Sheets of "sinusitis secondary conditions" get passed around online. I checked the diagnostic codes on them against the rating schedule itself. Several are wrong. Here is what the regulation actually says.
This is the regulation the whole page hangs on.
The sheets never print these, and you cannot check your own rating without them.
Some conditions are not listed anywhere in the schedule. That is not a dead end.
Under 38 CFR 4.20, an unlisted condition is rated under the closest listed condition — the one closest in the functions affected, the anatomical location, and the symptoms.
Under 38 CFR 4.27, that gets a built-up hyphenated code. The first two digits come from the part of the schedule covering the body system involved. The last two digits are 99. So an unlisted ear condition builds from 6299- and an unlisted nose or throat condition from 6599-.
Filing everything at once can collapse into one rating.
38 CFR 4.14: "The evaluation of the same disability under various diagnoses is to be avoided." Sinusitis, rhinitis and nasal polyps overlap heavily — they share symptoms and share a code. Vertigo and Meniere's syndrome cannot be paid at the same time at all.
Each one still needs its own medical nexus opinion under 38 CFR 3.310.
| Condition | Diagnostic code | What the schedule actually says |
|---|---|---|
| Allergic rhinitis (hay fever) | Correct DC 6522 | DC 6522 is "Allergic or vasomotor rhinitis." With polyps = 30%. Without polyps, but with greater than 50-percent obstruction of the nasal passage on both sides, or complete obstruction on one side = 10%. Below that it is 0% — service-connected, but no money. Know that before you expect a check. |
| Chronic rhinitis, nonallergic | Depends DC 6522 or DC 6523 | DC 6522 covers vasomotor and nonallergic rhinitis, on the same thresholds above. If it is bacterial rhinitis, the code is DC 6523: rhinoscleroma = 50%; permanent hypertrophy of the turbinates and greater than 50-percent obstruction of the nasal passage on both sides or complete obstruction on one side = 10%. Both prongs are required. Turbinate hypertrophy by itself is 0%. |
| Nasal polyps | Wrong on the sheets DC 6522, not 6524 | Polyps are not a separate code. They are the 30% level inside DC 6522 — "With polyps." DC 6524 is "Granulomatous rhinitis," which is Wegener's granulomatosis and lethal midline granuloma at 100%, other granulomatous infection at 20%. It has nothing to do with ordinary nasal polyps. Coding polyps to 6524 throws away the 30%. |
| Deviated nasal septum | Correct DC 6502 | Right code, hard gate, and you should see it before you file. DC 6502 "Septum, nasal, deviation of" pays 10% for "Traumatic only, with 50-percent obstruction of the nasal passage on both sides or complete obstruction on one side." A septum deviation blamed on chronic sinus disease rather than on trauma, or one without that much obstruction, rates 0%. |
| Eustachian tube dysfunction | No such code There is no DC 3817 | 38 CFR Part 4 has no 3000-series codes at all. Eustachian tube dysfunction is unlisted and must be rated by analogy under 38 CFR 4.20, with a built-up 6299- code under 4.27. I will not print a specific analogue here — no official source designates one, and the code most often suggested online pays only through measured hearing loss, so a veteran with normal audiometry gets 0% under it. Claim it as unlisted and let the rater choose on your evidence. |
| Otitis media, chronic (middle ear) | Two codes DC 6200 or DC 6201 | DC 6200 is chronic suppurative otitis media, mastoiditis or cholesteatoma, and pays 10% only "During suppuration, or with aural polyps." Chronic nonsuppurative otitis media with effusion — serous otitis media, the kind that usually follows sinus and eustachian tube disease — is DC 6201, rated as hearing impairment. Note to DC 6200: "Evaluate hearing impairment, and complications such as labyrinthitis, tinnitus, facial nerve paralysis, or bone loss of skull, separately." Those separate ratings are where the money is — 6200 by itself caps at 10%. |
| Vertigo / dizziness | Correct DC 6204 | DC 6204, peripheral vestibular disorders: occasional dizziness = 10%; dizziness and occasional staggering = 30%. The schedule requires objective findings supporting a diagnosis of vestibular disequilibrium — your own report of dizziness is not enough. Hearing impairment is rated separately and combined. |
| Meniere's syndrome (if that is the diagnosis) | Your choice DC 6205 or separate ratings | Note to DC 6205, word for word: "Evaluate Meniere's syndrome either under these criteria or by separately evaluating vertigo, hearing impairment, and tinnitus, whichever method results in a higher overall evaluation. Do not combine an evaluation for hearing impairment, tinnitus, or vertigo with an evaluation under diagnostic code 6205." So separate ratings for vertigo (6204), hearing loss (6100) and tinnitus (6260) are an affirmative alternative the regulation requires VA to consider — with real hearing loss and tinnitus they often combine higher. You cannot have both methods. Ask for whichever pays more. |
| Chronic pharyngitis (throat) | Wrong on the sheets Not separately listed | DC 6516 is "Laryngitis, chronic" — the larynx, the voice box, not the pharynx. Chronic pharyngitis has no code of its own, so a bare 6516 is wrong. Correct printing is a built-up analogous code under 38 CFR 4.20 and 4.27: not separately listed — rated by analogy with a 6599- code, and the examiner selects the closest listed condition. Be careful with DC 6521, "Pharynx, injuries to" — it has exactly one level, 50%, for stricture or obstruction of the pharynx, absence of the soft palate from trauma, chemical burn or granulomatous disease, or soft-palate paralysis with nasal regurgitation and speech impairment. There is nothing under it. Ordinary chronic pharyngitis meets none of that and lands on 0%. |
| Laryngitis, chronic | Correct DC 6516 | DC 6516, "Laryngitis, chronic," carries a 10% level for "Hoarseness, with inflammation of cords or mucous membrane." Get the hoarseness and the inflammation documented on examination, not just reported. |
| Loss of smell (anosmia) | Wrong on the sheets DC 6275, not 6270 | There is no DC 6270 anywhere in the rating schedule. DC 6275 is "Sense of smell, complete loss" = 10%. Note under 38 CFR 4.87a: a rating is assigned under 6275 only if there is an anatomical or pathological basis for the condition. Reporting that you cannot smell, with nothing in the record explaining why, gets 0%. |
| Loss of taste (ageusia) | Wrong on the sheets DC 6276, not 6270 | DC 6276 is "Sense of taste, complete loss" = 10%. Smell and taste are two separate codes, not one shared code — the sheets that print 6270 twice cost you a rating. Same gate under 38 CFR 4.87a: an anatomical or pathological basis must be shown. |
| Conjunctivitis, chronic or allergic | Wrong on the sheets DC 6018, not 6000 | DC 6000 is "Choroidopathy, including uveitis, iritis, cyclitis, or choroiditis" — a completely different eye disease. DC 6018 is "Chronic conjunctivitis (nontrachomatous)." Active, with objective findings such as red thick conjunctivae and mucous secretion = 10%. Inactive is rated on residuals, such as visual impairment and disfigurement. |
| Obstructive sleep apnea | Correct DC 6847 | DC 6847, Sleep Apnea Syndromes: 100% chronic respiratory failure with carbon dioxide retention or cor pulmonale, or requires tracheostomy; 50% "Requires use of breathing assistance device such as continuous airway pressure (CPAP) machine"; 30% persistent day-time hypersomnolence; 0% asymptomatic but with documented sleep disorder breathing. The 50% turns on the device being shown as medically required in your record — a CPAP you bought yourself, with no sleep study and no prescription behind it, will not carry 50%. This is the code on this page most likely to be revised; check it before you file. |
| Asthma, bronchial | Correct DC 6602 | Rated on pulmonary function testing and on your medication requirement. Get the testing done — this code is not rated on symptoms you describe. |
| Chronic bronchitis | Correct DC 6600 | Also rated on pulmonary function testing results. |
| Reactive airway disease | By analogy DC 6602 criteria | Reactive airway disease is not separately listed. It is rated by analogy to DC 6602, bronchial asthma, under 38 CFR 4.20, shown as a built-up hyphenated code under 4.27. State the analogy on the claim rather than quoting a bare code. |
| Migraine headaches | Correct DC 8100 | A neurological code, at 38 CFR 4.124a, not a respiratory one. Frequency and severity of prostrating attacks drive the rating, so a headache log in the medical record matters. |
| Chronic fatigue syndrome | Correct DC 6354 | Found at 38 CFR 4.88b, the infectious disease schedule. |
| Temporomandibular disorder (the jaw joint — older sheets say "TMJ") | Correct DC 9905 | Right code, dated name. VA rewrote this code effective 2021 and the official name is now "Temporomandibular disorder (TMD)." Ratings turn on your maximum unassisted vertical interincisal opening — how wide you can open on your own — on lateral excursion, and on whether you are restricted to mechanically altered food. Ask that the examiner measure and record all of it. |
| Dental conditions tied to sinus disease | Far narrower than advertised DC 9913 | DC 9913 is "Teeth, loss of, due to loss of substance of body of maxilla or mandible without loss of continuity." Its Note limits it: "These ratings apply only to bone loss through trauma or disease such as osteomyelitis, and not to the loss of the alveolar process as a result of periodontal disease, since such loss is not considered disabling." A rating also requires that the lost chewing surface cannot be restored by a suitable prosthesis. Sinus-related tooth pain, or ordinary tooth loss, does not rate under 9913. Separately — and this is the door that stays open — eligibility for VA dental treatment is a different question entirely, decided by the dental class system in 38 CFR 17.161, not by this code. Ask about dental class eligibility at your VA facility. |
A code is a scoring rule. Something has to be measured before it scores.
A representative from an accredited Veterans Service Organization will work your claim at no charge to you. That is the first call, and a twenty-condition secondary filing is exactly the kind of claim you want a trained set of eyes on.