Sinusitis, Rhinitis, and Other Conditions of the Nose, Throat, Larynx, and Pharynx

Your doctor will complete VA Form 21-0960N-3 (Sinusitis, Rhinitis, and Other Conditions of the Nose, Throat, Larynx, and Pharynx DBQ) after examining you. This walkthrough helps you prepare them. The DBQ is a standardized questionnaire; your doctor's answers directly determine your VA rating. Brief them on these specific points before the exam so nothing important is missed or underdocumented.

Common mistakes

• ×Asking your doctor to just "fill out the VA form" without briefing them - an uninformed completion is often generic and leads to lower ratings.
• ×Bringing the DBQ to a provider who has never seen you before - your treating physician who knows your history will write the most credible documentation.
• ×Going to the exam and waiting for the doctor to ask questions - come prepared with specific examples of your worst days and functional limitations.

These are the key clinical questions from the Sinusitis, Rhinitis, and Other Conditions of the Nose, Throat, Larynx, and Pharynx DBQ. Help your doctor understand what each question is asking and give them concrete examples for your situation. Print this section and bring it to the appointment. 1. How many incapacitating episodes of sinusitis do you have per year? WHY IT MATTERS: The number of incapacitating episodes directly determines rating level for sinusitis TIPS: An incapacitating episode requires bed rest and treatment by a physician; Track every episode with dates and doctor visits 2. How many courses of antibiotics have you needed in the past 12 months? WHY IT MATTERS: Three or more non-incapacitating episodes with antibiotics per year supports a 10% rating; six or more supports 30% TIPS: Keep pharmacy records showing antibiotic prescriptions; Include both oral and nasal antibiotics 3. What is the percentage of nasal obstruction on each side? WHY IT MATTERS: Deviated septum rating requires 50% obstruction of both sides or complete obstruction of one side TIPS: Request that the examiner measure obstruction percentage; Note if obstruction worsens with allergies or infections 4. Are nasal polyps present? WHY IT MATTERS: Presence of polyps supports a 30% rating for sinusitis TIPS: Request CT scan if polyps are suspected but not confirmed; Document any surgical removal of polyps 5. Is there chronic laryngitis with hoarseness or voice changes? WHY IT MATTERS: Laryngitis with hoarseness, inflammation, and mucous membrane thickening is rated at 10-30% TIPS: Describe voice changes and how they affect communication and work

Common mistakes

• ×Not tracking antibiotic courses and incapacitating episodes
• ×Failing to get CT scan showing chronic sinus disease
• ×Not mentioning nasal polyps or requesting examination for them

VA raters use the Sinusitis, Rhinitis, and Other Conditions of the Nose, Throat, Larynx, and Pharynx DBQ to determine your disability rating. The most important rating factors for this condition are: 1. Number of incapacitating episodes per year requiring prolonged antibiotics 2. Number of non-incapacitating episodes per year requiring antibiotics 3. Presence of nasal polyps 4. Degree of nasal obstruction (for deviated septum) 5. Whether surgery (such as Caldwell-Luc) has been performed 6. For rhinitis: whether polyps are present or there is greater than 50% obstruction For each factor, give your doctor specific examples from your daily life so they can document accurately (not generically).

Common mistakes

• ×Describing symptoms on a good day instead of typical or worst days
• ×Not claiming rhinitis and sinusitis separately when both are present

Authority

• 38 CFR 4.1 - Functional impairment as the basis for rating.

Preparation checklist for the Sinusitis, Rhinitis, and Other Conditions of the Nose, Throat, Larynx, and Pharynx DBQ exam: 1. Bring a log of all sinus infections and antibiotic treatments for the past year 2. Obtain recent CT scan of sinuses showing chronic disease 3. Document how symptoms affect work attendance and daily functioning 4. List all medications including nasal sprays, antihistamines, and antibiotics 5. If you have had sinus surgery, bring operative reports Remember: Describe your WORST days, not your average days. VA raters evaluate the full range of your disability including its worst manifestations.

Common mistakes

• ×Describing your best days or average functioning instead of your worst - VA rates the full range of disability.
• ×Minimizing symptoms out of stoicism or pride - accurate documentation is not exaggeration; it is honesty.
• ×Not mentioning secondary symptoms, side effects, or additional conditions the doctor may not ask about.