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C&P Exam Prep: Complete Loss of Sense of Smell
DBQ Overview
Interview + Physical- Form Name
- Loss_of_Sense_of_Smell_and_or_Taste
- Form Code
- Loss_of_Sense_of_Smell_and_or_Taste
- Page Count
- 5
- Examiner Type
- Otolaryngologist or Physician
- Estimated Duration
- 20-30 minutes
- Exam Format
- Interview + Physical
What to Expect During Your Exam
Exam Overview
To document the nature, severity, and functional impact of complete or partial loss of the sense of smell (anosmia or hyposmia) for VA disability rating purposes under Diagnostic Code 6275, 38 CFR - 4.87a.
What the examiner evaluates:
- Presence and severity of anosmia (complete inability to detect any odor) versus hyposmia (reduced ability to detect odors)
- Onset date and history of smell loss, including any service-connected cause or event
- Associated loss of taste (ageusia or hypogeusia), which may be rated separately
- Nasal anatomy and pathology via physical examination (e.g., polyps, septal deviation, mucosal changes)
- Review of prior diagnostic testing including CT, MRI, or olfactory testing results
- Functional impact on daily activities, nutrition, safety, and quality of life
- Whether condition is static, progressive, or subject to fluctuation
- Secondary complications such as malnutrition, depression, or safety hazards (inability to smell smoke or gas)
Exam will likely include a structured interview about symptom history and functional impact, followed by a brief physical examination of the nasal passages. Formal olfactory testing (e.g., University of Pennsylvania Smell Identification Test / UPSIT, or Sniffin' Sticks) may or may not be performed depending on examiner and facility resources. Be prepared for the examiner to document your condition entirely based on history and physical if formal olfactory testing is not available on site.
Typical duration: 20-30 minutes
Subjective Olfactory History Assessment
The veteran's self-reported ability to detect odors across a range of everyday situations, including strong odors (smoke, gas, food burning), pleasant odors (food, flowers), and subtle odors.
What to expect:
The examiner will ask detailed questions about when you noticed the smell loss, whether it is complete or partial, whether it fluctuates, and how it affects daily life. Be specific and detailed - vague answers may result in an incomplete DBQ.
Key thresholds:
- Complete inability to detect any odor (Anosmia) — 10% rating under DC 6275 for complete loss of sense of smell
- Partial/reduced ability to detect odors (Hyposmia) — Rated under DC 6275 as a non-compensable (0%) finding, or may be evaluated under analogous codes depending on severity and functional impact
Tips:
- Be specific: state clearly whether you can detect ANY odors at all, or whether some faint detection remains
- Mention inability to detect dangerous odors such as smoke, natural gas, and spoiled food - this is a critical safety concern
- Describe impact on appetite and nutrition if smell loss has reduced your enjoyment of eating
- Note whether any taste function remains or is also affected
Pain considerations: Anosmia is not typically associated with pain; however, if the underlying cause (e.g., sinusitis, nasal polyps, head trauma) produces facial pain, pressure, or headaches, describe these symptoms accurately and in full.
Formal Olfactory Testing (UPSIT / Sniffin' Sticks / Butanol Threshold Test)
Objective measurement of olfactory function using standardized odor identification, detection threshold, or discrimination tests. Results can confirm anosmia (score near chance level), hyposmia (reduced score), or normosmia (normal score).
What to expect:
If formal testing is performed, you will be asked to identify odors from scratch-and-sniff cards or vials and choose from multiple-choice answers. Testing is painless and takes 15-20 minutes. Not all VA C&P examiners will have these tools available.
Key thresholds:
- UPSIT score 6-18 out of 40 (at or near chance) — Confirms anosmia - supports 10% rating under DC 6275
- UPSIT score 19-29 out of 40 — Indicates hyposmia - may not reach threshold for 10% compensable rating under DC 6275 alone
- UPSIT score 30-40 out of 40 — Normal range - examiner may question claim severity; ensure subjective history is detailed and consistent
Tips:
- If you have prior olfactory test results from a private provider or VA treatment record, bring copies to the exam
- Be honest during testing - answer to the best of your ability, even if you detect nothing
- If you are having a relatively 'better' day and can detect slight odors, still describe your typical worst-day experience verbally to the examiner
Pain considerations: Formal olfactory testing is non-invasive and painless. If nasal congestion or inflammation is present on the day of the exam, inform the examiner, as temporary congestion can affect results and may not reflect your baseline condition.
Nasal Endoscopy / Physical Examination of Nasal Passages
Direct visualization of nasal anatomy to identify structural or mucosal causes of anosmia, including nasal polyps, septal deviation, mucosal atrophy, scarring, or signs of chronic sinusitis.
What to expect:
The examiner may visually inspect your nasal passages using a light and speculum, or with a small endoscope. This is a brief, mildly uncomfortable (but typically not painful) procedure.
Key thresholds:
- Structural abnormalities identified (polyps, scarring, atrophy) — Supports organic basis for anosmia - strengthens nexus to service-connected cause
- No structural findings on exam — Does not disprove anosmia - olfactory nerve damage, head trauma, and viral injury (e.g., post-COVID) may produce anosmia without visible nasal pathology
Tips:
- If your anosmia is neurological in origin (e.g., traumatic brain injury, post-viral), clarify this to the examiner - olfactory nerve damage will not show on nasal exam
- Request that any prior CT or MRI of sinuses or brain be reviewed, especially if these show olfactory bulb atrophy or trauma
Pain considerations: If nasal examination causes discomfort due to chronic inflammation or prior injury, communicate this to the examiner and have it documented.
Imaging Review (CT Sinuses / Brain MRI)
Prior CT or MRI imaging reviewed by the examiner to identify structural causes such as chronic sinusitis, olfactory groove meningioma, olfactory bulb atrophy, or traumatic injury consistent with the veteran's service history.
What to expect:
The examiner will review any imaging already in your VA records. New imaging is not typically ordered at the C&P exam itself. Ensure any relevant prior imaging is in your VA or claims file before the exam.
Key thresholds:
- Olfactory bulb atrophy or olfactory tract injury on MRI — Strong objective evidence supporting neurological anosmia - highly relevant for nexus and rating
- Chronic pan-sinusitis or polyposis on CT — Supports obstructive anosmia - may also support claims for sinusitis under separate diagnostic codes
Tips:
- If you have had head trauma, TBI, or blast exposure in service, request brain MRI with olfactory bulb evaluation if not already in your record
- If you had post-COVID anosmia and it relates to a service period, ensure COVID diagnosis and timeline are documented
Pain considerations: Imaging review is performed from records and does not involve any physical discomfort during the C&P exam itself.
Rating Criteria Breakdown
| Rating % | Criteria | Key Symptoms |
|---|---|---|
| 10% | Complete loss of sense of smell (anosmia) - complete inability to detect any odor. |
CFR: Under 38 CFR - 4.87a, DC 6275, complete loss of sense of smell is assigned a 10% disability rating. This is the only compensable rating level under this diagnostic code. Partial loss (hyposmia) is rated as non-compensable (0%) under the same code unless analogous rating provisions apply. |
| 0% | Partial (incomplete) loss of sense of smell (hyposmia) - reduced but not absent ability to detect odors. Non-compensable under DC 6275 but should still be documented accurately. |
CFR: Hyposmia (partial loss) is rated at 0% under DC 6275. Veterans with hyposmia should ensure this is accurately documented as it may serve as a baseline for future increases if the condition worsens to complete anosmia. |
10% Complete loss of sense of smell (anosmia) - complete inabili ...
Complete loss of sense of smell (anosmia) - complete inability to detect any odor.
Key Symptoms
- Total inability to detect any odor regardless of intensity
- Cannot smell smoke, gas, burning food, or other warning odors
- Cannot smell food, flowers, perfume, or any environmental odor
- May have associated taste disturbance due to loss of retronasal olfaction
- Confirmed or consistent with prior olfactory testing showing at- or near-chance performance
CFR: Under 38 CFR - 4.87a, DC 6275, complete loss of sense of smell is assigned a 10% disability rating. This is the only compensable rating level under this diagnostic code. Partial loss (hyposmia) is rated as non-compensable (0%) under the same code unless analogous rating provisions apply.
0% Partial (incomplete) loss of sense of smell (hyposmia) - red ...
Partial (incomplete) loss of sense of smell (hyposmia) - reduced but not absent ability to detect odors. Non-compensable under DC 6275 but should still be documented accurately.
Key Symptoms
- Reduced sensitivity to odors - can detect very strong smells but not subtle ones
- Inconsistent odor detection - sometimes smells certain things but not others
- Difficulty identifying specific odors even when detected
- May be present during flares of sinusitis or nasal congestion and improve partially when inflammation resolves
CFR: Hyposmia (partial loss) is rated at 0% under DC 6275. Veterans with hyposmia should ensure this is accurately documented as it may serve as a baseline for future increases if the condition worsens to complete anosmia.
How to Describe Your Symptoms
Severity and Completeness of Smell Loss
How to describe:
Clearly state whether your smell loss is total or partial. If total, use concrete examples: 'I cannot smell smoke when standing next to a campfire,' 'I cannot smell strong bleach or ammonia,' 'I cannot smell my own body odor or cologne.' Emphasize inability to detect even the most pungent and obvious odors.
Worst-day example:
“On my worst days - which is essentially every day - I cannot smell anything at all. I have stood next to a running car exhaust pipe and smelled nothing. I cannot smell food burning on the stove. My family has had to warn me about smells I should be able to detect easily. I have no ability to detect any odor, mild or strong.”
What the examiner listens for:
The examiner needs to document whether this is complete anosmia (10% compensable) versus hyposmia (0%). They are specifically listening for your ability to describe total absence of any odor detection to check the 'anosmia' box on the DBQ.
Understatements to avoid:
Avoid saying 'My smell isn't as good as it used to be' or 'Sometimes I can smell things a little.' These statements suggest hyposmia, not anosmia, and may result in a 0% non-compensable rating even if your actual functional loss is complete most of the time.
Safety Hazards and Functional Impact
How to describe:
Describe specific real-world situations where your inability to smell has created safety risks or required compensatory behavior. Be concrete: smoke detectors installed throughout home, others in household assigned to check for gas leaks, unable to detect spoiled food by smell alone.
Worst-day example:
“Because I cannot smell gas or smoke, I have had to install multiple gas detectors and smoke alarms throughout my home. I once continued cooking not realizing food had burned badly because I could not smell it. I cannot tell if food has spoiled - I have gotten sick from food I could not smell was rotten. I rely entirely on expiration dates and visual checks because my nose provides no safety warning.”
What the examiner listens for:
The examiner is looking for functional impairment beyond the sensory loss itself - safety implications and compensatory adaptations directly inform the functional impact section of the DBQ and support the 10% rating justification.
Understatements to avoid:
Do not minimize the safety dimension by saying 'It's inconvenient but I manage fine.' The inability to detect smoke, gas, carbon monoxide byproduct odors, or spoiled food is a genuine safety impairment and should be communicated with appropriate weight.
Impact on Appetite, Nutrition, and Quality of Life
How to describe:
Explain how smell loss has affected your enjoyment of eating, appetite, and nutritional intake. Most flavor perception is actually olfactory - loss of smell causes significant reduction in taste experience. Describe any unintentional weight loss, reduced appetite, or social withdrawal related to inability to enjoy shared meals.
Worst-day example:
“Food has almost no flavor or enjoyment for me anymore. I can detect basic tastes - sweet, salty, bitter - but the complex flavors that make food enjoyable are completely gone. I have lost interest in eating and have lost [X] pounds since my smell disappeared. Social meals with family feel isolating because I cannot share in the sensory experience others have.”
What the examiner listens for:
The examiner is completing the functional impact section of the DBQ. Documentation of nutritional, social, and quality-of-life impacts strengthens the overall picture of disability even at the 10% rating level, and is important if the veteran is also claiming associated taste loss (ageusia/hypogeusia) as a separate disability.
Understatements to avoid:
Avoid saying 'My taste is fine' if retronasal olfactory loss has affected your food experience - the flavor loss associated with anosmia is real and should be described accurately.
Onset, Course, and Service Connection Narrative
How to describe:
Tell a clear, chronological story: when you first noticed the smell loss, what event or condition you believe caused it (in-service head trauma, blast exposure, chemical exposure, chronic sinusitis beginning in service, post-viral illness during service), how it has progressed or remained constant, and any treatments attempted.
Worst-day example:
“I first noticed I could not smell anything following [specific in-service event - e.g., an IED blast in 2005, a chemical exposure incident, or a severe head injury]. Within weeks of that event, smells that used to be obvious to me were completely gone. I reported this to sick call / my unit medic at the time. Since then, the condition has not improved - it has been complete anosmia for [X years]. I have seen [providers] and been told the nerve damage is likely permanent.”
What the examiner listens for:
The examiner must document the history and onset for the nexus opinion. A clear, specific, service-connected onset date tied to a documented in-service event is critical. The examiner fills DBQ field 79 (history including onset and course) - your narrative directly informs what they write.
Understatements to avoid:
Avoid vague statements like 'I think it started sometime during my deployment.' Be as specific as possible about the triggering event, date, and any contemporaneous sick call or medical records that document the event.
Associated Taste Loss
How to describe:
If you also experience loss of taste (ageusia) or reduced taste (hypogeusia), describe this separately and clearly. Taste and smell are evaluated on the same DBQ but may be rated as separate disabilities. Specify whether you cannot taste sweet, salty, sour, bitter, umami - or whether all taste sensation is absent.
Worst-day example:
“In addition to my complete smell loss, I also cannot detect flavors beyond the most basic sensations. Everything I eat tastes like a bland version of itself - I can tell something is sweet or salty but that is all. The richness of flavor that used to make eating enjoyable is entirely absent.”
What the examiner listens for:
The examiner will document ageusia (complete lack of taste, DC field 138) or hypogeusia (decrease in taste, DC field 141) as separate diagnoses from anosmia/hyposmia. These are evaluated under different diagnostic codes and can result in additional ratings.
Understatements to avoid:
Do not fail to mention taste loss if it is present. Many veterans focus only on smell and do not realize that associated taste loss may be separately compensable.
Common Mistakes to Avoid
Describing symptoms as 'reduced' or 'not as good' instead of 'completely absent'
The difference between anosmia (complete, 10% compensable) and hyposmia (partial, 0% non-compensable) is the single most critical distinction in this DBQ. Imprecise language suggesting partial loss will result in a non-compensable 0% rating even if your loss is functionally complete.
Instead: Use clear, absolute language when accurate: 'I cannot smell anything - not strong odors, not weak odors, not any odor at all.' Bring specific examples of strong odors you have been unable to detect. If your loss is truly complete, say so unambiguously.
Impact: 0% vs. 10%
Failing to mention associated taste loss
Loss of smell often causes significant loss of flavor perception. Veterans who do not mention this on the DBQ miss the opportunity for a separate rating for ageusia or hypogeusia under related diagnostic codes, which could result in additional compensation.
Instead: Proactively tell the examiner: 'In addition to my smell loss, I have also experienced a significant reduction in my ability to taste food. I would like this documented as well.'
Impact: Separate taste loss rating
Not describing safety hazards and functional impact
The DBQ has a dedicated functional impact section. An examiner who only checks 'anosmia' without documenting real-world functional consequences produces a less complete record. Functional impact documentation supports the rating and any future TDIU or secondary claims.
Instead: Prepare 3-5 specific real-world examples of how anosmia has affected your safety (gas/smoke detection), nutrition (appetite and weight), daily activities, and social life. Present these proactively during the exam.
Impact: 10% rating completeness and secondary claims
Assuming the examiner will order olfactory testing
Formal olfactory testing (UPSIT, Sniffin' Sticks) is not universally available at all VA facilities and may not be ordered at the C&P exam. Veterans sometimes assume objective test results will automatically be part of the exam.
Instead: If you have had prior olfactory testing from a private ENT, neurologist, or VA treatment provider, bring copies of the results. If not, consider obtaining formal testing before your C&P exam through a private provider and submitting the results into your claims file.
Impact: 10% rating evidentiary support
Not connecting smell loss to a specific in-service event or condition
The examiner must provide a nexus opinion - was the condition caused by or a result of military service? If the veteran cannot provide a plausible service-connected cause, the examiner cannot write a supportive nexus opinion.
Instead: Prepare your service nexus narrative before the exam: identify the in-service event (TBI, blast exposure, chemical exposure, chronic sinusitis starting in service, etc.), approximate date, and any service records or STRs that document the event. Present this history clearly to the examiner.
Impact: Service connection grant/denial
Minimizing symptoms because 'it's only a 10% condition'
Even a 10% rating has significant value for the veteran's combined disability rating, access to healthcare, and establishing service connection for secondary conditions. Additionally, anosmia that is under-documented may complicate future claims for related conditions (sinusitis, TBI, etc.).
Instead: Report your symptoms fully and accurately regardless of anticipated rating level. Every documented symptom creates a record that supports current and future claims.
Impact: 10% and combined rating
Prep Checklist
Before Your Exam
Day Of
During the Exam
After the Exam
Your Rights During a C&P Exam
- You have the right to request that your C&P examination be recorded (audio or video) in most states - notify the examiner at the start of the appointment and check your state's consent requirements.
- You have the right to review your complete claims file, including all C&P examination reports, through VA.gov or by submitting a records request.
- You have the right to submit your own personal statement (VA Form 21-4138) describing your symptoms and functional impact - this becomes part of your official claims record.
- You have the right to submit buddy statements from family members, friends, or fellow veterans who can attest to your functional limitations related to smell loss.
- You have the right to obtain private medical opinions and olfactory testing and submit these into your claims file as evidence.
- You have the right to challenge an inadequate or inaccurate C&P exam by requesting a new examination or submitting additional evidence demonstrating the exam was inadequate.
- You have the right to request a hearing officer conference or Board of Veterans' Appeals hearing if you disagree with a rating decision.
- You have the right to free VSO representation at all stages of the claims process - contact your state VSO, American Legion, DAV, VFW, or other accredited VSO for assistance.
- Under the PACT Act, veterans exposed to burn pits, airborne hazards, or other toxic exposures have expanded presumptive service connection opportunities that may be relevant if smell loss is related to such exposures.
- You have the right to a fully favorable decision if the evidence is in equipoise (equal for and against) - the benefit of the doubt standard under 38 CFR - 3.102 requires the VA to resolve reasonable doubt in your favor.
Related Conditions
- Complete Loss of Sense of Taste (Ageusia) Frequently co occurs with anosmia and is evaluated on the same DBQ under a separate diagnostic code. Most flavor perception depends on olfaction smell loss typically produces significant taste impairment. May be separately ratable.
- Chronic Sinusitis A common cause of anosmia. Obstructive anosmia from chronic sinusitis may be evaluated under DC 6510 6514 in addition to DC 6275. If sinusitis is service connected, anosmia may be ratable as a secondary condition or as part of the same disability.
- Traumatic Brain Injury (TBI) TBI including blast related injury is a leading cause of post traumatic anosmia through shear injury to the olfactory filaments or contusion of the olfactory bulb. Veterans with service connected TBI may claim anosmia as a secondary condition.
- Nasal Polyps Nasal polyps can obstruct olfactory airflow and cause or worsen anosmia. If polyps are service connected or secondary to service connected sinusitis, they may support or amplify the anosmia claim.
- Post-COVID Conditions (Long COVID) Post viral anosmia following COVID 19 infection is increasingly common. If a veteran contracted COVID 19 during active service or in a service connected context, post COVID anosmia may be ratable. Long COVID has been recognized as a disability under the ADA and VA is developing rating policies.
- Depression and Mental Health Conditions Chronic anosmia is associated with significantly increased rates of depression, social isolation, and reduced quality of life. Veterans with service connected anosmia who develop depression may have a basis for a secondary mental health claim under 38 CFR 3.310.
- Hyposmia (Partial Loss of Sense of Smell) The less severe form of olfactory loss evaluated under the same DC 6275. Currently rated at 0% (non compensable) but should be documented as it establishes a baseline if the condition progresses to complete anosmia.
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This C&P exam preparation guide is for educational purposes only and does not constitute legal, medical, or claims advice. Always consult with a qualified Veterans Service Organization (VSO) representative or VA-accredited attorney for guidance specific to your claim. Never exaggerate, minimize, or fabricate symptoms during a C&P examination.