10 Most Common Secondary Conditions to Tinnitus
If you’re a veteran dealing with tinnitus, you’re not alone — and it’s not just the constant ringing in your ears you need to worry about. Tinnitus can lead to a whole host of other serious health conditions. Many veterans don’t realize that they might be eligible to claim secondary conditions that are proximately due to or aggravated by their service-connected tinnitus.
Today, I’ll break down the Top 10 Secondary Conditions to Tinnitus, backed by medical research. You’ll gain insight into how these conditions are connected so you can claim the full range of VA disability benefits you deserve through secondary service connection. Understanding these connections is key to maximizing your claim and receiving the compensation you’re entitled to.
Pro Tip: Despite upcoming changes to how the VA rates tinnitus, veterans remain eligible to file for secondary conditions related to their service-connected tinnitus. These changes won’t impact your ability to seek additional compensation for conditions like migraines, anxiety, or depression that stem from your tinnitus. So, even as the VA adjusts its criteria, your right to claim secondary conditions remains safe and secure.
What is Tinnitus for VA Disability Benefits?
Tinnitus, often referred to as “ringing in the ears,” is the perception of sound without any external noise source. Veterans frequently experience this condition due to exposure to loud noises, explosions, gunfire, or machinery during their service. Tinnitus is the #1 most common and most claimed service-connected VA disability among all the conditions eligible for benefits.
The sound veterans hear may not just be ringing; it can manifest as buzzing, clicking, or roaring noises in one or both ears. Tinnitus can be a debilitating condition, interfering with sleep, concentration, and overall quality of life.
The VA assigns a 10% disability rating for tinnitus, regardless of whether it affects one ear or both ears. The rating for tinnitus is capped at 10% according to 38 CFR § 4.87, Diagnostic Code 6260. Even if the symptoms are severe, the maximum rating remains at 10%. This is because the VA considers tinnitus as a subjective condition, where the severity of the sound itself cannot be measured beyond the veteran’s report.
Important Note: Veterans can still seek additional compensation for secondary conditions related to tinnitus, such as anxiety, depression, or sleep disturbances, which could raise their overall disability rating if connected to their tinnitus. That’s the main focus of this article.
How to Establish Secondary Service Connection for Tinnitus
Under 38 CFR § 3.310, secondary service connection is established for disabilities that are either directly caused by or aggravated by an existing service-connected condition. In the case of tinnitus, if you develop another condition because of it, you may be eligible for secondary service connection.
To successfully claim a secondary condition due to tinnitus, three key elements must be met:
#1. Diagnosis of the Secondary Condition
You must have a current diagnosis of the secondary condition you’re claiming (e.g., migraines, anxiety, depression, Meniere’s Syndrome, etc.). This can be supported by medical records from your VA doctor, private healthcare providers, or other credible sources.
#2. Service-Connected Primary Condition (Tinnitus)
You must already have tinnitus recognized as a service-connected disability by the VA. Even if it is rated at 0%, it qualifies as the primary condition for establishing a secondary claim.
#3. Medical Nexus Evidence
The most critical part is providing a nexus (link) between your service-connected tinnitus and the secondary condition. This requires a nexus letter from a private healthcare provider explaining that your secondary condition is “at least as likely as not” caused or aggravated by your tinnitus. The provider should offer detailed medical reasoning that ties the two conditions together.
Evidence You’ll Need
- Medical Diagnosis: The diagnosis of your secondary condition (e.g., migraines, depression) must be included in your medical records.
- Service-Connected Condition: Documentation showing your tinnitus is already service-connected.
- Nexus Letter: This letter should come from a qualified healthcare provider who explicitly links your secondary condition to tinnitus, detailing how tinnitus worsened or led to the condition.
By establishing these elements with strong medical evidence and submitting a well-documented claim, you increase your chances of receiving secondary service connection for conditions caused or aggravated by tinnitus.
Okay, let’s reveal and explain the 10 easiest secondary conditions to tinnitus for VA disability compensation benefits.
#1. Anxiety Secondary to Tinnitus
Tinnitus can lead to anxiety as the constant noise creates ongoing stress. Studies have shown that tinnitus increases anxiety levels due to the frustration and helplessness caused by the inability to control the sound. The continuous ringing can cause veterans to feel overwhelmed, particularly in quiet environments or situations where they need focus. Research demonstrates that a significant percentage of tinnitus sufferers also experience anxiety, with one study showing that around 79.1% of veterans with tinnitus had a diagnosis of anxiety. This emotional distress can exacerbate the perception of tinnitus, creating a vicious cycle of anxiety and tinnitus worsening each other.
#2. Depression Secondary to Tinnitus
Depression is another common condition tied to tinnitus. The psychological toll of living with persistent ringing or buzzing in the ears can result in feelings of hopelessness, sadness, and isolation. Veterans may feel that tinnitus limits their quality of life, preventing them from enjoying social interactions, work, or peaceful environments. Research reveals that around 59.3% of tinnitus sufferers also report depression. Additionally, the longer someone experiences tinnitus without relief, the more likely they are to develop depressive symptoms due to the ongoing frustration and disruption caused by the condition.
#3. Hearing Loss Secondary to Tinnitus
Tinnitus and hearing loss are closely linked, as they both result from damage to the auditory system. Hearing loss is one of the most common causes of tinnitus, and veterans with service-connected hearing loss may develop or experience worsening tinnitus. The damage to the hair cells in the inner ear, which process sound, often leads to both hearing loss and the perception of sound (tinnitus) when no external noise is present. Studies estimate that up to 90% of tinnitus cases are associated with some form of hearing loss, making this a common secondary condition.
#4. Hyperacusis Secondary to Tinnitus
Hyperacusis is an increased sensitivity to normal everyday sounds and can develop as a secondary condition to tinnitus. Veterans with hyperacusis find that sounds that wouldn’t normally be bothersome become intolerably loud or painful. This condition often co-occurs with tinnitus because both involve heightened sensitivity in the auditory system. Research highlights that up to 40% of tinnitus sufferers also experience hyperacusis, making it difficult for veterans to tolerate environments with varying noise levels, which can limit social and occupational functioning.
#5. Insomnia Secondary to Tinnitus
Insomnia is one of the most frequently reported secondary conditions related to tinnitus. Veterans with tinnitus may struggle to fall asleep or stay asleep due to the constant noise in their ears, especially in quiet environments at night. Sleep deprivation can worsen the effects of tinnitus, contributing to a cycle of sleeplessness and increased tinnitus perception. Medical studies confirm that sleep disturbances are common in tinnitus sufferers, with many individuals reporting significant difficulty in maintaining restful sleep due to the condition.
#6. Meniere’s Syndrome Secondary to Tinnitus
Meniere’s Disease is a disorder of the inner ear that causes episodes of vertigo, hearing loss, and tinnitus. Veterans with tinnitus may develop Meniere’s Disease as a secondary condition, experiencing increased vertigo and dizziness due to the fluid buildup in the inner ear. Tinnitus often worsens during Meniere’s episodes, and the disorder can severely affect balance and hearing. Research on Meniere’s suggests that the co-occurrence of tinnitus and vertigo significantly impairs daily life, leading to frequent claims for service connection.
#7. Migraines Secondary to Tinnitus
Tinnitus can be a trigger for migraines, or it may worsen migraine symptoms. Research indicates that individuals with tinnitus are more likely to suffer from migraines due to shared neural pathways between hearing and pain processing in the brain. Migraines can be debilitating, causing severe headaches, nausea, and light sensitivity. Studies show that around 27% of tinnitus sufferers experience migraines, making this a common secondary condition. The constant noise from tinnitus may exacerbate the severity and frequency of migraines.
#8. Sleep Apnea Secondary to Tinnitus
The connection between sleep apnea and tinnitus is emerging in medical research, with evidence suggesting that tinnitus can worsen sleep disturbances, which may contribute to or exacerbate sleep apnea. Veterans with tinnitus-related insomnia are at a higher risk for developing obstructive sleep apnea (OSA) due to the fragmented sleep patterns. Tinnitus interrupts the ability to maintain restful sleep, and over time, this can lead to or worsen OSA, characterized by frequent interruptions in breathing during sleep. Sleep apnea secondary to tinnitus is less directly established but can still be connected due to their shared impact on sleep health. Note: Sleep apnea secondary to tinnitus is a more difficult connection to make than some of the others listed here. For a list of sleep apnea secondary conditions, click here.
#9. Somatic Symptom Disorder Secondary to Tinnitus
Somatic Symptom Disorder occurs when an individual develops an extreme focus on physical symptoms, such as tinnitus, leading to significant emotional distress and impairments in daily functioning. Veterans with tinnitus may become hyper-focused on the ringing in their ears, causing them to experience heightened stress, anxiety, and worry about the condition. Over time, this can lead to the development of somatic symptom disorder, where the tinnitus becomes a source of ongoing emotional and physical preoccupation. This condition is recognized as a secondary claim to tinnitus due to the psychological impact of persistent, unresolved symptoms.
#10. Vertigo Secondary to Tinnitus
Vertigo is another secondary condition that can develop in veterans with tinnitus, especially when the tinnitus is related to inner ear disorders. Vertigo involves a sensation of dizziness or spinning, often triggered by balance issues in the inner ear, where tinnitus also originates. Veterans with both conditions may experience episodes of extreme disorientation, making it difficult to maintain balance and function normally. Studies on inner ear disorders show that tinnitus and vertigo frequently co-occur, particularly in cases of Meniere’s Disease or other vestibular dysfunctions.
Source List
· Baguley, David M., et al. “Hyperacusis and Tinnitus.” Noise & Health, vol. 15, no. 63, 2013, pp. 85–90, https://doi.org/10.4103/1463-1741.110294.
· Eggermont, Jos J., and Larry E. Roberts. “The Neuroscience of Tinnitus.” Trends in Neurosciences, vol. 27, no. 11, 2004, pp. 676–682, https://doi.org/10.1016/j.tins.2004.08.010.
· Kröner-Herwig, Birgit, et al. “The Management of Chronic Tinnitus — Comparison of Different Approaches.” German Medical Science, vol. 12, 2014, https://doi.org/10.3205/000193.
· Langguth, Berthold, et al. “Tinnitus and Depression.” World Journal of Biological Psychiatry, vol. 12, no. 7, 2011, pp. 489–500, https://doi.org/10.3109/15622975.2011.575178.
· Schulz, Andreas, et al. “Tinnitus and Its Relation to Depression, Anxiety, and Stress — A Population-Based Cohort Study.” Journal of Clinical Medicine, vol. 12, no. 3, 2023, MDPI, https://doi.org/10.3390/jcm12031169.
· Zappulla, Rachel A., et al. “The Association Between Tinnitus and Insomnia: A Systematic Review.” Journal of Clinical Sleep Medicine, vol. 16, no. 2, 2020, pp. 357–363, https://doi.org/10.5664/jcsm.8198.
About the Author
Brian Reese is one of the world’s leading VA disability benefits experts and the #1 bestselling author of VA Claim Secrets and You Deserve It. Frustrated with the VA claim process, Brian founded VA Claims Insider to help disabled veterans win their VA disability compensation faster. He has served over 10 million military members and veterans since 2013. A former Air Force officer, Brian deployed to Afghanistan in 2011. He is a Distinguished Graduate from the U.S. Air Force Academy and holds an MBA from Oklahoma State University, where he was a National Honor Scholar.
