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Rhinitis-Sinusitis

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I was diagnosed possible Rhinitis in the service back in 1972. I went to a ENT specialist last week and diagnosed with septal deviation and chronic sinusitis. Their doing a sleep study next week and an allergy test in 2 weeks. My nose feels like Hoover Dam when they release the water.ha. Here's my questions;

Once your diagnosed, like me in 72. Can VA come back and say it was only temperary?

Is Rhinitis, sinusitis, and allergies rated as one?

Are there any secondary problems that can be claimed for this?

Thanks!!!



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29 answers to this question

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Is Rhinitis, sinusitis, and allergies rated as one? There is no objective standard of law that requires the VA to view these conditions as a single condition or having a single common etiology. Thus, you would have to show a medical link.

Once your diagnosed, like me in 72. Can VA come back and say it was only temperary? You were diagnosed with possible rhinitis in 1972. If it were me I would get those old records and go over them with a fine tooth comb. Make sure that you understand exactly what they said and how many times symptoms were noted in the records. Do not go by your memory of what you recollect those records say. If you have only one notation in 1972 of possible rhinitis I really doubt that you will be able to get a doctor to developed any significant medical evidence.

There are irritant conditions with similar symptoms to rhinitis that are temporary. There are five different causes of rhinitis including; mechanical and allergic etiologies The irritant conditions are definitely temporary and the allergic etiologies are temporary in many cases. This is where it becomes important to see exactly what your service medical records say in regards to the actual symptoms and the number of times your diagnosed in 1972. <BR style="mso-special-character: line-break"><BR style="mso-special-character: line-break">

Your current diagnosis is septal deviation and sinusitis. If you do some research I am pretty sure you will find that in order for the VA to service connects septal deviation there must be an in-service report of an injury to the nose. Additionally, it appears you’re trying to establish septal deviation and sinusitis as secondary to the possible rhinitis. You need to run that by a doctor. However, unless there is something in your service medical record the Dr. can work with I think it will be hard to show a connection between possible rhinitis and a current condition almost 40 years later. There is a whole lot that can go on and 40 years.

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Posted · Report post

Is Rhinitis, sinusitis, and allergies rated as one? There is no objective standard of law that requires the VA to view these conditions as a single condition or having a single common etiology. Thus, you would have to show a medical link.

Once your diagnosed, like me in 72. Can VA come back and say it was only temperary? You were diagnosed with possible rhinitis in 1972. If it were me I would get those old records and go over them with a fine tooth comb. Make sure that you understand exactly what they said and how many times symptoms were noted in the records. Do not go by your memory of what you recollect those records say. If you have only one notation in 1972 of possible rhinitis I really doubt that you will be able to get a doctor to developed any significant medical evidence.

There are irritant conditions with similar symptoms to rhinitis that are temporary. There are five different causes of rhinitis including; mechanical and allergic etiologies The irritant conditions are definitely temporary and the allergic etiologies are temporary in many cases. This is where it becomes important to see exactly what your service medical records say in regards to the actual symptoms and the number of times your diagnosed in 1972. <BR style="mso-special-character: line-break"><BR style="mso-special-character: line-break">

Your current diagnosis is septal deviation and sinusitis. If you do some research I am pretty sure you will find that in order for the VA to service connects septal deviation there must be an in-service report of an injury to the nose. Additionally, it appears you're trying to establish septal deviation and sinusitis as secondary to the possible rhinitis. You need to run that by a doctor. However, unless there is something in your service medical record the Dr. can work with I think it will be hard to show a connection between possible rhinitis and a current condition almost 40 years later. There is a whole lot that can go on and 40 years.

My SMR shows I went to the clinic 4 months sraight complaining the same symptoms. The MD wrote Persistent Rhinitis and appears purulent but suspect possible underlying allergic component. Mild bronchitis.

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It would help to fill in forty years of time with statements of treatment or both your statements and statements from people who know you that you have chronic visable problems with nasal discharge.

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It would help to fill in forty years of time with statements of treatment or both your statements and statements from people who know you that you have chronic visable problems with nasal discharge.

Thanks for the info and link. Where did you get the info you posted about the different types of sinusitis that are temperary?

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I was refering to allergies that are temporary not sinusitis. In either case the word acute referes to a temporary condition. It appears from the link I found on purulent discharge that sinusitus is also acute. However, the article states that the chronic variety is more common. As far as acute allergic conditions goes I found a table many years ago while researching allergies that showed the type of allergy versus the more common manifestations. If I remember correctly IgE allergies are considered commonly acute. In any event your best bet is to file the claim and see what the C&P examiner says. Then if there is a problem you can get an IMO. Sometimes it is better to rebut the VA than to anticipate what they will come up with. I had an allergy claim that they drug out for seven years.

The fact that you had four months of symptoms in the military is significant. There are laws that say if the condition can be determined to be chronic while in the military any subsequent manifestation is service connected unless there is clear and convincing evidence to the contrary. If the C&P exam does not get you service connected then try and get an IMO that says that your condition in the military was more likely than not chronic prior to discharge, This will lower the evedentiary burden you have on showing post service continuity of symptoms.

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I was refering to allergies that are temporary not sinusitis. In either case the word acute referes to a temporary condition. It appears from the link I found on purulent discharge that sinusitus is also acute. However, the article states that the chronic variety is more common. As far as acute allergic conditions goes I found a table many years ago while researching allergies that showed the type of allergy versus the more common manifestations. If I remember correctly IgE allergies are considered commonly acute. In any event your best bet is to file the claim and see what the C&P examiner says. Then if there is a problem you can get an IMO. Sometimes it is better to rebut the VA than to anticipate what they will come up with. I had an allergy claim that they drug out for seven years.

The fact that you had four months of symptoms in the military is significant. There are laws that say if the condition can be determined to be chronic while in the military any subsequent manifestation is service connected unless there is clear and convincing evidence to the contrary. If the C&P exam does not get you service connected then try and get an IMO that says that your condition in the military was more likely than not chronic prior to discharge, This will lower the evedentiary burden you have on showing post service continuity of symptoms.

Thanks again Hoppy. I also had an MRI in 92' showing polyps in the sinus cavity. I'll talk to the ENT specialist with my service records and see what he say's. I'm defintely filing!

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Posted · Report post

I am rated seperately for Allergic rhinitis, and sinusitis. They should be rated seperately since they are two different diseases.

You will have to show the va that the problems you presently have are related to those problems you had in service. If you cannot show treatment since 1972 you might have a very hard time proving service service connection.

While your doctor could write a letter showing a NEXUS, based on what you have said here, I don't know how he would justify a Nexus opinion. Best of luck

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I am rated seperately for Allergic rhinitis, and sinusitis. They should be rated seperately since they are two different diseases.

You will have to show the va that the problems you presently have are related to those problems you had in service. If you cannot show treatment since 1972 you might have a very hard time proving service service connection.

While your doctor could write a letter showing a NEXUS, based on what you have said here, I don't know how he would justify a Nexus opinion. Best of luck

Thanks for helping Teac. Was your' a presumption award, or after that? Even though I was diagnosed in 72, I noted sinusis on my exiting exam in 76. A 92' MRI showed polyps in the maxillary cavity. How much evidence is justifiable to the VA? Did you have to fight to get yours SC? I'm still fairly new with the VA scuttle.

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Only a doctor can determine the odds of your claim being granted. File a claim and let the doctors figure it out. In the link I posted the veteran was discharged in 1954. He had four months of purulent symptoms in the military. His first post service treatment record was 1996. He was granted service connection. Note that he made a statement that he had ongoing symptoms after service that the examiner thought was believable. I am familiar with many types of claims whereby veterans statement are given weight when there is also objective medical evidence supporting the original diagnosis. I was service connected thirty years after discharge for my angioedema. The only in-service symptom I had of angioedema was nasal obstruction with slight facial edema. Angioedema was not even a diagnostic term used when I was in the service. I had to get an immunologist to review my service medical records and say that my symptoms of angioedema first occurred in the military. File the claim for any condition you have been diagnosed with post service that is remotely associated with purulent nasal discharge or nasal obstruction. It may require a fight. I feel you have a valid claim.

http://www4.va.gov/vetapp03/Files/0304166.txt

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Only a doctor can determine the odds of your claim being granted. File a claim and let the doctors figure it out. In the link I posted the veteran was discharged in 1954. He had four months of purulent symptoms in the military. His first post service treatment record was 1996. He was granted service connection. Note that he made a statement that he had ongoing symptoms after service that the examiner thought was believable. I am familiar with many types of claims whereby veterans statement are given weight when there is also objective medical evidence supporting the original diagnosis. I was service connected thirty years after discharge for my angioedema. The only in-service symptom I had of angioedema was nasal obstruction with slight facial edema. Angioedema was not even a diagnostic term used when I was in the service. I had to get an immunologist to review my service medical records and say that my symptoms of angioedema first occurred in the military. File the claim for any condition you have been diagnosed with post service that is remotely associated with purulent nasal discharge or nasal obstruction. It may require a fight. I feel you have a valid claim.

http://www4.va.gov/v...les/0304166.txt

You never cease to amaze me Hoppy!!! You must of worked hard to find that Vet's claim. For me it's like fishing in an ocean trying to catch a Rainbow trout! ha. I read the appeal, it was quit supportive. I just hope an appeal isn't the latter. BUT! It does sound like an IMO would be the route to success. I too, think I have a valid claim, but!!!!! Thanks for researching this for me Hoppy

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Most the time I use the BVA cite. However, when I have multilpe search terms I use google. I type in "citation NR" and search. This gives me VA cases that google has indexed. Then I use search within a search which is at the bottom of the google page. Then I typed "sinusitis is granted" in to google. That gives me the winners. I was planning on using one more search within a search for purulent. However, I found this case on the first page of the results. The whole project took less than fifteen minutes.

I am also good at catching trout in the ocean. I used to fish off the Malibu Pier. I caught and landed a steelhead from the pier. That is really rare. I also hooked a whale from the pier. It just happened to swim by my line and got snagged. Unfortunatley, or better yet fortunately it just swam away and broke my line.

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Most the time I use the BVA cite. However, when I have multilpe search terms I use google. I type in "citation NR" and search. This gives me VA cases that google has indexed. Then I use search within a search which is at the bottom of the google page. Then I typed "sinusitis is granted" in to google. That gives me the winners. I was planning on using one more search within a search for purulent. However, I found this case on the first page of the results. The whole project took less than fifteen minutes.

I am also good at catching trout in the ocean. I used to fish off the Malibu Pier. I caught and landed a steelhead from the pier. That is really rare. I also hooked a whale from the pier. It just happened to swim by my line and got snagged. Unfortunatley, or better yet fortunately it just swam away and broke my line.

I didn't realize a steelhead was a trout! ha We in Arizona are still waiting for California to sink from an earthquake so we can have ocean front property!!!

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If you have a copy of your entrance physical that shows you did not have a deviated septum upon entering the service, and a separation physical that shows you did in fact acquire a deviated septum, I would argue that you may not need evidence of trauma to your nose, that the exam results would be adequate. The reason I say this is due to the fact that no one goes running to the doctor every time they get hit in the face while playing sports, accidentally falling while running, etc., however, those entrance and separation physicals speak volumes!

I worked with a veteran who entered the Army with no record of deviated septum in his entrance physical, no record of it on his separation physical, no record of it on his subsequent entrance physical for the USAF, but several years later, it showed up in his separation physical from the USAF. The VA tried to argue that the deviated septum was congenital, not acquired. Without formal evidence of trauma, we appealed that and won service connection at 0%. I think an internet search would show a clinical connection between deviated septum and Obstructive Sleep Apnea (which I'm assuming is the purpose of the sleep study you've scheduled), however, it would be much more useful to get an ENT physician to perform an evaluation and say as much. Likewise on the relationship between sinusitis and sleep apnea.

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I was awarded back to 2002:

Deviated Nasal Septum (granted 0%..1985)

Sinusitis associated with taumatic deviated nasal septum.........10%

Rhinitis associated with tramuatic deviated nasal septum..........10%

Headaches associated with traumatic deviated nasal septum...10%

One of the cases you might see is mine..

When I got out it took me a few years to save up the money to get the operation on my nose, as the VA wouldn't even look at it...I looked up the original doctor who performed my surgery in 1975.

I figured he must be in his eighties, but I went on looking for him anyway..I found the Doctor, he was still working, and he remembered my case and his work...This doctor was an ENT that worked in conjunction with a Dentist to repair service injuries related to my teeth and nose..This ENT doctor did the IME/IMO that I submitted..

They are separate ratings...

Forgot to say that I had a proven service nose injuries, backed with eye witnesses...

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In a claim like this with so many years between the events of the disease. Even though something is in your SMR's it is always better when you can show some kind of treatment for the condition that is continuous.

I had in my SMR's a doc's notes where I was seen for stomach problems and prescribed a acid reducing pill. Now ever since I have been in Nam I have had problems with my stomach and have taken antacid pills most of my life over the counter. Like Tums, pep-to bismal and just about anything that was on the market.

I have not filed for this because I have NO doc's notes or anything for treatments since 69. Now I might be able to win this claim but I would bet it would have to go to NOD and probably BVA for any kind of approval,

I just do not have the stomach (pun intended) for it.

Good luck on your claim! JMHO

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Stillhere,

I do not mean to sound adversarial. However, I refrain from making generalizations about medical conditions. Each claim with long periods of time between the military and the first post service treatment are very different. I have made this statement on hadit on several occasions. Continuity of symptoms after discharge is a medical determination that is to be made by a doctor based on the individual merits of each diagnosis. Comparing undiagnosed stomach ailments to a condition that was specifically diagnosed including detailed notations of observable symptoms which included purulent nasal discharge is like comparing apples to oranges. I am not saying that your generalization is anywhere near as obvious as an over site as a VSO who use to post on hadit. To your credit you do say that it is better to get medical statements showing continuity.

I do not even like to give the impression that a claim will be more difficult without continuity of treatment. It is purely a medical determination that can only be made by a doctor who has reviewed the entire medical history. My angioedema claim was awarded 30 years after my discharge because a immunologist write an opinion that my symptoms first occurred in the military and there was no known cure. The issue of how many years went by between the military and my first post service treatment was never addressed in the decision. It just so happened that it was nine years.

There was a very knowledgeable VSO that posted on hadit who use to give really good advice about how the VA adjudicates claims and the procedures for advancing claims. However, he had a habit of playing doctor and on several occasions he specifically told people that they could not win their claim because too much time went by since the military and their first post service treatment. In one claim where the VSO told the veteran too much time went by after the military it involved a knee injury that was identical to my knee claim. I was service connected even though the first post service treatment was ten years after discharge. The VSO had never seen any diagnoses, reports or xray’s from the military for the veteran that he told that he could not get service connected.

My knee claim was awarded a rating even though I had no treatment for ten years after the military. What is funny is that I did not even specifically ask for a disability rating. It did not occur to me that I was disabled at the time I filed the claim. I filed the claim before the surgery and figured the surgery would fix the problem. I asked for a post surgical covalence rating for one month. The DAV told me to throw in the phrase when I filed the claim that “I was applying for any and all benefits available to me”. I figured the VA should give me a covalence rating because a doctor had told me in the military that I would need surgery at a later time to fix my knee. He did not even write in my SMR that surgery would be required at a later date. However, there was a diagnosis made at that time by the military doctor and observable symptoms were noted. 10 years later the VA surgery was exploratory and they did not find any significant structural changes. The VA took it upon them to award a 10% rating based on the symptomology.

One last thought is to consider that your statements in the absence of medical treatment can be given weight as shown in the case below.

The Veteran had active service from April 1974 to March 1975. 4. Private medical records reveal that the Veteran was diagnosed with degenerative disc disease in approximately 1984 and that he continues to have symptoms of low back pain. 5. VA medical opinions dated April 2007 and July 2008, relate the Veteran's current low back disability to active service.

The veteran reports a continuity of symptomatology of low back pain and discomfort dating from service. He is competent to testify as to these easily identifiable symptoms of low back pain. Espiritu v. Derwinski, 2 Vet. App. 492 (1992); see also, Washington v. Nicholson, 19 Vet App 362 (2005), citing Layno v. Brown, 6 Vet. App. 465, 469-71 (1994) (holding that lay testimony is competent if it is limited to matters that the witness has actually observed and is within the realm of the witness' personal knowledge).

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I agree Hoppy,

But I do like to let vets know what they could and will be probably in for with the VA.

He has to be made aware of that also. Just like the case from the BVA you posted. I wonder how many others like that made it to the BVA and were denied??

A disabled veteran that comes here for advice on their claim should be able to get some honest opinions and that is what I gave.

As far as comparing me to a VSO I personally don't see where that comes into play. Unless you are trying to discredit my opinion for some reason?

When I first came to Hadit I soon after also joined another veteran board and between the two I often got conflicting results. I thanked them for both and went with what I thought would work for me.

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I agree Hoppy,

But I do like to let vets know what they could and will be probably in for with the VA.

He has to be made aware of that also. Just like the case from the BVA you posted. I wonder how many others like that made it to the BVA and were denied??

A disabled veteran that comes here for advice on their claim should be able to get some honest opinions and that is what I gave.

As far as comparing me to a VSO I personally don't see where that comes into play. Unless you are trying to discredit my opinion for some reason?

When I first came to Hadit I soon after also joined another veteran board and between the two I often got conflicting results. I thanked them for both and went with what I thought would work for me.

Stillhere & Hoppy, I have a few post-service Dr visits since I been out, but how much is enough? I realize the more the merrier. I'm pretty much the same as other Vets, we just outright don't go to the doc every time we stub our toe! I have ALOT of documented visits complaining of headaches and dizziness thru out the service and post-service, but couldn't put a finger on a diagnoses. Can someone post me a VA Form 21-4138, with an example to the proper way of wording a claim, and submitting evidence? We have only one Service Rep in our little town, and he's alway's swamped with other Vets. I know I shouldn't do this myself, but I have no other means or support, except for you folks!!!

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Go here and fill in the form. Just put in your form # and the form will come up.

http://www4.va.gov/vaforms/

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Go here and fill in the form. Just put in your form # and the form will come up.

http://www4.va.gov/vaforms/

Sorry Stillhere, what I meant was could someone show me an example on how to fill one out, etc. If I wanted to add more evidence to the existing claim. Do I write the codes for each entry.

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Sorry Stillhere, what I meant was could someone show me an example on how to fill one out, etc. If I wanted to add more evidence to the existing claim. Do I write the codes for each entry.

OK sorry.

I have only been doing this since 2003 but I will share what I did and worked for me. On my first claim for DM2 and PN and ED and heart pain.

I just wrote on the letter of support form (which I think is the form your talking about) that I had these dx's and problems and how they effected me and that I wanted to file a formal claim for compensation. Only took like maybe 6 months total and I was grated 40% with SMC K for my ED.

That will get your ball rolling. Now if you want me to post my letter I guess I could without the personal stuff but you really want it I feel to sound like it is from the actual vet.

I could be wrong if so someone will come along and offer another way I am sure.

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OK sorry.

I have only been doing this since 2003 but I will share what I did and worked for me. On my first claim for DM2 and PN and ED and heart pain.

I just wrote on the letter of support form (which I think is the form your talking about) that I had these dx's and problems and how they effected me and that I wanted to file a formal claim for compensation. Only took like maybe 6 months total and I was grated 40% with SMC K for my ED.

That will get your ball rolling. Now if you want me to post my letter I guess I could without the personal stuff but you really want it I feel to sound like it is from the actual vet.

I could be wrong if so someone will come along and offer another way I am sure.

I gotch ya. Appreciate the comeback!

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Thanks for helping Teac. Was your' a presumption award, or after that? Even though I was diagnosed in 72, I noted sinusis on my exiting exam in 76. A 92' MRI showed polyps in the maxillary cavity. How much evidence is justifiable to the VA? Did you have to fight to get yours SC? I'm still fairly new with the VA scuttle.

Sorry for the late response, I don't get on here as mudh as I should...

In my case I was diagnosed in 1986 at retirement for Sinusitis, years prior to my retirement i was diagnosed with allergic rhinitis. When I retired in 1986 I was awarded service connection for he allergic rhinitis but denied for sinusitis... finally afer many years and after much research I had three different doctors write nexus opinions and I was awarded service connection for sinusitis in Jan 2004. I presently have a claim in requesting an eairler effective date back to 1986...

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Stillhere,

I was not trying to discredit you. I actually said in so many words that you did a better job of explaining the medical merits than the SO did. I also respect your honest opinion and agree that you should never under estimate the ability of the VA to be adversarial. However, it is my honest opinion that when it comes to the medical merits I do not feel it is appropriate for anybody without medical expertise to predict the outcome of their own claim or anybody else's claim. It is a free country and if an individual wants to consider forgoing a claim because they decided to play doctor and failed to properly assess the strength of the medical merits of their own claim or they are not ready for the battle then that is their choice.

I have a preference for posting BVA cases. I feel they are stronger than peoples opinions based on generalized application of non specific outcomes about the strength of a case. Rather than wonder how many BVA cases were denied it would be better to post some losers for people to consider. Reading the losers can help uncover problems that will result in strengthening the claim. The reason I post BVA cases is so that the veteran will go to the search engine and do their own research. However, I start by posting winners. I do not always have time to research every angle to every claim.

I have assisted several veterans who regretted playing doctor and adjudicator and gave up on their own claims prior to a C&P exam and who were later awarded service connection when the claim was refiled and fully developed without going to appeal. I do not handicap the medical merits of any claim before the claim is filed. My point is that the medical merits of a claim are often complex and not only is it hard for the VA to figure out what is going on it is also hard for the veteran to figure out how strong the medical merit of a claim is. This is complicated by the fact that many veterans log on to hadit and have not even read the medical records in decades.

There are so many presumptive diseases. actual diseases and injuries that manifest with different symptoms at different times in a individuals life that a veteran reviewing the file and a SO reviewing the file is not adequate. These obscure diseases and delayed symptoms of injuries are not so rare. I have two of them and there have been many other veterans here over the years with complex medical symptomoloigy.

I say if you have any post service condition that you do not known exactally how or why you have this condition based on a medical opinion then file a claim. Hopefully the VA will schedule a C&P, if not , then an IMO is the other option.

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