Tinnitus, the Most Claimed Disability in the VA
Tinnitus is more commonly called “ringing in the ears” but the true medical definition is the perception of any noise that is not actually present. Many people with tinnitus hear ringing, buzzing, clicking or whistling sounds. The condition can be temporary or chronic (ongoing).
Tinnitus is actually a symptom or underlying condition of another health problem; it is not a disease in and of itself. Usually, the person has damage to the ear and tinnitus is a resulting issue. Amazingly, tinnitus is one of the most commonly claimed VA disabilities because it can be associated with so many underlying conditions, such as:
• Age-related or noise-induced hearing loss
• Ear obstructions including wax and foreign objects
• Head or neck (cervical spine) trauma
• TMJ disorder in the jaw
• Sinus problems
• Traumatic brain injury (TBI)
• Certain medications like NSAIDs, antibiotics, cancer meds, diuretics, thyroid medications, certain high blood pressure meds, lyme disease meds and drugs used for atherosclerosis and fibromyalgia.
Because hearing loss, TBI and cervical neck issues are very common among veterans, so are claims for tinnitus VA disability. Tinnitus falls under the VA’s general classification for hearing loss, and the VA has specific ratings that apply.
The tinnitus must be service-related, and you must have appropriate medical confirmation of yur tinnitus. See an audiologist, who can perform the proper tests to evaluate both the presence and severity of your condition. Tinnitus is normally related to hearing loss, so the audiologist will perform one or more of the following tests:
• Speech recognition testing
• Pure tone audiogram
• Acoustic reflex test
• Otoacoustic emission test
Typically, the VA uses two of the tests–speech recognition and pure tone audiogram—most often to determine tinnitus VA disability, and the VA also requires that a licensed audiologist perform the two specific tests.
• The first test is the Maryland CNC test that measures speech recognition ability.
• The second test is a pure-tone audiometric test that is used to determine the level of hearing loss you have experienced. Both tests are required for the VA to perform a complete hearing loss VA disability evaluation.
If you use your own audiologist rather than one from the VA, that is fine; just make sure you tell them you need these two tests to satisfy VA requirements. These are standard tests that every audiologist should know. Prior to the tests, also be sure to remove hearing aids you may wear.
Your audiologist and doctor can learn more about caring for veterans with hearing loss by referring to the Veterans Health Initiative (VHI) study guide on hearing impairment. The guide provides an overview of how to diagnose, prevent, and treat veteran hearing loss.
Before you file your claim, it is also important to have a nexus statement, which is basically a description and evidence that your tinnitus is related to your military service.
We see many veterans who were continuously exposed to loud noises working on ships or aircraft carriers, or near explosives or gunfire while in combat. You must provide strong evidence so that the VA will rule that more likely than not your tinnitus was caused during your service.
You must have the following paperwork to submit to the Veterans Administration:
• A currently diagnosed hearing condition, such as hearing loss or tinnitus
• Evidence of your military service causing the hearing condition
• a doctor’s opinion linking your current hearing condition to your military service
• your nexus statement
The VA uses its “Schedule of Ratings Disabilities” to rate hearing issues (Section 4.87, and “diagnostic codes 6200 to 6260”). The rating scale is 0 to 100%; a zero rating is no disability and a 100% rating allows maximum hearing loss VA disability benefit payment.
The VA mostly sees claims for common hearing issues like hearing loss and tinnitus, but other disabilities of the ear and hearing are included in this rating:
• Loss of one or both ears. This rating is 30% for one ear and 50% for loss of both ears.
• A perforated eardrum (the VA will rate this at 0% because you can remain completely functional).
• Peripheral vestibular disorders (dizziness and balance issues caused by inner ear disorders). This is rated at 10% if the disorder causes occasional dizziness or 30% when accompanied by both dizziness and staggering or balance issues
• Cancer. A six-month period of a 100% after you complete cancer treatment
The only VA rating available for tinnitus is 10%, whether your ringing is in one or both ears, or periodic or constant. If you have both conditions—hearing loss and tinnitus–the rating is additive, meaning one percentage for hearing loss and one for tinnitus.
It is very important to tie your hearing loss to active duty, which means full-time service in the Army, Navy, Air Force, Marine Corps or Coast Guard. Reservists and National Guard members may also qualify if called to active duty. Dishonorable discharges will disqualify you for benefits as will a felony charge.