty understanding complex commands, and impaired judgment.

• 70%: Deficiencies in most areas such as work, school, family relations, judgment, thinking, or mood, with symptoms like suicidal ideation, near-continuous panic or depression, and impaired impulse control.

• 100%: Total occupational and social impairment due to symptoms like persistent delusions or hallucinations, grossly inappropriate behavior, and intermittent inability to perform activities of daily living.

Meniere’s Syndrome Secondary to Tinnitus

Meniere’s Syndrome is a complex inner ear disorder that includes tinnitus, vertigo, and hearing loss. For veterans with tinnitus, Meniere’s Disease introduces additional balance and spatial orientation issues, making daily activities risky or challenging. Episodes of vertigo—characterized by intense spinning sensations—can lead to falls or accidents and prevent veterans from driving, working, or performing tasks that require physical coordination. The unpredictability of these episodes can add to the emotional toll, affecting veterans’ independence and confidence.

VA Disability Ratings for Meniere’s Syndrome Secondary to Tinnitus

The VA rates Meniere’s syndrome secondary to tinnitus as an ear condition under CFR 38, Part 4, VA Schedule of Ratings, Diagnostic Code 6205, Meniere’s Syndrome (Endolymphatic Hydrops), with ratings of 30%, 60%, or 100% as follows:

• 30% Rating: Hearing impairment with vertigo less than once a month, with or without tinnitus.

• 60% Rating: Hearing impairment with attacks of vertigo and cerebellar gait occurring from one to four times a month, with or without tinnitus.

• 100% Rating: Hearing impairment with attacks of vertigo and cerebellar gait occurring more than once weekly, with or without tinnitus.

Note: Evaluate Meniere’s Syndrome either under these criteria or by separately evaluating vertigo (as a peripheral vestibular disorder), hearing impairment, and tinnitus, whichever method results in a higher overall evaluation. But do not combine an evaluation for hearing impairment, tinnitus, or vertigo with an evaluation under diagnostic code 6205.

Migraines Secondary to Tinnitus

Tinnitus can act as a trigger for migraines or worsen existing migraine symptoms. The brain pathways that process sound and pain can interact in ways that make veterans with tinnitus more prone to migraines, resulting in severe headaches, nausea, and light sensitivity. For some, the intensity of the migraines may increase with tinnitus, leading to frequent and debilitating episodes. Managing both tinnitus and migraines can be challenging, and the combined effect can severely limit a veteran’s ability to work, socialize, or enjoy daily activities.

VA Disability Ratings for Migraines Secondary to Tinnitus

The VA rates migraines secondary to tinnitus from 0% to 50% under 38 CFR § 4.124a, Diagnostic Code 8100, depending on the frequency, severity, and duration of migraine attacks, as well as their impact on a veteran’s ability to function in work, life, and social settings as follows:

• 0% Rating: Assigned when migraines occur but do not produce prostrating attacks, meaning they have minimal or no significant impact on daily activities and do not require rest.

• 10% Rating: Given for migraines with characteristic prostrating attacks that occur on average once every two months over the last several months. These attacks may interfere with activities but are not frequent enough to cause significant functional impairment.

• 30% Rating: Applies when migraines involve characteristic prostrating attacks occurring on average once a month over the last several months. These attacks require rest and significantly disrupt daily functioning, making it challenging to engage in work or social activities during the episodes.

• 50% Rating: The highest rating, reserved for migraines with very frequent, completely prostrating, and prolonged attacks that are productive of severe economic inadaptability. This rating reflects a serious level of impairment, where migraines significantly affect the veteran’s ability to work or perform daily tasks consistently. Veterans can still qualify for a 50% rating even if they are employed, as the rating is based on the extent of the impairment caused by the migraine attacks, not the employment status itself.

Sleep Apnea Secondary to Tinnitus

The connection between tinnitus and sleep apnea is complex, but many veterans with tinnitus-related insomnia find that poor sleep quality increases their risk for sleep apnea. Fragmented sleep and difficulty achieving deep rest can contribute to obstructive sleep apnea (OSA), a condition where breathing repeatedly stops and starts during sleep. Veterans with both tinnitus and sleep apnea may experience more severe fatigue, irritability, and cognitive issues due to the compounded effects on sleep and overall health.

VA Disability Ratings for Sleep Apnea Secondary to Tinnitus

The VA ratings sleep apnea secondary to tinnitus from 0% to 50% under 38 CFR § 4.97, Diagnostic Code 6847. Ratings are based on the severity of symptoms and the required treatment as follows:

• 0% Rating: This rating is for veterans who have a diagnosis of Sleep Apnea but do not require continuous positive airway pressure (CPAP) or other breathing assistance. Symptoms might exist, but they don’t significantly impact daily functioning, work performance, or social interactions.

• 30% Rating: Veterans receive a 30% rating if their Sleep Apnea causes persistent daytime hypersomnolence (excessive daytime sleepiness). This level of impairment can lead to disruptions in daily life and challenges in maintaining regular activities due to fatigue and drowsiness.

• 50% Rating: A 50% rating is given to veterans who require a CPAP machine to manage their Sleep Apnea symptoms. CPAP therapy is typically prescribed when Sleep Apnea symptoms significantly interfere with quality of sleep, resulting in adverse effects on work, life, and social functioning. This rating acknowledges that the veteran’s condition requires ongoing treatment for effective management and to improve daily functioning.

• 100% Rating: The highest rating, 100%, is assigned for veterans with chronic respiratory failure due to Sleep Apnea, conditions involving carbon dioxide retention, or those requiring a tracheostomy. This rating reflects the most severe level of impairment, where Sleep Apnea severely impacts the veteran’s health and requires extensive medical intervention.

Somatic Symptom Disorder Secondary to Tinnitus

Somatic Symptom Disorder can develop when a person becomes excessively preoccupied with physical symptoms, like the unending noise of tinnitus. This preoccupation may lead veterans to dwell on their tinnitus, amplifying stress and emotional distress. Over time, the mental focus on tinnitus becomes overwhelming, turning the condition into a persistent source of worry. This constant fixation can result in anxiety and a cyclical pattern of heightened symptom awareness, making it difficult for veterans to focus on other areas of life.

VA Disability Ratings for Somatic Symptom Disorder Secondary to Tinnitus

The VA rates somatoform disorders secondary to tinnitus under the General Rating Formula for Mental Disorders, assigning disability ratings from 0% to 100% based on the severity of symptoms and their impact on occupational and social functioning. The rating levels are:

• 0%: Symptoms are diagnosed but do not interfere with occupational and social functioning or require continuous medication.

• 10%: Mild or transient symptoms that decrease work efficiency only during periods of significant stress, or symptoms controlled by continuous medication.

• 30%: Occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, with generally satisfactory functioning.

• 50%: Reduced reliability and productivity due to symptoms like panic attacks more than once a week, difficulty understanding complex commands, and impaired judgment.

• 70%: Deficiencies in most areas such as work, school, family relations, judgment, thinking, or mood, with symptoms like suicidal ideation, near-continuous panic or depression, and impaired impulse control.

• 100%: Total occupational and social impairment due to symptoms like persistent delusions or hallucinations, grossly inappropriate behavior, and intermittent inability to perform activities of daily living.

Vertigo Secondary to Tinnitus

Vertigo, or the sensation of dizziness and spinning, often appears alongside tinnitus, especially in cases of inner ear disorders. For veterans, this combination can lead to significant disorientation, making tasks like standing, walking, or driving challenging and unsafe. The episodes can vary in severity, sometimes causing nausea or vomiting, and may severely restrict physical activities. When vertigo and tinnitus co-occur, they compound the impact on balance and mobility, creating barriers to daily independence and activities that require stable orientation and movement.

VA Disability Ratings for Vertigo Secondary to Tinnitus

The VA rates vertigo secondary to tinnitus at either 10% or 30% under CFR 38, Part 4, VA Schedule of Ratings, DC 6204, Peripheral Vestibular Disorders, depending on the frequency, severity and duration of symptoms as follows:

• 10%: Vertigo with occasional dizziness.

• 30%: Vertigo with dizziness and occasional staggering.

Note: Objective findings supporting the diagnosis of vestibular disequilibrium are required before a compensable evaluation can be assigned under this code. Hearing impairment or suppuration shall be separately rated and combined.

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