Sinusitis & Rhinitis VA Rating Criteria

The General Rating Formula for Sinusitis (DCs 6510-6514)

VA collapses all chronic sinusitis sub-types (pansinusitis 6510, ethmoid 6511, frontal 6512, maxillary 6513, sphenoid 6514) into one general formula in § 4.97. The same percentages apply regardless of which sinus is affected.

• 0% — Detected by X-ray only, no episodes.
• 10% — One or two incapacitating episodes per year of sinusitis requiring prolonged (4-6 weeks) antibiotic treatment; OR three to six non-incapacitating episodes per year characterized by headaches, pain, and purulent discharge or crusting.
• 30% — Three or more incapacitating episodes per year requiring prolonged antibiotic treatment; OR more than six non-incapacitating episodes per year.
• 50% — Following radical surgery with chronic osteomyelitis; OR near constant sinusitis characterized by headaches, pain, tenderness, and purulent discharge or crusting after repeated surgeries.

What VA means by 'incapacitating'

VA defines an incapacitating episode for sinusitis as one that requires bed rest and treatment by a physician. Document each episode with a clinical visit, an antibiotic course (the regulation specifies 4-6 weeks of antibiotic treatment), and notes in the record reflecting the need for bed rest. Self-treated flare-ups without a clinician visit usually do not count as incapacitating.

Allergic & Vasomotor Rhinitis — DC 6522

• 10% — Without polyps, but with greater than 50-percent obstruction of nasal passage on both sides OR complete obstruction on one side.
• 30% — With polyps.

Presumptive pathways for sinusitis and rhinitis

Chronic sinusitis and chronic rhinitis are on the PACT Act presumptive list for burn-pit and airborne hazard exposure for Gulf War, post-9/11 Southwest Asia, and certain other deployment-era veterans. They are also among the chronic multisymptom illnesses VA will service-connect on a presumptive basis under 38 CFR § 3.317 for Gulf War veterans even without identified cause, when the condition manifested during qualifying service or by December 31, 2026 (the current sunset date).

Where these claims break down

• ×Counting self-treated flare-ups as 'incapacitating' — the regulation requires physician-supervised treatment and bed rest.
• ×Filing rhinitis and sinusitis under the same diagnostic code — they are separately ratable under DC 6522 and DCs 6510-6514 respectively, with no pyramiding when both are independently documented.
• ×Missing the burn-pit / PACT Act presumptive pathway — even without a nexus letter, exposed veterans can claim sinusitis and rhinitis as presumptive.
• ×Letting the rating sit at 10% when the treatment record actually shows more than six non-incapacitating episodes per year — that pattern supports a 30% increase claim.

Frequently Asked Questions