VA Disability Rating for Sinusitis
A sinusitis VA rating may result in monthly compensation depending on the severity of your condition, and it could provide access to VA disability programs designed to help those who cannot work. You must provide clear evidence your sinusitis resulted from or was aggravated by your service, and you can combine your sinusitis disability score with your other VA disabilities to increase your total rating. Veterans Guide can help you learn more about VA disability ratings.
Sinusitis is one of the conditions recognized by the VA as eligible for a disability rating and possible monthly compensation at varying levels. Your sinusitis VA rating depends on several factors, including whether you need surgery, how often your sinusitis results in bed rest and a physician’s care, and how often you suffer pain, headaches, and other symptoms.
You can have a VA disability rating for sinusitis alone or in combination with other disabilities, such as migraines. If you had sinusitis before your service and your time in the military aggravated your condition, you can also receive a rating based on that aggravation.
Veterans and Sinusitis
Sinusitis is a condition in which the tissue in your sinuses becomes swollen. Sinusitis causes symptoms such as:
- Pressure in your face that is sometimes painful
- Runny nose with thick mucus
Acute sinusitis episodes are usually due to colds and do not last long, but chronic sinusitis symptoms can last 12 weeks or longer. The VA recognizes chronic sinusitis in its disability rating system. It also recognizes rhinitis, a condition with similar symptoms caused by an inflammation of the tissue inside your nose rather than in your sinuses.
Exposure to certain toxins can lead to sinusitis and other health problems. The VA recognizes that veterans who served in certain areas and were exposed to burn pits and other hazards came home with illnesses. If you served in one of those areas, the VA presumes that your sinusitis is related to your service.
Veterans may also experience sinusitis as a result of another condition. For example, a facial injury could cause a deviated septum, leading to sinusitis.
How Does the VA Rate Sinusitis?
The VA lists symptoms and outcomes that help you determine your potential sinusitis VA rating. Ratings run from 0 percent to 100 percent in increments of 10.
A key phrase throughout VA ratings for sinusitis is “incapacitating episodes.” The VA ratings define these episodes as requiring bed rest and doctor’s treatment. The VA has four ratings for sinusitis if it is your only disabling condition.
Rating Table for Sinusitis VA Disability Claims
Only detectable by X-ray
One or two yearly incapacitating episodes that require four to six weeks of antibiotics or three to six annual non-incapacitating episodes with headaches, pain, and nasal discharge or crusting
Three or more yearly incapacitating episodes requiring four to six weeks of antibiotics or more than six annual non-incapacitating episodes with pain, headaches, and discharge or crusting
After radical surgery with a chronic bone infection or near constant sinusitis with headaches, pain and tenderness, and discharge or crusting after repeated surgeries
The VA uses Public Disability Benefits Questionnaires (DBQs) to help collect the evidence you need to support your sinusitis disability claim. The form for sinusitis and rhinitis includes spaces for your doctor to list your diagnosis and other conditions and check off your symptoms.
You must ask your doctor to fill out this form as completely as possible, as it contains, along with your medical records, much of the evidence you need to get a disability rating that matches the seriousness of your sinusitis.
When there is reasonable doubt about whether a condition is service-related or about disability ratings, the VA must rule for the veteran. A case in which the Board of Veterans’ Appeals ruled in favor of a veteran with sinusitis and migraines provides an informative look at the evidence the VA considers and how reasonable doubt can work in your favor.
Total Disability Based on Individual Unemployability and Sinusitis
Total Disability based on Individual Unemployability (TDIU) is a VA program for veterans who cannot support themselves through substantially gainful employment because of their disability. If you are approved for TDIU, you get the same benefits as someone rated 100 percent disabled, even if your rating is lower.
Generally, you must have at least one service-connected disability rated at least 60 percent, or two or more disabilities, with one at 40 percent and a combined rating of at least 70 percent.
To get TDIU for sinusitis, you must provide medical evidence, such as medical test results or doctor’s notes, that support the fact that you cannot work. You must submit the application form and a request for employment information to support your case.
Sinusitis as a Secondary Disability
Sinusitis is sometimes tied to conditions such as a deviated septum, sleep apnea, or migraines. If you have any of these secondary conditions, your disability rating can increase by combining the separate ratings.
The VA does not simply add two ratings to get a combined rating. Instead, it uses a table of combined ratings to prevent a total from being over 100 percent. For example, if you have a 50 percent rating for sinusitis and a 50 percent rating for migraines, your total combined score is 75. This is rounded up to give you an 80 percent disability rating.
If you have more than two disabilities, the VA combines all your scores to create a final disability rating.
Service Connection by Aggravation
If you had sinusitis before you served, and your military duty worsened your condition, you can claim an aggravation of a preservice disability. You will need convincing medical evidence that the change in your sinusitis was due to your service and not just the general progression of the condition.
You will need to provide medical evidence that you had sinusitis before you entered the service or show through past medical records or a doctor’s determination that you had sinusitis that was not noted when you joined the military.
To get your aggravated rating, the VA assigns a disability rating that matches the condition of your sinusitis before your service. They then assign a rating based on the evidence you submitted in your disability claim. The difference between the two reflects the level of aggravation of your condition.
How To Obtain VA Disability Compensation for Sinusitis?
If you believe your sinusitis is related to or was aggravated by your military service, you can file a claim with the VA for disability payments and access to VA disability programs.
You can apply online or fill out VA Form 21-526EZ and mail it to the VA Claims Intake Center. You can also bring your application to your nearest VA regional office. To support your claim, you must include the following evidence:
- VA hospital and medical records
- Private medical records
- Supporting statements from family members, friends, people you served with, and others who witnessed your condition
Make sure your doctor includes your DBQ for sinusitis with your other records. It is not necessary, but the form was created with VA disability requirements in mind, so having it can speed up the processing.
Before ruling on your claim, the VA may require you to undergo a Compensation and Pension, or C&P, exam. They use the exam in cases where your other evidence is not enough to show that your condition is service-related or to determine your disability rating. You may also have to undergo future review exams to determine if the severity of your condition has changed.
If you need help to understand your sinusitis VA rating or have other questions about disability and the VA, contact Veterans Guide.
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