VA Disability Rating for Granulomatous Rhinitis (DC 6524)
Diagnostic Code 6524 · 38 CFR §4.97
What Is It?
Granulomatous rhinitis is a chronic inflammatory nasal condition involving granuloma formation — clusters of immune cells that form in response to persistent inflammation. The most significant form is granulomatosis with polyangiitis (formerly called Wegener granulomatosis), an autoimmune condition that can affect the nose, sinuses, lungs, and kidneys. This condition causes nasal crusting, bloody discharge, tissue destruction (including saddle nose deformity), and can be life-threatening if it spreads to other organs. Veterans may develop this from environmental exposures or as an autoimmune condition triggered during service.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | Granulomatosis with polyangiitis (Wegener) — active disease with widespread involvement requiring immunosuppressive therapy, with impaired renal function or pulmonary involvement. |
| 50% | Active disease with nasal and sinus involvement requiring ongoing medication, with episodes of flare requiring intensified treatment. |
| 20% | Disease in remission on maintenance therapy with mild residual nasal symptoms. |
Evidence Needed
- Biopsy results confirming granulomatous inflammation
- ANCA (anti-neutrophil cytoplasmic antibody) blood test results
- ENT evaluation documenting nasal tissue damage
- Records of immunosuppressive medication and treatment history
- Kidney and lung function tests if those organs are involved
- Service medical records or nexus letter establishing service connection
C&P Exam Tips
- Bring biopsy and ANCA test results confirming the diagnosis
- Document all organ systems affected — nasal, sinus, lung, kidney
- List all immunosuppressive medications with dosages and side effects
- Describe disease flare episodes and how they affect your function
- If there is nasal tissue destruction or deformity, have it photographed and documented
How to File
File on VA Form 21-526EZ with biopsy results, ANCA testing, treatment records, and evidence of service connection. Claim each affected organ system separately.
Common Mistakes
Only claiming the nasal condition Granulomatosis with polyangiitis can affect multiple organs. Claim nasal, lung, and kidney involvement as separate conditions. Not documenting immunosuppressive treatment The level of treatment required is a key rating factor. Document all medications and their dosages.
Frequently Asked Questions
Is granulomatosis with polyangiitis the same as Wegener granulomatosis?
Yes. The name was changed to granulomatosis with polyangiitis, but it is the same disease. Older medical records may use the name Wegener granulomatosis.
Can each affected organ be rated separately?
Yes. If the disease affects your nose, lungs, and kidneys, each organ system can receive its own disability rating.