Veterans make claims for tinnitus more than any other disability or impairment in the VA system. Veterans filed almost 160,000 claims for tinnitus in 2015 alone.  What is this condition, what causes it, and why is it claimed so often?

    Let’s clear up some misconceptions about tinnitus. Many people will tell you that tinnitus is “ringing in the ears”, which is partially correct, but not the entire definition.

    For starters, tinnitus is not a disease, but a symptom of an underlying health condition. Tinnitus can be temporary (acute) or ongoing (chronic) causing long-term hearing problems.

    In other words, tinnitus is the persistent perception of external noise that is not actually present due to a sensorineural reaction in the brain from ear or auditory damage.

    The most commonly reported tinnitus noise can include ringing, but can also be whistling, hissing, buzzing, swooshing or clicking and is often caused by loud noise exposure.

    Tinnitus is a condition that the VA rates under 38 CFR § 4.87, Schedule of Ratings – Ear, Diagnostic Code 6260. This means that tinnitus VA ratings are a flat 10 percent disability rating for both ears. It would be next to impossible to attain a higher rating than 10% for tinnitus.

    It’s worth noting that VA is proposing new changes that would raise the standards for disability compensation ratings for veterans with tinnitus.

    Tinnitus Rating Proposed Changes 2022

    Currently, if a veteran has tinnitus and can prove it, they may file a VA service-connection claim and potentially receive up to a 10% disability rating. However, the proposed revisions for tinnitus VA ratings would change that by only acknowledging tinnitus as a symptom of the Veteran’s underlying condition and award service-connected compensation for tinnitus as part of that illness.

    Veterans would no longer be able to get service-connected compensation for tinnitus as a separate, standalone condition. Below we’ll get into conditions that we see commonly linked with tinnitus.

    Unlike many other conditions, regular or recurrent tinnitus carries a maximum rating of 10%, regardless of how bad it is or whether it is present in one or both ears.

    If you’ve been in the VA disability system, then you likely know that VA ratings are usually determined by how bad or severe your disabling symptoms are.

    How much VA compensation do you get for tinnitus?

    The maximum tinnitus VA rating will always be 10% but veterans can receive an increased rating if their service connected tinnitus directly led to or worsened other serious conditions; OR if their tinnitus was caused by an injury and/or disease that occurred during their time in service.

    And an extra caveat, when and if your service-connected disabilities are preventing you from working then the veteran should be eligible for  unemployability benefits, which is the same as 100% disability rating.  

    What serious conditions are related to tinnitus?

    Some veterans get secondary problems from tinnitus, or vice-versa a serious medical condition leads to tinnitus—like depression, traumatic brain injury, or hyperacusis.  Many of these serious disabilities can be severely disabling and sometimes leads to veterans not being able to work or stay employed.

    • Hearing loss : hearing loss– whether age-related or noise induced— is often associated with tinnitus and can require hearing aids. A lot of times the person notices the tinnitus but not the hearing loss itself. The brain receives less external stimuli.  This process changes around specific frequencies may be a way of the brain filling in the auditory gap.  A gap of the sounds and frequencies it has lost due to hearing loss.
    • TBI: Traumatic brain injuries can lead to tinnitus again for similar reasons as head and neck trauma. The damage caused to the middle ear by concussive shock injures the auditory system. About 60% of all the tinnitus cases that VA diagnoses are due to mild-severe TBI.
    • High Blood Pressure .
    • Meniere’s Disease .
    • Fibromyalgia .
    • Mental Health conditions like PTSD , Depression , Anxiety , etc.
    • TMJ Pain : (Temporomandibular Joint Dysfunction) the joint that connects the jaw to the skull is located in front of the ear canal. For this reason, the tightening of the jaw muscles due to conditions such as TMJ can cause tinnitus since the auditory system and the jaw share muscles.
    • Extreme Sinus pressure and barometric pressure: any type of abnormal pressure on the middle ear can cause tinnitus symptoms; diving, flying, head colds; concussive explosions; and even just blowing your nose.
    • Obstructions of the ear: excessive wax, head congestion, loose hairs from the inner ear canals, and dirt. Often when the obstruction is removed, the tinnitus will stop. However, sometimes it can cause permanent damage.
    • Hypo and Hyperthyroidism
    • Lyme Disease
    • Atherosclerosis
    • Otosclerosis

    List of medications with reported tinnitus symptoms

    • Ototoxic drugs: many prescription drugs have the side effect of tinnitus. In most cases it is a short-lived side effect, going away once the drug is no longer being used. However, in some cases it can be chronic. Drugs that are known to be more likely to cause chronic tinnitus include:
    • Non-steroidal Anti-inflammatories (NSAID)
    • Certain antibiotics
    • Certain cancer medications
    • Water pills and diuretics
    • Quinine based medications (these include  Mefloquine ; Chloroquine; and other medications ending with quine)

    How To Get Tinnitus Service Connected

    Audiologists have tests and protocols designed to diagnose and evaluate your tinnitus. For the purposes of VA disability benefits, a claimant veteran would be required to attend a C&P exam for tinnitus (compensation & pension).

    Because tinnitus is often linked with hearing loss, a hearing test is usually administered along with tinnitus testing. Most hearing/tinnitus testing includes:

    • Speech recognition testing
    • Pure tone audiogram
    • Tympanogram
    • Acoustic reflex test
    • Otoacoustic emission test
    • Eardrum Tests & More

    How is a VA claim for tinnitus denied?

    How do you prove tinnitus when only you can hear it? For tinnitus, there are specific ways to prove your case with the VA. The VA standards for disability for hearing loss are determined by the test results of speech recognition; pure tone threshold average; and/or combinations of both.

    Nexus statement letter for tinnitus can help

    Having a  nexus statement  is very important for proving your tinnitus VA claim. Were you stationed near loud noises like working on a flight line, working with or near explosives, explosives or, gunfire?  These loud noise exposures can all serve as proof and evidence for a nexus statement to show a connection between your military service and your tinnitus from your doctor.

    Evidence for Your Tinnitus VA Claim

    To show proof of loud noise exposure during military time, you can use service records or  lay statements .  Service records can be your own—coming from your service jacket.  These records would show helpful items like your MOS and active duty stations.

    But you could also use service records of your unit or ship or base.  Lay statements are statements from friends or service members that knew you during military service.

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