The VA ratings for sinusitis are 0%, 10%, 30%, and 50%. To file a claim for sinusitis, veterans must show that they were diagnosed with sinusitis, prove a service connection, and show a medical connection between their diagnosis and service event.
The Stone Rose Law Firm helps veterans file initial and supplemental claims for sinusitis. We also help veterans to appeal sinusitis claim denials. If you need help with your sinusitis benefits claim with the U.S. Department of Veterans Affairs (the VA), call us at (480) 498-8998 to talk with a veterans claim specialist and to schedule a free consultation to evaluate your claim options.
If the VA approves your claim for sinusitis disability benefits, then you can receive benefits corresponding to the severity of your symptoms, the treatment required, and how often you experience incapacitating episodes. The corresponding VA disability ratings are 0%, 10%, 30%, and 50%.
The VA rates sinusitis under Diagnostic Codes 6510-6514, using the General Rating Formula for Sinusitis. The criteria for each rating are as follows:
Your sinusitis condition does not interfere with your daily life activities and is only detectable by x-ray images.
Although a 0% disability rating does not qualify you for monthly compensation benefits, it does qualify you for other benefits, including VA healthcare benefits.
Your sinusitis condition is manageable by over-the-counter medications or occasional doctor visits.
You experience one or two incapacitating episodes per year that require antibiotic treatment for four to six weeks or three to six non-incapacitating episodes with symptoms including headaches, pain, a pus-like nasal discharge, or crusting.
Your symptoms require you to see your doctor regularly to manage them. They affect your daily life activities and may require prescription medications to treat pain and sinus congestion.
You experience three or more incapacitating episodes every year that require four to six weeks of antibiotic treatment, or more than six annual episodes in which you experience pain, headaches, purulent discharge, or crusting.
Sinusitis significantly impacts your daily life activities and your ability to work. You experience frequent episodes that require significant medical attention, possibly including radical surgery.
Even after surgery, possibly multiple surgeries, you may till experience chronic bone infections or constant sinusitis symptoms, including headaches, chronic pain and tenderness, discharge, and crusting.
Your sinuses exist in four paired sets: frontal, ethmoid, maxillary, and sphenoid. Sinusitis, which is also known as a sinus infection, describes what happens when your sinuses swell and cannot drain properly. This clogging can promote the growth of bacteria in your sinuses, causing further irritation and worsening your symptoms.
Sinusitis is a condition that many military veterans experience because of the contaminated environments they are exposed to during service. In other cases, service-connected sinusitis can result from trauma to the face or nose.
Sinusitis manifests through symptoms that are often similar to what you might experience from infections like a cold or the flu. Common symptoms of sinusitis include:
Sinusitis comes in two forms: acute, and chronic. The VA recognizes chronic sinusitis for VA disability benefits.
The difference between acute and chronic sinusitis is that acute sinusitis is short-term, lasting for less than three months in its symptoms. Chronic sinusitis symptoms are those which persist for more than three months even when treated.
In rare cases, chronic sinusitis can spread to other parts of your body. This can lead to vision impairment, bone and skin infections, or even a life-threatening meningitis infection.
Common causes of chronic sinusitis include respiratory tract infections, a crooked or deviated nasal septum resulting from trauma, or nasal polyps. Other causes include autoimmune or inflammatory diseases, and repeated episodes of acute sinusitis.
Rhinitis is a condition that results from inflammation of nasal tissue instead of your sinuses. Rhinitis symptoms are often similar to those of sinusitis.
To be eligible to receive a VA disability rating, you must be able to show the VA that it is more likely than not that your disability health conditions are connected to your time in active military service. There are multiple ways you can do this: by a presumptive service connection, or a direct connection if a presumptive connection does not exist, or through a secondary or aggravating condition.
To establish a direct connection between your sinusitis disability and your military service, you must be able to show the following:
The same environmental and physical factors that can lead to a presumptive service connection can establish a direct service connection. These service-connected conditions include exposure to high-particulate atmospheric environments like burn pits and sand storms, chemical exposure, and physical injuries to your face or nose.
To help you gather the necessary evidence to support your disability claim, you can use the disability benefits questionnaire (DBQ) for sinusitis. Your treating healthcare professional will usually complete this form for you. Although the DBQ form is not required to file a disability benefits claim, it can be helpful to provide the VA examiner who considers your claim with the information necessary to make a decision on your application.
The application itself is VA Form 21-526EZ. You can complete this form and submit it online, or by mail, or in person at your nearest regional VA office.
In addition to Form 21-526EZ and your DBQ form, your application should include enough documentary evidence to establish a service connection. This documentation can include your military service records, your records of medical records of treatment, and supporting statements from people who have observed your sinusitis condition and can testify in writing to its effects on you. These supporting statements are sometimes referred to as, “buddy letters.”
In some cases, the circumstances of your service can themselves be sufficient to establish the required service connection without you needing to establish proof through supporting documentation. This is known as a presumptive service-connected disability.
For sinusitis, a presumptive service connection exists if you meet either of the following conditions:
Either of these conditions qualifies you as having presumed exposure to toxic substances that can cause sinusitis. This exposure was often the result of exposure to burn pits where the military disposed of materials like trash, fuel, medical waste, lubricants, Styrofoam, paint, and hazardous chemicals.
Moreover, the natural environment of places like Iraq and Afghanistan often meant working in dusty and sandy environments, both of which could contribute to the onset of sinusitis and respiratory diseases like asthma and rhinitis. And if you served in the Persian Gulf War, the particulates from burning oil wells were also a potential source of airborne irritants.
Sometimes, sinusitis can develop as a secondary condition caused by another disabling condition that the VA recognizes for a VA rating.
For example, if you have two or more disabilities, like an existing VA rating for a deviated septum, rhinitis, ear infection, respiratory infection, sleep apnea, or migraines, these are disabilities that can contribute to a sinusitis condition. In this case, your sinusitis VA rating would become part of a combined VA rating.
To learn more about how combined disabilities can influence the VA monthly compensation benefits you may be eligible for, see our VA Disability Calculator.
Having a sinusitis condition does not necessarily prevent you from joining the military. If your time in service sees your pre-existing sinusitis worsen, then you may qualify for VA disability benefits if you can show that the worsening of the condition was because of an event or occurrence in your service and not only a natural progression of the condition.
To get an aggravated rating, the VA will assign you a disability rating matching the level based on your pre-existing condition when you joined the service. It will then assign a new disability rating based on the evidence you submitted in your aggravated disability claim.
During its evaluation of your benefits claim, the VA may schedule you for a C&P exam. This exam aims to give the VA more information to decide whether to approve your claim and, if it does, what your disability rating should be.
Attending your C&P exam is essential. If you miss it, the VA could delay processing your claim or even deny it.
A C&P exam usually has two parts. First, a VA examiner will review your claim documentation and ask you some questions about your symptoms. It is important to answer these questions honestly and to the best of your ability. Next, the examiner may have you undergo a physical exam and perform some tests.
If you have not already prepared a sinusitis DBQ with the help of your doctor, then preparing one in advance of your C&P exam can be helpful for the VA examiner’s consideration. Also, a VA disability claims attorney can help you to prepare for your C&P exam by familiarizing you with the process and the questions the examiner will likely ask you, which will make the exam itself a less stressful and more beneficial experience.
Although sinusitis by itself cannot qualify you for a total disability VA rating, it can contribute to your ability to receive total disability compensation through Total Disability Individual Unemployability (TDIU).
TDIU can apply to you if your VA disabilities keep you from obtaining, or holding, substantially gainful employment. Here is how a VA rating for sinusitis can qualify you for TDIU:
If you have a sinusitis VA rating of 50 percent and a combined rating of at least 70 percent, then you can qualify for TDIU.
Or, if your VA rating for sinusitis is less than 40% but you have another VA disability of at least that level, your sinusitis VA rating can contribute to a combined disability rating of at least 70%.
Either way, TDIU would qualify you to receive the equivalent of a 100% VA disability rating.
The success of your VA disability claim for sinusitis based on TDIU is not always contingent on whether you can meet the percentage calculations above. If, for example, you have a sinusitis condition and cannot be substantially gainfully employed, then you might also qualify for TDIU through the VA’s extraschedular mechanism.
This would require you to prove that your disability or disabilities, even though they do not otherwise allow you to receive TDIU benefits, still uniquely qualify you for them under 38 CFR 4.16(b).
The VA does not always approve of benefits claims on the first attempt. Sometimes, for any of a number of reasons, it may deny your claim for sinusitis benefits. This does not mean that you must give up your claim.
You have options to appeal a VA claim denial. These can be informal, like submitting a supplemental claim application with new and relevant information or requesting a review by another VA examiner, up to a formal hearing before a VA law judge. This is where having an experienced VA disability attorney to represent you can be decisive in helping you overcome an initial claim denial.
At Stone Rose Law, we are accredited VA claims lawyers who serve veterans nationwide in the VA disability claims process.
A Stone Rose Law VA disability lawyer can help you prepare your disability claim for sinusitis benefits, monitor your claim status, and consult with you before disability examinations.
If the VA denies your original claim, our VA benefits law firm will assign a VA disability appeals lawyer to help you pursue a VA appeal with the Board of Veterans Appeals while providing free representation on a contingency fee basis.
You won’t pay any fees to your VA disability lawyer unless we win your appeal. For more information about how one of our VA disability lawyers can help you with your sinusitis VA disability compensation claim or appeal, request a free assistance consultation at (480) 498-8998. Or, if you prefer, you can reach us online.
