Rhinitis and Sinusitis VA Ratings Explained (DC 6510–6522)

Rhinitis and sinusitis are rated under entirely different frameworks. Rhinitis is measured anatomically - how much of the nasal passage is obstructed and whether polyps are present. Sinusitis is measured episodically - how many flare-ups occur in a year and how severe each one is.

Understanding which framework applies explains why two veterans with similar symptoms receive very different evaluations. For how these conditions become service connected in the first place, see how service connection works for rhinitis, sinusitis, and asthma.

Allergic and vasomotor rhinitis - Diagnostic Code 6522

DC 6522 has exactly two evaluation levels:

• 30 percent - with polyps
• 10 percent - without polyps, but with greater than 50 percent obstruction of the nasal passage on both sides, or complete obstruction on one side

Why rhinitis claims are commonly rated at 0 percent

Because the criteria are anatomical, an examination that documents symptoms without measuring obstruction supports nothing above a noncompensable evaluation. A veteran who uses daily nasal steroids, has constant congestion, and cannot breathe through one side at night will still receive 0 percent if the examiner's report says only that rhinitis is present.

The remedy is documentation, not argument: an examination that states the percentage of obstruction on each side, notes whether polyps were visualized, and describes findings on nasal endoscopy where performed.

Chronic sinusitis - Diagnostic Codes 6510 through 6514

Pansinusitis, ethmoid, frontal, maxillary, and sphenoid sinusitis all use the same General Rating Formula for Sinusitis. The distinguishing code identifies which sinus is affected; the criteria are identical.

• 50 percent - following radical surgery with chronic osteomyelitis, or near constant sinusitis with headaches, pain, and tenderness of the affected sinus, and purulent discharge or crusting after repeated surgeries
• 30 percent - three or more incapacitating episodes per year requiring prolonged antibiotic treatment, or more than six non-incapacitating episodes per year of headaches, pain, and purulent discharge or crusting
• 10 percent - one or two incapacitating episodes per year requiring prolonged antibiotics, or three to six non-incapacitating episodes per year
• 0 percent - detected by imaging only

Episode counting is where sinusitis ratings are won or lost

The formula turns almost entirely on a number: how many episodes occurred in the past twelve months. An incapacitating episode is defined in the regulation as one requiring bed rest and treatment by a physician, with prolonged antibiotic treatment of four to six weeks.

Veterans who manage flare-ups at home, or who see a provider only when a course of antibiotics runs out, often have no documentation of the episodes they actually experienced. A dated symptom log, pharmacy refill history, and after-visit summaries do more for a sinusitis evaluation than any narrative statement.

Rating both conditions

Rhinitis and sinusitis are distinct diagnostic codes, but 38 CFR 4.14 prohibits evaluating the same manifestation under more than one code. Separate evaluations are appropriate where the conditions are separately diagnosed and produce distinct disabling manifestations. Our guide on combining sinusitis and rhinitis ratings works through how that is handled and how 38 CFR 4.25 combines the results.

Deviated septum and nasal obstruction

A deviated nasal septum is rated separately under DC 6502, capped at 10 percent and limited to deviations that are traumatic in origin. Because the obstruction criteria overlap with rhinitis, examiners should identify what is causing the obstruction. See deviated septum VA ratings.

What to do with a rating that does not match the symptoms

When the evaluation appears inconsistent with the condition, the usual explanation is that the examination never captured the findings the criteria require. Identifying that gap is a records question before it is anything else.

A paid medical records review reads the file against the criteria and identifies what the evidence currently supports. Related reading: our respiratory evidence guide.