Veterans with service-connected tinnitus often deal with more than just persistent ringing in their ears. In many cases, tinnitus is linked to other debilitating conditions, such as migraine headaches. In this article, we’ll explore the relationship between tinnitus and migraines and provide guidance on how veterans can obtain VA disability benefits through secondary service connection.
How VA Rates Migraine Headaches Secondary to Tinnitus
VA awards disability ratings for migraines based on their severity and the impact they have on the veteran’s life. Once a link is established between the veteran’s tinnitus and migraines, VA will assign a rating for the migraines in addition to the tinnitus rating.
Veterans may receive ratings up to 50% for migraines if their attacks are frequent, completely prostrating, and cause severe economic inadaptability. See the details on migraine headache ratings here.
The challenge for many veterans is proving that their migraines are related to tinnitus. Veterans who experience debilitating migraine headaches triggered by tinnitus should maintain detailed records of their symptoms, including how often they experience migraines and how severely these migraines impact their daily activities and work life. Find out more below.
How to Prove a Migraine Is Secondary to Tinnitus
To successfully prove a headache migraine is secondary to tinnitus, veterans need to build a strong claim that combines medical evidence, personal records, and lay statements. Below are key steps veterans should take, along with resources that can help them submit a compelling claim to VA:
1. Medical Evidence
Establishing a service connection for migraines secondary to tinnitus requires solid medical evidence demonstrating that tinnitus either causes or aggravates the veteran’s migraines. Veterans can gather relevant research and studies through trusted medical resources to strengthen their case:
- American Migraine Foundation: The American Migraine Foundation provides comprehensive resources on migraine symptoms and their triggers, including how they may be connected to tinnitus.
- PubMed: Veterans can search for peer-reviewed articles on PubMed to find scientific studies linking tinnitus to migraines.
- Cochrane Library: The Cochrane Library offers access to systematic reviews and clinical trials that can support claims related to migraines and tinnitus.
- Google Scholar: Use Google Scholar to locate research papers that discuss the relationship between tinnitus and migraines.
These resources can assist veterans in finding evidence that strengthens the link between their conditions. It’s crucial to work with a healthcare provider to review this evidence and incorporate it into their claim.
2. Compensation & Pension (C&P) Exam
A Compensation & Pension (C&P) exam is essential in proving migraines secondary to tinnitus. Veterans should feel confident about the C&P exam they receive, and if they believe the exam is incomplete or inaccurate, they may request a second exam. Here are tips to navigate this process:
- Prepare for the C&P Exam: Veterans should bring all medical evidence to the exam, including personal records that show how often migraines occur, whether they occur in conjunction with the veteran’s tinnitus, and how they impact daily life.
- Requesting a Second Exam: If, after having reviewed the C&P exam report, a veteran feels that the first C&P exam did not fully capture their condition or if something seems off, they could try to request a second C&P exam. Veterans should consult their legal representative or a VA-accredited organization to guide them through this process.
3. Obtaining a Private Medical Opinion
In addition to a C&P exam, veterans may consider obtaining a private medical opinion (often referred to as an Independent Medical Opinion or IMO). This step can be especially helpful if the veteran’s case is complex or if the VA exam was insufficient.
- Private Medical Evidence: VA encourages veterans to submit private medical records for consideration. These records often provide long-term insight into the veteran’s health and may carry significant weight because of the trusted relationship between the veteran and their private healthcare provider.
- How to Submit Private Medical Evidence: Veterans can either gather records directly from their healthcare providers or complete VA Forms 21-4142 and 21-4142a to authorize VA to obtain their private medical records on their behalf. Veterans can find these forms on VA’s website or by contacting their representative.
4. Gathering Lay Statements and Keeping Personal Records
Veterans should also collect lay statements and maintain personal records to further support their claims:
- Lay Statements: Veterans can submit personal statements, as well as statements from family members, friends, or coworkers who have witnessed their migraines. These accounts help paint a picture of how migraines affect the veteran’s day-to-day life and work.
- Buddy Statements: Veterans who served alongside the claimant may also provide statements about shared experiences, such as noise exposure during service, that could have led to both tinnitus and migraines.
- Keeping Personal Records: Veterans should maintain detailed records of their migraines, including how often they occur, their severity, and any triggers linked to tinnitus. Tools like Migraine Buddy, Headache Log, or other health tracking apps can help veterans document their condition in real-time and share this information with healthcare providers.
By combining medical evidence, a solid C&P exam, private medical opinions, and personal records, veterans can build a comprehensive claim for migraines secondary to tinnitus. If they need assistance, working with a VA-accredited attorney or representative can help them navigate the process. If you are trying to appeal a poor outcome to your VA claim, contact us for a free case evaluation today.
Case Example: Proving Migraines Secondary to Tinnitus
In this case, a Gulf War veteran who served from 1988 to 1992 filed a claim for disability benefits for migraines secondary to service-connected tinnitus. Initially, the veteran received a 10% disability rating for tinnitus but believed the migraines, occurring because of the tinnitus, warranted additional compensation. After appealing, the Board of Veterans’ Appeals reviewed the evidence.
The Board ultimately decided to grant service connection for migraines, recognizing that the veteran’s migraines were caused by their service-connected tinnitus. This decision increased the veteran’s overall disability rating and resulted in higher compensation for the added severity of the migraines.
How This Claim Was Won:
- Service-Connected Tinnitus: The veteran had already established a service connection for tinnitus, with an initial rating of 10%. This rating became the foundation for proving that migraines were a secondary condition.
- Medical Nexus Between Tinnitus and Migraines: The veteran provided medical evidence, including a 2015 Disability Benefits Questionnaire (DBQ), which documented that tinnitus was aggravating the veteran’s migraines. The medical professional cited research showing the connection between tinnitus and migraines, strengthening the veteran’s claim.
- Comprehensive Medical Evidence: Multiple medical examinations and opinions were presented, including a thorough rationale from a physician in favor of the migraine-tinnitus connection. The Board gave significant weight to the physician’s opinion, which was supported by scientific literature.
- Persistence in the Appeal Process: Although an initial denial occurred, the veteran’s appeal and submission of additional medical evidence led to a favorable decision. The veteran’s case also benefited from the heightened benefit-of-the-doubt standard due to missing service treatment records.
This case highlights how veterans can successfully prove migraines as secondary to tinnitus, even when the initial condition carries only a 10% rating. By demonstrating how tinnitus aggravated the veteran’s migraines, this veteran was able to receive a higher overall disability rating and more appropriate compensation for their conditions.
Were You Exposed to Things That Trigger Both Migraines and Tinnitus?
Veterans are often exposed to various environmental and physical factors known to lead to both migraines and tinnitus. Here’s a few examples of injuries or exposure during military service that could allow you to establish service connection:
- Loud Noise Exposure: (i.e. gunfire, explosions, heavy machinery, aircraft engines, combat situations) Repeated exposure to loud noises can cause auditory damage leading to tinnitus and hearing loss. The stress from constant noise exposure, combined with damage to the auditory system, may also trigger migraines, especially for veterans prone to headaches.
- Blast Injuries: (i.e. IED explosions, grenades, bomb blasts) Blast waves can damage the inner ear, leading to tinnitus, while the concussive force and trauma from these explosions can cause brain injuries, including migraines and other neurological issues like traumatic brain injuries (TBI), which is strongly linked to headaches and migraines.
- Head Trauma: (i.e. physical injuries sustained in combat, falls, vehicle accidents or during training exercises) Head injuries can result in post-traumatic headaches like migraines and tinnitus due to damage to the auditory system, the brain or both. These conditions can develop immediately or over time, especially if the veteran suffered from a concussion or a traumatic brain injury.
- Stress and Anxiety from Combat: (i.e. high stress environments during combat, deployments or other intense military operations) Veterans often experience high levels of anxiety or post-traumatic stress disorder (PTSD), which are known to aggravate migraines and tinnitus.
- Exposure to Toxic Substances: (i.e. burn pits, chemicals and other environmental hazards in combat zones or during training) Exposure to chemicals or toxins like those found in burn pits or other hazardous environments can lead to neurological issues, causing migraines. Some toxins can also damage the auditory system, leading to tinnitus.
Filing a Claim for Migraines Secondary to Tinnitus
Veterans seeking to file a VA disability claim for migraines secondary to tinnitus should follow these steps:
- Gather Medical Evidence: Ensure that both your tinnitus and migraines are well-documented by healthcare professionals. Keep track of medical appointments, diagnoses, and treatments related to both conditions.
- Request a Nexus Letter: A nexus letter is often crucial in winning a claim for a secondary condition. Your healthcare provider should explain how your tinnitus is connected to your migraines in clear terms. Again, you might find it beneficial to reference scientific research connecting these two conditions to bolster the letter.
- Submit a Claim: File your claim with VA, ensuring that all medical evidence, service records, and the nexus letter are included, and in a timely manner.
How Connecting Secondary Conditions Impacts VA Ratings
Tinnitus alone carries a maximum VA disability rating of 10%. However, secondary service connection allows veterans to connect additional conditions to their service-connected tinnitus, potentially increasing their overall VA disability rating. If a veteran can prove that their migraines are secondary to tinnitus, they could receive additional compensation based on the frequency and severity of the migraines. This can significantly boost the veteran’s overall disability rating and provide much-needed financial support.
But establishing secondary conditions, like migraines linked to tinnitus, isn’t necessarily just about increasing the rating — it paints a more complete picture of the overall toll a veteran’s service-related injuries have taken on their life. For many veterans, conditions like tinnitus are often part of a larger set of interconnected health issues that continue to affect their lives long after service. By connecting these secondary conditions, veterans and their families may receive the full range of benefits and compensation they deserve.
Get Help with Your VA Claim
Navigating the VA disability claims process can be complex, especially when dealing with secondary conditions like migraines. Veterans who are trying to appeal a denied claim may benefit from seeking help from a VA-accredited attorney to guide them through the process. If you were denied benefits, contact us today for a free case evaluation.
Content Reviewed by
Cassandra, an Accredited Agent and claims advocate for Matthew Hill & Shelly Mark’s teams, reviewed the information provided in this post.
