The Playbook › Condition guides
Chronic sinusitis and rhinitis are two of the most widely granted conditions since the PACT Act, because both are now presumptive for veterans exposed to burn pits and airborne hazards. If you served in a covered location, you do not have to prove what caused them.
Getting service connected is the easier half. The rating depends on details most veterans never write down: how many episodes a year, how long antibiotics lasted, and how blocked the nose is.
The short version
- Chronic sinusitis is rated at 0%, 10%, 30%, or 50%, mainly on the number of episodes per year.
- Rhinitis is rated at 10% or 30%, based on nasal obstruction or polyps.
- Both are presumptive under the PACT Act for veterans with qualifying service in Southwest Asia and other covered locations.
- You can hold a rating for each, if the symptoms are distinct.
- Both commonly support a secondary claim for sleep apnea.
On this page
Chronic sinusitis
All types of chronic sinusitis use one formula.
| Rating | Criteria |
|---|---|
| 0% | Detected by X-ray only |
| 10% | One or two incapacitating episodes a year requiring prolonged antibiotic treatment lasting four to six weeks; or three to six non-incapacitating episodes a year with headaches, pain, and purulent discharge or crusting |
| 30% | Three or more incapacitating episodes a year requiring prolonged antibiotic treatment; or more than six non-incapacitating episodes a year with headaches, pain, and purulent discharge or crusting |
| 50% | Following radical surgery with chronic osteomyelitis; or near-constant sinusitis with headaches, pain and tenderness of the affected sinus, and purulent discharge or crusting after repeated surgeries |
Two kinds of episode
- An incapacitating episode means one that requires bed rest and treatment by a physician.
- A non-incapacitating episode is a flare-up with headaches, facial pain, and thick discharge or crusting that you get through without bed rest.
For most veterans the realistic path is through non-incapacitating episodes: three to six a year for 10%, and more than six for 30%. That makes the count the single most important fact in your claim.
Rhinitis, Diagnostic Code 6522
| Rating | Criteria |
|---|---|
| 10% | Without polyps, but with greater than 50% obstruction of the nasal passage on both sides, or complete obstruction on one side |
| 30% | With polyps |
This covers allergic and vasomotor rhinitis. The examiner assesses how blocked each side is and looks for polyps, sometimes with a scope. If an ear, nose and throat specialist has documented polyps or measured obstruction, submit that record.
Getting service connected
Presumptive under the PACT Act
Chronic sinusitis and chronic rhinitis are presumptive for veterans who served:
- On or after September 11, 2001, in Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Uzbekistan, or Yemen
- On or after August 2, 1990, in Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, Somalia, or the United Arab Emirates
including the airspace above. You need a current diagnosis of a chronic condition and proof of service in a covered location. No nexus opinion is required. See the PACT Act.
Direct
Repeated sick call visits for sinus infections, congestion, or allergies during service, with continuing treatment since.
Secondary
A deviated septum from an injury in service, for example, can lead to chronic sinusitis.
How to document episodes
Because the sinusitis rating is a count, build the record deliberately.
- See a provider for each flare-up when you can. An episode that is in your medical record is far stronger than one you describe from memory.
- Keep a log: date, symptoms (headache, facial pain, discharge, crusting), how long it lasted, medication, and whether you were in bed.
- Keep pharmacy records. Antibiotic courses show both the number of episodes and their length.
- Tell your doctor the yearly count and ask that it be noted.
- Describe it in your statement using the terms in the criteria.
Can you get both ratings?
Yes, where the conditions cause different symptoms: sinusitis rated on infections, pain, and discharge, and rhinitis rated on obstruction or polyps. VA will not rate the same symptom twice, so the evidence should show what each condition causes.
At the C&P exam
- Give the number of episodes in the past 12 months, split into those that put you in bed and those that did not.
- Say how many antibiotic courses you had and how long each lasted.
- Describe headaches, facial pain, discharge, and crusting.
- Mention any sinus surgeries and whether symptoms returned.
- For rhinitis, describe how blocked each side is, and whether you have been told you have polyps.
See the C&P exam guide.
What these conditions can lead to
- Sleep apnea. Nasal obstruction is a recognized contributor. This is one of the more common secondary claims. See sleep apnea ratings.
- Headaches or migraines. See migraine ratings.
- Asthma and other respiratory conditions, several of which are also presumptive under the PACT Act.
Secondary claims need a medical opinion. See secondary conditions.
If you were denied before August 2022
Claims for sinusitis and rhinitis were often denied for lack of proof of cause. If you have qualifying service, file a Supplemental Claim. The presumption did not exist when you were denied. See what to do after a denial.
Free printable checklist. Everything to gather before you file, what to bring to your C&P exam, and what to check in your decision, on two pages.
Last reviewed October 2026. This guide is general educational information, not legal or medical advice, and this site is not affiliated with the Department of Veterans Affairs. Rules and rates change. Confirm details on VA.gov or with an accredited representative. See our disclaimer and editorial policy.