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6819
§ 4.97 Schedule of ratings—respiratory system.

Nasal cavity and paranasal sinus cancer

Malignant neoplasm of nasal cavity and paranasal sinuses (unspecified)

What the rating means

Nasal cavity and paranasal sinus cancer is rated under diagnostic code 6819 as a malignant neoplasm of the respiratory system. VA assigns a 100 percent rating while the cancer is active and during any treatment, including surgery, radiation (X-ray), chemotherapy, or other therapeutic procedures. The 100 percent rating does not stop the moment treatment ends. It continues beyond the end of treatment. Six months after treatment ends, VA requires a mandatory examination to determine the appropriate rating going forward. If the examination shows no local recurrence and no spread to other parts of the body, VA will then rate you based on whatever residual effects or lasting problems remain from the cancer or its treatment. Any change to your rating after that examination is subject to the protections in 38 CFR § 3.105(e), which governs reductions in disability evaluations.

Rating levels

  • 100% — Neoplasms, malignant, any specified part of respiratory system exclusive of skin growths

VA doesn't add ratings together. It combines them using the table in 38 CFR § 4.25, so two ratings usually total less than their sum.

Evidence that helps

While the cancer is active or treatment is ongoing, medical records confirming the diagnosis and documenting your treatment are the core evidence. Oncology notes, pathology reports, operative reports, radiation treatment records, and chemotherapy logs all establish that the 100 percent criteria are met. After the mandatory six-month post-treatment examination, the focus shifts to residuals. At that stage, imaging results, scope or biopsy findings, and physician notes addressing whether there has been any local recurrence or metastasis become critical. If no recurrence or spread is found, records documenting lasting effects — such as breathing difficulties, facial pain, vision changes, or speech problems — help VA rate those residuals accurately. Your own statements, and statements from people who know you, describing how remaining symptoms affect your work, sleep, and daily activities can also help show the severity of any residuals.

Presumptive conditions

If your service meets the rules below, VA presumes this condition is connected to it.

  • Chronic disease — 38 CFR § 3.309(a)
  • PACT Act — 38 U.S.C. § 1120

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.