VA Rating for Tinnitus 

Tinnitus, a persistent ringing, buzzing, or other noise with no external source, is the most common disability among veterans. Over 2.9 million veterans have been service-connected for tinnitus, making it the top claimed condition for VA disability benefits.

Given the constant exposure to loud noises during military service, it’s no surprise tinnitus affects so many veterans. And with proposed changes to how tinnitus will be rated by the VA, it’s more important than ever for veterans to understand how to service-connect their tinnitus to other conditions.  

How the VA Rates Tinnitus 

Under the current system, tinnitus is rated as a stand-alone condition under Diagnostic Code (DC) 6260, which provides a 10% rating, regardless of whether one or both ears are affected.  

10% is the maximum rating a veteran can receive for tinnitus on its own. This is why we recommend service connecting additional conditions. Find out more about how to increase your rating. 

Is Tinnitus a Presumptive VA Disability? 

Currently, the VA does not consider tinnitus a presumptive condition. However, veterans exposed to burn pits, Agent Orange, or other toxic substances who later develop conditions like hearing loss or brain injuries may experience tinnitus as a secondary symptom. The PACT Act may assist veterans in service-connecting the underlying conditions that cause tinnitus. 

Here’s some examples of presumptive PACT Act conditions that could potentially be related to or worsen tinnitus for veterans to consider: 

• Respiratory (Breathing-Related) Conditions such as Asthma, Chronic Bronchitis, Chronic Sinusitis, Chronic Rhinitis, COPD, Emphysema, Interstitial Lung Disease (ILD), Pulmonary Fibrosis: These conditions could contribute to tinnitus as many respiratory issues, especially chronic sinusitis and rhinitis, can impact ear function. Blocked sinuses and inner ear pressure changes can exacerbate tinnitus symptoms. COPD hearing loss and tinnitus are also becoming more commonly recognized. 
• Head Cancer (any type), Neck Cancer, Respiratory Cancer (any type): Tumors in the head (like acoustic neuromas), neck, or respiratory system can directly affect hearing structures, leading to or worsening tinnitus. 
• Sarcoidosis: This inflammatory disease can affect various organs, including the ears, and may lead to hearing loss or tinnitus due to its systemic impact. 
• Granulomatous Disease: This condition can impact ear health and function if the granulomas (small areas of inflammation) affect the ear canal or auditory system (in over 60% of patients according to one study), leading to or worsening tinnitus.  
• Hypertension (for Vietnam Era Veterans): Hypertension is known to be linked to pulsatile tinnitus. Elevated blood pressure can cause or worsen tinnitus by increasing pressure in the blood vessels near the inner ear. 
• Pleuritis: Inflammation of the tissues around the lungs (pleura) could potentially influence ear pressure dynamics, contributing to tinnitus. 
• Radiation Exposure (in presumptive locations): Radiation exposure during cleanup operations, especially if it involved the head or neck region, could contribute to ear damage, which may lead to tinnitus. 

Getting VA Disability for Tinnitus 

To receive VA disability for tinnitus, veterans must provide three key pieces of evidence: 

• Current diagnosis of tinnitus – Even though there is no objective test for tinnitus, a diagnosis from a healthcare provider is still required. 
• In-service event – The veteran must show that an event, injury, or exposure during service could have caused or aggravated the tinnitus. 
• Nexus letter – A medical opinion linking the veteran’s tinnitus to their military service. 

Evidence such as medical records, lay statements from fellow service members or family, and personal testimony can significantly strengthen your claim. 

Case Example: Service Connection for Tinnitus 

In this case, a veteran who served in the U.S. Army from September 1982 to December 1982, February 1984 to March 1984, and September 1985 to May 2005, filed a claim for service connection for tinnitus. The veteran initially received a denial-of-service connection for tinnitus in 2007. However, after appealing the decision, the Board of Veterans’ Appeals (BVA) reviewed the evidence, including service treatment records and VA examinations. 

The Board ultimately decided to grant service connection for tinnitus, recognizing the veteran’s recurrent tinnitus began during active service and continued post-service. The Board found the evidence to be at least in equipoise, meaning there was sufficient balance between positive and negative evidence to rule in favor of the veteran. 

Key Factors That Contributed to Winning the Claim

• Detailed Medical Evidence: The veteran’s case was strongly supported by service treatment records documenting a long period of ringing in the ears, and a VA medical examination conducted in October 2007. The medical examiner noted the veteran’s history of intermittent tinnitus, linking it to his time in service. 
• Consistent Symptom Documentation: The veteran consistently reported experiencing tinnitus during and after service, which was documented in both service treatment records and during the VA examination. This continuity of symptomatology was critical in establishing the chronic nature of the tinnitus. 

This case demonstrates how important it is for veterans to provide continuous medical evidence and personal testimony that support the onset and persistence of conditions like tinnitus. With thorough documentation and consistent statements, veterans have a strong chance of winning their claims for VA disability benefits. 

While the maximum rating for tinnitus alone is 10%, you can increase your overall rating by connecting tinnitus to secondary conditions. Many veterans experience other health issues alongside tinnitus, which may qualify for additional compensation.  

What Conditions are Secondary to Tinnitus?

• Hearing Loss – Often associated with tinnitus. 
• Traumatic Brain Injury (TBI) – TBIs can cause or worsen tinnitus. 
• Mental Health Conditions – Anxiety, depression, and PTSD are frequently associated with tinnitus. 
• Meniere’s Disease – A disorder of the inner ear that can cause vertigo and tinnitus. 
• Hypertension – Some evidence suggests a link between high blood pressure and tinnitus. 
• Sleep Disorders – Ringing in the ears can disrupt sleep, leading to conditions like insomnia and sleep apnea. 
• Migraine Headaches – Linked to both tinnitus and auditory issues. 
• Erectile Dysfunction – Can result from stress, mental health issues, or medications related to tinnitus. 
• Chronic Fatigue Syndrome (CFS) – Fatigue is often worsened by the presence of tinnitus. 
• Bruxism – Jaw clenching or teeth grinding is commonly linked to tinnitus. 
• Somatic Symptom Disorder – Hearing constant buzzing or ringing in the ears may worsen emotional stress. 

Filing claims for secondary conditions can significantly increase your VA rating and compensation. 

100% VA Rating for Tinnitus 

A 100% rating for tinnitus alone is not possible, but veterans may qualify for a 100% rating if tinnitus is combined with other severe conditions such as Meniere’s Disease or severe hearing loss (see the case below), or if the combination of conditions qualifies them for Total Disability based on Individual Unemployability (TDIU). 

How a Veteran Obtained a Total Disability Rating Based on Individual Unemployability for Hearing Loss and Tinnitus 

In this case, a veteran who served in the U.S. Air National Guard from March 1957 to March 1963 and from May 1963 to September 1989, as well as active duty from April 3, 1993, to April 17, 1993, filed a claim for a total disability rating based on unemployability (TDIU) due to his service-connected disabilities of bilateral hearing loss and tinnitus. Initially, the veteran’s combined disability rating was 60%, and his claim for TDIU was denied by the VA Regional Office in January 2013. The veteran believed that his service-connected conditions prevented him from maintaining substantially gainful employment and appealed the decision. 

The Board of Veterans’ Appeals ultimately decided in favor of the veteran, granting entitlement to a total disability rating based on unemployability. The Board recognized that the veteran’s severe hearing loss and tinnitus significantly impaired his ability to work, especially in a professional environment where verbal communication is crucial. 

Key Factors That Contributed to Winning the Claim 

• Workplace Impact Documentation: The veteran’s claim was supported by multiple detailed statements from his co-workers and supervisors, which described how his severe hearing loss negatively impacted his ability to communicate in meetings and other work-related settings. This documentation highlighted the extent to which his service-connected conditions affected his ability to perform his job effectively, ultimately leading to early retirement. 
• Expert Medical Opinions: The veteran’s case included private medical evaluations and a VA audiology examination, which confirmed the severity of his hearing loss and its functional impact. His audiologist also noted that even with the use of hearing aids, the veteran still struggled significantly with understanding speech, especially in noisy environments or group settings, further proving that his hearing impairment was a barrier to employment. 
• Functional Impact Reports: Throughout the appeals process, the veteran provided detailed accounts of how his hearing loss and tinnitus limited his day-to-day activities and professional responsibilities. His inability to engage in phone conversations or hear in group settings was emphasized as a major hindrance to his job performance. 
• Inability to Use Accommodations: Despite wearing hearing aids and making other accommodations at work, the veteran’s hearing loss continued to significantly impact his ability to communicate. This showed that, even with assistive devices, his service-connected conditions could not be mitigated to a degree that would allow him to continue working in his professional field. 

This case highlights the importance of comprehensive medical evidence and consistent symptom documentation in proving a veteran’s entitlement to TDIU. By providing detailed records of his work limitations due to service-connected hearing loss and tinnitus, the veteran successfully demonstrated that his disabilities prevented him from maintaining gainful employment. 

Case Example: Medications Exacerbating Tinnitus Symptoms 

In this case, a veteran who served in the United States Marine Corps from February 1970 to November 1974 filed a claim for tinnitus, arguing that it was secondary to his service-connected hypertension and related medications. The veteran experienced buzzing in both ears and believed his antihypertensive medications caused or exacerbated his tinnitus symptoms. After appealing the initial denial, the Board of Veterans’ Appeals reviewed the evidence and considered the relationship between tinnitus and hypertension. 

The Board ultimately decided to grant service connection for tinnitus as secondary to the veteran’s service-connected hypertension. The Board recognized that the veteran’s use of antihypertensive diuretic medications was linked to the development of his tinnitus, based on medical evidence and research showing an association between these medications and tinnitus. 

Key Factors That Contributed to Winning the Claim 

• Medical Literature Supporting the Link: The Board relied on medical research that demonstrated a plausible connection between the use of antihypertensive medications, particularly diuretics, and the onset or worsening of tinnitus. Studies cited showed that patients treated with diuretics had a significantly higher incidence of tinnitus compared to others. 
• Accurate Medical Documentation: The veteran’s medical records clearly documented his use of antihypertensive diuretics, such as chlorthalidone, which was essential in establishing the link between his service-connected hypertension and tinnitus. The records also reflected consistent references to the diuretic medications used for hypertension treatment over time. 
• Expert Medical Opinions: While earlier medical opinions questioned the connection, a comprehensive review in August 2022 by a board-certified family nurse practitioner supported the claim. This opinion highlighted that while the overall percentage of patients who experience tinnitus due to hypertension medications was relatively low, the veteran’s specific use of diuretics and their known side effects made the connection plausible. 
• Veteran’s Lay Statements: The veteran’s testimony about his tinnitus symptoms, their onset, and his medication use were consistent and credible, reinforcing the medical evidence. His detailed personal accounts were critical in supporting his claim, particularly as tinnitus symptoms can be difficult to objectively verify. 

Note on Medications that May Exacerbate Tinnitus 

It’s important to note that certain medications, like antihypertensive diuretics, are known to exacerbate or trigger tinnitus symptoms. In this case, the veteran’s use of chlorthalidone played a crucial role. Other medications that can potentially worsen tinnitus include: 

• Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen 
• Antibiotics such as erythromycin and vancomycin 
• Chemotherapy drugs like cisplatin 
• Loop diuretics like furosemide 
• Antimalarial drugs like quinine 

This list is not exhaustive, and veterans who are on medication and experience tinnitus should ensure all relevant medications are included in their VA claim to strengthen their case. 

My Claim Was Denied, What Can I Do? 

If your tinnitus claim is denied, you have several options: 

• File a Notice of Disagreement (NOD) within one year of the VA decision. 
• Request a Higher-Level Review from a senior VA reviewer. 
• File a Supplemental Claim with new and relevant evidence. 

It’s important to act within the allowed time frame and provide any missing documentation or evidence to strengthen your appeal. Reach out to a VA-accredited representative for help navigating this process.