Tinnitus secondary to hearing loss wins far more often than tinnitus overall

The Board of Veterans' Appeals granted tinnitus claimed as secondary to hearing loss in 65.7% of its decisions from 2018 to 2026. Across all tinnitus decisions, direct and secondary, the grant share was 41.4%, which puts this secondary claim 24.3 percentage points above the overall rate.

The figures come from 1,375 Board decisions that decided tinnitus as secondary to service-connected hearing loss under 38 CFR 3.310. Only 7.3% ended in a denial. When the Board did not grant, it usually remanded: remands made up 26.0% of decisions.

Share of decisions each year. 2026 is a partial year.

A dip, then a rebound

The grant share was highest at the start of the period: 72.8% in 2018 and 72.6% in 2019. It fell to 61.0% in 2020 and reached its low in 2023, at 55.9%. That was also the year remands peaked, at 34.8%.

In 2025, grants climbed back to 69.6% and remands fell to 21.7%. Comparing 2018–2019 with 2024–2025, the grant share fell 7.5 percentage points, from 72.7% to 65.2%, while remands rose from 21.5% to 25.5%.

Leaving remands out, the Board granted 94.1% of the claims it decided on the merits in 2018 and 2019, and 88.0% in 2024 and 2025. Across all years the merits grant rate was 89.9%. The data does not show why remands rose in the middle years or why they dropped in 2025.

What goes with a grant

A positive nexus opinion shows the widest gap. The Board granted on the merits in 97.1% of decisions with one in the record and 81.6% of decisions without one. With a favorable VA exam, the rate was 96.1%; without, 86.8%. With a private medical opinion, 94.5%; without, 86.2%.

In the recordNot in the record

Positive nexus opinion

97.1%

81.6%

Favorable VA exam

96.1%

86.8%

Private medical opinion

94.5%

86.2%

Combat service

90.4%

89.9%

Merits decisions only (granted or denied). Associations, not causes.

Two patterns run the other way. Records with a lay statement had a merits grant rate of 89.1%, against 95.5% for records without one. Records with a negative nexus opinion were granted on the merits in 88.6% of decisions, against 95.7% without one. Even with a negative opinion in the file, most claims decided on the merits were granted. Combat service made little difference: 90.4% with it, 89.9% without.

These are associations, not causes. A record that includes a positive opinion may be stronger in other ways, and the data does not show what drove any single outcome.

The benefit of the doubt comes up often. In 84.2% of grants, the Board applied 38 CFR 3.102.

What the decisions say

The most common reason in denials was "va examiner: less likely than not related to service," cited in 32 denials. Next were "service records negative or silent" (14) and "no in-service complaints, treatment or diagnosis" (13). Those two reasons concern what happened during service, which suggests the Board often weighed a direct theory alongside the secondary one.

In grants, the leading reason was "caused by the service-connected disability," cited in 197 grants. "Current diagnosis established" appeared in 137 and "service connection established" in 93.

Read the decisions

Recent examples, with the Board's reasons as summarized by AI:

• A26040562, granted in 2026: granted secondary to granted hearing loss.
• A26039043, granted in 2026: conceded in-service noise exposure and TERA.
• A26038234, granted in 2026: current diagnosis of tinnitus.
• A26014214, denied in 2026.
• A25111022, denied in 2025: service connection for hearing loss was denied, precluding secondary claim.
• A25105802, denied in 2025: no in-service event recalled for tinnitus onset.

For representatives

• A positive nexus opinion went with a merits grant rate of 97.1%, compared with 81.6% without one. An opinion that addresses the link to the service-connected hearing loss, not only to in-service noise, fits the reason most often cited in grants.
• The examiner's negative opinion is the most common denial reason. Check whether it addresses causation and aggravation under 38 CFR 3.310, or only direct service.
• Remands, not denials, account for most non-grants. Reviewing the record for gaps before the Board decides may matter more than rebutting a denial.