C&P Exam for Allergic Rhinitis: What to Expect and How to Prepare

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After you’ve filed a VA claim for allergic rhinitis, you’re probably going to be scheduled for a Compensation and Pension (C&P) exam.

The purpose of a C&P exam for allergic rhinitis (also called hay fever) is for the examiner to determine three things:

• #1. Determine if the veteran has allergic rhinitis and if it’s diagnosed.

• #2. Give their medical opinion for service connection depending on the type of claim you filed (new claim, increase claim, secondary claim, aggravation claim, or presumptive claim).

• #3. Evaluate the veteran’s severity of symptoms in terms of frequency (how often), severity (how bad), and duration (how long) and any negative impacts to their work, life, and social functioning.

Pro Tip: The VA rates allergic rhinitis at either 10% or 30%. If you have allergic rhinitis with polyps, it’s rated at 30%. If you have allergic rhinitis without polyps, but with greater than 50 percent obstruction of the nasal passage on both sides, or complete obstruction on one side, it’s rated at 10 percent.

What to Expect During a C&P Exam for Allergic Rhinitis

VA C&P exams can be conducted in-person, via telehealth, over the phone, or through a records only review (called an ACE exam).

For allergic rhinitis, you can expect a face-to-face examination with a healthcare professional who will review your medical records and ask important questions related to your claim.

Here’s six things you can expect at your allergic rhinitis C&P exam:

• Questionnaire and Interview: The examiner will likely start with a detailed questionnaire or interview about your symptoms, their frequency, severity, and duration, and impacts on your daily life. Be prepared to discuss your military service history, when your symptoms first began, any known triggers, and how you manage them (e.g., medications, lifestyle adjustments).

• Medical History Review: The examiner will review your medical records and history related to allergic rhinitis, including previous treatments, doctor visits, hospitalizations, and any diagnostic tests you’ve undergone (e.g., allergy tests).

• Physical Examination: The physical exam will focus on the nose, throat, and eyes, looking for signs of allergic reaction such as swelling, redness, or nasal congestion. The examiner may also assess your ability to breathe through your nose and any signs of sinusitis or other complications arising from allergic rhinitis.

• Functional Impact: One of the main goals of the exam is to assess how your condition affects your ability to work and perform daily activities. Be honest and thorough in explaining any limitations you face, such as difficulty sleeping, increased sick leave at work, problems concentrating, or issues with physical activity due to your symptoms.

• Respiratory Function Tests: Depending on your symptoms and medical history, the examiner might also conduct or order respiratory function tests to assess the impact of allergic rhinitis on your breathing.

• Completion of the VA Disability Benefits Questionnaire (DBQ) for Rhinitis: The examiner will document their findings on the Sinusitis/Rhinitis and Other Conditions of the Nose, Throat, Larynx and Pharynx DBQ, which is then submitted to the VA Rater for further processing. Eventually, the VA Rater will either approve, deny, or defer your claim.

Potential Causes or Aggravating Factors for Allergic Rhinitis in Veterans

Allergic rhinitis in military veterans can be caused or aggravated by a variety of factors related to their service environment and conditions.

Keep in mind that allergic rhinitis can be a presumptive disability condition, which makes it easier to get service connected.

Some of the common causes and aggravating factors to think about prior to your C&P exam include:

• Exposure to Pollutants and Chemicals: Military personnel can be exposed to a wide range of pollutants and chemicals, including diesel exhaust, jet fuel, smoke from burn pits, and other airborne toxins, which can trigger or worsen allergic rhinitis.

• Dust and Sand: Service in arid, desert environments expose veterans to fine dust and sand particles, which can irritate the nasal passages and exacerbate allergic symptoms.

• Mold and Damp Conditions: Deployment or living conditions in areas with high humidity or mold can lead to allergic reactions in susceptible individuals.

• Stress: The high levels of stress experienced during military service can impact the immune system and exacerbate allergic reactions.

• Seasonal Allergens: Depending on the geographic location of service, exposure to different pollens and seasonal allergens can trigger allergic rhinitis.

• Animal Dander: Close quarters in military settings can increase exposure to animal dander if service animals are present, leading to allergic symptoms.

• Smoke and Propellants: Exposure to smoke from firearms, explosives, and other military equipment can irritate the airways and nasal passages, triggering allergic rhinitis.

• Frequent Relocation: Military service often involves moving to new locations with different climates and allergens, which can trigger allergic reactions in individuals who were previously not exposed to such allergens.

• Occupational Hazards: Certain military occupations may involve exposure to materials and substances that can trigger or aggravate allergic rhinitis, such as working in close proximity to certain fuels, lubricants, and other chemicals.

• Change in Environment: Transitioning from service in foreign climates back to civilian life or to a different climate can also trigger allergic rhinitis due to new or differing allergen exposures.

What Questions Will I Be Asked at a C&P Exam for Rhinitis?

Here’s a list of questions you’ll either get asked directly or the examiner will be documenting during your exam:

#1. Does the veteran now have, or has he/she ever been diagnosed with Rhinitis?

#2. Is there greater than 50% obstruction of the nasal passage on both sides due to Rhinitis?

#3. Is there complete obstruction on the left side due to Rhinitis?

#4. Is there complete obstruction on the right side due to Rhinitis?

#5. Is there permanent hypertrophy of the nasal turbinates?

#6. Are there nasal polyps?

#7. Does the veteran have any of the following granulomatous? Check all that apply.

• Granulomatous rhinitis
• Rhinoscleroma
• Wegener’s granulomatosis
• Lethal midline granuloma
• Other granulomatous infection (describe).

#8. Are there any other pertinent findings of Rhinitis?

#9. Have imaging studies of the sinuses or other areas been performed? If yes, indicate the type and results.

#10. Is there any evidence of a Deviated Septum?

#11. Does the veteran’s Rhinitis impact his/her ability to work? If yes, describe impact with one or more examples.

#12. What is the likely cause or origin of the veteran’s allergic rhinitis?

#13. In your medical opinion, is it at least as likely as not that the veteran’s allergic rhinitis is due to military service?

#14. For secondary service connection, is the veteran’s allergic rhinitis proximately due to or aggravated by another condition?

#15. For presumptive service connection, did the veteran serve in a qualifying location during a qualifying period?

#16. Is there anything else you’d like to add? Please explain.

How to Prepare for Your Allergic Rhinitis C&P Exam

Here are some tips to help you prepare for your allergic rhinitis C&P exam:

• Gather Records and Documents: Collect all relevant medical records, including diagnosis reports, treatment history, and any correspondence related to your allergic rhinitis. This documentation will provide essential evidence to support your claim during the examination. Review the documents in detail and feel free to bring hard copies with you to the C&P exam for reference.

• Create a Symptoms Diary: Keep a detailed log of your allergic rhinitis symptoms, noting the frequency, severity, and duration of episodes. Document any factors that exacerbate or alleviate your symptoms, such as specific allergens, environmental triggers, or medication usage. This diary will help you articulate the impact of allergic rhinitis on your work, life, and social functioning during the C&P exam.

• List Functional Impacts: Make a list of specific ways in which allergic rhinitis affects your ability to perform daily tasks and activities. This may include symptoms like nasal congestion, sneezing, itchy eyes, sleep disturbances, and reduced productivity. Providing concrete examples of how allergic rhinitis negatively impacts your daily functioning will strengthen your case during the exam.

• Review the DBQ for Allergic Rhinitis: It’s a good idea to review the allergic rhinitis DBQ before your exam. Be prepared to describe the onset and progression of your symptoms over time, as well as any treatments you have pursued and their effectiveness (if any).

DBQ for Allergic Rhinitis [Download]

The DBQ for Sinusitis/Rhinitis and Other Conditions of the Nose, Throat, Larynx and Pharynx will be completed electronically by the C&P examiner at your exam.

We’ve made a copy available for review and download below:

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