VA Disability Rating for Chronic Sphenoid Sinusitis (DC 6514)
Diagnostic Code 6514 · 38 CFR §4.97
What Is It?
Chronic sphenoid sinusitis is inflammation of the sphenoid sinuses, located deep in the skull behind the nasal cavity near the brain and important nerves. Because of their deep location, sphenoid sinus infections can cause pain at the top of the head, behind the eyes, and at the back of the head, rather than the typical facial pressure of other sinus infections. Veterans may develop this condition from repeated upper respiratory infections, environmental exposures, or complications of other sinus disease.
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, 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. |
| 0% | Detected by imaging only with no active symptoms. |
Evidence Needed
- CT scan showing sphenoid sinus disease
- ENT evaluation documenting episode frequency and severity
- Treatment records with antibiotic courses and durations
- Episode log with dates and symptoms
- Service medical records linking sinus problems to service
C&P Exam Tips
- Sphenoid sinusitis is harder to diagnose clinically — a CT scan is essential for documentation
- Describe the specific headache pattern: top of head, behind the eyes, or back of the head
- Track episodes carefully since the rating criteria are frequency-based
- Make sure the examiner specifically identifies which sinuses are affected on imaging
How to File
File on VA Form 21-526EZ with CT scan results showing sphenoid sinus disease, treatment records, and episode documentation.
Common Mistakes
Misdiagnosis as tension headaches Sphenoid sinusitis headaches can be mistaken for other headache types. A CT scan can confirm the sinus origin. Not getting a CT scan Sphenoid sinusitis is not visible on physical exam and requires imaging to confirm.
Frequently Asked Questions
Why is sphenoid sinusitis harder to diagnose?
The sphenoid sinuses are deep in the skull and cannot be examined directly. CT scanning is usually required to confirm the diagnosis, unlike maxillary or frontal sinusitis which can sometimes be assessed clinically.
Is it rated the same as other sinusitis types?
Yes. All chronic sinusitis types use the same rating criteria based on episode frequency and severity.