Secondary service connection
Major depressive disorder secondary to tinnitus: BVA grant rates and what wins
From 2017 to 2026, the Board of Veterans' Appeals decided major depressive disorder claimed as secondary to tinnitus in 421 decisions. It granted the issue in 44.9% of them, above the 35.3% grant rate for all major depressive disorder issues, denied it in 13.3%, and remanded it in 39.2%. Counting only decisions on the merits, 77.1% were granted.
Decisions
421
2017–2026
Granted
44.9%
All major depressive disorder: 35.3%
Granted on the merits
77.1%
Granted ÷ (granted + denied)
Remanded
39.2%
Denied: 13.3%
See all major depressive disorder decisions, direct and secondary.
Major depressive disorder secondary to tinnitus: outcomes by year
| Year | Issues decided | Granted | Denied | Remanded | Other |
|---|---|---|---|---|---|
| 2017 | 30 | 43.3% | 20.0% | 26.7% | 10.0% |
| 2018 | 52 | 51.9% | 11.5% | 34.6% | 1.9% |
| 2019 | 48 | 60.4% | 8.3% | 27.1% | 4.2% |
| 2020 | 38 | 47.4% | 7.9% | 44.7% | 0.0% |
| 2021 | 37 | 43.2% | 18.9% | 37.8% | 0.0% |
| 2022 | 39 | 38.5% | 15.4% | 43.6% | 2.6% |
| 2023 | 42 | 50.0% | 4.8% | 45.2% | 0.0% |
| 2024 | 43 | 37.2% | 20.9% | 41.9% | 0.0% |
| 2025 | 71 | 36.6% | 12.7% | 47.9% | 2.8% |
| 2026 | 23 | 39.1% | 17.4% | 34.8% | 8.7% |
Each row counts issues (each condition the Board decided), so the shares add up to 100%. Other: dismissed, withdrawn or no clear outcome. Years with fewer than 20 issues are left out.
Evidence in granted and denied major depressive disorder decisions
For each kind of supporting evidence: how often the Board granted the major depressive disorder issue on the merits when the decision mentioned it, compared with decisions that did not. These are associations, not causes, and evidence is recorded per decision, not per issue.
| In the record | Decisions | Granted when present | When absent | Difference |
|---|---|---|---|---|
| Positive nexus opinion | 197 | 96.8% | 41.4% | +55.5 pts |
| Private medical opinion | 238 | 85.4% | 58.1% | +27.3 pts |
| Favorable VA exam | 83 | 93.5% | 71.6% | +22.0 pts |
| Lay statement | 334 | 74.0% | 91.1% | −17.1 pts |
- The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 73.5% of the decisions that granted major depressive disorder.
- The Board found the veteran's statements credible in 29.1% of grants and 7.1% of denials.
Negative evidence in the record
An unfavorable exam or a negative nexus opinion often sits in the same record as favorable evidence, and the Board weighs them against each other. So these rows show how often major depressive disorder was still granted when the record contained the negative item, not that the item helped.
| In the record | Decisions | Granted when present | When absent | Difference |
|---|---|---|---|---|
| Negative nexus opinion | 280 | 72.3% | 86.0% | −13.7 pts |
| Unfavorable VA exam | 339 | 72.3% | 96.0% | −23.7 pts |
How these claims are argued
A secondary claim says tinnitus caused major depressive disorder or made it worse, and names how. Below: whether the Board's decision discussed aggravation, and the medical link each decision names, with how often those issues were granted.
Aggravation discussed
made worse by the disability, 3.310(b)
40.7%
granted, of 167 issues (39.5% of all)
Causation only
caused by the disability, 3.310(a)
47.7%
granted, of 256 issues (60.5% of all)
| Medical link named | Issues | Granted |
|---|---|---|
Sleep disruption Granted “Service connection for depressive disorder with insomnia was granted as secondary to the Veteran's service-connected tinnitus.” A26000076 (2026) Denied “Insomnia symptoms subsumed by OSA diagnosis” A26017819 (2026) | 44 | 43.2% |
Stress Granted “A 70% rating for depression was granted, finding that the Veteran's symptoms, including difficulty adapting to stress, depression, and exacerbation of mood and anxiety, more closely approximated the criteria for this rating.” A25047120 (2025) Denied “Veteran's own treatment records link mental health issues to marital stress and alcohol abuse..” A25051440 (2025) | 27 | 25.9% |
Based on words in the AI-written summary and reasons for each issue, not a reading of the full decision. 19.9% of the 423 issues name at least one medical link; the rest only say “secondary to” the disability. One issue can name several links. Granted is the share of those issues granted (remands count as not granted). A link named in a denial was often the argument the Board rejected.
Why the Board granted or denied major depressive disorder
Most common reasons in grants
- Caused by the service-connected disability35
- Current diagnosis established28
- Service connection established20
- Aggravated by the service-connected disability17
- VA examiner: less likely than not related to service3
- Criteria for service connection met3
- No contrary medical opinion in the record2
- No contrary medical opinion of record2
Most common reasons in denials
- VA examiner: less likely than not related to service12
- No current diagnosis9
- Service records negative or silent7
- Preponderance of the evidence against the claim5
- No in-service complaints, treatment or diagnosis2
- Depression in remission, symptoms mitigated by medication1
- Depressed mood considered part of anxiety disorder1
- Claim denied as secondary to tinnitus, which was not service-connected1
Numbers are decisions that gave the reason. Reasons are short phrases extracted by AI from each decision; common wordings of the same reason are grouped. Benefit of the doubt is reported above.
Recent major depressive disorder decisions
Granted
Current diagnosis of major depressive disorder.; Service-connected hearing loss and tinnitus.; Private medical opinion found it more likely than not that the psychiatric disorder is related to service-connected hearing loss and tinnitus.
Favorable VA medical opinions; Mood disorder proximately due to tinnitus; Resolved doubt in Veteran's favor
Service-connected tinnitus; Lay evidence of sleeplessness and irritability; Private medical opinions noting association between tinnitus and depression/anxiety; Resolution of reasonable doubt in Veteran's favor
Denied
Service treatment records negative for psychiatric disability.; Separation examination normal; denied psychiatric symptoms.; Post-service onset attributed to 1997 on-the-job injury.; Conflicting reports regarding symptom onset and cause.; VA psychiatric opinions found no nexus to service or service-connected conditions.; Private opinion found minimally probative; lacked specific factual support.; Board assigned greater weight to December 2024 VA opinion.; Evidence persuasively against nexus and in-service onset.
No objective clinical evidence of depression diagnosis; VA examiner diagnosed insomnia disorder, not depression; Private medical opinion lacked adequate rationale
No separate psychiatric disorder diagnosed; Insomnia symptoms subsumed by OSA diagnosis; Evidence weighs against service connection
What VA needs to grant a secondary claim
Secondary service connection means VA disability benefits for a condition caused or made worse by a disability that is already service connected (38 CFR 3.310). The claim needs three things:
- A current diagnosis of major depressive disorder.
- Tinnitus is already service connected.
- Medical evidence linking them (a nexus opinion): major depressive disorder was caused by tinnitus (3.310(a)), or was made worse beyond its natural progress by it (aggravation, 3.310(b)).
VA's procedures for these claims are in M21-1 V.ii.2.D. When the evidence for and against is about even, VA must decide in the veteran's favor (38 CFR 3.102).
Other conditions secondary to tinnitus
Major depressive disorder secondary to other conditions
See all conditions secondary to tinnitus or psychiatric disorders as a primary or secondary condition.
Rules that apply to secondary major depressive disorder claims
- 38 CFR 3.310
Secondary service connection and aggravation
Read it in VA Law Explorer - M21-1 V.ii.2.D
Secondary service connection and aggravation of non-service-connected disabilities
Read it in VA Law Explorer - 38 CFR 3.102
Reasonable doubt (benefit of the doubt)
Read it in VA Law Explorer
Research your major depressive disorder case
Narrow by year, judge, evidence or secondary condition, read the decisions, and export a research memo.
How these numbers are calculated
- Counts decisions in which the Board decided a major depressive disorder issue claimed as secondary to tinnitus, by the outcome of that issue.
- The primary disability is read from the decision text ("secondary to …") and grouped by name, so spellings such as "PTSD" and "posttraumatic stress disorder" count together.
- Secondary claims also include aggravation of a non-service-connected condition by a service-connected one (38 CFR 3.310(b)).
- The data comes from CaseScribe's AI extraction of public BVA decisions (2017–2026) and can contain errors. It is updated automatically as new decisions are added.