Maximize Your VA Rating for Migraine Headaches Secondary to Tinnitus 

Veterans with service-connected tinnitus often deal with more than just persistent ringing in their ears. In many cases, tinnitus is linked to other debilitating conditions, such as migraine headaches. Once you establish a link between your tinnitus and migraines, the VA will assign a rating for the migraines in addition to your tinnitus rating.

What VA Rating Can You Get for Migraine Headaches Secondary to Tinnitus?

VA rates migraines 0%, 10%, 30% or 50%, based on their severity and the impact they have on the veteran’s life. The maximum rating for migraines is 50% if their attacks are frequent, completely prostrating, and cause severe economic inadaptability. The challenge for many veterans is proving that their migraines are related to tinnitus.

If you are experiencing debilitating migraine headaches triggered by tinnitus, you should maintain detailed records of your symptoms. This includes documenting how often you experience migraines and how severely these migraines impact your daily activities and work life.

How to Prove a Migraine Is Secondary to Tinnitus 

To successfully prove a migraine headache is secondary to tinnitus, you need to build a strong claim. This should combine medical evidence, personal records, and lay statements. 

1. Medical Evidence

Establishing a service connection for migraines secondary to tinnitus requires solid medical evidence demonstrating that tinnitus either causes or aggravates your migraines. You can gather relevant research and studies through trusted medical resources to strengthen your case: 

• American Migraine Foundation: Provides comprehensive resources on migraine symptoms and their triggers, including how they may be connected to tinnitus. 
• PubMed and Google Scholar: Search for peer-reviewed articles and research papers to find scientific studies linking tinnitus to migraines. 
• Cochrane Library: Offers access to systematic reviews and clinical trials that can support claims related to migraines and tinnitus. 

2. Compensation & Pension (C&P) Exam

The C&P exam is essential in proving that migraines are secondary to tinnitus. You should feel confident about the C&P exam you receive. However, if you believe the exam is incomplete or inaccurate, you can request another examination. 

• Preparation: You should bring all medical evidence and personal records to the exam. Show how often migraines occur, whether they occur in conjunction with your tinnitus, and how they impact daily life.
• Requesting a Second Exam: If, after reviewing the C&P exam report, you feel that the first exam did not fully capture your condition or if something seems off, you could try to request a second C&P exam. Consult your legal representative or a VA-accredited organization to guide you through this process.

3. A Private Medical Opinion

In addition to a C&P exam, you may consider obtaining an Independent Medical Opinion (IMO), which is a private medical opinion. This step is helpful if your case is complex or if the VA exam was insufficient. 

• Private medical evidence often provides long-term insight into the veteran’s health and may carry significant weight because of the trusted relationship between the veteran and their private healthcare provider. VA encourages veterans to submit private medical records for consideration.
• How to submit private medical evidence: either gather records directly from healthcare providers or complete VA Forms 21-4142 and 21-4142a to authorize VA to obtain the private medical records. You can find these forms on the VA’s website or by contacting their representative. 

4. Lay Statements and Personal Records 

• Lay Statements: You can submit personal statements, as well as statements from family members, friends, or coworkers who have witnessed your migraines. These accounts help paint a picture of how migraines affect your day-to-day life and work. 
• Buddy Statements: Fellow veterans can also confirm shared service experiences, such as noise exposure during service, that could have led to both tinnitus and migraines. 
• Keeping Personal Records: You should maintain detailed records of your migraines, including how often they occur, their severity, and any triggers linked to tinnitus. Tools like Migraine Buddy, Headache Log, and other health-tracking apps can help you document your condition in real time and share this information with healthcare providers. 

By combining medical evidence, a solid C&P exam, private medical opinions, and personal records, you can build a comprehensive claim for migraines secondary to tinnitus. If you need assistance, working with a VA-accredited attorney or representative can significantly increase your chances. Contact us for a free review of your case if you are trying to appeal an unfavorable VA decision.

Were You Exposed to Things That Trigger Both Migraines and Tinnitus?

Veterans are often exposed to various environmental and physical factors that cause both migraines and tinnitus. The following exposures can help you establish service connection and get VA ratings for both: 

• Loud Noise Exposure: Repeated exposure to loud noises, such as gunfire, explosions, heavy machinery, aircraft engines, and combat situations can cause auditory damage. This leads to tinnitus and hearing loss. The stress from constant noise exposure, combined with damage to the auditory system, may also trigger migraines, especially for veterans prone to headaches. 
• Blast Injuries: IED explosions, grenades, or bomb blasts can damage the inner ear, leading to tinnitus. The concussive force and trauma from these explosions can cause brain injuries, including migraines and other neurological issues like traumatic brain injuries (TBI), which are strongly linked to headaches and migraines.
• Head Trauma: Head injuries sustained in combat, falls, vehicle accidents, or during training exercises can result in post-traumatic headaches like migraines and tinnitus due to damage to the auditory system, the brain, or both. These conditions can develop immediately or over time, especially if the veteran suffered from a concussion or a traumatic brain injury. 
• Stress and Anxiety from Combat: High-stress environments during combat, deployments, or other intense military operations contribute to high levels of anxiety or post-traumatic stress disorder (PTSD). These are known to aggravate migraines and tinnitus.
• Exposure to Toxic Substances: Chemicals or toxins found in burn pits or other hazards in combat zones can lead to neurological issues, causing migraines. Some toxins can also damage the auditory system, leading to tinnitus.

Filing a VA Claim for Migraines Secondary to Tinnitus

1. Gather Medical Evidence: Ensure that both your tinnitus and migraines are well-documented by healthcare professionals. Keep track of medical appointments, diagnoses, and treatments related to both conditions. 
2. Request a Nexus Letter: A nexus letter is often crucial in winning a claim for a secondary condition. Your healthcare provider should explain how your tinnitus is connected to your migraines in clear terms. You might find it beneficial to reference scientific research connecting these two conditions to bolster the letter.
3. Submit a Claim: File your claim with VA, ensuring that all medical evidence, service records, and the nexus letter are included, and in a timely manner.

How Connecting Secondary Conditions Impacts VA Ratings

The VA rates tinnitus alone at a maximum of 10%. However, secondary service connection allows veterans to connect additional conditions to their service-connected tinnitus, potentially increasing their overall VA disability rating. 

If you can prove that your migraines are secondary to tinnitus, you could receive additional compensation based on the frequency and severity of the migraines. This can significantly boost your overall disability rating and provide much-needed financial support. 

But establishing secondary conditions, like migraines linked to tinnitus, isn’t necessarily just about increasing the rating, it paints a more complete picture of the overall toll a veteran’s service-related injuries have taken on their life. 

Case Example: Proving Migraines Secondary to Tinnitus 

In case Nr: 21047063, a Gulf War veteran who served from 1988 to 1992 appealed his claim for migraines secondary to service-connected tinnitus before the Board of Veterans Appeals.

The veteran had initially received a 10% disability rating for tinnitus but believed the migraines, occurring because of the tinnitus, warranted additional compensation. The Board of Veterans’ Appeals reviewed the evidence and decided to grant service connection for migraines, recognizing that the veteran’s migraines were caused by their service-connected tinnitus.

How This Claim Was Won

1. Service-Connected Tinnitus: The veteran had already established a service connection for tinnitus, with an initial rating of 10%. This rating became the foundation for proving that migraines were a secondary condition. 
2. Medical Nexus Between Tinnitus and Migraines: The veteran provided medical evidence, including a 2015 Disability Benefits Questionnaire (DBQ), which documented that tinnitus was aggravating the veteran’s migraines. The medical professional cited research linking tinnitus to migraines, strengthening the veteran’s claim.
3. Comprehensive Medical Evidence: Multiple medical examinations and opinions were presented, including a thorough rationale from a physician supporting the migraine-tinnitus connection. The Board gave significant weight to the physician’s opinion, which was supported by scientific literature.
4. Persistence in the Appeal Process: Although an initial denial occurred, the veteran’s appeal and submission of additional medical evidence led to a favorable decision. The veteran’s case also benefited from the heightened benefit-of-the-doubt standard due to missing service treatment records.

By demonstrating how tinnitus aggravated the veteran’s migraines, this veteran was able to receive a higher overall disability rating and more appropriate compensation for their conditions.

Get Help with Your VA Claim

Navigating the VA disability claims process can be complex, especially when dealing with secondary conditions. A VA-accredited attorney can help you appeal a denied claim for migraines secondary to tinnitus (and increase your chances of winning). If you were denied benefits, contact us today for a free case evaluation.

Content Reviewed by

Cassandra Crosby

Cassandra Crosby is an Accredited Agent and VA Trainer for Hill & Ponton, which she joined in the spring of 2016. She has a Bachelor’s Degree in Legal Studies and over 20 years of experience of management of non-profits programs in Mental Health, Substance Abuse, and Victim Services. A Florida native, she was a military daughter/spouse and has familial ties to the Marines, Air Force, Navy, and Army.