Secondary service connection
Hearing loss secondary to tinnitus: BVA grant rates and what wins
From 2017 to 2026, the Board of Veterans' Appeals decided hearing loss claimed as secondary to tinnitus in 400 decisions. It granted the issue in 13.5% of them, below the 20.5% grant rate for all hearing loss issues, denied it in 18.8%, and remanded it in 67.8%. Counting only decisions on the merits, 41.9% were granted.
Decisions
400
2017–2026
Granted
13.5%
All hearing loss: 20.5%
Granted on the merits
41.9%
Granted ÷ (granted + denied)
Remanded
67.8%
Denied: 18.8%
See all hearing loss decisions, direct and secondary.
Hearing loss secondary to tinnitus: outcomes by year
| Year | Decisions | Granted | Denied | Remanded |
|---|---|---|---|---|
| 2017 | 25 | 12.0% | 36.0% | 52.0% |
| 2018 | 23 | 17.4% | 21.7% | 60.9% |
| 2019 | 28 | 21.4% | 7.1% | 71.4% |
| 2020 | 42 | 14.3% | 21.4% | 64.3% |
| 2021 | 67 | 13.4% | 14.9% | 71.6% |
| 2022 | 50 | 18.0% | 18.0% | 64.0% |
| 2023 | 51 | 9.8% | 13.7% | 76.5% |
| 2024 | 48 | 14.6% | 14.6% | 70.8% |
| 2025 | 56 | 7.1% | 25.0% | 67.9% |
Evidence in granted and denied hearing loss decisions
For each kind of supporting evidence: how often the Board granted the hearing loss 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 | 42 | 60.9% | 37.7% | +23.1 pts |
| Favorable VA exam | 48 | 58.3% | 38.1% | +20.2 pts |
| Private medical opinion | 76 | 37.1% | 43.6% | −6.5 pts |
| Lay statement | 299 | 37.4% | 78.6% | −41.2 pts |
- The Board applied the benefit-of-the-doubt rule (38 CFR 3.102) in 94.4% of the decisions that granted hearing loss.
- The Board found the veteran's statements credible in 35.2% of grants and 17.3% 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 hearing loss 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 | 272 | 36.4% | 53.7% | −17.3 pts |
| Unfavorable VA exam | 336 | 39.5% | 70.0% | −30.5 pts |
Why the Board granted or denied hearing loss
Most common reasons in grants
- Service connection established8
- In-service noise exposure conceded8
- Current diagnosis established4
- Caused by the service-connected disability3
- Continuity of symptomatology since service3
- Tinnitus likely aggravates hearing loss2
- VA examiner: less likely than not related to service2
- Associated with service-connected tinnitus2
Most common reasons in denials
- Preponderance of the evidence against the claim12
- VA examiner: less likely than not related to service9
- Service records negative or silent8
- No in-service complaints, treatment or diagnosis5
- No current diagnosis5
- No continuity of symptomatology4
- Continuity of symptomatology since service2
- No competent medical evidence of nexus to service or tinnitus2
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 hearing loss decisions
Granted
Veteran's credible reports of decreased hearing acuity and worsening tinnitus; Private audiologist conclusion links hearing loss to tinnitus; Negative VA opinion inadequate for relying solely on lack of threshold shift
Veteran claims hearing loss due to acoustic trauma from artillery.; Service connection for tinnitus is established.; April 2025 VA opinion found hearing loss aggravated by tinnitus.; May 2025 VA opinion questioned aggravation, but Board favored April opinion.; Board applied benefit of the doubt due to approximate balance of evidence.; Spicer v. McDonough ruling applied to find hearing loss caused by tinnitus.
Veteran claimed hearing loss secondary to tinnitus.; Favorable findings in December 2024 rating decision.; Board agreed with favorable findings and granted service connection.
Denied
No in-service indication of hearing loss in service treatment records.; Hearing loss attributed to aging/presbycusis, not noise exposure.; No medical literature supports tinnitus causing or worsening hearing loss.
Only audiological evaluation from June 2010 showed normal hearing in left ear and mild loss in right ear.; Examiner opined hearing loss not related to service.; Veteran failed to attend June 2022 VA examination after canceling a prior one, frustrating evidence development.
No evidence of right ear hearing loss during service or within one year following separation.; VA examinations consistently showed normal right ear hearing with no significant threshold shifts.; Examiners opined delayed onset of noise-induced hearing loss is unlikely and hearing loss in one ear does not affect the opposite ear.
Rules that apply to secondary hearing loss 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 4.85
Evaluation of hearing impairment
Read it in VA Law Explorer - 38 CFR 4.87 · DC 6100
Schedule of ratings: ear
Read it in VA Law Explorer - 38 CFR 3.385
Disability due to impaired hearing
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.2
Evaluating hearing impairment: definition, test methods, exceptional patterns
Read it in VA Law Explorer
Research your hearing loss 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 hearing loss 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.