Top 4 Secondary Conditions to Tinnitus 

Tinnitus can significantly affect daily life, but the side effects are more pronounced when coupled with a secondary condition.   

There are several secondary conditions to tinnitus, and understanding your eligibility may increase your monthly VA benefits.  

This guide will cover the top four secondary conditions to tinnitus. We’ll explain more about VA secondary conditions, how the VA rates secondary conditions to tinnitus, how to service-connect your condition, and how to file a VA claim.  

Understanding VA Secondary Conditions

Tinnitus is considered a low-value claim because the highest VA rating is 10%. However, if your service-connected tinnitus leads to a secondary condition, you may be entitled to a higher VA rating. 

For example, if you’re service-connected for tinnitus, and your tinnitus causes another VA-ratable condition, you may qualify for a VA rating for your secondary condition (e.g., insomnia). 

(In addition, tinnitus can be a secondary condition if it is caused by another primary service-connected condition).  

4 VA Secondary Conditions to Tinnitus

1. Insomnia  

2. Migraines 

3. Depression 

4. Somatic Symptom Disorder  

Insomnia Secondary to Tinnitus

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

A 2021 study found that insomnia occurs in 10%-80% of tinnitus patients, with most reports noting over a 40% frequency.  

For example, you may notice the ringing in your ears more at night and, therefore, have difficulty sleeping. 

VA Ratings for Insomnia Secondary to Tinnitus

The VA rates insomnia at 10%, 30%, 50%, 70%, and 100%, under CFR Title 38, Part Schedule for Rating Disabilities, Diagnostic Codes (DC) for Mental Disorders.   

Migraines Secondary to Tinnitus

Tinnitus is frequently linked to several types of headache disorders, including migraines.  

According to The American Migraine Foundation, patients report their tinnitus symptoms worsen only when having a migraine.  

VA Ratings for Migraines Secondary to Tinnitus

VA ratings for migraines secondary to tinnitus range from 0% to 50%, with breaks at 10% and 30%.  

Nexus Letter for Migraines Secondary to Tinnitus

A nexus letter for migraines secondary to tinnitus may help strengthen your VA claim by providing a clear link between your two conditions. A nexus letter is a document written by a medical professional that explains the relationship between your service-connected tinnitus and the secondary condition you’re claiming. 

Depression Secondary to Tinnitus

Research shows a direct link between depression and veterans suffering from tinnitus, primarily due to the distress and impairment across cognitive, functional, and psychiatric spectra.  

In addition, veterans with tinnitus are also at a greater risk for additional mental health disorders, including anxiety.  

Symptoms of depression include, but are not limited to: 

• Feeling sad or hopeless nearly every day 

• Losing interest in daily activities 

• Not sleeping enough  

• Losing or gaining weight 

• Feeling unworthy or guilty  

• Irritability 

VA Ratings for Depression Secondary to Tinnitus

Depression secondary to tinnitus can be rated at 0%, 10%, 30%, 50%, 70%, or 100% under the General Rating Formula for Mental Disorders, depending upon the severity of your depression and how your mental health symptoms affect your work, life, and social functioning. 

Note: You can contact the Veterans Crisis Line 24/7 for confidential support by dialing 988 and selecting 1. (You don’t have to be enrolled in VA benefits or health care to connect.) 

Somatic Symptom Disorder Secondary to Tinnitus

Somatic Symptom Disorder (SSD) is defined by the Mayo Clinic as an “extreme focus on physical symptoms, such as pain, fatigue, or tinnitus, causing major emotional distress and functional problems.” 

If you constantly focus on the ringing in your ears, you may experience significant occupational and social impairments.  

Generally, a person’s reaction to their condition is excessive to the actual severity of their medical condition.  

VA Ratings for SSD Secondary to Tinnitus

SSD secondary to tinnitus is rated at 0%, 10%, 30%, 50%, 70%, or 100% under the General Rating Formula for Mental Disorders, depending on the severity of the condition and its impact on work, life and social functioning.   

Secondary Conditions to Tinnitus: Nexus Letters

If you can prove your service-connected tinnitus caused an additional condition or worsened a preexisting one, you may qualify for a higher VA rating.  

One way to help prove a secondary service connection is through a Nexus Letter from a qualified medical professional. 

Generally, a nexus letter for secondary conditions is needed unless the condition is straightforward, like a back nerve condition secondary to a service-connected back problem. 

Establishing a Service Connection for a Secondary Condition

You must service-connect your condition to receive a VA rating for a secondary condition to tinnitus.  

A VA service connection requires: 

• A current medical diagnosis (documented in a medical record) of the secondary VA disability you’re attempting to link to the current service-connected disability (tinnitus) AND 

• A current service-connected primary disability (tinnitus) AND 

• Medical nexus evidence establishing a connection between the service-connected primary condition (tinnitus) AND the current disability you’re trying to connect secondary

Receiving VA Benefits for Multiple Health Conditions

You may be familiar with the complicated “VA Math” concept, where 1+1 doesn’t necessarily equal 2.  

For example, if you have a 10% VA rating for tinnitus and receive a 50% VA rating for depression, you’re not awarded a 60% VA rating.  

Instead, tinnitus secondary conditions are based on schedules, which calculate your impairment after the primary disability is considered. You can use a VA Disability Calculator to check your combined VA rating.  

Filing for Secondary Claims to Tinnitus

You can file for VA secondary conditions to tinnitus by using one of the three options below: 

1. Go to VA.gov and open a new claim using the online VA Form 21-526EZ– Application for Disability Compensation and Related Compensation Benefits  

2. You can also print the form, fill it out, and send it to this address: 

3. You can also bring your application to a VA regional office near you  

If you have been previously denied, you can file an appeal. Our team at Telemedica can prepare a Rebuttal Letter to help address incorrect or inaccurate statements in your VA denial letter. 

Telemedica Can Help

Secondary conditions vary among veterans with tinnitus, and your treatment and support should be tailored to your specific needs.   

It’s vital you seek professional help when addressing both the primary symptoms of tinnitus and any secondary conditions as a comprehensive approach for effective management and recovery.  

The team at Telemedica is standing by to answer your questions. Contact us today!