Secondary service connection
Tinnitus secondary to hearing loss: BVA grant rates and what wins
From 2017 to 2026, the Board of Veterans' Appeals decided tinnitus claimed as secondary to hearing loss in 1,456 decisions. It granted the issue in 65.6% of them, above the 41.1% grant rate for all tinnitus issues, denied it in 7.3%, and remanded it in 25.7%. Counting only decisions on the merits, 89.9% were granted.
Decisions
1,456
2017–2026
Granted
65.6%
All tinnitus: 41.1%
Granted on the merits
89.9%
Granted ÷ (granted + denied)
Remanded
25.7%
Denied: 7.3%
How VA rates tinnitus
Once service connection is granted, VA assigns a disability rating from the rating schedule: 38 CFR 4.87, diagnostic code 6260 (Tinnitus, recurrent). The rating is the same whether the condition is service connected directly or as secondary to another disability.
| Rating | Criteria |
|---|---|
| 10% | Tinnitus, recurrent |
- Note (1): 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.
- Note (2): Assign only a single evaluation for recurrent tinnitus, whether the sound is perceived in one ear, both ears, or in the head.
- Note (3): Do not evaluate objective tinnitus (in which the sound is audible to other people and has a definable cause that may or may not be pathologic) under this diagnostic code, but evaluate it as part of any underlying condition causing it.
Text of 38 CFR 4.87 as of Feb 27, 2026. Confirm the current text at the source before relying on it.
See all tinnitus decisions, direct and secondary.
Tinnitus secondary to hearing loss: outcomes by year
| Year | Issues decided | Granted | Denied | Remanded | Other |
|---|---|---|---|---|---|
| 2017 | 81 | 64.2% | 7.4% | 19.8% | 8.6% |
| 2018 | 180 | 72.8% | 5.0% | 20.6% | 1.7% |
| 2019 | 234 | 72.6% | 4.3% | 22.2% | 0.9% |
| 2020 | 177 | 61.0% | 10.7% | 27.7% | 0.6% |
| 2021 | 128 | 61.7% | 7.8% | 29.7% | 0.8% |
| 2022 | 165 | 64.2% | 7.9% | 26.1% | 1.8% |
| 2023 | 161 | 55.9% | 8.7% | 34.8% | 0.6% |
| 2024 | 145 | 60.7% | 9.0% | 29.0% | 1.4% |
| 2025 | 138 | 69.6% | 8.7% | 21.7% | 0.0% |
| 2026 | 49 | 73.5% | 2.0% | 22.4% | 2.0% |
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 Other: dismissed, withdrawn or no clear outcome.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 tinnitus decisions
For each kind of supporting evidence: how often the Board granted the tinnitus 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 | 627 | 97.0% | 81.5% | +15.6 pts |
| Treating physician opinion | 53 | 100.0% | 89.5% | +10.5 pts |
| Favorable VA exam | 404 | 96.2% | 86.6% | +9.6 pts |
| Private medical opinion | 556 | 94.5% | 86.2% | +8.3 pts |
| Combat service | 150 | 91.1% | 89.8% | +1.4 pts |
| Lay statement | 1,206 | 89.2% | 94.9% | −5.7 pts |
- The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 84.0% of the decisions that granted tinnitus.
- The Board found the veteran's statements credible in 55.6% of grants and 18.7% 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 tinnitus 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 |
|---|---|---|---|---|
| Unfavorable VA exam | 1,297 | 89.4% | 95.0% | −5.6 pts |
| Negative nexus opinion | 1,155 | 88.7% | 95.0% | −6.3 pts |
How these claims are argued
A secondary claim says hearing loss caused tinnitus 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)
16.3%
granted, of 129 issues (8.8% of all)
Causation only
caused by the disability, 3.310(a)
70.4%
granted, of 1,329 issues (91.2% of all)
Based on words in the AI-written summary and reasons for each issue, not a reading of the full decision. 0.5% of the 1,458 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 tinnitus
Most common reasons in grants
- Caused by the service-connected disability212
- Current diagnosis established144
- Service connection established98
- In-service noise exposure conceded32
- Tinnitus is a symptom associated with hearing loss29
- Tinnitus associated with hearing loss23
- Service connection for hearing loss granted20
- Secondary service connection granted15
Most common reasons in denials
- VA examiner: less likely than not related to service32
- Service records negative or silent15
- No in-service complaints, treatment or diagnosis13
- No continuity of symptomatology5
- Current diagnosis established4
- Continuity of symptomatology since service4
- Preponderance of the evidence against the claim4
- In-service noise exposure conceded3
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 tinnitus decisions
Granted
Granted secondary to granted hearing loss; VA examiner opinion noted association between tinnitus and hearing loss
Conceded in-service noise exposure and TERA; Existing service connection for bilateral hearing loss; Judicial notice that hearing loss can cause tinnitus; Benefit of doubt resolved in Veteran's favor
Current diagnosis of tinnitus; At least as likely as not associated with service-connected right ear hearing loss; Benefit of the doubt resolved in veteran's favor
Denied
Current diagnosis of tinnitus.; VA examiner opined tinnitus proximately due to bilateral hearing loss.; Service connection for bilateral hearing loss was denied.; No evidence suggests tinnitus is due to other service-connected disability.
Service connection for hearing loss was denied, precluding secondary claim.; VA medical opinions found tinnitus less likely than not related to service.; No in-service onset of tinnitus reported.
No in-service event recalled for tinnitus onset.; VA examiners found less likely than not relation to military noise exposure.; No documentation of tinnitus in service or within one year of discharge.; Secondary claim to hearing loss not raised at time of AOJ decision.
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 tinnitus.
- Hearing loss is already service connected.
- Medical evidence linking them (a nexus opinion): tinnitus was caused by hearing loss (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).
See all conditions secondary to hearing loss or tinnitus as a primary or secondary condition.
Rules that apply to secondary tinnitus 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 - 38 CFR 4.87 · DC 6260
Schedule of ratings: ear
Read it in VA Law Explorer - M21-1 V.iii.2.B.1
Service connection for hearing loss and tinnitus, incl. Guard and Reserve duty
Read it in VA Law Explorer - M21-1 V.iii.2.B.3
Tinnitus: sympathetic reading, medical opinions, liberalizing provisions
Read it in VA Law Explorer
Research your tinnitus 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 tinnitus issue claimed as secondary to hearing loss, 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.