Sinusitis and Rhinitis Claims Guide

Chronic sinusitis and rhinitis are among the most common conditions veterans bring home, especially after burn-pit and dust exposure. They are rated in very different ways: sinusitis is scored by counting your flare-ups over a year, while rhinitis turns on whether you have nasal polyps or a blocked airway. This guide explains how DC 6510 and DC 6522 work, why both are now burn-pit presumptives under the PACT Act, and the evidence that wins.

What Sinusitis and Rhinitis Are

Sinusitis is inflammation of the sinuses that keeps coming back, with facial pain and pressure, headaches, congestion, and discharge. It is rated under diagnostic code 6510 and the related sinus codes (6511 to 6514), all on the same scale. Rhinitis is chronic inflammation of the nasal lining, allergic or vasomotor, with a runny or blocked nose and sometimes polyps, rated under diagnostic code 6522. Both sit in the respiratory schedule (see 38 CFR § 4.97).

They can be rated at the same time. Sinusitis and rhinitis are separate conditions on separate scales, so a veteran with both can carry a rating for each. They are not the same diagnosis and do not overlap for pyramiding purposes.

How They Get Service Connected

  • Burn pits and airborne hazards (PACT Act presumptive). Chronic sinusitis and chronic rhinitis are both on the list of conditions presumptively linked to burn-pit and airborne-hazard exposure. Covered veterans with a qualifying exposure generally do not have to prove the medical link. See the PACT Act and burn-pit presumptives.
  • Direct. A chronic sinus or nasal condition that began in service, documented then or shown continuous since, with a current diagnosis and a nexus.
  • Secondary. Sinusitis or rhinitis caused or worsened by another service-connected condition, for example a deviated septum, or GERD driving chronic irritation. See secondary conditions.

Across published DC 6510 decisions, here is how often the Board granted by the legal theory the claim was argued on:

Grant rate by exposure flag

How often the Board granted DC 6510 issues that carried each exposure signal, next to the overall baseline:

Common Secondary Conditions

Chronic sinus and nasal disease connects to other claims in both directions, often through a shared airway problem or exposure. Each bar below is the Board's grant rate for DC 6510 in that pairing, with the number of decisions under it. They describe the published record across many veterans, not a prediction about any one claim.

Conditions linked as causing sinusitis (sinusitis as the secondary)

Claims where sinusitis was argued as secondary to an already service-connected condition:

Conditions sinusitis is linked to causing (sinusitis as the primary)

Conditions veterans have claimed as caused or aggravated by service-connected sinusitis:

How the VA Rates Sinusitis (DC 6510): Count the Episodes

Sinusitis is scored almost entirely by how often it flares in a 12-month period, and how bad those flares are. The rating counts two kinds of episode:

  • Incapacitating episode: a flare that requires bed rest and treatment by a physician, and prolonged (4 to 6 weeks) antibiotics.
  • Non-incapacitating episode: a flare with headaches, pain, and purulent discharge or crusting, but that does not put you in bed under a doctor's care.
RatingWhat it takes over 12 months
50%Following radical surgery with chronic osteomyelitis, or near-constant sinusitis with headaches, pain, tenderness, and discharge or crusting after repeated surgeries
30%Three or more incapacitating episodes needing prolonged antibiotics, or more than six non-incapacitating episodes
10%One or two incapacitating episodes, or three to six non-incapacitating episodes
0%Detected by imaging only, with no qualifying episodes
Keep an episode diary. Because the rating is a count, the veterans who do best track every flare: the date, the symptoms, whether they saw a doctor, and what antibiotics they took and for how long. A vague "I get sinus infections a lot" is hard to rate; a dated log of six episodes is not.

How the VA Rates Rhinitis (DC 6522): Polyps and Obstruction

Rhinitis is rated on physical findings, not episode counts.

RatingFinding
30%Allergic or vasomotor rhinitis with nasal polyps
10%Without polyps, but with more than 50% obstruction of the nasal passage on both sides, or complete obstruction on one side

The key facts are whether polyps are present and how blocked the airway is, so the exam should look inside the nose and document both. A deviated septum is rated separately under its own code and can be claimed alongside rhinitis.

Go deeper: open the full sinusitis breakdown
  • What the VA measures at your C&P exam
  • Evidence that has won at the Board
  • Inside the rater's playbook: grant, denial, and remand rates
  • Secondary condition map
See the full DC 6510 breakdown →

Evidence That Wins

  • An episode log for sinusitis, dated, with symptoms, doctor visits, and the antibiotics and their length. This is what the count-based rating is built from.
  • Treatment records showing the pattern over the past year, prescriptions, imaging, and any surgeries.
  • An exam of the nose for rhinitis, documenting polyps and the percentage of nasal obstruction on each side.
  • Proof of a qualifying exposure for the presumptive path: deployment records or the burn-pit registry.
  • The Sinusitis and Rhinitis DBQ, which captures the episodes, polyps, and obstruction the ratings depend on. See the DBQ guide.

Common Mistakes

The same handful of missteps account for most lost or under-rated sinus and nasal claims. Among the Board's classified service-connection denials for sinusitis, here is what claims most often fell short on:

  • Not documenting the episodes. Sinusitis is rated by counting flares. Without dated records of how many episodes you had and whether they were incapacitating, the rating comes in low.
  • Confusing incapacitating with non-incapacitating. An incapacitating episode requires bed rest, a physician, and prolonged antibiotics. Mixing the two up sends the count to the wrong row.
  • Missing polyps or obstruction for rhinitis. Rhinitis turns on polyps and the percentage of nasal blockage. If the exam did not look for them, the finding that earns the rating is absent.
  • Skipping the presumptive path. Chronic sinusitis and rhinitis are burn-pit presumptives. Veterans with qualifying exposure sometimes try to prove a direct link the presumption already covers.
  • Claiming one when you have both. Sinusitis and rhinitis are separate conditions on separate scales. If you have both, claim both.

Frequently Asked Questions

How does the VA rate chronic sinusitis?
By counting flare-ups over a 12-month period. Three or more incapacitating episodes (bed rest, a physician, and prolonged antibiotics) or more than six non-incapacitating episodes reach 30 percent; one or two incapacitating or three to six non-incapacitating reach 10 percent. A dated episode log is the key evidence.
What gets rhinitis to 30 percent?
Nasal polyps. Allergic or vasomotor rhinitis with polyps is 30 percent. Without polyps, greater than 50 percent obstruction on both sides or complete obstruction on one side is 10 percent. The exam should look inside the nose and record both.
Are sinusitis and rhinitis covered by the PACT Act?
Yes. Chronic sinusitis and chronic rhinitis are both on the burn-pit and airborne-hazard presumptive list. Covered veterans with a qualifying exposure generally do not have to prove the medical link separately.
Can I get a rating for both sinusitis and rhinitis?
Yes. They are separate conditions rated on separate scales, so having both can carry a rating for each. It is not pyramiding because they are different diagnoses.
What counts as an incapacitating episode?
A sinusitis flare that requires bed rest and treatment by a physician, along with prolonged (4 to 6 weeks) antibiotic treatment. A flare you manage at home without a doctor is a non-incapacitating episode, which is counted differently.

Related Tools and Guides

Sources: 38 CFR 4.97, respiratory ratings · VA, burn-pit and airborne hazards · CCK Law, sinusitis. Educational only, not legal advice, and not a prediction of any individual claim. Rating criteria change; confirm current details in 38 CFR 4.97. For help with your claim, find a VA-accredited representative.