Chronic Sinusitis C&P Exam

Inside the exam room

1. You will be asked about sinus episodes over the past year, including headache, pain, and drainage. Give dates and say which episodes were treated by a clinician.

2. The examiner will review antibiotics, treatment dates, prescribed bed rest, surgery, and scans. Identify how long each treatment lasted and any bed rest your clinician prescribed.

3. You will be asked how symptoms affect work and daily tasks. Explain how often they happen, how long they last, and whether treatment helps.

How VA rates chronic sinusitis

Record how often sinus episodes happen, their symptoms, and antibiotic or surgical treatment. An incapacitating episode has a specific meaning here: it requires bed rest and treatment by a physician. VA uses the General Rating Formula for Sinusitis under 38 CFR § 4.97, DCs 6510–6514. The schedule distinguishes physician-treated episodes needing bed rest and physician treatment (incapacitating episodes) from episodes without that bed-rest requirement with headache, pain, and pus-like drainage (purulent discharge) or crusting.

What each rating percentage means

Match the whole description with your exam and records. A single symptom or illustration does not decide your rating.

Rating	What the rule requires
0%	Detected by X-ray only
10%	One or two episodes needing bed rest and physician treatment (incapacitating episodes) yearly requiring 4-6 weeks of antibiotics, OR 3-6 episodes without that bed-rest requirement yearly with headaches, pain, and pus-like drainage (purulent discharge) or crusting
30%	Three or more episodes needing bed rest and physician treatment (incapacitating episodes) yearly requiring 4-6 weeks of antibiotics, OR more than six episodes without that bed-rest requirement yearly with headaches, pain, and pus-like drainage (purulent discharge) or crusting
50%	Radical surgery with chronic bone infection (osteomyelitis), OR near-constant sinusitis with headaches, pain and tenderness, and pus-like drainage (purulent discharge) or crusting after repeated surgeries

Check these details in your records

The examiner uses a condition form called a Disability Benefits Questionnaire (DBQ). Compare these items with your own records and explain what actually happens in daily life.

Sinusitis detected by X-ray only0%DCs 6510–6514
One or two episodes needing bed rest and physician treatment (incapacitating episodes) per year requiring 4-6 weeks of antibiotics, OR 3-6 episodes without that bed-rest requirement per year with headaches, pain, and pus-like drainage (purulent discharge) or crusting10%
Three or more episodes needing bed rest and physician treatment (incapacitating episodes) per year requiring 4-6 weeks of antibiotics, OR more than six episodes without that bed-rest requirement per year with headaches, pain, and pus-like drainage (purulent discharge) or crusting30%
Following radical surgery with chronic bone infection (osteomyelitis), OR near-constant sinusitis with headaches, pain and tenderness of the affected sinus, and pus-like drainage (purulent discharge) or crusting after repeated surgeries50%

What may happen in the exam room

The examiner reviews scans and camera examinations inside the nose (endoscopy)
They check the nose and sinuses
They review antibiotic prescriptions, surgeries, and when sinus problems occurred

What the measurements tell you

Number and type of episodes in the past year
How long each long course of antibiotics lasted
Headache, pain/tenderness, pus-like drainage (purulent discharge), or crusting
Surgery history

Questions the examiner may cover

How many qualifying episodes occurred in the past 12 months?
Which episodes required bed rest and physician treatment?
How long were antibiotic courses?
Have you had repeated sinus surgery?

Questions to expect

How many distinct episodes occurred in the past year?

Explain: Record dates, headache, pain and pus-like drainage or crusting. Separate ordinary episodes from those requiring physician treatment and bed rest.

Rating connection: The general sinusitis formula distinguishes incapacitating and non-incapacitating episodes, with different count and symptom requirements.

What antibiotics, surgery or continuing symptoms are documented?

Explain: Identify antibiotic course lengths, prescribed bed rest, operations and symptoms after surgery.

Rating connection: Higher pathways require the stated episode, treatment or post-surgical findings. Missing work alone is not the definition of an incapacitating episode.

Your answer outline

In the past 12 months, I remember [number or approximate number] episodes around [dates]. During [episode], I had [actual symptoms] for [duration]. I received [care listed in your records and how long the medicine was prescribed]. My clinician [bed-rest instruction, or none that you know of]. [Effect on routine].

Mark approximate dates and counts as estimates.

My notes: ________________________

Service connection records

1. How is this connected to your service?

For a direct claim, identify your current disability, what happened in service, and evidence linking them. Being on active duty or orders alone does not prove that link.

Write the 5 Ws and how: who was there; what happened; when; where; why you were there; how the problem began. Add duty status, treatment, witnesses, and records. Mark uncertain dates as estimates.
Guard or Reserve: find your orders, dates, duty type, and any line-of-duty records. Active duty, training, and drills have different rules.
Secondary condition: it may start after service. Identify the service-connected condition and evidence that it caused or worsened this problem. A medical opinion may help explain the link.
Started before service? Record what changed during service. Presumptive condition? Check the required diagnosis and service history; qualifying claims do not require separate proof of a link.
Already service connected and seeking an increase? Focus on what has worsened and the records showing it.

If you do not know the cause, say so. Do not guess a medical connection.

Explain what changes in daily life

Describe both what you can do and what becomes difficult. Include how often it happens and how long it lasts.

Use records and dates to distinguish episode types.
Describe headache, sinus pain, discharge, and crusting during each episode.
Do not call an episode incapacitating unless it required bed rest and physician treatment.

Common mistakes to avoid

Estimating episode counts without records
Confusing allergic rhinitis congestion with sinusitis episodes
Calling self-directed rest an incapacitating episode

Records to get ready before the exam

Sinusitis/Rhinitis DBQ
Antibiotic and urgent-care records
Imaging/endoscopy
Surgical reports
Episode calendar

Preparation notes

Bring a concise 12-month episode timeline.
Continue prescribed care unless a clinician tells you otherwise.

Official rating rule and code numbers

Use this source to check the full rule and its medical terms: 38 CFR 4.97, DCs 6510-6514. Source review recorded 2026-09-04.

Could one health problem have caused another?

A condition VA has already linked to your service may cause another health problem or make it worse. VA calls this secondary service connection. Having both conditions does not prove the link. Your records need to show a current diagnosis and explain how the first condition or its treatment affected the second.

Start with your records. Find the current diagnosis, the condition VA already linked to service, and evidence from someone qualified to explain the connection.
Ask about cause and worsening. Did the first condition or its treatment cause the new disability, or make an existing disability worse? These are different questions. The rules call them causation under 38 CFR § 3.310(a) and aggravation under § 3.310(b). If both are raised by your records, the medical opinion should address both; answering only the cause question may not be enough (El-Amin).
If treatment may be involved, collect the dates. List the medicine or surgery prescribed for the condition VA linked to service, the side effect, and the new diagnosis. Bring pharmacy records and dates when treatment started or stopped. A provider must explain the connection in your case; taking a medicine alone does not prove it.
If weight gain may be involved, ask how it fits. Weight gain or obesity can be a step between the first condition and another diagnosed disability under VAOPGCPREC 1-2017. Obesity itself does not receive a VA disability rating.
You do not need absolute certainty. VA uses the “at least as likely as not” standard and the reasonable-doubt rule under 38 CFR § 3.102. Ask a VA-accredited representative how the evidence applies to your claim.
The same symptom cannot be counted twice. This is the rule against pyramiding in 38 CFR § 4.14. Mental-health diagnoses generally share one § 4.130 rating when they affect the same work and social abilities. Trouble sleeping may be a symptom rather than a separate disability.
Check whether VA already assumes a link to service. Some conditions qualify based on where or when you served. These are called presumptive conditions. Examples can include chronic rhinitis, chronic sinusitis, hypertension after qualifying herbicide exposure, and type 2 diabetes. Sleep apnea (OSA) is not a PACT Act presumptive. Check eligibility before seeking a medical opinion about the link.
An exam form and a medical opinion do different jobs. A Disability Benefits Questionnaire (DBQ) records the diagnosis and how severe it is. It may not explain why it is linked to service, often called a nexus. A VA-accredited veterans service organization (VSO) can help you file at no charge.

If another prescribed treatment may have caused a problem, ask your health care provider to record what happened and explain the connection in your case.

Sources: 38 CFR § 3.310 · 38 CFR § 4.14 · VA-accredited representatives

C&P exam for chronic sinusitis: what to expect and how VA rates it.