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Tinnitus rates a single 10 percent under Diagnostic Code 6260, however loud it is and whether it is in one ear or both. That cap is why the conditions tinnitus leads to matter so much. Under 38 CFR § 3.310, a condition caused or worsened by your service-connected tinnitus is service connected too, and it is rated under its own diagnostic code, often far above 10 percent. This page covers what you can claim secondary to tinnitus, how VA decides those claims, which ones to file first, and how the Board ruled on each.
What can you claim secondary to tinnitus?
Any condition a doctor can tie to your tinnitus, with reasoning, can be claimed. In the Board's 2021 to 2026 decisions the most common were:
- Migraines and headaches. See migraines secondary to tinnitus.
- Sleep apnea. See sleep apnea secondary to tinnitus.
- Vertigo and balance problems. See vertigo secondary to tinnitus.
- Mental health conditions, such as depression and anxiety, which the Board often writes as an acquired psychiatric disorder.
- Insomnia, with an important limit explained below. See insomnia secondary to tinnitus.
The Board section further down lists every condition claimed secondary to tinnitus with enough rulings to show, with its count and grant rate.
How secondary service connection works for tinnitus
VA grants a secondary claim in two ways under 38 CFR § 3.310:
- Caused by. Your service-connected tinnitus caused the condition, at least as likely as not.
- Aggravated by. The condition is worse because of your tinnitus, meaning it would be less severe but for the tinnitus (M21-1 V.ii.2.D). VA rates only the part above the condition's baseline before the aggravation.
The file needs three things: service-connected tinnitus, a current diagnosis of the secondary condition, and a medical opinion linking the two with reasoning. An opinion that answers only the "caused by" question and skips aggravation is inadequate (El-Amin v. Shinseki, 26 Vet. App. 136 (2013)), and the Board sends such claims back.
The most common secondary conditions to tinnitus
Hearing loss, rated separately under DC 6100
Tinnitus and hearing loss are clinically intertwined but legally separate. The same in-service noise exposure that produces tinnitus very often produces measurable hearing loss as well, and hearing loss is rated on its own under a frequency-and-severity chart that can run from 0% to 100%. Hearing loss is usually claimed directly from the noise exposure, not as secondary to tinnitus, and veterans who file for tinnitus without also pursuing a hearing loss evaluation can miss the second rating entirely.
Migraines secondary to tinnitus
Chronic tinnitus is linked in the medical literature to sleep disruption and stress responses that are documented contributors to headache frequency and severity. Migraines under DC 8100 rate from 0% to 50%, with the 30% and 50% levels turning on how often prostrating attacks happen. A successful migraine claim can carry far more weight than the underlying tinnitus rating. See migraines secondary to tinnitus for what the opinion needs.
Sleep apnea secondary to tinnitus
Sleep apnea is a breathing disorder, so the link to tinnitus is less direct than for headaches, and the opinion has to explain the pathway carefully. Sleep apnea that requires a CPAP rates 50 percent under DC 6847. See sleep apnea secondary to tinnitus.
Insomnia and sleep problems
Chronic tinnitus is well documented as a cause of trouble falling and staying asleep. But under current VA guidance (M21-1 V.iii.13.1.k), insomnia that is secondary to another service-connected disability, tinnitus included, is not given a separate secondary rating; the sleep symptoms are included in the tinnitus evaluation. For tinnitus alone that evaluation is a single 10 percent, though one 2025 Board decision rated tinnitus with insomnia together under the mental disorders formula at 30 percent. A separate insomnia rating needs direct service connection. If tinnitus has led to a diagnosed mental health condition, chronic sleep impairment counts within that condition's rating. See insomnia secondary to tinnitus.
Anxiety and depression secondary to tinnitus
The clinical literature on tinnitus-related psychological distress is substantial. Chronic tinnitus affects mood, concentration and sleep, and the relationship between severe chronic tinnitus and depression has been studied for decades. Mental health conditions are rated under the General Rating Formula for Mental Disorders at 0, 10, 30, 50, 70 or 100 percent, and all of a veteran's mental health diagnoses share one rating. The evidence that matters is a clinician's explanation of how your tinnitus caused or worsened the condition, tied to the treatment record.
Vertigo and balance disturbance
Tinnitus is sometimes a symptom of a broader inner ear condition, and the argument for vertigo secondary to tinnitus is case specific. It often turns on whether an ENT diagnosis ties the two together. Peripheral vestibular disorders under DC 6204 rate at 10% or 30%, and Meniere's disease under DC 6205 rates at 30%, 60% or 100%. See vertigo secondary to tinnitus.
Temporomandibular disorders
Some clinical literature connects chronic tinnitus and TMJ disorders. TMJ ratings under DC 9905 are usually modest, but where a doctor documents the link, a secondary claim is possible.
Which secondary claims to file first
Not every possible secondary claim is worth filing. Three questions sort them:
- Is there a current diagnosis? No diagnosis, no claim. Sleep apnea needs a sleep study; migraines need a treatment record of the headaches and how often they stop you.
- Can it be rated on its own? Migraines, sleep apnea, vertigo and mental health conditions have their own ratings. Insomnia caused by tinnitus does not under current guidance, and a second mental health diagnosis does not add a second mental health rating.
- Will a doctor explain the link? The medical opinion decides most of these claims. If no clinician will put the reasoning in writing, start there.
Raven Nexus organizes your records and the relevant research into a draft your doctor can review, and the secondary conditions tool helps sort which claims are plausible for you.
How secondary ratings combine with tinnitus
VA combines ratings under 38 CFR § 4.25, largest first, and each smaller rating takes its share of what remains. A veteran with an anxiety condition at 50 percent, migraines at 30 percent, tinnitus at 10 percent and hearing loss at 10 percent combines like this: 50, then 30 percent of the remaining 50 brings it to 65, then 10 percent of 35 brings it to about 69, then 10 percent of 31 brings it to about 72, which VA rounds to 70 percent. Tinnitus alone is 10 percent; the chain it anchors is what moves the total.
Questions veterans ask about secondary conditions to tinnitus
What conditions are secondary to tinnitus?
The most common in Board decisions are migraines, sleep apnea, vertigo and mental health conditions such as anxiety and depression. Any condition a doctor can tie to your tinnitus with reasoning can be claimed under 38 CFR § 3.310.
Is hearing loss secondary to tinnitus?
Usually not. Hearing loss and tinnitus are rated separately, and hearing loss is normally claimed directly from the same in-service noise exposure rather than as secondary to tinnitus.
Can insomnia caused by tinnitus get its own VA rating?
Not under current VA guidance. Insomnia secondary to another service-connected disability is included in that disability's evaluation, which for tinnitus alone is a single 10 percent. A separate insomnia rating needs direct service connection, and a diagnosed mental health condition caused by tinnitus is rated on its own.
Do I need a nexus letter for a condition secondary to tinnitus?
Usually yes. The VA examiner may give an opinion, but secondary claims to tinnitus are often denied on the link itself, so a private opinion that answers both "caused by" and "aggravated by" with reasoning is often what decides them.
Can tinnitus cause anxiety or depression for VA purposes?
Yes, if a clinician diagnoses the condition and explains how your tinnitus caused or worsened it. The mental health condition is then rated under the General Rating Formula for Mental Disorders.
Sources
- 38 CFR § 3.310, secondary service connection; M21-1 V.ii.2.D, aggravation of a nonservice-connected disability by a service-connected one; M21-1 V.iii.13.1.k, insomnia.
- 38 CFR § 4.87, Diagnostic Codes 6100, 6204, 6205 and 6260; 38 CFR § 4.124a, Diagnostic Code 8100; 38 CFR § 4.97, Diagnostic Code 6847; 38 CFR § 4.130; 38 CFR § 4.150, Diagnostic Code 9905; 38 CFR § 4.25, combined ratings.
- El-Amin v. Shinseki, 26 Vet. App. 136 (2013), an opinion must address aggravation.
- Board figures on this page: Claim Raven's read of every Board decision from 2021 to 2026 that it holds.