If you are struggling with depression or anxiety because of the ringing in your ears, you are not alone, and you are not imagining it. More importantly, you may be eligible for VA disability benefits for these mental health secondary conditions to tinnitus.
If you are a veteran living with tinnitus, you know the sound well. It’s that high-pitched ringing, buzzing, or hissing that no one else can hear. It’s there when you wake up, it follows you through your day, and it screams the loudest when you try to sleep at night.
For many veterans, tinnitus is more than just an annoyance. It is a constant, invisible tormentor that grates on your nerves, ruins your focus, and robs you of your peace. It is no surprise, then, that this physical condition often leads to serious mental health challenges.
At VMHA, we understand that the invisible wounds of service are often the most painful. This guide will walk you through everything you need to know about filing a mental health claim secondary to tinnitus, so you can get the comprehensive rating—and the peace of mind—you deserve.
It is easy to dismiss tinnitus as “just a little ringing.” But when that ringing never stops, it changes your brain. It puts your body in a constant state of “fight or flight,” keeping you on edge. It can make you irritable with your spouse, anxious in quiet rooms, and depressed about a future where silence is impossible.
The connection is not just anecdotal; it is medical fact. Chronic tinnitus is strongly linked to sleep deprivation, which is a known trigger for major depression and anxiety. When you can’t sleep, you can’t heal. When you can’t concentrate, your work suffers. This cycle can quickly spiral into a severe mental health crisis.
According to a study published by the National Institutes of Health (NIH), veterans with severe tinnitus were found to be substantially more likely to screen positive for depression and anxiety compared to those without the condition. This proves that as the ringing gets worse, your mental health often follows. If this sounds like you, then a mental health secondary condition to tinnitus is right for you.
To get benefits for your mental health, you do not always need to prove that a specific event in service caused your depression or anxiety. Instead, you can prove that a service-connected physical condition caused it. This is a Secondary Service Connection.
In this case, your tinnitus is the “primary” service-connected disability. If you can prove that your tinnitus is the “proximate cause” or “aggravating factor” of your mental health condition, the VA must grant you benefits for the mental health condition as if it happened in service.
This is a powerful pathway for veterans. You might not have a combat record that “justifies” PTSD in the eyes of a rater, but if you have service-connected tinnitus that keeps you awake for days on end, leading to severe depression, you have a valid claim.
The VA will not automatically grant your claim just because you have tinnitus and are sad. You must bridge the gap between the two. You need to prove that “Condition A” (Tinnitus) caused “Condition B” (Mental Health).
To do this, you need three things:
The Nexus Letter must provide the medical rationale. It isn’t enough to say “he is depressed.” The doctor must explain how the chronic auditory intrusion of tinnitus disrupts your sleep and cognitive function, leading to the development of a mood disorder.
We hear from veterans every day who are confused about how this works. Here are the answers to the most common questions about filing for mental health secondary to tinnitus.
You can file for both, and the VA will acknowledge both, but you will only receive one single mental health rating. This is due to the VA’s rule against “pyramiding.” The VA does not stack mental health ratings (e.g., 30% for anxiety + 30% for depression). Instead, they look at all your symptoms from anxiety, depression, and PTSD together to determine your total level of occupational and social impairment.
No. The maximum VA rating for tinnitus itself is only 10%. You cannot get higher than 10% for tinnitus alone, no matter how loud the ringing is. However, that 10% rating is the “golden key” that unlocks secondary claims. Even if your tinnitus rating is low, the secondary mental health rating can be very high—up to 100%—depending on how much it impacts your life.
Yes, but you first need to get your tinnitus service-connected. Tinnitus is the most common disability among veterans because it is often presumed to be caused by noise exposure (guns, engines, machinery) associated with your specific MOS (Military Occupational Specialty). Once you establish that primary link, you can then file your secondary mental health claim.
According to the VA Annual Benefits Report, Tinnitus is currently the number one service-connected disability for all veterans, with over 3 million veterans receiving compensation. This means the VA is very familiar with the condition, but often, secondary mental health impacts get overlooked unless you provide strong evidence.
When you file this claim, do not rely on medical records alone. You need to tell your story. Write a Statement in Support of Claim (VA Form 21-4138).
Be specific about the “functional impact.” Do not just say, “It’s annoying.” Say something like this: “The ringing in my ears is so loud that I cannot focus on conversations with my wife, leading to arguments and isolation. It wakes me up 4-5 times a night, leaving me exhausted and too depressed to go to work. I have stopped going to social events because quiet rooms make the noise unbearable, causing panic attacks.” This narrative creates a picture of your life that a simple diagnosis code cannot convey.
Many veterans think they should “tough it out” or that their ringing isn’t “bad enough” to justify a mental health claim. But mental health conditions are progressive. If your tinnitus is ruining your sleep and making you anxious today, it could lead to severe hopelessness or job loss tomorrow.
Filing a claim now does two things:
The difference between a denial and an approval often comes down to one document: the Independent Medical Opinion (IMO).
The VA’s examiners are often rushed. They might spend 15 minutes with you and conclude that your depression is just “due to life,” ignoring the constant torment of your tinnitus. You need an expert in your corner who understands the medical science connecting the ear to the brain.
At VMHA, our licensed psychologists specialize in these complex secondary claims. We know how to write the Nexus Letter that connects the dots for the VA rater. We provide the comprehensive, evidence-based rationale that proves your anxiety or depression is inextricably linked to the ringing in your ears.
Don’t let the noise control your life or your benefits. You served your country, and you deserve to be made whole.
Ready to build a winning claim?
Contact us today to learn how our Independent Medical Opinions can help you secure your rating for Mental Health Secondary Conditions to Tinnitus.
Email us at info@vmhaforvets.com or call us at 214-307-2198.
