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6514
§ 4.97 Schedule of ratings—respiratory system.

Chronic sphenoid sinusitis

Persistent inflammation of the sphenoid sinuses located behind the nose.

What the rating means

Chronic sphenoid sinusitis (Diagnostic Code 6514) is rated under the General Rating Formula for Sinusitis, which covers Diagnostic Codes 6510 through 6514. Four percentage levels are possible: 50%, 30%, 10%, and 0%.

A 50% rating applies if you had radical surgery followed by chronic osteomyelitis, or if you have near-constant sinusitis with headaches, pain and tenderness of the affected sinus, and purulent discharge or crusting after repeated surgeries. A 30% rating applies if you have three or more incapacitating episodes per year requiring prolonged antibiotic treatment lasting four to six weeks, or more than six non-incapacitating episodes per year with headaches, pain, and purulent discharge or crusting. A 10% rating applies if you have one or two incapacitating episodes per year requiring that same prolonged antibiotic treatment, or three to six non-incapacitating episodes per year with headaches, pain, and purulent discharge or crusting. A 0% rating applies when the condition is detected by X-ray only. An incapacitating episode is one that requires bed rest and treatment by a physician.

Evidence that helps

Medical records that document the frequency and character of your sinusitis episodes are central to supporting a rating. For the higher levels, records showing radical surgery, a diagnosis of chronic osteomyelitis, or repeated surgeries with ongoing symptoms would be relevant. Physician notes, operative reports, and imaging can show these findings.

For the 30% and 10% levels, treatment records showing how many times per year you were prescribed prolonged antibiotic courses of four to six weeks — and whether those episodes required bed rest and physician care — help establish whether episodes were incapacitating. Office visit notes, pharmacy records, and discharge summaries that describe headaches, sinus pain and tenderness, purulent discharge, or crusting support non-incapacitating episode counts.

A 0% rating is supported by imaging such as X-rays or CT scans that show the condition without accompanying documented symptoms or treatment. Statements from you or people who know you describing how recurring episodes affect your ability to work or carry out daily activities can help show the real-world impact of your symptoms alongside clinical records.

Secondary conditions

Conditions that are often caused or made worse by this one. If you have any of these, they may be claimable as secondary service connection.

  • Sleep apnea