What is Tinnitus, and How Does It Relate to Depression?
Tinnitus is a complex condition that is commonly characterized by ringing in the ears, although symptoms can vary and include:
One of the most common causes of tinnitus is exposure to loud noises that damage the inner ear. This is the major reason why many veterans suffer from tinnitus, because they are consistently working in close proximity to gunfire, jet engines, explosives, and other loud noises. Tinnitus can make it difficult to concentrate, can be accompanied by or cause headaches, and can lead to an increased likelihood of developing depression.
Depression presents differently in many people, but there are several common symptoms that most individuals with depression exhibit:
- Persistent feelings of sadness, hopelessness, and worthlessness
- Tiredness and lack of energy
- Lack of interest or pleasure in most or all normal activities
- Angry outbursts
- Trouble thinking and concentrating
In a recent study conducted on veterans with tinnitus, clinicians found that 59.3 percent of the study participants had depression and 58.2 percent of the study participants had both depression and anxiety. These findings align with research done by other otolaryngologists in the field, who found that the likelihood of someone developing lifetime depression and anxiety is significantly higher among individuals with tinnitus than it is for the general population.
Establishing Service Connection
The most important thing you need in order to establish service connection for tinnitus and depression secondary to tinnitus is evidence in the form of medical records, including both in-service and private medical treatment. Ideally, these records will show that (1) your tinnitus was diagnosed in-service or caused by an in-service incident and (2) that your tinnitus has caused you to develop depression. These types of records can also be supported by military service records showing that you were consistently exposed to loud noises or were involved in an incident that could have caused tinnitus (such as being close to an explosion), statements from family members and friends who are familiar with your condition, and medical opinions from specialists who are experienced treating veterans with tinnitus and depression and clarifying the nexus between (1) the veteran’s service and his or her tinnitus and (2) the veteran’s tinnitus and his or her depression.
How the VA Rates Depression and Tinnitus
Under 38 CFR § 4.87, recurrent tinnitus (Diagnostic code 6260) has a maximum schedular rating of 10%, regardless of whether it is persistent (occurs all the time) or intermittent (occurs with breaks). Depression has a more complex rating scale, and under 38 CFR § 4.130, it can be rated based on the following criteria:
Diagnostic code 9433 (Persistent depressive disorder), 9434 (Major depressive disorder), and 9435 (Unspecified depressive disorder):
- Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name: 100%
- Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships: 70%
- Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships: 50%
- Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events): 30%
- Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by continuous medication: 10%
- A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication: 0%
Tinnitus and TDIU claims
Severe, constant tinnitus can make it difficult to accomplish routine daily tasks. Despite the severe effects tinnitus can have on your life, the maximum schedular disability rating for tinnitus is only 10 percent; however, due to the intense effects tinnitus can have on daily living, many veterans with this condition are unable to hold substantially gainful occupations and are therefore eligible for a total disability rating based on individual unemployability (a TDIU rating), especially if they are able to obtain service connection for depression secondary to their tinnitus.
Assistance with Your Depression Secondary to Tinnitus Claim
If you or a veteran you know are suffering from tinnitus and looking for help with your VA disability claim, please do not hesitate to contact us our office via this website or by calling the number displayed. Our veterans disability attorneys are experienced in proving depression secondary to tinnitus and are here to help you get the compensation you have earned. Our office will take care of referring you to medical experts who have experience examining veterans and providing opinions for VA disability claims. We will also help you navigate the complicated VA disability ratings system. No matter the case, we work hard to ensure that the VA evaluates your claim properly, and there is no fee unless we win your case.