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Chronic sinusitis and allergic or vasomotor rhinitis — both PACT Act presumptive conditions for burn-pit veterans. This guide quotes the actual rating criteria from 38 CFR Part 4 for diagnostic code 6522, explains what the C&P examiner measures, covers the presumptive and secondary routes to service connection, and lists the reasons these claims come back denied — and how each gets fixed.
How the VA rates sinusitis and rhinitis in 2026 — the exact criteria
These are the criteria a VA rater applies, quoted from the rating schedule (§ 4.97). Your rating is the highest level whose wording your evidence meets — and evidence that never uses these words tends to be rated at the bottom.
DC 6522 — Allergic or vasomotor rhinitis
| Rating | Criteria (38 CFR Part 4 wording) |
|---|---|
| 30% | With polyps |
| 10% | Without polyps, but with greater than 50-percent obstruction of nasal passage on both sides or complete obstruction on one side |
Chronic sinusitis (DC 6510–6514) uses the General Rating Formula for Sinusitis: 50% following radical surgery with chronic osteomyelitis, or near-constant sinusitis after repeated surgeries; 30% for three or more incapacitating episodes per year requiring prolonged (4–6 weeks) antibiotics, or more than six non-incapacitating episodes per year; 10% for one or two incapacitating episodes or three to six non-incapacitating episodes per year; 0% detected by X-ray only.
Chronic sinusitis and chronic rhinitis are PACT Act presumptive conditions for covered burn-pit and toxic-exposure veterans (38 CFR 3.320).
Honest ceiling: 30% with nasal polyps.
What the C&P examiner measures
The examiner documents polyps, degree of nasal obstruction on each side, and the frequency of sinus episodes and antibiotic courses over the past year. Bring the pharmacy record of antibiotic courses — that is how the 10/30 percent levels for sinusitis are counted.
The questions that get at the rating criteria — answer them for yourself before the exam:
- Are you congested most of the time, or is it seasonal?
Service connection: presumptive, direct, or secondary
Chronic sinusitis and chronic rhinitis are PACT Act presumptives (38 CFR 3.320) for veterans who served in the covered Southwest Asia, Afghanistan and related locations on or after August 2, 1990 / September 11, 2001 — no nexus opinion needed.
Every service-connection claim has three legs: a current diagnosis (the C&P exam can supply it), an in-service event, injury, exposure or an already-connected condition, and a link between the two — which the VA's own examiner addresses at the exam for direct and secondary claims, and which the law supplies for presumptive ones. You do not need a private opinion to file; you need one only if the VA denies for lack of nexus, and a supplemental claim within one year keeps your effective date.
Secondary conditions veterans miss
Conditions that commonly develop because of this one can be service-connected on top of it, each with its own rating:
- Sleep apnea secondary to rhinitis — Alternative OSA anchor when there is no MH condition
What the medical literature says
PACT Act (2022), 38 USC 1119-1120 presumptives; NASEM Respiratory Health Effects of Airborne Hazards (2020)
Chronic rhinitis and chronic sinusitis are presumptive for covered burn-pit/airborne-hazard veterans. Why it matters: Covered theater + current diagnosis = presumptive.
Why sinusitis and rhinitis claims get denied — and the fix
- PACT Act presumption not applied because the covered location or dates were not in the file — the DD-214 and deployment orders settle it.
- Episode counts not documented — pharmacy records of antibiotic courses are the evidence.
A denial is a grade on the evidence packet, not a verdict on you. Filed as a supplemental claim within one year, the fix keeps your original effective date.
Filing it right the first time
- Intent to File first. It locks your effective date for a year — back pay runs from that day, not from the day the package is ready.
- File everything at once. Every condition with a real symptom and a plausible route — direct, presumptive, secondary, increase — goes in one claim. The VA's duty to assist schedules the exam and pulls your records; a condition held back "for more evidence" only starts its clock later.
- Your statement in the criteria's words. A Statement in Support of Claim (VA Form 21-4138) that describes your worst days and your typical days using the language in the table above is the evidence the rater reads first.
- Your records. VA records through Blue Button, decision letters and code sheet from VA.gov, and private records from each doctor's office or patient portal — or a signed 21-4142 so the VA pulls them.
- Prepare for the exam. Know what the examiner measures (above) and answer honestly, including the bad days.
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See If You Qualify →Frequently asked questions
What is the VA rating for sinusitis and rhinitis?
Sinusitis and Rhinitis is rated under diagnostic code 6522 (§ 4.97) at 10%, 30%. The percentage depends on which criteria in the rating schedule your evidence meets — the full table is on this page.
What is the highest VA rating for sinusitis and rhinitis?
The highest schedular rating available is 30%. Typical grants land around 10%, but every case is decided on its own evidence.
Is sinusitis and rhinitis a presumptive condition?
Chronic sinusitis and chronic rhinitis are PACT Act presumptives (38 CFR 3.320) for veterans who served in the covered Southwest Asia, Afghanistan and related locations on or after August 2, 1990 / September 11, 2001 — no nexus opinion needed.
Can sinusitis and rhinitis be claimed as a secondary condition — or cause one?
Yes. Sleep apnea secondary to rhinitis. A secondary condition is rated on top of the primary one, and the VA's own C&P examiner can supply the connecting opinion.
Do I need a nexus letter for sinusitis and rhinitis?
Not to file. The VA's duty to assist schedules a C&P exam where its own examiner addresses the connection, and presumptive conditions need no opinion at all. A private opinion becomes worth buying only if the VA denies for lack of nexus — a supplemental claim within one year keeps your original effective date.
Rating criteria verified against eCFR (38 CFR Part 4) — last reviewed 2026-09-19. Regulations change; confirm anything decision-critical at ecfr.gov.