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VA Sinusitis, Rhinitis and Throat Conditions DBQ

Chronic sinusitis, allergic and non-allergic rhinitis, traumatic deviated septum, chronic laryngitis, laryngectomy, laryngeal stenosis, aphonia and pharyngeal injury are documented for VA disability claims on this 9-page questionnaire. The clinician records which sinuses are affected, sinus surgeries, non-incapacitating and incapacitating episodes in the past 12 months, nasal obstruction percentages and polyps, voice and airway findings, and imaging, endoscopy, biopsy or PFT results.

Who completes it

The Veteran's treating or examining clinician completes the form and signs the Section 13 examiner's certification. The Veteran does not fill in any part.

Submitting and payment

How to submit it
The signed DBQ goes back to the Veteran, who uploads it with the claim on VA.gov or mails it to the VA Evidence Intake Center; a representative may file it instead.
Who pays
VA does not pay or reimburse the cost of completing this DBQ; any fee is arranged between the Veteran and the provider.

Good to know

  • An incapacitating sinusitis episode requires bed rest and physician-prescribed treatment; the form counts those needing 4 to 6 weeks of antibiotics in the past 12 months.
  • Rhinitis and traumatic septal deviation are rated on obstruction: more than 50 percent on both sides, or complete obstruction on one side.
  • Laryngeal stenosis requires PFTs with a flow-volume loop to assess upper airway obstruction, with FEV-1 reported in bands.
  • Anatomical loss of part of the nose is documented on the scars questionnaire instead, and osteomyelitis after radical sinus surgery needs the Osteomyelitis DBQ.

Get the official form

Download the current version from the source each time; forms change without notice.

Sinusitis/Rhinitis and Other Conditions of the Nose, Throat, Larynx and Pharynx Disability Benefits Questionnaire

Official pagePDF

How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

Vero is not affiliated with, or endorsed by, the agencies and insurers listed here. Read our editorial policy.

Frequently asked questions

How are sinusitis episodes counted on the VA sinusitis DBQ?

Item 4E counts non-incapacitating episodes with headaches, pain and purulent discharge or crusting in the past 12 months, from 1 to 7 or more. Item 4F counts incapacitating episodes needing prolonged antibiotics of 4 to 6 weeks. Item 4D asks whether sinusitis is near constant.

Does allergic rhinitis go on this form?

Yes. Allergic, non-allergic, bacterial and granulomatous rhinitis are listed. Section 5 asks whether obstruction exceeds 50 percent on both sides or is complete on either side, whether turbinates are permanently hypertrophied, whether nasal polyps are present, and about granulomatous conditions such as rhinoscleroma.