Anxiety VA claims: secondary conditions and what the Board grants

How does VA rate anxiety?

Under the General Rating Formula for Mental Disorders in 38 CFR 4.130, from 0 to 100 percent, by how much the symptoms impair work and social life. It is the same formula used for depression and PTSD.

Treatment records, statements about work and family life, and a current VA exam are what the rating rests on. A mental condition that is diagnosed but does not affect work or require medication is rated at 0 percent.

Can anxiety be secondary to tinnitus or hearing loss?

Yes, under 38 CFR 3.310(a), with a medical opinion. Tinnitus is the condition anxiety is most often claimed secondary to: the Board granted 49 of 197 (24.9%). Secondary to hearing loss it did worse: 12 of 84 (14.3%).

Under 38 CFR 3.310(a), a condition caused or made worse by a service-connected disability is service connected too. Many anxiety claims at the Board are built this way, on the strain of living with a physical condition.

Granted

All anxiety claims

22.6%

PTSD

38.1%

Migraine

32.4%

Knee condition

31.7%

Shoulder condition

25.0%

Tinnitus

24.9%

Sleep apnea

23.8%

Back condition

22.0%

TBI

15.8%

Hearing loss

14.3%

Share of decided claims granted; a remand counts as not granted. One count per veteran. Secondary claims are the ones the Board marked as secondary to that condition.

Claimed secondary to	Granted	Veterans	Share
Tinnitus	49	197	24.9%
PTSD	59	155	38.1%
Back condition	33	150	22.0%
Hearing loss	12	84	14.3%
Knee condition	26	82	31.7%
Sleep apnea	10	42	23.8%
TBI	6	38	15.8%
Shoulder condition	9	36	25.0%
Migraine	11	34	32.4%

Can anxiety be secondary to chronic pain from a knee or back condition?

Yes. Anxiety claimed secondary to a knee condition was granted for 26 of 82 veterans (31.7%), and secondary to a back condition for 33 of 150 (22.0%).

In the first grant below, the Board found credible evidence that the back condition made the veteran's anxiety harder to manage: aggravation counts under 38 CFR 3.310(b) as well as causation.

Which secondary claims win most often?

Anxiety claimed secondary to PTSD (38.1%), migraine (32.4%) and a knee condition (31.7%), against 22.6% for anxiety claims overall.

Look up your client's group

Every base, exposure, job and medal with at least 15 decided anxiety claims, 57 groups in all. None clears our bar for a lead.

Bases 7Exposures 20Military jobs 13Medals 17

Bar: share of this group's anxiety claims the Board granted. Red line: all anxiety claims, 22.6% granted. A bar past the line won more often than usual.

×

More often than usual: how much more often anxiety comes up in this group's decisions than in all Board decisions. It shows how common the condition is here, not how often it wins.

Set aside

For groups VA does not presume, veterans whose decision shows service VA already presumes for anxiety (for example Vietnam or Thailand for Agent Orange) are left out, because for them the presumption is the answer.

Sort byGrant shareMore often than usualClaims decided

• Fort Jackson
  29.2% granted · 7 of 24

  1.6×more often

• Fort Dix, NJ
  22.2% granted · 4 of 18

  1.5×more often

• Fort Hood
  20.8% granted · 5 of 24

  1.3×more often

• Fort Benning
  20.0% granted · 3 of 15

  0.9×more often

• Fort Gordon (Eisenhower)
  15.8% granted · 3 of 19

  1.6×more often

• Camp Lejeune
  15.4% granted · 18 of 117

  0.8×more often

• Marine Corps Base Camp Pendleton, California
  10.5% granted · 2 of 19

  1.1×more often

Read the decisions

Recent decisions, with the Board's reasoning as summarized by AI:

• A25109471, December 2025: anxiety granted secondary to a service-connected back condition; credible evidence showed the back condition worsened the veteran's ability to manage the anxiety.
• A25107278, December 2025: an acquired psychiatric disorder including generalized anxiety disorder granted secondary to service-connected knee disabilities, with the benefit of the doubt.
• A25109485, December 2025: anxiety disorder claimed secondary to chronic pain, denied; the Board gave more weight to a VA examiner who found no diagnosed psychiatric disability than to a private diagnosis.

What the data cannot tell you

Anxiety claims are often worded broadly ("an acquired psychiatric disorder, to include anxiety"), and the count follows the diagnostic code, so it includes some claims for related conditions rated the same way (insomnia, for example). Secondary counts include only claims the Board marked as secondary to a condition. These are historical outcomes, not predictions.

For representatives

• Get the diagnosis first, from a clinician who explains how it meets the diagnostic criteria.
• Get a medical opinion that explains how the service-connected condition causes or worsens the anxiety, not only that both are present.
• Argue aggravation as well as causation under 38 CFR 3.310.