Sinusitis VA Rating: Chronic Sinusitis and Rhinitis Criteria

Diagnostic Codes 6510 through 6514: Which sinus cavities are covered

In 38 CFR 4.97, the VA assigns five diagnostic codes based on which paranasal sinus cavities are chronically inflamed:

• Diagnostic Code 6510 (Sinusitis, pansinusitis, chronic): Chronic inflammation affecting all paranasal sinus cavities simultaneously.
• Diagnostic Code 6511 (Sinusitis, ethmoid, chronic): Inflammation of the ethmoid sinuses between the upper nasal bridge and the inner corners of the eyes.
• Diagnostic Code 6512 (Sinusitis, frontal, chronic): Inflammation of the frontal sinuses above the eyes in the lower forehead.
• Diagnostic Code 6513 (Sinusitis, maxillary, chronic): Inflammation of the maxillary sinuses behind the cheekbones on either side of the nose.
• Diagnostic Code 6514 (Sinusitis, sphenoid, chronic): Inflammation of the sphenoid sinuses deep within the skull behind the ethmoid sinuses.

Regardless of which code applies—or whether multiple sinuses are involved—all five codes are rated under the General Rating Formula for Sinusitis (DCs 6510 through 6514). A veteran with both chronic maxillary sinusitis (DC 6513) and chronic frontal sinusitis (DC 6512) receives one combined sinusitis evaluation rather than separate ratings for each cavity.

General Rating Formula for Sinusitis table (38 CFR 4.97, DCs 6510–6514)

Under the binding Note to the General Rating Formula for Sinusitis in 38 CFR 4.97, “An incapacitating episode of sinusitis means one that requires bed rest and treatment by a physician.”

Under the VA compensation schedule effective 2025-12-01, a standalone 10% rating pays $180.42 per month, a 30% rating pays $552.47 per month, and a 50% rating pays $1,132.90 per month for a veteran with no dependents.

Detailed breakdown of each chronic sinusitis rating tier

Every compensable tier under the General Rating Formula for Sinusitis provides two pathways to qualify: one based on incapacitating episodes (or radical surgery with osteomyelitis at 50%) and another based on non-incapacitating episodes (or near-constant symptoms after repeated surgeries at 50%).

0 percent noncompensable rating

The VA assigns 0% when chronic sinusitis is detected by X-ray, CT scan, or endoscopy—such as mucosal thickening or sinus opacification—without meeting the episode frequency required for 10%, or under 38 CFR 4.31 when service-connected sinusitis causes fewer than three non-incapacitating episodes per year. A 0% rating establishes service connection, qualifies the veteran for no-cost VA health care and medications, and preserves the right to file for an increase if episodes worsen.

10 percent disability rating

A veteran qualifies for 10% by meeting either criterion over the past 12 months:

1. Incapacitating pathway: One or two incapacitating episodes per year requiring prolonged (four to six weeks) antibiotic treatment, physician-prescribed bed rest, and physician treatment.
2. Non-incapacitating pathway: Three to six non-incapacitating episodes per year characterized by headaches, facial pain, and purulent discharge or nasal crusting.

Most veterans rated at 10% qualify through the non-incapacitating pathway because standard care rarely pairs four-to-six-week antibiotics with physician-ordered bed rest.

30 percent disability rating

A 30% evaluation applies when chronic sinusitis reaches either threshold:

1. Incapacitating pathway: Three or more incapacitating episodes per year requiring prolonged (four to six weeks) antibiotic treatment, physician-directed bed rest, and treatment.
2. Non-incapacitating pathway: More than six (seven or more) non-incapacitating episodes per year characterized by headaches, pain, and purulent discharge or crusting.

Medical records, urgent care visits, prescription logs, or lay statements must document at least seven distinct flare-ups over 12 months featuring sinus headaches, facial pain, and purulent drainage or crusting.

50 percent disability rating

The maximum schedular rating under Diagnostic Codes 6510 through 6514 is 50%, requiring one of two post-surgical outcomes:

1. Radical surgery with chronic osteomyelitis: Radical sinus surgery (such as a Caldwell-Luc procedure) resulting in chronic bone infection (osteomyelitis) of the sinus walls.
2. Near-constant sinusitis after repeated surgeries: Two or more sinus surgeries—such as multiple functional endoscopic sinus surgeries (FESS), antrostomies, or ethmoidectomies—followed by near-constant sinusitis characterized by headaches, pain and tenderness of the affected sinus, and purulent discharge or crusting.

A single sinus surgery without a second operation does not satisfy the “repeated surgeries” requirement unless radical surgery with chronic osteomyelitis is present.

Allergic, vasomotor, bacterial, and granulomatous rhinitis ratings (DCs 6522–6524)

Under 38 CFR 4.97, the VA rates chronic nasal mucosal inflammation under three rhinitis diagnostic codes alongside traumatic septal deviation.

Rhinitis and nasal septum rating table (38 CFR 4.97, DCs 6522–6524 and DC 6502)

Most rhinitis claims are evaluated under Diagnostic Code 6522 (Allergic or vasomotor rhinitis):

• 10% rating criteria: Requires greater than 50% obstruction of the nasal passage on both sides, or complete (100%) obstruction on one side, without polyps. (Traumatic deviated septum under DC 6502 requires 50% or greater bilateral obstruction.)
• 30% rating criteria: Assigned whenever service-connected allergic or vasomotor rhinitis includes nasal polyps confirmed by rhinoscopy, endoscopy, or sinus CT imaging, regardless of airflow obstruction percentage.

PACT Act presumptive service connection under 38 CFR 3.320

Under the PACT Act of 2022 and 38 CFR 3.320(a)(2), the VA presumes service connection for asthma, rhinitis, and sinusitis (to include rhinosinusitis) when manifested to any degree at any time after separation from a qualifying period of active military, naval, air, or space service under 38 CFR 3.320(a)(5)–(6):

• The Southwest Asia theater of operations (during the Persian Gulf War, from August 2, 1990 onward): Iraq, Kuwait, Saudi Arabia, the neutral zone between Iraq and Saudi Arabia, Bahrain, Qatar, the United Arab Emirates, Oman, the Gulf of Aden, the Gulf of Oman, the Persian Gulf, the Arabian Sea, the Red Sea, and the airspace above these locations.
• Additional qualifying locations under 38 CFR 3.320(a)(5)(ii) (on or after September 19, 2001, during the Persian Gulf War): Afghanistan, Syria, Djibouti, or Uzbekistan. (Separately, the PACT Act statutory presumption in 38 U.S.C. 1120 and 38 U.S.C. 1119(c)(1) also covers chronic sinusitis and chronic rhinitis for qualifying service on or after August 2, 1990 in Somalia and on or after September 11, 2001 in Egypt, Jordan, Lebanon, and Yemen, and the airspace above these locations.)

Veterans outside presumptive locations can establish direct service connection under 38 CFR 3.303 using in-service medical or exposure records, or secondary connection under 38 CFR 3.310 when service-connected rhinitis or septal deviation blocks sinus drainage.

What to expect at a sinusitis and rhinitis C&P exam (DBQ)

During a Compensation and Pension (C&P) exam, the clinician completes the Sinusitis, Rhinitis and Other Conditions of the Nose, Throat, Larynx and Pharynx Disability Benefits Questionnaire (DBQ), available on the VA Public DBQs portal:

1. Diagnosis and affected sinuses: Identifies chronic pansinusitis, maxillary, frontal, ethmoid, or sphenoid sinusitis, and/or allergic, vasomotor, bacterial, or granulomatous rhinitis.
2. Episode frequency (past 12 months): Records incapacitating episodes requiring physician-prescribed bed rest and 4–6 weeks of antibiotics, and non-incapacitating episodes (none, 1–2, 3–6, or more than 6) with headaches, pain, and purulent discharge or crusting.
3. Surgical history: Documents radical sinus surgery with chronic osteomyelitis or repeated sinus surgeries and near-constant residuals.
4. Nasal passage exam: Uses anterior rhinoscopy to check each nostril for >50% bilateral obstruction, 100% unilateral obstruction, turbinate hypertrophy, or visible nasal polyps.
5. Diagnostic imaging: Reviews X-rays, sinus CT scans, or endoscopy reports confirming mucosal thickening, sinus opacification, fluid levels, or polyps.

Separate ratings and secondary conditions

Under 38 CFR 4.14, the VA cannot rate the same symptom twice. Because chronic sinusitis (DCs 6510–6514) is rated on sinus episodes, pain, and purulent drainage while allergic rhinitis (DC 6522) is rated on nasal passage obstruction or polyps, veterans diagnosed with both can receive separate concurrent ratings.

Under 38 CFR 3.310(a), chronic sinusitis or rhinitis may also support secondary service connection when backed by a medical nexus opinion:

• Obstructive sleep apnea (DC 6847): Severe nasal blockage or polyps increase upper airway resistance during sleep, which may cause or aggravate pharyngeal airway collapse (rated at 0%, 30%, 50% with a prescribed CPAP, or 100% under 38 CFR 4.97).
• Migraine headaches (DC 8100): Chronic sinus inflammation may trigger or aggravate neurovascular migraines, rated at 0%, 10%, 30%, or 50% under 38 CFR 4.124a when distinct from sinus headaches.
• Complete loss of smell or taste (DCs 6275 and 6276): Under 38 CFR 4.87a, complete loss of smell (DC 6275, anosmia) and complete loss of taste (DC 6276, ageusia) are each rated at 10% when supported by an anatomical or pathological basis such as polyps or repeated sinus surgeries.
• Asthma (DC 6602), chronic bronchitis (DC 6600), and chronic laryngitis (DC 6516): Purulent post-nasal drip and upper airway inflammation may aggravate lower airway hyperreactivity or vocal cord inflammation.

(Note: The February 15, 2022 proposed rule in 87 FR 8474 remains unfinalized; current 38 CFR 4.97 rules govern all claims, and established ratings are protected under 38 CFR 3.951(a).)

Combining ratings and when to seek accredited help

When you hold multiple VA disability ratings, the VA combines them using the Combined Ratings Table in 38 CFR 4.25 rather than adding percentages directly. Model how a sinusitis or rhinitis rating affects your monthly compensation with the VA combined rating calculator.

If your claim was denied, assigned 0% despite frequent episodes, or involves a PACT Act supplemental claim, consider working with a VA-accredited representative. Veterans Service Organizations (VSOs)—such as the DAV, VFW, and American Legion—provide representation free of charge, while VA-accredited claims agents and attorneys assist with appeals through the VA Office of General Counsel Accreditation Search.