Conditions Claimed as Secondary to Tinnitus

Step 3 of the method is secondary conditions. A secondary condition is one that grew out of a condition the VA already rates.

Tinnitus is the ringing, buzzing or hissing you hear with no sound around you. It's one of the conditions veterans are rated for most, and it's also one of the smallest ratings on the schedule. That's why so many veterans look at what else can be claimed with it.

Already rated for tinnitus? Add it to the free Claim Map to see the conditions the Board has seen claimed with it.

Tinnitus itself stops at 10

The rating schedule gives recurrent tinnitus one rating, and here is the rule that says so.

Assign only a single evaluation for recurrent tinnitus, whether the sound is perceived in one ear, both ears, or in the head.

That rating is 10. Both ears is still 10. So the tinnitus rating does not go up, and asking for an increase on the tinnitus itself has nowhere to go. A condition that grew out of it is rated on its own, and the VA combines ratings rather than adding them.

The same code carries a second rule about what tinnitus can sit beside.

A separate evaluation for tinnitus may be combined with an evaluation under diagnostic codes 6100, 6200, 6204, or other diagnostic code, except when tinnitus supports an evaluation under one of those diagnostic codes.

In plain words, you can hold the tinnitus rating and a rating for hearing loss or a balance disorder at the same time. The exception is when the tinnitus is the thing carrying that other rating. It is not counted twice.

What a secondary claim needs

Here's the rule on secondary conditions, starting in the middle of its first sentence.

… disability which is proximately due to or the result of a service-connected disease or injury shall be service connected.

Proximately due to means the first condition led to the second. Three things have to be in your file. A diagnosis of the second condition. Tinnitus that is already service connected. And a medical opinion tying the one to the other that says why.

A claim here needs a doctor to find that the tinnitus led to or worsened the second condition. It isn't a finding of ours. Whether it's true for you is a question for your doctor.

The same rule holds a second route, aggravation, for a condition you already had that the tinnitus made worse. It needs a baseline, which is medical evidence of how bad that condition was before the tinnitus started making it worse. Without a baseline the VA will not concede aggravation.

What the Board has seen claimed with tinnitus

Four pairings show up far more than the rest. Each has its own page of counts.

• Vertigo and balance problems: 853 issues across every year we have indexed, 23 percent granted of the ones decided.
• Depression, anxiety and other mental health conditions: 760 issues, 51 percent granted of the ones decided.
• Migraines and headaches: 614 issues, 53 percent granted of the ones decided.
• Hearing loss: 272 issues, 28 percent granted of the ones decided.

granted more oftengranted less often thicker means claimed more oftenpairing not involving tinnitus

Tap a line to read what that pairing has to show.

Two things those counts are not. Every decision counted here is an appeal, so the regional office decided the claim first and the veteran disagreed. These are not the odds on a first claim. And past decisions don't predict yours. A Board decision binds only the case it decided.

The Claim Map lists these conditions with their diagnostic codes and rating steps. Choose tinnitus to find them.

How each one is rated

A balance disorder is rated on how often you are dizzy. Occasional dizziness is 10. Dizziness with occasional staggering is 30. Those are percentages, and the code carries a warning.

Objective findings supporting the diagnosis of vestibular disequilibrium are required before a compensable evaluation can be assigned under this code.

Objective findings means test results, not only what you tell the examiner. Ask what balance testing your record holds.

Migraines are rated on prostrating attacks, meaning attacks that stop you and send you to lie down. One every two months on average is 10. About one a month is 30. The top step, 50, asks for very frequent prolonged attacks that make it hard to keep work. A headache diary that records how often an attack stops you is the evidence that fits this ladder.

Depression and anxiety use one formula for all of them. How the VA rates depression and anxiety walks through its words at each step.

Hearing loss is rated from two tests, a pure tone test and a speech recognition test. The rating comes off the audiogram, not off a description.

If you have vertigo, hearing loss and tinnitus together, ask whether Meniere's syndrome fits. The schedule rates it either as one condition or as the three rated separately, whichever gives the higher result, and never both ways at once.

The written playbook gives up to eight of your main conditions a chapter each. A chapter has the rating ladder and what the Board granted and denied in cases like yours. See what the playbook covers.

What our counts show

Tinnitus has its own page of Board counts, tinnitus. Across every year we have indexed it runs to 96,480 issues, 47 percent granted of the ones decided.

On that page, 88 percent of granted issues and 70 percent of denied ones sit in decisions that mention a medical opinion. A mention is not a reason for the outcome, but it shows how often the question turns on what a doctor wrote.

What to do

1. Send VA an intent to file first. If your complete claim reaches VA within a year of it, VA counts the claim as filed on the day the intent to file arrived. It doesn't have to name a condition, so you don't need the diagnosis or the opinion to send it. It doesn't work for a supplemental claim, where you add evidence and ask VA to decide again.
2. Get the second condition diagnosed in writing, by name. Ask for the test results too, the audiogram for hearing, the balance testing for vertigo.
3. Check that your tinnitus is service connected. If it is, name it in the claim as the condition the second one is secondary to.
4. Ask your doctor for the reasoning, not only the conclusion. How it happened in you, and what in your records shows it. The phrase to ask for is at least as likely as not. Step 1 covers that letter.
5. Say what you've lost, not only what you feel. What you stopped doing, what you avoid now.
6. File the claim with all of it attached, within a year of your intent to file.

The nine steps lays out the rest. I'm not your representative.