Chronic Sinogenic Headache

DC 6514Organs of Sense38 CFR 4.97, DC 6514

Chronic headaches caused by ongoing sinus disease such as chronic sinusitis. The pain is centered around the forehead, cheeks, or behind the eyes and gets worse with sinus infections or weather changes. The VA rates sinogenic headaches under sinusitis criteria based on how often you need treatment.

How the VA rates this condition

The VA rates this condition based on the type, severity, and frequency of your symptoms. The examiner will evaluate your specific symptoms and how they affect your daily life and ability to work.

Diagnostic code

DC 6514

Rating range

0% – 50%

Rating levels

Rating criteria are defined in 38 CFR 4.97, DC 6514. This guide presents a plain-language summary and is not a substitute for the full regulatory text. Always consult a VSO or VA-accredited attorney for case-specific advice.

Rating Levels

You have severe chronic sinus headaches after radical sinus surgery, with constant headache pain, chronic crusting, and frequent purulent discharge. You may have had multiple surgeries without improvement.

What the VA looks for

Radical sinus surgery performed
Chronic headache pain post-surgery
Chronic osteomyelitis of sinuses if applicable
Purulent discharge or crusting despite surgery
Multiple sinus surgeries documented
Near-constant headache pain documented
Significant occupational impairment from headaches

Common Pitfalls

⚠Not getting a CT scan of the sinuses to document chronic sinusitis — the VA needs imaging evidence that your headaches are caused by sinus disease, not just a report of headaches. A normal CT weakens the claim.
⚠Not distinguishing sinus headaches from migraines or tension headaches — sinus headaches have specific features (facial pressure, worsening with bending over, purulent discharge). An ENT evaluation helps confirm the sinus origin of your headaches.
⚠Not documenting every sinus infection and antibiotic course — the VA rating depends on how many incapacitating episodes you have per year. Keep records of every doctor visit, prescription, and missed work day due to sinus problems.
⚠Not claiming the headaches as secondary to a service-connected sinusitis or deviated septum — if you already have a rating for sinusitis or nasal injury, the chronic headaches should be claimed as a secondary condition.

Related DBQ Forms

DBQ Sinusitis/Rhinitis

View evidence checklist →See secondary conditions →

Condition Rating Guides

Understand what the VA looks for at each rating level — loading conditions…

Chronic Sinogenic Headache

How the VA rates this condition

The VA rates this condition based on the type, severity, and frequency of your symptoms. The examiner will evaluate your specific symptoms and how they affect your daily life and ability to work.

Diagnostic code

DC 6514

Rating range

0% – 50%

Rating levels

Rating Levels

What the VA looks for

Radical sinus surgery performed
Chronic headache pain post-surgery
Chronic osteomyelitis of sinuses if applicable
Purulent discharge or crusting despite surgery
Multiple sinus surgeries documented
Near-constant headache pain documented
Significant occupational impairment from headaches

Common Pitfalls

⚠Not getting a CT scan of the sinuses to document chronic sinusitis — the VA needs imaging evidence that your headaches are caused by sinus disease, not just a report of headaches. A normal CT weakens the claim.

⚠Not distinguishing sinus headaches from migraines or tension headaches — sinus headaches have specific features (facial pressure, worsening with bending over, purulent discharge). An ENT evaluation helps confirm the sinus origin of your headaches.

⚠Not documenting every sinus infection and antibiotic course — the VA rating depends on how many incapacitating episodes you have per year. Keep records of every doctor visit, prescription, and missed work day due to sinus problems.

⚠Not claiming the headaches as secondary to a service-connected sinusitis or deviated septum — if you already have a rating for sinusitis or nasal injury, the chronic headaches should be claimed as a secondary condition.