Home › Conditions › Secondary claims › Migraines ← Tinnitus
A secondary claim is a condition caused or worsened by one the VA has already service-connected (38 CFR 3.310). The causation fight is already half-won — the VA agreed your tinnitus came from service; the question is only whether it caused or aggravated the migraines. That's a medical question with a recognized answer.
The connection
Constant ringing is not a background nuisance — it is a neurological stressor that disrupts sleep and raises baseline arousal, both established migraine triggers, and the two conditions share overlapping neural pathways in the current research. For a veteran with service-connected tinnitus who later develops migraines, this is a recognized secondary theory worth developing properly.
How the VA rates migraines
DC 8100 — Migraine
| Rating | Criteria (38 CFR Part 4 wording) |
|---|---|
| 50% | With very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability |
| 30% | With characteristic prostrating attacks occurring on an average once a month over last several months |
| 10% | With characteristic prostrating attacks averaging one in 2 months over last several months |
| 0% | With less frequent attacks |
"Prostrating" is not defined in the schedule; in practice it means an attack that forces you to stop what you are doing and lie down. "Severe economic inadaptability" does not require unemployability (Pierce v. Principi, 18 Vet. App. 440 (2004)).
Full criteria, exam and evidence guide: VA rating for Migraines. And the anchor: VA rating for Tinnitus.
What the claim needs — the three legs
- The anchor: service connection for the tinnitus (see how that condition is rated). Not connected yet? File both in the same claim — the VA decides the anchor first, then the secondary against it.
- A current diagnosis of migraines — the VA rates diagnosed conditions. If you only have the symptoms, file them anyway: the C&P exam supplies the diagnosis, and a "no diagnosis" denial is repaired with a supplemental claim that keeps your date.
- The medical link. An opinion stating it is "at least as likely as not" that the tinnitus caused or aggravated the migraines. The VA's own C&P examiner supplies this free in most cases; your own doctor can too. A paid independent opinion is the answer to a denial, not the first move.
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See If You Qualify →Frequently asked questions
Can I claim migraines secondary to tinnitus?
Yes, if three things hold: the tinnitus (or its equivalent) is service-connected, you have a current diagnosis of migraines, and a medical opinion connects the two. The connection described on this page is a recognized pathway raters see regularly.
Do I need to pay for a nexus letter for migraines secondary to tinnitus?
Usually not. The VA's own C&P examiner can supply the connecting opinion at your exam for free, and your own treating doctor can also provide it. A paid independent opinion is worth buying only after a denial for lack of nexus — a supplemental claim within one year keeps the original effective date.
What if the primary condition isn't service-connected yet?
File them together in the same claim. The VA decides the primary first and then the secondary against it in the same decision; a secondary filed alone against a condition the VA has not connected fails. Filing both at once under one Intent to File protects the effective date for both.
Last reviewed 2026-09-19.