Chronic Sinusitis
Chronic sinusitis (all types: ethmoid, frontal, maxillary, sphenoid, pansinusitis) is rated under DC 6510-6514, all using the same schedule. Ratings are based on the frequency of incapacitating and non-incapacitating episodes. Important: sinus headaches cannot receive a separate rating under the migraine schedule. They are typically rated together as 'chronic sinusitis with sinus headaches.' However, you can get separate ratings for sinusitis and rhinitis. This is a burn pit presumptive condition. Note: the sinusitis must be chronic. A diagnosis of 'acute' sinusitis will not be rated, though recurrent acute rhinosinusitis (RARS) is considered chronic despite the name.
VA Rating Levels
Sinusitis detected only by X-ray imaging.
One or two incapacitating episodes per year requiring prolonged (4-6 weeks) antibiotic treatment, or three to six non-incapacitating episodes per year with headaches, pain, and purulent discharge or crusting.
Three or more incapacitating episodes per year requiring prolonged antibiotic treatment, or more than six non-incapacitating episodes per year with headaches, pain, and purulent discharge or crusting.
Following radical surgery with chronic osteomyelitis, or near-constant sinusitis with headaches, pain, tenderness of the affected sinus, and purulent discharge or crusting after repeated surgeries.
Exam Tips & Key Evidence
- →An incapacitating episode means you needed bed rest and treatment by a physician. Keep documentation of any episodes that required you to take time off work or stay in bed.
- →Sinus headaches cannot be rated separately under the migraine code. They are typically included as part of your sinusitis rating, so make sure your examiner documents both the sinus symptoms and the headaches together.
- →You can receive separate ratings for sinusitis and rhinitis, so if you have both conditions, make sure they are claimed individually.
- →Sleep apnea is a common secondary condition to sinusitis. If you have both, consider filing sleep apnea as secondary to your sinus condition.
- →The condition must be diagnosed as chronic. If your records say 'acute sinusitis,' work with your doctor to clarify whether it is actually recurrent or chronic.
Commonly Related Conditions
38 CFR Reference
38 CFR 4.97, DC 6510-6514