Chronic Sinusitis

DC 6510Respiratory38 CFR 4.97, DC 6510

Long-term inflammation of the sinuses causing facial pain, pressure, congestion, and drainage. The VA rates chronic sinusitis based on how often you have incapacitating episodes and whether you need antibiotic treatment.

Rating Levels

You had radical surgery with chronic osteomyelitis (bone infection) following repeated operations, or your sinuses are near-constantly draining with frequent incapacitating episodes. This is the maximum rating.

What the VA looks for

Radical sinus surgery with chronic osteomyelitis
Near-constant sinusitis symptoms
Repeated sinus surgeries
Persistent purulent discharge or crusting
Chronic headaches and facial pain/tenderness

Common Pitfalls

⚠Not documenting the frequency of episodes — keep a symptom diary that tracks each sinus infection, the duration, and whether antibiotics were prescribed.
⚠Not distinguishing "incapacitating" from "non-incapacitating" episodes — an incapacitating episode requires bed rest and treatment by a physician. Document when a doctor ordered rest.
⚠Not getting a CT scan — X-rays may not show chronic sinusitis as clearly. A CT scan provides better evidence of chronic mucosal thickening or polyps.
⚠Not filing for rhinitis separately if you also have nasal congestion and polyps — sinusitis and rhinitis use different diagnostic codes.

Related DBQ Forms

DBQ Sinusitis, Rhinitis, and Other Conditions of the Nose, Throat, Larynx, and Pharynx

View evidence checklist →See secondary conditions →

Condition Rating Guides

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

Rating Levels

What the VA looks for

Radical sinus surgery with chronic osteomyelitis
Near-constant sinusitis symptoms
Repeated sinus surgeries
Persistent purulent discharge or crusting
Chronic headaches and facial pain/tenderness

Common Pitfalls

⚠Not documenting the frequency of episodes — keep a symptom diary that tracks each sinus infection, the duration, and whether antibiotics were prescribed.

⚠Not distinguishing "incapacitating" from "non-incapacitating" episodes — an incapacitating episode requires bed rest and treatment by a physician. Document when a doctor ordered rest.

⚠Not getting a CT scan — X-rays may not show chronic sinusitis as clearly. A CT scan provides better evidence of chronic mucosal thickening or polyps.

⚠Not filing for rhinitis separately if you also have nasal congestion and polyps — sinusitis and rhinitis use different diagnostic codes.