Category: Veterans Disability Law
Sinusitis VA Rating: Symptoms, Causes, and VA Compensation for Sinusitis
If you served in the active military and are now experiencing lasting nose, ear, throat, or sinus issues that incapacitate you for weeks at a time, you may be eligible for VA disability compensation for chronic sinusitis. You might be misinterpreting your chronic sinusitis as allergies or seasonal colds when in reality it’s a legitimate condition caused by lasting impacts of your military service. Reach out to our lawyers here at Tuley to see if you’re eligible for a chronic sinusitis VA rating.
What Is Chronic Sinusitis?
The cavities inside your nose and head are called sinuses. These sinuses can become infected or irritated for a variety of reasons. If the sinuses become swollen and/or inflamed for longer than three months regardless of treatment, it is considered chronic sinusitis. Chronic sinusitis interferes with mucus drainage, causing a stuffy nose. This may lead to minor inconveniences such as swollen eyes or difficulties breathing through your nose. Chronic sinusitis is a relatively common condition that can flare up from external or internal factors.
Acute sinusitis involves the same symptoms as chronic sinusitis but is merely an infection of the sinuses. Regardless of how severe your symptoms are, you will not be diagnosed with chronic sinusitis unless you experience lasting symptoms for at least three months.
Chronic Sinusitis Symptoms
Most symptoms of chronic sinusitis can be treated with the use of over-the-counter medication. However, they can still cause you to be bedridden for days at a time. Some of the possible symptoms of chronic sinusitis include the following:
- Sore throat caused by nasal discharge
- Difficulty breathing from a stuffed up nose
- Runny nose or mild cold
- Pain around eyes, nose, and forehead
- Reduced senses of smell and taste
- Ear pain
- Discolored discharge from the throat
If you’re experiencing acute sinusitis, all of these symptoms should heal over a period of time with or without medication. However, if any of these persist for more than 10 days, you should go and see your doctor.
Chronic Sinusitis Causes
Acute sinusitis infections can develop as a result of bacterial or viral buildup in the sinuses. This can happen during a cold or because of a more serious illness. Chronic sinusitis can also be caused by a variety of things, but some of the most common causes are as follows:
- Deviated septum — If the wall between the nostrils is crooked, it may restrict sinus passages, causing a buildup of mucus and bacteria.
- Respiratory tract infections — When the respiratory tract becomes infected and inflamed, the sinus membranes will thicken and block mucus drainage.
- Nasal polyps — These are painless, benign growths that grow in the nose or sinuses and can cause nasal blockages.
- Asbestos — Prolonged exposure to construction materials, garbage, and asbestos can cause chronic sinusitis.
- Surgery complications — These complications can arise if you received some form of oral or facial surgery that had a lasting impact on your sinuses.
- Scars — Scar tissue in the nose or sinus passages can cause the buildup of bacteria or mucus.
If any of these causes or others occur during a veteran’s time in the active military, they may be eligible for VA disability benefits.
How Does VA Rate Chronic Sinusitis?
Sinusitis is a respiratory issue and is therefore rated under 38 CFR § 4.97, Schedule of Ratings – respiratory system. Diagnostic codes 6510-6514 are dedicated to different variations of sinusitis. The rating criteria are as follows:
- 0% — If the sinusitis is only detected by X-ray and there are no noticeable symptoms
- 10% ($144 per month) — The veteran experiences either a) one or two episodes of sinusitis per year lasting four to six weeks that incapacitate them and require prolonged antibiotic treatment; or b) between three and six episodes per year that do not incapacitate them but bring headaches, purulent discharge, and pain
- 30% ($441 per month) — The veteran experiences either a) three or more episodes of sinusitis per year lasting four to six weeks that incapacitate them and require antibiotic treatment, or b) more than six episodes of sinusitis per year that do not incapacitate them but bring headaches, purulent discharge, and pain
- 50% ($905 per month) — This rating is given either a) after radical surgery with chronic osteomyelitis, or b) for continuous sinusitis that almost always presents headaches, purulent discharge, and pain, even after repeated surgeries
The term “incapacitating” means that the patient required bed rest and medical treatment from a healthcare professional.
Proving Service Connection for Your Chronic Sinusitis
For any VA disability claim, the most important factor is the connection between your disability and your military service. Many people experience chronic sinusitis as a result of non-service-connected factors, so you must make the differentiation to earn compensation.
When attempting to prove service connection for your chronic sinusitis, it’s important to have as much documentation supporting your diagnosis as possible. Any medical or service records related to your condition can help to increase your rating. This includes proof of doctor visits, records of prescriptions, and/or letters from employers documenting how many days you were sick. Letters from peers or loved ones can also communicate the effects that your condition has had on your life and the lives of those around you.
Sinusitis Direct Service Connection
A direct service connection for chronic sinusitis involves linking the condition directly to some form of experience or in-service event. The three necessary elements of this claim are:
- A current medical diagnosis from a professional
- An event, injury, or illness that occurred during service
- A medical link, or nexus, between the current diagnosis and the incident in service
The medical nexus is typically the opinion of a medical professional stating that a veteran’s condition was “at least as likely as not” caused by the in-service event.
Sinusitis Secondary Service Connection
Secondary service-connected conditions are those that arise from another condition that was already service-connected. For example, a veteran could experience a severe injury to their face that deviates their septum. That veteran may already have earned service connection for that facial injury. If that deviated septum later causes chronic sinusitis to develop, the veteran may be able to receive service connection as a secondary condition.
Sinusitis Presumptive Service Connection
The simplest form of service connection is a presumptive service connection. This occurs when VA has already declared that those individuals who served in certain places at specific times do not need to prove anything because it’s already assumed that their condition was a result of their service. Presumptive service connection for chronic sinusitis could be given to individuals who served under conditions that were hazardous to their health, or veterans who dealt with burn pits that could lead to lasting respiratory issues.
Surviving family members or dependents of veterans who died of service-connected conditions might also be eligible for VA survivors’ benefits.
Chronic Sinusitis FAQs
Can you get TDIU for chronic sinusitis?
Total Disability for Individual Unemployability (TDIU) is awarded to veterans that can no longer hold substantially gainful employment as a result of their service-connected disability. It is not possible for someone to get a 100% TDIU rating for sinusitis alone. Chronic sinusitis can only go up to 50%. However, it can be joined with other ratings to increase the total combined rating.
What are the different types of chronic sinusitis?
There are four separate pairs of sinuses. When applying for chronic sinusitis VA benefits, it may be beneficial to understand the difference between your sinuses to properly explain your condition to the doctor. The four sinus pairs are frontal, ethmoid, maxillary, and sphenoid:
- Frontal — These are right above your eyes. This can cause your eyebrows and forehead to hurt when touched and often results in severe headaches.
- Ethmoid — This pair is right between your eyes and on the sides of your nose.
- Maxillary — These are located in your cheeks below your eyes. They’re right above your top teeth and might cause your jaw to hurt. The maxillary sinuses can get infected when you get your wisdom teeth removed.
- Sphenoid — These are located behind your eyes and in the sides of your head and often cause your eyes to hurt when severe.
Pansinusitis means that you have an infection all over. You can’t get a higher rating for one or another and you can’t double up on them. You can get disability benefits even if only one of your sinuses is infected.
Do I get a presumptive service connection for chronic sinusitis if I served in the Gulf War?
Conditions related to the Persian Gulf War and Gulf War Illness are still being investigated. Lasting effects could stretch far beyond sinusitis. If you served in the Gulf War at any point, you may be eligible for a variety of conditions, not just chronic sinusitis.
How do I determine the severity and rating of my chronic sinusitis?
If you believe you have symptoms of chronic sinusitis, you can make a claim to VA. VA will then set up a compensation and pension (C&P) exam with an approved practitioner. At this examination, your conditions, history, and service events will be indexed and the healthcare professional will develop an opinion on your sinusitis. They will send their opinion to VA and you will receive your VA rating decision soon after.
If you are not happy with VA’s final decision, you can appeal the decision through the Board of Veterans’ Appeals or one of the appeal lanes.
Tuley Law Office
Reach out to our experienced VA disability lawyers at Tuley Law Office. If your chronic sinusitis is losing you money because of your inability to work or medical expenses, let us help you get that money back. We have the knowledge to help you navigate VA’s dense language and vague regulations. Call us at (812) 625-2053 or fill out our online contact form for more information.
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