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Sinus and stuffy nose

Chronic sinusitis and rhinitis (including burn pit / PACT Act)

What it is

Sinusitis is swelling and infection of the hollow spaces around your nose; rhinitis is a stuffy, runny nose that keeps coming back.

VA's code numbers for this: 6510, 6511, 6512, 6513, 6514, 6522

What the examiner will do

Who does it: A VA doctor or a VA contract examiner. VA's exam page (updated Aug 15, 2025) names four contract companies: Loyal Source Government Services, OptumServe Health Services, Leidos QTC Health Services, and Veterans Evaluation Services (VES). (LHI is an older name; it is now part of OptumServe.) You can't pick which one. Answer every call or letter about scheduling.

  • A VA or contract doctor, NP, or PA. Often 15-30 minutes.
  • They look in your nose, check blockage and polyps, press on your sinuses, and review CT scans and treatment records.
  • Questions: How many sinus infections this year? How many needed antibiotics, and for how long? Bed rest? Surgeries? Deployment history?

Tests, in plain words

'Incapacitating episode'
A sinus infection bad enough that a doctor treats you and you need bed rest. (Rule's words: 'requires bed rest and treatment by a physician.')
'Purulent discharge'
Thick yellow or green drainage (pus).
Nose exam / scope
The examiner looks inside your nose, sometimes with a small camera, to see blockage and polyps.
CT scan
A detailed X-ray of the sinuses.
PACT Act
Rhinitis and sinusitis (including rhinosinusitis) are presumptive for burn pit/airborne hazard exposure with qualifying service (same places and dates as asthma).

The examiner fills out a form called a DBQ. You can read it ahead of time: Sinusitis, Rhinitis and Other Conditions of the Nose, Throat, Larynx and Pharynx DBQ (opens VA's site).

The rating levels, in plain words

VA picks the level that best matches how often and how badly the condition affects you.

  • 0%

    SINUSITIS: Shows up only on an X-ray or scan.

    VA's exact words

    Detected by X-ray only

    Rule: 38 CFR 4.97, General Rating Formula for Sinusitis (DCs 6510-6514)

  • 10%

    SINUSITIS: 1-2 bad episodes a year that need bed rest, a doctor, and 4-6 weeks of antibiotics, OR 3-6 milder episodes a year with headaches, pain, and pus-like drainage or crusting.

    VA's exact words

    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 of sinusitis characterized by headaches, pain, and purulent discharge or crusting

    Rule: 38 CFR 4.97, General Rating Formula for Sinusitis (DCs 6510-6514)

  • 30%

    SINUSITIS: 3+ bad episodes a year needing 4-6 weeks of antibiotics, OR more than 6 milder episodes a year.

    VA's exact words

    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 of sinusitis characterized by headaches, pain, and purulent discharge or crusting

    Rule: 38 CFR 4.97, General Rating Formula for Sinusitis (DCs 6510-6514)

  • 50%

    SINUSITIS: After major sinus surgery with bone infection, OR almost constant sinusitis after repeated surgeries.

    VA's exact words

    Following radical surgery with chronic osteomyelitis, or; near constant sinusitis characterized by headaches, pain and tenderness of affected sinus, and purulent discharge or crusting after repeated surgeries

    Rule: 38 CFR 4.97, General Rating Formula for Sinusitis (DCs 6510-6514)

  • 10%

    RHINITIS (DC 6522): No polyps, but nose more than half blocked on both sides, or fully blocked on one side.

    VA's exact words

    Without polyps, but with greater than 50-percent obstruction of nasal passage on both sides or complete obstruction on one side

    Rule: 38 CFR 4.97, DC 6522

  • 30%

    RHINITIS: Nasal polyps (soft growths inside the nose).

    VA's exact words

    With polyps

    Rule: 38 CFR 4.97, DC 6522

What to track before your exam

What to write down: Each sinus episode: dates, symptoms, doctor visits, antibiotics and how long, bed rest days. For rhinitis: daily blockage and sprays.

How: Keep a running list for 12 months. Get a pharmacy printout showing antibiotic courses and nasal sprays. If a doctor tells you to rest, ask that it be written in the visit note.

Your log: what to write each time

  1. Start date
  2. End date
  3. Headache / face pain / pus-like drainage / crusting?
  4. Saw a doctor? (Y/N)
  5. Antibiotic name and days
  6. Doctor said bed rest? days
  7. Nose blocked: one side / both / how much

Tap Print this page to get a blank log sheet and your exam-day checklist on paper.

Exam-day checklist

Tick each one off. Nothing you tick is saved or sent anywhere.

What to bring: Bring a photo ID, your list of medicines and doses, your home log, and any new private records you have not sent to VA yet. VA says you don't have to bring anything, but your notes help you remember. A spouse or caregiver may come along. VA says you can ask the examiner if they can stay in the room. The examiner may ask them to wait outside.

Tell the examiner

Honest exam rules

  • Tell the whole truth. Don't add to it. Don't shrink it.
  • Describe a normal day AND your worst days. Say how often the worst days happen.
  • Answer the question you were asked. Skip the habit of saying 'I'm fine' or 'it's not that bad' when it is.
  • It's OK to read from your log or notes. Hand the examiner a copy if they will take it.
  • Don't act out symptoms or guess at numbers. If you don't know or can't remember, say so.
  • If something hurts or makes you worse during the exam, say so right then.
  • Fraud warning: knowingly giving VA false information is a federal crime (18 U.S.C. 1001) and can cost you all your benefits (38 U.S.C. 6103). Honest, complete answers protect you.

Common mistakes

  • Episodes treated at home or urgent care not in your VA file. Bring records and pharmacy printouts.

    Where this comes from: 38 CFR 4.97, General Rating Formula for Sinusitis (DCs 6510-6514)

  • 'Incapacitating' needs bed rest AND a physician's treatment. If the doctor didn't note bed rest, it may count as a milder episode.

    Where this comes from: 38 CFR 4.97, General Rating Formula for Sinusitis (DCs 6510-6514) Note

  • Nose checked on a clear day; blockage shows less than usual. Tell the examiner what bad days look like.

    Where this comes from: HTB practice note (secondary)

  • Not claiming under PACT.

    Where this comes from: 38 CFR 3.320(a)(2)(ii)-(iii)

Questions to ask together

A spouse, grown child or friend can read these out loud. Talk about each one before the exam, so nothing gets left out.

  1. How many sinus infections did you have in the last 12 months?
  2. How many needed antibiotics, and for how many weeks?
  3. Did a doctor tell you to stay in bed? How many days?
  4. Is your nose blocked on one side or both? All the time?
  5. Where and when did you deploy?

Rule changes you may hear about

Today's rules (above) are what VA uses unless a change is final.

  • Proposed, not law yet

    VA proposed renaming these as 'rhinosinusitis' (new codes 6222-6226) with a new rating formula, and changing rhinitis so the 10% level would require continuous therapy to control symptoms (polyps would stay 30%).

    Where it stands: Proposed Feb 15, 2022. Not final as of Oct 30, 2026.

    87 FR 8474, RIN 2900-AQ72

Sources

Checked against VA's rules on October 30, 2026.

Helping The Brave doesn't file or prepare claims. This guide is free education, not medical or legal advice. The VA examiner measures and VA decides your rating.