Sinusitis and rhinitis are not one claim; they are two diagnostic codes that can each carry a rating. And the sinusitis levels turn on a defined term veterans use loosely: an incapacitating episode means physician-prescribed bed rest, so miserable undocumented weeks count for nothing, while a single documented polyp moves rhinitis from 10 to 30 percent on its own.
Two related conditions, two different codes
Chronic sinusitis and rhinitis often travel together, but VA rates them separately. Sinusitis (inflammation of the sinuses) falls under diagnostic codes 6510 through 6514, and allergic or vasomotor rhinitis (inflammation inside the nose) under code 6522, all in the respiratory schedule (38 CFR 4.97). Because they are different codes for different parts of the airway, a veteran can hold a rating for each.
How sinusitis is rated (6510 to 6514)
All forms of chronic sinusitis share one General Rating Formula built around incapacitating and non-incapacitating episodes:
- 0 percent: detected by imaging only, with no symptoms.
- 10 percent: one or two incapacitating episodes a year requiring prolonged (four to six weeks) antibiotics, or three to six non-incapacitating episodes a year with headaches, pain, and purulent discharge or crusting.
- 30 percent: three or more incapacitating episodes a year requiring prolonged antibiotics, or more than six non-incapacitating episodes a year.
- 50 percent: following radical surgery with chronic osteomyelitis, or near constant sinusitis with headaches, pain and tenderness, and purulent discharge or crusting after repeated surgeries.
An incapacitating episode has a specific meaning here: it requires bed rest prescribed by a physician. The prolonged antibiotic course (four to six weeks) is a separate criterion stated at the 10 and 30 percent levels, not a required part of what makes an episode incapacitating. An episode that meets the bed-rest standard qualifies as incapacitating even if the antibiotic course differs. Together, those two elements are what separates the 10 and 30 percent levels.
How rhinitis is rated (6522)
Allergic and vasomotor rhinitis has its own short scale:
- 10 percent: without polyps, but with greater than 50 percent obstruction of both nasal passages, or complete obstruction on one side.
- 30 percent: with polyps.
The presence of nasal polyps is the single fact that moves rhinitis from 10 to 30 percent, so whether polyps are documented matters a great deal.
The PACT Act connection
Chronic sinusitis and chronic rhinitis are both on the PACT Act presumptive list for veterans exposed to burn pits and other airborne hazards, diagnosed within the regulatory window. For a qualifying veteran, the connection is presumed.
Details that affect your combined rating
- Sinusitis and rhinitis are separate codes and can each carry their own rating.
- An incapacitating episode is a defined term, requiring physician-prescribed bed rest and a prolonged antibiotic course, so casual sick days do not count.
- Polyps are the line for rhinitis, moving it from 10 to 30 percent, so make sure they are noted when present.
- Both can be PACT Act presumptive for airborne hazard and burn pit exposure within the window.
- Count and document your episodes, because the sinusitis levels turn on how many you have in a year.