Chronic Sinusitis
Chronic sinusitis is long-term inflammation and infection of the sinus cavities causing headaches, facial pain, and discharge. VA rates all forms on one shared formula based on how many sinusitis episodes you have per year and how severe they are.
Presumptive condition — PACT Act - burn pits / airborne hazards, Gulf War particulate matter (38 CFR 3.320)
Chronic sinusitis is presumptive under the PACT Act for veterans with qualifying service: the Southwest Asia theater on or after August 2, 1990, or Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Uzbekistan, Yemen, or their airspace on or after September 11, 2001. The earlier Gulf War particulate-matter rule (38 CFR 3.320) also presumes sinusitis manifesting within 10 years of separation.
How the VA rates it
Sinusitis uses diagnostic codes 6510-6514 depending on which sinuses are involved (6510 is pansinusitis, meaning all sinuses), but every code is rated under the same General Rating Formula for Sinusitis. The formula counts incapacitating episodes (ones requiring bed rest prescribed by a doctor plus prolonged 4-6 week antibiotic treatment) and non-incapacitating episodes (headaches, pain, and purulent discharge or crusting) per year.
Rating criteria by percentage
Rated up to 50%Following radical sinus surgery with chronic osteomyelitis (bone infection), or near-constant sinusitis with headaches, pain and tenderness of the affected sinus, and purulent discharge or crusting after repeated surgeries.
Three or more incapacitating episodes per year requiring prolonged (4-6 week) antibiotic treatment, or more than six non-incapacitating episodes per year with headaches, pain, and purulent discharge or crusting.
One or two incapacitating episodes per year requiring prolonged (4-6 week) antibiotic treatment, or three to six non-incapacitating episodes per year with headaches, pain, and purulent discharge or crusting.
Sinusitis detected by X-ray only, without qualifying symptomatic episodes.
What those terms mean
- incapacitating episode
- — A flare-up so bad that a doctor prescribed bed rest for it. The VA counts how many days of doctor-prescribed bed rest you had in the past year.
Secondary condition strategy
Commonly claimed secondary to this
Conditions veterans often develop from this one — each can be its own rating under 38 CFR 3.310.
- Sleep Apnea — Chronic nasal and sinus obstruction can contribute to or aggravate obstructive sleep apnea.
- Migraines / Chronic Headaches — Chronic headaches are sometimes claimed secondary to recurrent sinusitis.
This is often secondary to
If you already have one of these service-connected, it may support connecting this condition.
- Deviated Septum — Impaired sinus drainage from a deviated septum can cause or aggravate chronic sinusitis.
- Allergic Rhinitis — Chronic rhinitis commonly leads to or aggravates chronic sinusitis.
Evidence that strengthens this claim
- Track episodes in writing: dates, symptoms, and every antibiotic course. The rating turns on episodes per year, so a documented count is your strongest evidence.
- An 'incapacitating episode' specifically means one requiring bed rest prescribed by a physician plus treatment — ask your doctor to document bed rest when it applies.
- Get imaging (CT or X-ray) confirming chronic sinus disease, plus any ENT specialist records and surgical history.
- For PACT Act claims, confirm your service records show qualifying locations and dates.
Related diagnostic codes
More respiratory conditions
Sleep Apnea (Obstructive, Central, or Mixed)
Sleep apnea is a disorder where breathing repeatedly stops during sleep. VA rates it on how it is treated and how severe the effects are, from documented-but-asymptomatic up to chronic respiratory failure.
Rated up to 100%
Asthma (Bronchial Asthma)
Asthma is a chronic airway disease causing wheezing, coughing, and shortness of breath. VA rates it on pulmonary function test (PFT) results or on how much medication and medical care it requires, whichever applies.
Rated up to 100%
Allergic Rhinitis
Allergic rhinitis is chronic nasal inflammation causing congestion, runny nose, and sneezing. VA rates it on whether nasal polyps are present and how blocked the nasal passages are, with a maximum of 30 percent.
Rated up to 30%
Chronic Obstructive Pulmonary Disease (COPD)
COPD is a progressive lung disease that obstructs airflow and makes breathing difficult. VA rates it almost entirely on objective pulmonary function test results, with higher ratings for oxygen therapy or heart complications.
Rated up to 100%
Chronic Bronchitis
Chronic bronchitis is long-term inflammation of the bronchial tubes with a persistent productive cough. VA rates it on the same pulmonary function test criteria used for COPD.
Rated up to 100%
Deviated Nasal Septum (Traumatic)
A deviated septum is a displacement of the wall between the nostrils that blocks airflow. VA rates it under a single 10 percent tier, and only when the deviation is traumatic (caused by injury).
Rated up to 10%
Disclaimer: Valor Rating is not affiliated with the U.S. Department of Veterans Affairs. This content is for educational purposes only and does not constitute legal or medical advice. Always review your documents carefully before submitting to the VA. For official guidance, consult an accredited VSO, claims agent, or attorney.