VA Disability Ratings for Sinusitis
What is Chronic Sinusitis?
Chronic sinusitis occurs when the spaces inside your nose and head (i.e., sinuses) are swollen and inflamed for three months or longer, despite treatment. This condition is rather common and typically interferes with the way mucus drains, causing your nose to be stuffy. As such, breathing through your nose may be difficult, and the area around your eyes might feel swollen or tender. Common signs and symptoms include:
- Nasal inflammation
- Thick, discolored discharge from the nose
- Drainage down the back of the throat (postnasal drainage)
- Nasal obstruction or congestion, causing difficulty breathing through your nose
- Pain, tenderness and swelling around your eyes, cheeks, nose, or forehead
- Reduced sense of smell and taste
- Ear pain
- Aching in your upper jaw and teeth
- Cough or throat clearing
Chronic sinusitis and acute sinusitis have similar symptoms, but acute sinusitis is a temporary infection of the sinuses often associated with a cold. As such, it is not as debilitating and typically resolves on its own. Common causes of chronic sinusitis may include the following:
- Nasal polyps – tissue growths that block the nasal passages or sinuses
- Deviated nasal septum – a crooked septum (i.e., the wall between the nostrils) may restrict or block sinus passages
- Respiratory tract infections – infections in your respiratory tract can inflame and thicken your sinus membranes and block mucus drainage
Veterans may develop this condition as a result of their active-duty military service, in which case they may be entitled to VA disability benefits.
Service Connection for Chronic Sinusitis
Chronic sinusitis can be caused by a number of things that veterans may experience while serving on active duty. For example, veterans may suffer from facial injuries that result in a deviated septum that then leads to chronic sinusitis. In other instances, veterans may be exposed to air pollutants and toxins emitted from burn pits. Inhaling such asbestos and contaminants can lead to complications with sinus functioning later on. Service connection for chronic this condition can be established in several different ways:
Direct Service Connection
To establish direct service connection for chronic sinusitis, veterans must demonstrate the following three elements:
- A current diagnosis
- An in-service event, injury, or illness
- A medical nexus linking the current diagnosis of chronic sinusitis to the in-service occurrence
For example, veterans can claim that their diagnosed chronic sinusitis is due to their burn pit exposure. In this case, a healthcare professional would have to provide an opinion stating that the veteran’s condition is “at least as likely as not” due to their in-service exposure.
Secondary Service Connection
A secondary service-connected condition is one that resulted from a separate condition that is already service-connected. If a veteran experienced a traumatic injury to their face that resulted in a deviated septum, they may be service-connected for that condition. If the veteran then develops chronic sinusitis as a result of their service-connected deviated septum, service connection may be warranted on a secondary basis.
How VA Rates Chronic Sinusitis
VA rates chronic sinusitis under 38 CFR § 4.97 according to the General Rating Formula for Sinusitis (Diagnostic Codes 6510 through 6514). The criteria are as follows:
- 50% – following radical surgery with chronic osteomyelitis, or; near constant sinusitis characterized by headaches, pain and tenderness or affected sinus, and purulent discharge or crusting after repeated surgeries
- 30% – three or more incapacitating episodes per year of sinusitis requiring prolonged (lasting four to six weeks) antibiotic treatment, or; more than six non-incapacitating episodes per year characterized by headaches, pain, and purulent discharge or crusting
- 10% – one or two incapacitating episodes per year of sinusitis requiring prolonged (lasting four to six weeks) antibiotic treatment, or; three to six non-incapacitating episodes per year characterized by headaches, pain, and purulent discharge or crusting
- 0% – detected by X-ray only
Importantly, an incapacitating episode of sinusitis refers to one that requires bed rest and treatment by a healthcare professional.
Chisholm Chisholm & Kilpatrick LTD May Be Able to Help With Your Denied VA Claim
If you are experiencing difficulty receiving VA benefits for a condition caused by military service, Chisholm Chisholm & Kilpatrick LTD may be able to help. Our team of experienced lawyers has the resources necessary to provide support and guidance throughout the VA disability claims process. Call 800-544-9144 for a free case evaluation.
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