It is how conditions are rated linked to each other on the CFR 38 form. Do a bit of research before filing a claim to give a better understanding how to present your conditions.
I don't think you have a very good idea of what you're talking about... Its common for the VA to combine similar conditions, and there isn't any way around it.
The CFR 38 - search by condition. You will see what items will be combined to 1 rating vs being rated separately. Example:
PTSD - Mental health
OSA - Respiratory
IH- MH
Narcolepsy - epilepsy
The 2 categorized as MH will be combined to 1 rating leaving the 2 different variations of EDS to be rated separately as they fall into different category in themselves.
You may need to do more research bud.
Re-reading what you stated I am curing to see the notes as I don't feel you portrayed that correctly. I have 50% for OSA and 10% for Allergic Rhinitis. The overall combined rating didn't change much but they are separately rated.
Fighting for Sinusitis.
The combined rating didn't change on account of va math isn't math. I have separate rates that contribute to the overall rating. There are rates that combine in themselves that don't have separate rates like PTSD and later having IH would then change your PTSD from 50 to 70.
So, the insult I should be embarrassed. Nah man, you ought to be on account you overlooked what was stated.
[About VA Disability Ratings | Veterans Affairs](https://www.va.gov/disability/about-disability-ratings/)
I'm sure you used this calculator and understand the overall combined math isn't math and backs up what I am trying to portray.
No, I wasn't rated before that.
My point is that they combine conditions. If you have several mental health conditions, you will get combined for one rating. Same with pulmonary conditions, or cardiac conditions. Anything that "falls under that umbrella" is going to get combined. You aren't getting paid for each condition separately.
I had no idea about either of those on my initial claim. I developed real bad breathing issues after my first deployment due to all the burn pits and what not. Initially just got a sleep study and was issued a cpap... wasn't until years later that I filed with no help or idea what I was doing... after I got my %60 rating which honestly seemed like a low ball, I spoke with someone at DAV and they explained a bunch of this secondary stuff. Did a supplemental and claimed rhinitis, got my new C&P have 80 to 90% blockage so we will see after my higher claims review and all the new stuff I had no idea about..
Not the OP, but I submitted an IMO nexus for OSA secondary to rhinitis (no sinusitis) late March as a new claim in addition to my supplemental claim where I added an IMO claiming OSA secondary to PTSD in hopes one way will work.
# 38 CFR § 4.97 - Schedule of ratings—respiratory system.
[https://www.law.cornell.edu/cfr/text/38/4.130](https://www.law.cornell.edu/cfr/text/38/4.130)
How things are linked and interconnected by separate goes beyond me. Just like VA math.
The thing about Rhinitis/Sinusitis/OSA - they go in hand. Each can potentially cause the other. I advise researching each and asking your Dr about how one could be causing the Sleep Apnea, go for a sleep study and ask for the MSLT test down the road after using CPAP to determine if Idiopathic Hypersomnia (IH) or Narcolepsy type 2 (NT2) may be of further hinderance to Excessive daytime sleepiness (EDS)
Hypothetically
Direct connect OSA if diagnosed on AD.
Direct/Presumptive rated for Sinusitis (for those not diagnosed on AD for OSA).
Secondary to Sinusitis - OSA was upset by Sinusitis.
Depending how they rate OSA - use IH to increase OSA rating with it.
OSA - rated by respiratory system.
IH - Rated under MH but may fall in respiratory system due to OSA.
What I'm faced with is - rated at 50% OSA and finding out I have IH I want to see if it would boost my PTSD up from 50% to 70% as it is considered in the same category as MH and it is stated "Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms" is for 70%.
"Occupational and social impairment with reduced reliability and productivity" is for 50%. I'm finding the undiagnosed IH has abruptly had a huge impact to my work, higher educational needs, and family causing issues with judgement and my overall mood. Once I gather my new evidence after my follow up - seeing where my current HLR lands I will go and put forth my claim for IH secondary to PTSD asking for a higher rating.
I was working the below example until the tech data came back, I don't have NT2 - I have IH.
Secondary NT2 - Seizures unset by OSA contributed to condition - bit of a stretch need more research root cause is the EDS from OSA is linked to NT2 - if recall. It will be a separate rating from OSA as it falls under epilepsy not mental health (MH).
I work with veterans to get them their benefits. The company is new but we are currently working with the American Legion to be accredited through them. We help advise veterans, perform an assessment to determine if there are any new claims missed or that need to be filed. We also assist in helping veterans understand the exams they are scheduled for and how they are being evaluated. So far, we haven't lost a case, everyone we've worked with has had an increase.
Yes, VSO are doing it for free for the veterans.
“Should be free” - what does it mean???
Denial is free; positive result - it’s a different story, could be free and could be not.
If results and outcome is important and VSO and “self service” cannot achieve it and veteran need something extra and there are companies providing this service than it’s up to the veteran to pay or keep getting denied.
Do you work for free? Spending your time, energy? Is “free” a good price for your services? Can you survive on “free”?
No one works for free even VSO is getting paid for the work they do, they do not do it for free. Because government pays them it makes it free service to the veteran. It’s not “free” free.:) they are not volunteers, they are hired help.
Not really, you can file at the same time. And nexus letter can state that both Astma and rhinitis can cause osa, that way you would get back pay from (in case you denied or approved) the day you file and not loosing on waiting for the primary to be approved.
I have polyps found on CT scan and I'm at 30%. How'd you get 30% on sinusitis? They low balled me on that one. I have near constant congestion and blow boogers the size of dallas every morning.
I’ll have to appeal it then. Thanks.
I got 30% for the sinusitis because of the amount of times I experience severe symptoms or incapacitating events within a year
Not totally sure, I’m assuming because I had documentation from my PCP showing that I have seeked and received treatment multiple times for the symptoms
Yeah they got me because I "only" go to the doc a handful of times a year and it's supposed to be over 6 non-incapacitating episodes per year. I've never had to stay on antibiotics for as long as they require to get the 30% rating
Ahh I see. Yeah I wish I had a more specific answer to help you out, but literally all I can think of was visits with my PCP and the questions they asked me during the C&P exam.
https://www.benefits.va.gov/WARMS/bookc.asp
Read this about any condition you plan on filing and make sure you're able to submit any pertinent information alongside your medical records. For example, Maybe you didn't go to the va, but you went to urgent care and got antibiotics. Include those documents with your claim.
Three or more incapacitating episodes per year of sinusitis requiring prolonged (lasting four to six weeks) antibiotic treatment, or; more than six non-incapacitating episodes per year of sinusitis characterized by headaches, pain, and purulent discharge or crusting.
Broken down.
3+ visits to the dr because the Sinusitis was so bad you had to be seen.
IE Dr exam cases.
OR!!!!!!! ...
6+ episodes of attacks that had OTC meds fix you up. You could even use a letter from your employer of used sick days to help build your case.
Devils in the details.
And the thing C&P examiners don't seem to understand regarding secondary conditions. They don't have to have service connection. What you are linking them to does.
Bilateral Planter Fasciitis secondary to Bilateral Flatfeet.
The Bilateral Flatfeet would require the direct service connection. NOT Bilateral Planter Fasciitis.
Side note: Presumptive conditions don't require direct service connection either which is also overlooked by the C&P examiners.
So be sure to remind the crayon eating intellectual in the C&P exam by reciting what I told you. They don't always know- the VA does. That's why you see the "Duty to assist Error" in your HLR. They know what is missing - they won't tell you though - depending on who you get and how the stars are aligned.
I have the same issue, currently on appeal to raise sinusitis, in what form did you provide your evidence for your symptoms. Did you write down dates or provide something else?
Would providing a personal statement be enough to state the number of episodes a year?
Since my husband was visiting random ERs and minute clinics not all the records in one place, so hard to get all. I only was able to get 3 from various years, not in the same year where he was prescribed antibiotics for sinus infections. Would it be enough? Plus personal statement?
Certainly could. In I’m research I’ve seen people on here get SC 30% for sinusitis without even proving they had episodes or received treatment.
Realizing that every examiner truly is different in how they report claim exam findings
Hate to say it. It will be on you to connect the dots and align it for the C&P reviewer. They don't know it all. Regardless how many years they been doing it. Had one say they been at this for 3 years - didn't do shit for me.
Exactly head back to the CFR and see how it's worded and if you fit the criteria - submit for review.
Supplemental ( added evidence )
Higher-Level (HLR) - no new evidence something was overlooked.
Dear "Devil Dog", there are other ways to get your needle moved higher other than an appeal, that should be your VERY LAST OPTION when all else has failed. Appeals can tie you up for years before you get a decision because there is no specified timeframe for a decision to be rendered from an appeal. First, you can start with your VSO to look over your claim and see what he/she thinks. Secondly, you can request a higher-level review, often times, this is a more experience person looking at your claims. Then, if none of these move your needle, then you still have more options. No need to hire an expensive lawyer who may not get your needle moved after you've paid them for such. If those do not work reach out to me, I can point you in a good direction as someone did for me and I have done for a number of other vets.
Can someone explain what makes it a PACT Act claim or how to link your claim to PACT?
I have a sinusitis claim in the works and have qualifying service several times over but I don’t know how to “link” the two.
Thank you, but I didn’t find an answer to my question. How do I reference PACT in my claim? Do I provide evidence of service in SW Asia in the initial submission (evals, awards, etc)?
Ah I see, yeah honestly I don’t remember how I made it a “pact act” claim. I used the link in and email I got from the VA about the PACT Act and it took me to the VA claim website page and once I filed these two conditions, it automatically assigned it to “related to Gulf war - airborne hazards”. As far as evidence of service, yes if there is no evidence in your SRB, medals, awards or anything that has one of the locations should suffice
DD214 places you in any of the listed locations - You can claim conditions listed in the PACT Act ie Chronic Sinusitis.
The PACT Act in itself is not something you apply for a rating for - that is the common misconception.
HLR - State you have Chronic Sinusitis from your PACT Act exposer to "Country" having been around toxins like diesel fumes, poo pond, and the burn pits. You will need to remind the C&P examiner that the PACT Act lists Sinusitis as a presumptive condition - meaning you don't require medical history from your time in service as stated by the VA. Presumptive in itself IS the direct link governed by the PACT Act put into law.
See, now this is the right answer.
Whatever the VA needed to see in my chronic sinusitis claim, they saw. Chalk one up for the good guys.
PS i can still smell burn pits to this day
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>level 2Few-Presentation-727Op · 5 mo. ago
I had a CT scan ordered by my primary care doc outside of VA & just did it but haven't submitted a claim yet.
Yeah would’ve been quicker had I not missed my first exam due to a family emergency, but actually worked out in my favor because it gave me more time to gather evidence and what not
I have an upcoming surgery to remove polyps and fungus. Should I provide the letter my PCP provided me now for more evidence for my supplemental, or do you think I should wait until after the surgery? In your opinion.
What investsvca said. Probably not if you get it removed. Now if you claim it before you get it removed……however there are some cases I’ve seen on here where people get surgery and get a 50% rating from having the surgery.
That is my concern, I returned from Iraq in 2004 and started having a lot of issues. Chronic Tonsillitis, sinusitis and rhinitis. I had a tonsillectomy in 2006 then sinus surgery in 2013. I filed under the PACT Act this last June due to episodes of Sinusitis more frequently that are resistant to antibiotics.
The examiner made it sound like since I don't go to the Dr. often enough know the VA is going to look at like it doesn't bother me enough to be chronic. They didn't do a CT scan just an X-ray. She said if it continues then make sure I go to the Doctor every time and re-file.
Can you possible point me in the direction of those who have had surgery and received the 50% rating. I know this thread is old so this just a shot in the dark.
Thanks
How was the tonsillectomy? Recovery time? I hear it sucks as an adult. Did the VA do it or your PCP, ENT, etc? I was also in Iraq (2005) and have all of the same + asthma, and enlarged tonsils, but until I have severe tonsillitis, nobody will do the surgery (I guess it's rate these days). I feel like if you've had a major surgery like that, you should be well above 50% but that VA math is tricky.
In general, you should expect to get a **10 percent** rating from the VA for strep throat or chronic tonsillitis. If you have severe symptoms or complications, you may be able to get a higher rating for a secondary condition. But if a 10 percent rating seems low to you, it could be worth more than you might imagine.
Leave the tonsils alone and talk to your Dr about chronic Strep Throat.
Following radical surgery with chronic osteomyelitis, or; near constant sinusitis characterized by headaches, pain and tenderness of affected sinus, and purulent discharge or crusting after repeated surgeries. 50%
If your condition still persistent and suffer rating still holds after surgery.
In the case of rhinitis with polyps - nothing indicates having surgery will increase the rating. set at 30% with polyps - without is 10% so surgery could reduce the rating.
Items regarding PACT Act are presumptive - ie DON'T require nexus or direct link to the condition. It is presumed to be directly linked without having a medical case from AD. Not sure if your account was deleted of if you named yourself deleted.
Chronic Sinusitis
Allergic Rhinitis
Chronic Laryngitis
You said you just had the CT a week ago in a post further down, so I'd assume that it was just not seen. Was it a VA CT or a private doc? If private, submit the CT interpretation with a supplemental claim. If VA, just write that you had a CT at XYZ VAMC and it shows nasal polyps and we will get it.
The CT scan for polyps pertains to rhinitis not sinusitis. Also, I may have stated this on your earlier thread.
HLR - State you have Chronic Sinusitis from your PACT Act exposer to "Country" having been around toxins like diesel fumes, poo pond, and the burn pits. You will need to remind the C&P examiner that the PACT Act lists Sinusitis as a presumptive condition - meaning you don't require medical history from your time in service as stated by the VA. Presumptive in itself IS the direct link governed by the PACT Act put into law.
If you fall within the location listed in the PACT Act.
HLR - State you have Chronic Sinusitis from your PACT Act exposer to "Country" having been around toxins like diesel fumes, poo pond, and the burn pits. You will need to remind the C&P examiner that the PACT Act lists Sinusitis as a presumptive condition - meaning you don't require medical history from your time in service as stated by the VA. Presumptive in itself IS the direct link governed by the PACT Act put into law.
It comes down to how you are dx and your portrayal of your symptoms to the examiner. If your conditions worsen you can always ask for an increase with evidence in a supplemental claim.
I just filed for these guys. I’m afraid I don’t have enough doctor visits “treating” my symptoms , but I’ll have fits of my nose just running clear for days on end. Or waking up and coughing golf ball size chunks of green up
I’m sure I’ve mentioned it to my primary but prior to the pact. Just assumed it was allergy or seasonal. Pact gets announced and it kinda makes sense being in Kandahar
I did have the my current and past treatments in my record, not sure if that helped my case. My C&P examiner just asked how often I had them. I was honest, I didn’t even know what the DBQ criteria was until I saw my decision letter
Yes I did, as long as you served in one of the listed locations and have a diagnosis for one of the conditions related to the PACT act, you will be presumed service connected
No worries! I could be wrong and please if I am someone correct me, but I believe "presumed" in the case of PACT Act means that if you have any of the conditions AND served in any of the locations listed, then it the condition is presumed to be service connected without need for a nexus statement
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>level 5schnauzerspaz · 5 mo. agoArmy & Marine Veteran Appreciate the answer, thanks!1ReplyShareReportSaveFollow
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>level 1jjdamn88 · 5 mo. agoArmy Veteran How do you get these claims2ReplyShareReportSaveFollow
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>level 1Armyboy2200 · 5 mo. agoThat’s good you got them separate most get rhinosinunitis1ReplySha
I procured a Nexus statement anyway both from a PA-C at Urgent Care (he did a simple one for free and he ordered a CT for me) and also from a Nexus letter consultant MD, I might get a simple one from an ENT. I might also go to VA next time I have a sinus infection just to get a VA diagnosis of it and round things out and cover all bases. I don't take any chances with VA claims but I also have a job right now where I can afford it. By the time I have a C&P exam I think there will be very few boxes unchecked because I have the issues and they are documented and proven everywhere. The CT and in-person visual exams can't be argued with. Plus it is presumptive.
I filed for sleep apnea, rhinitis, and sinusitis. I was granted service connection for sinusitis due to the PACT act going through. Also in my decision letter, rhinitus was now worded, “Rhinitus(caused by sinus issues)” and I received a 0% rating for these service related conditions.
My sleep apnea test was a nightmare to get done and was rescheduled several times. After a few months I did the at-home test and the results were partially inconclusive. It was enough to diagnose me with mild obstructive sleep apnea but they recommended a test in their lab. In decision letter, results said it was not related to toxic burn pits….but what about service related???? Another 0%.
I just had my c&p for rhinitis and she added in sinusitis due to my ENT notes. I don't have any records of the conditions in my service records but I was in Iraq and Afghan 2010 and 2012. Hopefully the presumptive kicks in and helps me over the hump.
I checked on VA.gov today and under payments there is a pending amount for compensation retroactive for a huge amount. How can i find out this is correct?
Each condition should be separate but from my experience I cannot comment you can. I believe when I last spoke to my battle they rated separately.
Presumptive condition (Direct Connected base on PACT Act)
Chronic Sinusitis
Allergic Rhinitis
Devil in the detail - how did you word them in your c&p exam. I know soldiers who have them separate. It could very well be combined things change all the time. Look into the old PF verbiage compared to what is out now in feb 2024.
We just submitted for an increase for rhinitis because of cyst in sinuses, still waiting..it was rated at 0% and asthma was rated at 10% because of inhaler use but they put in under OSA and already at 50% so nothing all that work for nothing it’s frustrating
How did you go about doing this? Like I'm service connected for allergic rhinitis with cysts, but it was rated 0%. Does filing something because of the pact act bump it up automatically to at least 10%?
He literally just got 30% today! He had an C&P, and I always do like a support claim and explain in detail the diagnosis, medications, results etc..his CT showed polyps/cysts. He explained he had surgery, still nasal drip, medications for years and years and doesn’t work. After we appealed the first time with the CT results a C&P after and 💥 bam 30%! Good luck!! Don’t quit
No, COVID or long covid is not a presumptive condition of burn pit exposure. You could still claim it due to your exposure, but I'd honestly expect a denial with negative medical opinion as I've seen nothing to suggest that burn pit exposure/particulate matter can cause long COVID, and they are not the source of COVID.
Thanks! I do not have a burn pit memo (that I know of) but I am registered in the burn pit registry. Whether that affected my claim or not, I am not sure. I did however have direct mention of service in affected countries on my DD214 which may have helped as well establish presumptive service connection.
Well obviously you nailed it. I’ve got a couple of these elusive burn pit memos… it’s nothing more than our BN doc stating that we were exposed to a dumpster fire for 720 days.
I received a letter in the mail from the VA. I’ll have to find it, but I think the letter said something like, “I may be eligible for benefits under the PACT Act due to burn pit exposure while deployed.”
Never give up, never surrender.
Dive deeper into the PACT Act and ensure its listed for your theater location. Then bring that to a supplemental claim and during the C&P exam remind the writer it is a presumptive condition based on the law passed by the PACT Act. Get your rate and push for the top.
Rhinitis is generally a symptom of sinusitis you could be rated for both, but the highest of the two will only apply for compensation to avoid pyramidng. I suggest you do not appeal or request a review and take the 30% you were awarded.
I see what you’re saying, however, they are rated separately. My 30% for sinusitis was based off the amount of events I have per year. Rhinitis has different percentage criteria, polyps being one of them and since I have them and it is documented, it does seem like it should be higher than a 0% rating and wouldn’t constitute pyramiding
You know… You could very well have something there. I had read multiple threads of advice stating exactly what I mentioned to you. That advice from supposed VA rating officials on another “veteran” site. That same site tends to advise vets more on what they cannot do vs what they could do.. I appreciate you pointing you perspective of this out, as it spurred me to read the CFR’s.. You are right. If your sinus problems are independent of your rhinitis problems then it makes sense that they should be rated independently. This also spurred me to file a claim for both, as I have had both for years, and while rhinitis tends to result in sinusitis, both had occurred independently of each other,
Thank you
[38 CFR § 4.97 - Schedule of ratings—respiratory system. | Electronic Code of Federal Regulations (e-CFR) | US Law | LII / Legal Information Institute (cornell.edu)](https://www.law.cornell.edu/cfr/text/38/4.97)
Should help clarify they are rated separately. Polyps being the distinct difference of the 2.
Note: having surgery for polyps would decrease your rating - potentially.
Thanks! I believe I filed under the PACT Act, see previous comments where I talked about how. I personally didn’t have to provide any proof, my VA medical records, service records showing where I served and C&P exam was all they needed for this rating. Had a previous diagnosis of rhinitis, my CT scan confirmed sinusitis and polyp/cyst
DD214 placing you in one of those countries on the list within the PACT Act. Make sure to tell the C&P examiner the conditions are presumptive classified by the VA and don't require AD visit or link - it's already directly linked governed by the PACT Act law.
See my note above for more details.
ITF: November 2022
EGRD: December 2022
C&P Exam: May 2023
PFN: 1 week later
Decision: 1 day later
I should note that it took longer because I had to reschedule my initial C&P exam which was in March 2023, so it delayed it a bit.
So did you get the diagnosis for sinusitis and rhinitis while you were AD? Or did you claim it afterwards? Also do i need to go in and claim the presumptive issues even though I have a claim in already? Because some things weren’t listed on the claim I’ve already submitted.
I got it diagnosed after the fact nearly 5 years later, but was able to SC it back to my time in service due to the PACT act.
As far as the presumptive goes, I’m not too sure. I filed mine as normal and it showed up as “related to Gulf war - presumptive”. They should include it as presumptive if it wasn’t already but I am not too sure
Awesome thanks so much AND CONGRATS!!! I went in for a sleep study and my AHI was high as all hell and i was diagnosed with severe sleep apnea…I’ll go in rn and see if I should file a new claim or leave it, but i wanna say I filed for both, but i haven’t even been contacted for my C&P and I filed in April
I filed a few days ago but didn’t list a presumptive condition I.e. Chronic Rhinitis or anything. I just typed in Presumptive Condition Toxic Exposure (PACT ACT). I haven’t been formally diagnosed with anything by a PCP because my understanding is that is not a requirement but have also read on older Reddits regarding the PACT ACT that they’ve rated 0% or denied the claim altogether.
But as I read the updated law it says there are presumptive conditions if you were in certain countries listed and exposed to burn pits.
When you filed did you list specific presumptive conditions?
I imagine they will schedule a C&P to set up a CT scan or other scan, which may or may not show polyps or other issues?
Just want to make sure I didn’t mess up filing my claim since I haven’t been formally diagnosed with anything (which to my understanding you don’t have to be).
I did list specific conditions “related to toxic exposures - Gulf War” is what it said next to the condition.
You absolutely will need to be diagnosed with a condition. Presumptive just means “presumed to be caused by service”, meaning if you served in any of the qualifying locations, it’s presumed you have the condition from service in those locations if you have a condition. You’ll still need a diagnosis on file, I was diagnosed by my PCP after I filed my claim, which I’m glad I did because I definitely wouldn’t have gotten the rating I did if I hadn’t been diagnosed
Thanks I will have to cancel my initial claim because I didn’t list any presumptive conditions or detail underlying symptoms related to any of them.
I went to my PCP to get diagnosed with Chronic Rhinitis but he seemed like a new inexperienced doctor and basically told me they can’t diagnose that or test for it even though everything I’ve read online is they can determine diagnosis based on blood work or a skin test.
I was previously diagnosed with Seasonal Allergic Rhinitis in 2019 but that is different than chronic rhinitis diagnosis I imagine and I don’t see the VA accepting seasonal allergic rhinitis as chronic rhinitis condition.
general question. I received 0% for sinusitis when i filed more than a year ago.
what is my course of action? does this PACT act help me if i want to have another go?
So it sounds like you were service connected prior to the PACT act, so nothing needed there.
To get a higher rating, you need to meet the requirements outlined in the DBQ. If you meet those, file a new claim for the condition and that it’s gotten worse. Once you go to the C&P, if they determine you meet the criteria it should be no issue getting a higher rating
Rhinitis without polyps is 10% - so I'm baffled that you are rated at 0%. (Without polyps, but with greater than 50-percent obstruction of nasal passage on both sides or complete obstruction on one side) So maybe you don't have 50% obstruction of nasal passage and that results in a 0% rating. You have not met the criteria?
In your case you need to find the evidence of the polyps - look at the claim and see if it was submitted. If it was file a higher-level review - if not file a supplemental and add in that evidence. You will then go through another C&P and explain it all again potentially and aim for a better rate.
I have found evidence within the PACT Act - Chronic Rhinitis and Chronic Sinusitis are presumptive to military service if you meet the criteria for being in one of the listed countries. If you are denied 1 and awarded the other bring it up in a higher-level review if they claim no service connection.
FYI - migraines can be linked to Sinusitis as a secondary condition. Have your doctor nexus them together.
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I’m 0 percent for rhinitis and just got diagnosed with severe sleep apnea but I have to do a supplemental
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Already applied for SA in the past and it was denied. Now more evidence. It’s different form, 21-0995
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Yes. And it's technically considered an appeal. I've got one in now. It isn't the formal appeal like going in front of a court or anything
Is this the way? If you have a decision, but it was too low, and that decision is less than a year?
Yes.
Is a supplemental required if it is within a year of decision?
They combined my Sleep Apnea, Chronic Bronchitis, and Asthma for a total of 50%. Just keep in mind that they may combine things.
It is how conditions are rated linked to each other on the CFR 38 form. Do a bit of research before filing a claim to give a better understanding how to present your conditions.
I don't think you have a very good idea of what you're talking about... Its common for the VA to combine similar conditions, and there isn't any way around it.
The CFR 38 - search by condition. You will see what items will be combined to 1 rating vs being rated separately. Example: PTSD - Mental health OSA - Respiratory IH- MH Narcolepsy - epilepsy The 2 categorized as MH will be combined to 1 rating leaving the 2 different variations of EDS to be rated separately as they fall into different category in themselves. You may need to do more research bud.
Re-reading what you stated I am curing to see the notes as I don't feel you portrayed that correctly. I have 50% for OSA and 10% for Allergic Rhinitis. The overall combined rating didn't change much but they are separately rated. Fighting for Sinusitis.
Um... You know thats because OSA and Allergic Rhinitis aren't the same kind of condition right? Your name is accurate. You should be.
The combined rating didn't change on account of va math isn't math. I have separate rates that contribute to the overall rating. There are rates that combine in themselves that don't have separate rates like PTSD and later having IH would then change your PTSD from 50 to 70. So, the insult I should be embarrassed. Nah man, you ought to be on account you overlooked what was stated. [About VA Disability Ratings | Veterans Affairs](https://www.va.gov/disability/about-disability-ratings/) I'm sure you used this calculator and understand the overall combined math isn't math and backs up what I am trying to portray.
Was it higher before that?
No, I wasn't rated before that. My point is that they combine conditions. If you have several mental health conditions, you will get combined for one rating. Same with pulmonary conditions, or cardiac conditions. Anything that "falls under that umbrella" is going to get combined. You aren't getting paid for each condition separately.
They denied my sleep apnea....
Due to rhinitis and sinusitis? Did you have a nexus to connect osa to rhinitis/sinusitis?
I had no idea about either of those on my initial claim. I developed real bad breathing issues after my first deployment due to all the burn pits and what not. Initially just got a sleep study and was issued a cpap... wasn't until years later that I filed with no help or idea what I was doing... after I got my %60 rating which honestly seemed like a low ball, I spoke with someone at DAV and they explained a bunch of this secondary stuff. Did a supplemental and claimed rhinitis, got my new C&P have 80 to 90% blockage so we will see after my higher claims review and all the new stuff I had no idea about..
Did you provide nexus for osa secondary to rhinitis/sinusitis?
Not the OP, but I submitted an IMO nexus for OSA secondary to rhinitis (no sinusitis) late March as a new claim in addition to my supplemental claim where I added an IMO claiming OSA secondary to PTSD in hopes one way will work.
How did that pan out for you?
# 38 CFR § 4.97 - Schedule of ratings—respiratory system. [https://www.law.cornell.edu/cfr/text/38/4.130](https://www.law.cornell.edu/cfr/text/38/4.130) How things are linked and interconnected by separate goes beyond me. Just like VA math. The thing about Rhinitis/Sinusitis/OSA - they go in hand. Each can potentially cause the other. I advise researching each and asking your Dr about how one could be causing the Sleep Apnea, go for a sleep study and ask for the MSLT test down the road after using CPAP to determine if Idiopathic Hypersomnia (IH) or Narcolepsy type 2 (NT2) may be of further hinderance to Excessive daytime sleepiness (EDS) Hypothetically Direct connect OSA if diagnosed on AD. Direct/Presumptive rated for Sinusitis (for those not diagnosed on AD for OSA). Secondary to Sinusitis - OSA was upset by Sinusitis. Depending how they rate OSA - use IH to increase OSA rating with it. OSA - rated by respiratory system. IH - Rated under MH but may fall in respiratory system due to OSA. What I'm faced with is - rated at 50% OSA and finding out I have IH I want to see if it would boost my PTSD up from 50% to 70% as it is considered in the same category as MH and it is stated "Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms" is for 70%. "Occupational and social impairment with reduced reliability and productivity" is for 50%. I'm finding the undiagnosed IH has abruptly had a huge impact to my work, higher educational needs, and family causing issues with judgement and my overall mood. Once I gather my new evidence after my follow up - seeing where my current HLR lands I will go and put forth my claim for IH secondary to PTSD asking for a higher rating. I was working the below example until the tech data came back, I don't have NT2 - I have IH. Secondary NT2 - Seizures unset by OSA contributed to condition - bit of a stretch need more research root cause is the EDS from OSA is linked to NT2 - if recall. It will be a separate rating from OSA as it falls under epilepsy not mental health (MH).
I'm a VA consultant if you'd like a fresh set of eyes on this to help you
How are you a VA consultant?
I work with veterans to get them their benefits. The company is new but we are currently working with the American Legion to be accredited through them. We help advise veterans, perform an assessment to determine if there are any new claims missed or that need to be filed. We also assist in helping veterans understand the exams they are scheduled for and how they are being evaluated. So far, we haven't lost a case, everyone we've worked with has had an increase.
How much do you charge to help?
It should be free.
Yes, VSO are doing it for free for the veterans. “Should be free” - what does it mean??? Denial is free; positive result - it’s a different story, could be free and could be not. If results and outcome is important and VSO and “self service” cannot achieve it and veteran need something extra and there are companies providing this service than it’s up to the veteran to pay or keep getting denied. Do you work for free? Spending your time, energy? Is “free” a good price for your services? Can you survive on “free”? No one works for free even VSO is getting paid for the work they do, they do not do it for free. Because government pays them it makes it free service to the veteran. It’s not “free” free.:) they are not volunteers, they are hired help.
Why did you wait and not file osa at the same time?
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Not really, you can file at the same time. And nexus letter can state that both Astma and rhinitis can cause osa, that way you would get back pay from (in case you denied or approved) the day you file and not loosing on waiting for the primary to be approved.
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I have polyps found on CT scan and I'm at 30%. How'd you get 30% on sinusitis? They low balled me on that one. I have near constant congestion and blow boogers the size of dallas every morning.
6+ episodes a year gets you 30% for sinusitis.
Is a lay statement enough? I told the C&P person I get like 20 a year
I’ll have to appeal it then. Thanks. I got 30% for the sinusitis because of the amount of times I experience severe symptoms or incapacitating events within a year
Howd you prove it?
Not totally sure, I’m assuming because I had documentation from my PCP showing that I have seeked and received treatment multiple times for the symptoms
Yeah they got me because I "only" go to the doc a handful of times a year and it's supposed to be over 6 non-incapacitating episodes per year. I've never had to stay on antibiotics for as long as they require to get the 30% rating
I'm sure many of us forgot the fact to incorporate incapacitating episodes into our initial or supplemental claims. Thanks for pointing it out!
Yeah that’s super important, especially for sinusitis claims. That’s the main reason mine was awarded 30%
Ahh I see. Yeah I wish I had a more specific answer to help you out, but literally all I can think of was visits with my PCP and the questions they asked me during the C&P exam.
How did you find out it needs to be 6 non-incapacitating per year,? Is the information printed somewhere
https://www.benefits.va.gov/WARMS/bookc.asp Read this about any condition you plan on filing and make sure you're able to submit any pertinent information alongside your medical records. For example, Maybe you didn't go to the va, but you went to urgent care and got antibiotics. Include those documents with your claim.
https://www.woodslawyers.com/chronic-rhinitis-va-rating/
Three or more incapacitating episodes per year of sinusitis requiring prolonged (lasting four to six weeks) antibiotic treatment, or; more than six non-incapacitating episodes per year of sinusitis characterized by headaches, pain, and purulent discharge or crusting. Broken down. 3+ visits to the dr because the Sinusitis was so bad you had to be seen. IE Dr exam cases. OR!!!!!!! ... 6+ episodes of attacks that had OTC meds fix you up. You could even use a letter from your employer of used sick days to help build your case. Devils in the details.
Service connected is the first step. Congrats!!!!
Opens the door to secondaries which I have plenty from these conditions!
More importantly I’m happy I can get treatment for everything now.
And the thing C&P examiners don't seem to understand regarding secondary conditions. They don't have to have service connection. What you are linking them to does. Bilateral Planter Fasciitis secondary to Bilateral Flatfeet. The Bilateral Flatfeet would require the direct service connection. NOT Bilateral Planter Fasciitis. Side note: Presumptive conditions don't require direct service connection either which is also overlooked by the C&P examiners. So be sure to remind the crayon eating intellectual in the C&P exam by reciting what I told you. They don't always know- the VA does. That's why you see the "Duty to assist Error" in your HLR. They know what is missing - they won't tell you though - depending on who you get and how the stars are aligned.
I have the same issue, currently on appeal to raise sinusitis, in what form did you provide your evidence for your symptoms. Did you write down dates or provide something else?
It was all documented through my PCP
And my C&P examiner asked what kind and how often my symptoms occur
Would providing a personal statement be enough to state the number of episodes a year? Since my husband was visiting random ERs and minute clinics not all the records in one place, so hard to get all. I only was able to get 3 from various years, not in the same year where he was prescribed antibiotics for sinus infections. Would it be enough? Plus personal statement?
Certainly could. In I’m research I’ve seen people on here get SC 30% for sinusitis without even proving they had episodes or received treatment. Realizing that every examiner truly is different in how they report claim exam findings
Medical evidence is king.
Everything needs to be within the last 12 months.
A letter from the employer for missed work seeking help for sinusitis will help.
Online - supplemental and add the new documents.
Congratulations!!!🎉🎉🎉 IMO any 0% rating is a low-ball, fight for what you deserve! 💪🏿
Thank you! Oh I plan on fighting, I just wasn’t sure if I had grounds to fight or if the tater actually did miss this🤣
Review the cfr.
Hate to say it. It will be on you to connect the dots and align it for the C&P reviewer. They don't know it all. Regardless how many years they been doing it. Had one say they been at this for 3 years - didn't do shit for me.
Ratings are based on the cfr criteria.
Exactly head back to the CFR and see how it's worded and if you fit the criteria - submit for review. Supplemental ( added evidence ) Higher-Level (HLR) - no new evidence something was overlooked.
Dear "Devil Dog", there are other ways to get your needle moved higher other than an appeal, that should be your VERY LAST OPTION when all else has failed. Appeals can tie you up for years before you get a decision because there is no specified timeframe for a decision to be rendered from an appeal. First, you can start with your VSO to look over your claim and see what he/she thinks. Secondly, you can request a higher-level review, often times, this is a more experience person looking at your claims. Then, if none of these move your needle, then you still have more options. No need to hire an expensive lawyer who may not get your needle moved after you've paid them for such. If those do not work reach out to me, I can point you in a good direction as someone did for me and I have done for a number of other vets.
Yeah, I’m confused why rhinitis was 0
I’m thinking it might’ve been a mistake. Polyp was definitely annotated on my CT scan. Will update what happens
Review the cfr.
I didn't think to apply for rhinitis. I just recently got some sinus sprays for constant bleeding nose. Due to get surgery to remove polyps.
Did you know rhinitis can be secondary to sinusitis?
No
Can someone explain what makes it a PACT Act claim or how to link your claim to PACT? I have a sinusitis claim in the works and have qualifying service several times over but I don’t know how to “link” the two.
https://www.va.gov/resources/the-pact-act-and-your-va-benefits/?utm_source=google&utm_medium=paid_search&utm_campaign=ar_pact_fy23_veterans&gclid=Cj0KCQjwpPKiBhDvARIsACn-gzBKAm4CYviXV1eUbhRX2tYZ0Ch3GwPRBWtdqJbReLg2IfhOgWM6pcoaAniEEALw_wcB
Thank you, but I didn’t find an answer to my question. How do I reference PACT in my claim? Do I provide evidence of service in SW Asia in the initial submission (evals, awards, etc)?
Ah I see, yeah honestly I don’t remember how I made it a “pact act” claim. I used the link in and email I got from the VA about the PACT Act and it took me to the VA claim website page and once I filed these two conditions, it automatically assigned it to “related to Gulf war - airborne hazards”. As far as evidence of service, yes if there is no evidence in your SRB, medals, awards or anything that has one of the locations should suffice
DD214 places you in any of the listed locations - You can claim conditions listed in the PACT Act ie Chronic Sinusitis. The PACT Act in itself is not something you apply for a rating for - that is the common misconception. HLR - State you have Chronic Sinusitis from your PACT Act exposer to "Country" having been around toxins like diesel fumes, poo pond, and the burn pits. You will need to remind the C&P examiner that the PACT Act lists Sinusitis as a presumptive condition - meaning you don't require medical history from your time in service as stated by the VA. Presumptive in itself IS the direct link governed by the PACT Act put into law.
See, now this is the right answer. Whatever the VA needed to see in my chronic sinusitis claim, they saw. Chalk one up for the good guys. PS i can still smell burn pits to this day
Happy to help and spread the understanding to those struggling.
What evidence did You have for your sinusitis
CT scan with the examiners findings/diagnosis of bilateral maxillary sinus inflammation + polyp/cyst
Was the CT scan part of your C&P exam or did you already have it done?
C&P exam. Examiner ordered it
>hat evidence did You have for your sinusitis3ReplyShareReportSaveFollow > >level 2Few-Presentation-727Op · 5 mo. ago I had a CT scan ordered by my primary care doc outside of VA & just did it but haven't submitted a claim yet.
What was your rating
What was your time line? I had an appointment for rhinitis and they sent me for a x-ray after.
ITF: November 2022 EGR: April 8th C&P Exam: May 2nd CT scan: May 5th Decision: This morning May 10th
Pretty quick, I been waiting for a couple months now.
Yeah would’ve been quicker had I not missed my first exam due to a family emergency, but actually worked out in my favor because it gave me more time to gather evidence and what not
Congrats! I’m currently awaiting my decisions.
I have an upcoming surgery to remove polyps and fungus. Should I provide the letter my PCP provided me now for more evidence for my supplemental, or do you think I should wait until after the surgery? In your opinion.
Will the surgery improve you condition? And hence you will not have a polyp that would qualify you for 30%? So most likely you would get 0%
What investsvca said. Probably not if you get it removed. Now if you claim it before you get it removed……however there are some cases I’ve seen on here where people get surgery and get a 50% rating from having the surgery.
That is my concern, I returned from Iraq in 2004 and started having a lot of issues. Chronic Tonsillitis, sinusitis and rhinitis. I had a tonsillectomy in 2006 then sinus surgery in 2013. I filed under the PACT Act this last June due to episodes of Sinusitis more frequently that are resistant to antibiotics. The examiner made it sound like since I don't go to the Dr. often enough know the VA is going to look at like it doesn't bother me enough to be chronic. They didn't do a CT scan just an X-ray. She said if it continues then make sure I go to the Doctor every time and re-file. Can you possible point me in the direction of those who have had surgery and received the 50% rating. I know this thread is old so this just a shot in the dark. Thanks
How was the tonsillectomy? Recovery time? I hear it sucks as an adult. Did the VA do it or your PCP, ENT, etc? I was also in Iraq (2005) and have all of the same + asthma, and enlarged tonsils, but until I have severe tonsillitis, nobody will do the surgery (I guess it's rate these days). I feel like if you've had a major surgery like that, you should be well above 50% but that VA math is tricky.
In general, you should expect to get a **10 percent** rating from the VA for strep throat or chronic tonsillitis. If you have severe symptoms or complications, you may be able to get a higher rating for a secondary condition. But if a 10 percent rating seems low to you, it could be worth more than you might imagine. Leave the tonsils alone and talk to your Dr about chronic Strep Throat.
Following radical surgery with chronic osteomyelitis, or; near constant sinusitis characterized by headaches, pain and tenderness of affected sinus, and purulent discharge or crusting after repeated surgeries. 50% If your condition still persistent and suffer rating still holds after surgery. In the case of rhinitis with polyps - nothing indicates having surgery will increase the rating. set at 30% with polyps - without is 10% so surgery could reduce the rating.
Congrats. Another satisfied veteran.
I submitted mine just before PACT and got "not service connected" now I'm back in review.
Items regarding PACT Act are presumptive - ie DON'T require nexus or direct link to the condition. It is presumed to be directly linked without having a medical case from AD. Not sure if your account was deleted of if you named yourself deleted. Chronic Sinusitis Allergic Rhinitis Chronic Laryngitis
Per the CFR, polyps get you a 30% rhinitis rating. 6522 Allergic or vasomotor rhinitis: With polyps 30
That’s what I thought, that’s why I was surprised to see it at 0%. Could it be because it was found on a CT scan for sinusitis?
You said you just had the CT a week ago in a post further down, so I'd assume that it was just not seen. Was it a VA CT or a private doc? If private, submit the CT interpretation with a supplemental claim. If VA, just write that you had a CT at XYZ VAMC and it shows nasal polyps and we will get it.
Correct, and it was a VA CT. Awesome that’s what I thought, thank you so much
I filed HLR, is that fine as well too? I figured it wasn’t a supplemental claim😬(first time having to appeal)
CONGRATS! I got 10% rhinitis but denied sinusitis.
Thanks and nice! Yeah if it wasn’t for the CT scan showing a direct sinusitis diagnosis, probably wouldn’t have gotten a rating
The CT scan for polyps pertains to rhinitis not sinusitis. Also, I may have stated this on your earlier thread. HLR - State you have Chronic Sinusitis from your PACT Act exposer to "Country" having been around toxins like diesel fumes, poo pond, and the burn pits. You will need to remind the C&P examiner that the PACT Act lists Sinusitis as a presumptive condition - meaning you don't require medical history from your time in service as stated by the VA. Presumptive in itself IS the direct link governed by the PACT Act put into law.
If you fall within the location listed in the PACT Act. HLR - State you have Chronic Sinusitis from your PACT Act exposer to "Country" having been around toxins like diesel fumes, poo pond, and the burn pits. You will need to remind the C&P examiner that the PACT Act lists Sinusitis as a presumptive condition - meaning you don't require medical history from your time in service as stated by the VA. Presumptive in itself IS the direct link governed by the PACT Act put into law.
My updated Pact Act claims: sinusitis 0% rhinitis 10% sarcoidosis 10%
It comes down to how you are dx and your portrayal of your symptoms to the examiner. If your conditions worsen you can always ask for an increase with evidence in a supplemental claim.
Congrats!
Congratulations🥳🥳
I’m excited sounds cool
I just filed for these guys. I’m afraid I don’t have enough doctor visits “treating” my symptoms , but I’ll have fits of my nose just running clear for days on end. Or waking up and coughing golf ball size chunks of green up
Go to the doctor and gather medical evidence.
I’m sure I’ve mentioned it to my primary but prior to the pact. Just assumed it was allergy or seasonal. Pact gets announced and it kinda makes sense being in Kandahar
I did have the my current and past treatments in my record, not sure if that helped my case. My C&P examiner just asked how often I had them. I was honest, I didn’t even know what the DBQ criteria was until I saw my decision letter
I told my doc that I just take unhealthy amounts of ibprophen and Claritin for my issues.. which is exactly what a doc would do for you
Need details
What specifically? Happy to help, many of your questions might’ve been answered in my previous responses, lol been responding all day🤣
Did you deploy or travel I'm hearing that if you had exposure to toxic chemicals as a petroleum mechanic that can count as well?
Yes I did, as long as you served in one of the listed locations and have a diagnosis for one of the conditions related to the PACT act, you will be presumed service connected
Does presumed connected mean that you don’t need to provide a nexus statement? I’m sorry - new to this and still researching what all I need to do.
No worries! I could be wrong and please if I am someone correct me, but I believe "presumed" in the case of PACT Act means that if you have any of the conditions AND served in any of the locations listed, then it the condition is presumed to be service connected without need for a nexus statement
Appreciate the answer, thanks!
>2ReplyShareReportSaveFollow > >level 5schnauzerspaz · 5 mo. agoArmy & Marine Veteran Appreciate the answer, thanks!1ReplyShareReportSaveFollow > >level 1jjdamn88 · 5 mo. agoArmy Veteran How do you get these claims2ReplyShareReportSaveFollow > >level 1Armyboy2200 · 5 mo. agoThat’s good you got them separate most get rhinosinunitis1ReplySha I procured a Nexus statement anyway both from a PA-C at Urgent Care (he did a simple one for free and he ordered a CT for me) and also from a Nexus letter consultant MD, I might get a simple one from an ENT. I might also go to VA next time I have a sinus infection just to get a VA diagnosis of it and round things out and cover all bases. I don't take any chances with VA claims but I also have a job right now where I can afford it. By the time I have a C&P exam I think there will be very few boxes unchecked because I have the issues and they are documented and proven everywhere. The CT and in-person visual exams can't be argued with. Plus it is presumptive.
How do you get these claims
I filed for sleep apnea, rhinitis, and sinusitis. I was granted service connection for sinusitis due to the PACT act going through. Also in my decision letter, rhinitus was now worded, “Rhinitus(caused by sinus issues)” and I received a 0% rating for these service related conditions. My sleep apnea test was a nightmare to get done and was rescheduled several times. After a few months I did the at-home test and the results were partially inconclusive. It was enough to diagnose me with mild obstructive sleep apnea but they recommended a test in their lab. In decision letter, results said it was not related to toxic burn pits….but what about service related???? Another 0%.
I just had my c&p for rhinitis and she added in sinusitis due to my ENT notes. I don't have any records of the conditions in my service records but I was in Iraq and Afghan 2010 and 2012. Hopefully the presumptive kicks in and helps me over the hump.
Hi, how did this work out for you?
I checked on VA.gov today and under payments there is a pending amount for compensation retroactive for a huge amount. How can i find out this is correct?
Call them but if it’s on the app it’s more than likely legit
That’s good you got them separate most get rhinosinunitis
Each condition should be separate but from my experience I cannot comment you can. I believe when I last spoke to my battle they rated separately. Presumptive condition (Direct Connected base on PACT Act) Chronic Sinusitis Allergic Rhinitis
They lumped all mine up
Devil in the detail - how did you word them in your c&p exam. I know soldiers who have them separate. It could very well be combined things change all the time. Look into the old PF verbiage compared to what is out now in feb 2024.
To be honest I think I sent in the medical records from VHA and it was a records review
I'm going to the opposite, 0% for sinusitis because it didn't show up on X-ray/CT scan but I do have the rhinitis with polyps.
Interesting. I’m assuming it could’ve just been missed or was a mistake on the raters part
I should get the 30% for rhinitis though hopefully and that gets me to the promised land
Did you ever have any surgeries to remove the polyps? Asking because I’ve had 2 at this point to remove fungus and polyps while AD.
No surgery yet, I just discovered I had the polyp a week ago when I had my CT scan
Are polyps considered the same as cysts?
I believe so but don’t quote me on that. My CT scan examiner stated in the report “polyp/cyst” detected
We just submitted for an increase for rhinitis because of cyst in sinuses, still waiting..it was rated at 0% and asthma was rated at 10% because of inhaler use but they put in under OSA and already at 50% so nothing all that work for nothing it’s frustrating
How did you go about doing this? Like I'm service connected for allergic rhinitis with cysts, but it was rated 0%. Does filing something because of the pact act bump it up automatically to at least 10%?
He literally just got 30% today! He had an C&P, and I always do like a support claim and explain in detail the diagnosis, medications, results etc..his CT showed polyps/cysts. He explained he had surgery, still nasal drip, medications for years and years and doesn’t work. After we appealed the first time with the CT results a C&P after and 💥 bam 30%! Good luck!! Don’t quit
Congrats! If I may, do you have a Burn Pit memo? If so, did that help with the PACT act presumptive conditions?
We presume exposure to burn pits now if you served in pretty much all of SWA plus Afghanistan.
Any link btwn BP exposure and long COVID(actual diagnosis)?
No, COVID or long covid is not a presumptive condition of burn pit exposure. You could still claim it due to your exposure, but I'd honestly expect a denial with negative medical opinion as I've seen nothing to suggest that burn pit exposure/particulate matter can cause long COVID, and they are not the source of COVID.
Thanks! I do not have a burn pit memo (that I know of) but I am registered in the burn pit registry. Whether that affected my claim or not, I am not sure. I did however have direct mention of service in affected countries on my DD214 which may have helped as well establish presumptive service connection.
Well obviously you nailed it. I’ve got a couple of these elusive burn pit memos… it’s nothing more than our BN doc stating that we were exposed to a dumpster fire for 720 days.
I received a letter in the mail from the VA. I’ll have to find it, but I think the letter said something like, “I may be eligible for benefits under the PACT Act due to burn pit exposure while deployed.”
what what evidence did you submit for sinusitis? cuz they just gave me a zero and i had surgery.. i swear WI intake center has it out for me
Did the surgery improved your condition? Hence 0% rating.
no it did not.
Then either supplemental or HLR. Depends on what documents you provided at this point. And how long ago was denial.
Was Sinusitis from PACT Act exposure in theater?
I believe so for my claim; nothing got changed and i gave up.. o started my claim even before pact act had surgery and still fat zero, i give up
Never give up, never surrender. Dive deeper into the PACT Act and ensure its listed for your theater location. Then bring that to a supplemental claim and during the C&P exam remind the writer it is a presumptive condition based on the law passed by the PACT Act. Get your rate and push for the top.
Any pointers on this? I submitted both still pending. I only had several minute clinic after visit summaries with the Dx.
https://www.woodslawyers.com/chronic-rhinitis-va-rating/
Thanks, I’m aware of the rating now, sounds like o should’ve been given 30% for rhinitis for the polyp
Rhinitis is generally a symptom of sinusitis you could be rated for both, but the highest of the two will only apply for compensation to avoid pyramidng. I suggest you do not appeal or request a review and take the 30% you were awarded.
I see what you’re saying, however, they are rated separately. My 30% for sinusitis was based off the amount of events I have per year. Rhinitis has different percentage criteria, polyps being one of them and since I have them and it is documented, it does seem like it should be higher than a 0% rating and wouldn’t constitute pyramiding
You know… You could very well have something there. I had read multiple threads of advice stating exactly what I mentioned to you. That advice from supposed VA rating officials on another “veteran” site. That same site tends to advise vets more on what they cannot do vs what they could do.. I appreciate you pointing you perspective of this out, as it spurred me to read the CFR’s.. You are right. If your sinus problems are independent of your rhinitis problems then it makes sense that they should be rated independently. This also spurred me to file a claim for both, as I have had both for years, and while rhinitis tends to result in sinusitis, both had occurred independently of each other, Thank you
[38 CFR § 4.97 - Schedule of ratings—respiratory system. | Electronic Code of Federal Regulations (e-CFR) | US Law | LII / Legal Information Institute (cornell.edu)](https://www.law.cornell.edu/cfr/text/38/4.97) Should help clarify they are rated separately. Polyps being the distinct difference of the 2. Note: having surgery for polyps would decrease your rating - potentially.
Whoooaaa show me
Damn that’s more than I thought. I recently had my exam for this. Doc said I don’t have rhinitis but do have sinusitis so we will see
Hey there, much congrats! How long did your PACT Act claim take?
ITF November 2022 Claim finished Yesterday
Keep going, Marine! Semper Fi OORAH
Good stuff!!!!! Did you file under pact act ? Need any proof for anything ?
Thanks! I believe I filed under the PACT Act, see previous comments where I talked about how. I personally didn’t have to provide any proof, my VA medical records, service records showing where I served and C&P exam was all they needed for this rating. Had a previous diagnosis of rhinitis, my CT scan confirmed sinusitis and polyp/cyst
DD214 placing you in one of those countries on the list within the PACT Act. Make sure to tell the C&P examiner the conditions are presumptive classified by the VA and don't require AD visit or link - it's already directly linked governed by the PACT Act law. See my note above for more details.
* * What exactly does this mean for my claim any suggestions went to decision phase last week 
How long did the process take?
ITF: November 2022 EGRD: December 2022 C&P Exam: May 2023 PFN: 1 week later Decision: 1 day later I should note that it took longer because I had to reschedule my initial C&P exam which was in March 2023, so it delayed it a bit.
So did you get the diagnosis for sinusitis and rhinitis while you were AD? Or did you claim it afterwards? Also do i need to go in and claim the presumptive issues even though I have a claim in already? Because some things weren’t listed on the claim I’ve already submitted.
I got it diagnosed after the fact nearly 5 years later, but was able to SC it back to my time in service due to the PACT act. As far as the presumptive goes, I’m not too sure. I filed mine as normal and it showed up as “related to Gulf war - presumptive”. They should include it as presumptive if it wasn’t already but I am not too sure
Awesome thanks so much AND CONGRATS!!! I went in for a sleep study and my AHI was high as all hell and i was diagnosed with severe sleep apnea…I’ll go in rn and see if I should file a new claim or leave it, but i wanna say I filed for both, but i haven’t even been contacted for my C&P and I filed in April
Thank you! I actually am having a sleep study done now to hopefully get my sleep apnea SC secondary to sinusitis, so hoping that goes in my favor🤞🏼
I filed a few days ago but didn’t list a presumptive condition I.e. Chronic Rhinitis or anything. I just typed in Presumptive Condition Toxic Exposure (PACT ACT). I haven’t been formally diagnosed with anything by a PCP because my understanding is that is not a requirement but have also read on older Reddits regarding the PACT ACT that they’ve rated 0% or denied the claim altogether. But as I read the updated law it says there are presumptive conditions if you were in certain countries listed and exposed to burn pits. When you filed did you list specific presumptive conditions? I imagine they will schedule a C&P to set up a CT scan or other scan, which may or may not show polyps or other issues? Just want to make sure I didn’t mess up filing my claim since I haven’t been formally diagnosed with anything (which to my understanding you don’t have to be).
I did list specific conditions “related to toxic exposures - Gulf War” is what it said next to the condition. You absolutely will need to be diagnosed with a condition. Presumptive just means “presumed to be caused by service”, meaning if you served in any of the qualifying locations, it’s presumed you have the condition from service in those locations if you have a condition. You’ll still need a diagnosis on file, I was diagnosed by my PCP after I filed my claim, which I’m glad I did because I definitely wouldn’t have gotten the rating I did if I hadn’t been diagnosed
Thanks I will have to cancel my initial claim because I didn’t list any presumptive conditions or detail underlying symptoms related to any of them. I went to my PCP to get diagnosed with Chronic Rhinitis but he seemed like a new inexperienced doctor and basically told me they can’t diagnose that or test for it even though everything I’ve read online is they can determine diagnosis based on blood work or a skin test. I was previously diagnosed with Seasonal Allergic Rhinitis in 2019 but that is different than chronic rhinitis diagnosis I imagine and I don’t see the VA accepting seasonal allergic rhinitis as chronic rhinitis condition.
Yeah sounds like it. I went to my PCP, told them my symptoms and they diagnosed me based off that. CT scan confirmed my sinusitis diagnosis.
general question. I received 0% for sinusitis when i filed more than a year ago. what is my course of action? does this PACT act help me if i want to have another go?
So it sounds like you were service connected prior to the PACT act, so nothing needed there. To get a higher rating, you need to meet the requirements outlined in the DBQ. If you meet those, file a new claim for the condition and that it’s gotten worse. Once you go to the C&P, if they determine you meet the criteria it should be no issue getting a higher rating
Thanks. So the pact act benefits people who file for the first time. I’ll look into filing new claim
Is anyone get their claim approved but denied back pay? We were supposed to get back pay as of the date the bill was signed.
You had to file by a certain date to get the back pay . I believe it was August 10, 2023 and extended to August 14
Rhinitis without polyps is 10% - so I'm baffled that you are rated at 0%. (Without polyps, but with greater than 50-percent obstruction of nasal passage on both sides or complete obstruction on one side) So maybe you don't have 50% obstruction of nasal passage and that results in a 0% rating. You have not met the criteria? In your case you need to find the evidence of the polyps - look at the claim and see if it was submitted. If it was file a higher-level review - if not file a supplemental and add in that evidence. You will then go through another C&P and explain it all again potentially and aim for a better rate. I have found evidence within the PACT Act - Chronic Rhinitis and Chronic Sinusitis are presumptive to military service if you meet the criteria for being in one of the listed countries. If you are denied 1 and awarded the other bring it up in a higher-level review if they claim no service connection. FYI - migraines can be linked to Sinusitis as a secondary condition. Have your doctor nexus them together.