VA Disability Assessments for Sinusitis Explained | CCK law (2023)

What is Chronic Sinusitis?

Chronic sinusitis occurs when the spaces inside the nose and head (ie, the sinuses) become swollen and inflamed for three months or more despite treatment. This condition is quite common and usually interferes with the way mucus drains, leading to a stuffy nose. As such, breathing through the nose can be difficult and the area around the eyes can become swollen or painful. Common signs and symptoms include:

• nasal inflammation
• Thick, discolored discharge from the nose
• Drainage in the back of the throat (postnasal drainage)
• Blockage or nasal congestion, causing difficulty breathing through the nose
• Pain, tenderness, and swelling around the eyes, cheeks, nose, or forehead
• Reduced odor and taste
• Earache
• Pain in the upper jaw and teeth
• cough or throat clearing
• Fatigue

Chronic sinusitis and acute sinusitis have similar symptoms, but acute sinusitis is a temporary sinus infection that is often associated with a cold. As such, it's not that debilitating and usually resolves on its own. Common causes of chronic sinusitis may include the following:

• Nasal polyps: growths of tissue that block the nasal passages or sinuses
• Deviated nasal septum: A crooked septum (i.e., the wall between the nostrils) can restrict or block the sinus passages
• Respiratory tract infections: Respiratory tract infections can inflame and thicken the sinus membranes and block mucus drainage.

Veterans may develop this condition as a result of their active military service, in which case they may be eligible for VA disability benefits.

Service connection for chronic sinusitis

Chronic sinusitis can be caused by a number of things that veterans may experience while on active duty. For example, a veteran may sustain facial injuries that result in a deviated septum, causing them to develop chronic sinusitis. In other cases, veterans may be exposed to air pollutants and toxins emitted by campfires. Breathing in toxic substances like asbestos and pollutants can lead to complications with sinus function in the future. The service connection for this chronic condition can be established in several different ways:

direct connection service

To establish a direct service connection for chronic sinusitis, veterans must demonstrate the following three elements:

• A current diagnosis by a medical professional;
• An event, injury or illness on duty; Is
• A medical nexus that links the current diagnosis of chronic sinusitis with the occurrence in service.

For example, veterans may claim that diagnosed chronic sinusitis is due tofire pit exposure. In that case, a health professional would have to provide an opinion that the veteran's condition is "at least probable" due to in-service exposure.

secondary service connection

Acondition connected to secondary serviceit is one that resulted from a separate condition that is already connected to the service. If a veteran has suffered a traumatic injury to the face that resulted in a deviated septum, he may be hired for that condition. If the veteran develops chronic sinusitis as a result of his service-connected deviated septum, service connection may be secondary justified.

Service connection assumed

Veterans who served in specific places and periods of time do not need to show a connection between their sinusitis and the service to qualify for VA disability compensation. In these cases, the VA presumes a link between the service and the condition, which means the veteran does not need to prove a link.

Recently, the Honoring Our PACT Act expanded the list of conditions eligible forSuspected service connection due to toxic exposure. A veteran may be eligible for this presumption if they have a diagnosis of sinusitis and meet the criteria for“veterans covered”.

A covered veteran is one who served:

• As of August 2, 1990, with active military, naval, air, or space service while assigned to a duty station, including the airspace listed above:
  • Bahrain
  • Irak
  • Kuwait
  • Oman
  • Train
  • Saudi Arabia
  • Somalia
  • united states emirates

• As of September 11, 2001, with active military, naval, air, or space service while assigned to a duty station, including the airspace listed above:
  • Afghanistan
  • Yibuti
  • Egypt
  • Jordan
  • Lebanon
  • Syria
  • Yemen
  • uzbekistan

Exposure and sinusitis in military pits

Military burn pits are large areas of land that were used by the US military to incinerate garbage in places like Iraq and Afghanistan in the post-9/11 era. While the practice was effective in reducing large amounts of waste, the pits emitted large clouds of toxic fumes that were later found to cause many adverse health effects.

Waste materials commonly dumped in these wells include:

• human waste
• hospital waste
• Ammunition
• Elegant
• The plastic
• Goma
• polystyrene
• Other toxic chemicals
• spoiled food
• lubricants
• Petroleum

At this time, there is little conclusive research on the long-term health impacts of traps. However, the main dioxin released by combustion pits iscalled TCDD and was also one of the main toxins in Agent Orange.

New presumption of particulate matter

However,VA recently announcedwhich, effective August 2, 2021, will begin processing disability claims for asthma, rhinitis, and sinusitis on a presumptive basis based on alleged particulate exposures. Veterans will only be eligible for this presumption if they meet certain criteria, including service in Southeast Asia and other specified areas and the manifestation of asthma, rhinitis, or sinusitis within 10 years of a qualifying period for military service. Many veterans who have been exposed to burns while in the service and have developed one of these three conditions can apply for service connection under this new presumption.

Specifically, the presumption affects veterans who served in Afghanistan, Uzbekistan, Syria, or Djibouti between September 19, 2001 and the present. It also covers veterans who served between August 2, 1990 and the present in the Southeast Asian theater of operations. The Southeast Asia theater of operations refers to the following areas:

• Irak
• Kuwait
• Saudi Arabia
• The neutral zone between Iraq and Saudi Arabia
• Bahrain
• Train
• United Arab Emirates
• Oman
• gulf of aden
• gulf of oman
• Persian Gulf
• Mar Arabe
• Red Sea
• The airspace above all these places

Despite this new presumption, the VA does not have a consistent approach to deciding these cases, so evidence from veterans is essential in obtaining burn claims. Often, the VA has no way to prove that veterans have been near fire pits, so affidavits from the veteran himself or affidavits from friends can help provide the necessary details.

Compensation and pension (C&P) exams for sinusitis

Once a sinus claim has been filed, the VA may request a W&P review, or. To do this, the VA can call the veteran or send him a letter. It is crucial that the VA have your current contact information so that you do not miss any C&P exam applications. It is also very important to appear for the exam, as failure to appear could result in the denial of the veteran's application.

The exam will usually be performed by a VA-contracted physician. Prior to the exam, the examiner will review the veteran's c-file. This will contain all documentation that was previously submitted to the VA, as well as the veteran's medical and service records. During the exam, the examiner may physically examine the veteran and ask questions about the veteran's symptoms or military service.

The veteran can also use a DBQ, orDisability Benefits Questionnaireto strengthen your claim. A Disability Benefits Questionnaire is a form created by the VA to help veterans address important aspects of their condition, such as symptoms, severity, possible causes, and relationship to other disabilities. Veterans can also request that their private physician complete a DBQ for them. A private doctor who treats a veteran's sinusitis can provide the VA with a more detailed picture of the veteran's condition through a DBQ.

How the VA Evaluates Chronic Sinusitis

AV evaluates chronic sinusitis in38 CFR § 4.97according to the General Classification Formula for Sinusitis (Diagnosis Codes 6510 to 6514). The criteria are the following:

• 50% -after radical surgery with chronic osteomyelitis, or; almost constant sinusitis characterized by headaches, pain and tenderness or affected sinus and purulent discharge or crusts after repeated surgeries
• 30% –three or more disabling episodes per year of sinusitis requiring prolonged antibiotic treatment (4 to 6 weeks duration), or; more than six non-disabling episodes per year characterized by headache, pain, and pus-like discharge or crusting
• 10% -one or two disabling episodes per year of sinusitis requiring prolonged antibiotic treatment (4 to 6 weeks duration), or; three to six nondisabling episodes per year characterized by headache, pain, and pus-like discharge or crusting
• 0% -detected only by X-ray

Importantly, a disabling episode of sinusitis refers to one that requires bed rest and treatment by a healthcare professional.

TDIU you have Sinusitis

Veterans who are unable to work due to their sinusitis may be eligible to receive a monthly VA disability benefit called Total Disability Based on Individual Delinquency, orTDIU. This benefit compensates veterans at the 100 percent qualifying level, even if their disability rating is less than that.

In general, there are two paths to qualify for TDIU:

• 38 CFR § 4.16a("Timeline")– For this type of TDIU, the veteran must have:
  • A condition evaluated inMinimum60 percentO
  • Of theconditions that can be combined to achieve70 percent, where a condition is foundMinimum40 percent
• 38 CFR § 4.16b("Extrascheduled")– This TDIU form is for veterans who may not be able to obtain the required qualifications for the regular TDIU, but are still unable to obtain substantially paying employment due to their conditions.
• • In this case, the veteran must prove that his condition solely impairs his ability to obtain substantially gainful employment and therefore must not be classified under the standard disability classification criteria.

Veterans with multiple conditions may have a combined classification that makes them eligible for TDIU. Specifically, a sinus rating may be combined with a rating from another condition to help a veteran qualify for scheduled TDIU, as long as the combined rating reaches at least 70 percent and one of the conditions has a minimum rating of 40 percent. hundred.

Chisholm Chisholm & Kilpatrick LTD can help you with your denied VA claim

If you are unable to obtain a VA benefit grant due to a condition caused by military service, Chisholm Chisholm & Kilpatrick LTD can help. Our team of seasoned attorneys has the resources and experience necessary to provide support and guidance throughout the VA disability claim process. Call 800-544-9144 for a free case evaluation.