VA Disability Rating for Chronic Maxillary Sinusitis (DC 6513)
Diagnostic Code 6513 · 38 CFR §4.97
What Is It?
Chronic maxillary sinusitis is persistent inflammation and infection of the maxillary sinuses, the largest sinuses located in the cheekbones on either side of the nose. This is the most commonly affected sinus and the most frequently claimed sinusitis condition among veterans. Symptoms include cheek pain and pressure, tooth pain in the upper jaw, nasal congestion, post-nasal drip, and foul-smelling discharge. Veterans frequently develop this condition from recurrent infections during deployment, environmental dust and sand exposure, or dental problems during service.
Rating Criteria
| Rating | Criteria |
|---|---|
| 50% | Following radical surgery with chronic osteomyelitis, or near constant sinusitis with headaches, pain and tenderness, and purulent discharge or crusting after repeated surgeries. |
| 30% | Three or more incapacitating episodes per year requiring prolonged antibiotic treatment of four to six weeks, or more than six non-incapacitating episodes per year with headaches, pain, and purulent discharge or crusting. |
| 10% | One or two incapacitating episodes per year requiring prolonged antibiotic treatment, or three to six non-incapacitating episodes per year with headaches, pain, and purulent discharge or crusting. |
| 0% | Detected by X-ray only without active symptoms. |
Evidence Needed
- CT scan showing chronic maxillary sinusitis with mucosal thickening or opacification
- Treatment records with antibiotic prescriptions, dates, and durations
- ENT specialist evaluation documenting chronicity and severity
- Detailed episode log with dates, symptoms, and treatment for each occurrence
- Service medical records showing sinus problems or environmental exposure
- Dental records if dental issues contributed to the maxillary sinus disease
C&P Exam Tips
- This is the most commonly claimed sinus condition — make your documentation thorough
- A sinus CT scan is far more convincing than an X-ray for showing chronic disease
- Track every episode carefully, including the exact antibiotic prescribed and how long you took it
- If your sinusitis is related to dental problems (tooth roots can extend into the maxillary sinus), document this connection
- Report upper tooth pain if present — this is a distinctive maxillary sinusitis symptom
How to File
File on VA Form 21-526EZ with CT scan results, treatment records showing antibiotic courses, and an episode frequency log. If secondary to allergic rhinitis or dental conditions, include a nexus letter.
Common Mistakes
Filing without a CT scan X-rays often miss chronic sinusitis. A CT scan shows mucosal thickening, polyps, and other evidence that X-rays cannot detect. Not documenting the full antibiotic duration Standard short courses do not count as prolonged treatment. You need records showing four-to-six-week antibiotic courses. Not connecting to deployment exposures If you served in dusty or sandy environments (Iraq, Afghanistan), document this exposure as a contributing factor.
Frequently Asked Questions
Is maxillary sinusitis the most common sinus claim?
Yes. The maxillary sinuses are the most frequently affected, and this is among the most commonly claimed sinus conditions for VA disability.
Can deployment to Iraq or Afghanistan cause chronic sinusitis?
Yes. Exposure to fine dust, sand, and burn pit smoke during deployments is a well-recognized contributor to chronic sinus disease. Document your deployment locations and exposure history.
What if I have sinusitis in multiple sinuses?
You cannot receive separate ratings for each sinus. The VA rates sinusitis as one condition regardless of which sinuses are affected, using the same criteria.