Fibromyalgia and Gulf War Veterans
What is Fibromyalgia?
Fibromyalgia is a condition characterized by unexplained, widespread pain throughout the body, persisting longer than three months. In order for the pain to be considered widespread, it must be on both the right and left sides of the body and both above and below the waist. Symptoms of fibromyalgia include the following:
- Chronic pain in muscles, tendons, and other soft tissues accompanied by “trigger points” that hurt when pressure is applied. These trigger points are usually on the neck, shoulders, back, hips, arms and legs
- Sleep disturbances
- Irritable bowel syndrome
- Chronic headache
- Impaired memory and concentration
- Morning muscle stiffness
There is currently no lab test to confirm a diagnosis of fibromyalgia. In the past, doctors would check 18 trigger points on a person’s body to see how many of them were painful when pressed firmly. However, this trigger point examination is no longer required. Instead, a fibromyalgia diagnosis can be made if a person has widespread pain for more than three months as indicated above, with no underlying medical condition that could cause the pain. Researchers and health care providers do not currently know a direct cause or cure for fibromyalgia, but symptoms can be managed. Most commonly, prescription drugs are provided to treat this condition.
Fibromyalgia: Presumptive Condition for Gulf War Veterans
For VA purposes, the Persian Gulf War refers to service in the Southwest Asia theater of military operations beginning on August 2, 1990. Veterans of Operation Desert Storm and Desert Shield meet the criteria for qualifying service during the Persian Gulf War, as do veterans of Operation New Dawn, Operation Iraqi Freedom (OIF), and in some instances, Operation Enduring Freedom (OEF). VA offers health registry examinations, health care, disability compensation, and other benefits to eligible Gulf War veterans. Their dependents and survivors may also be eligible for certain benefits.
Research on fibromyalgia and Gulf War veterans’ health found that 1990-1991 Gulf War deployment is associated with an increased risk for this condition. As a result, fibromyalgia is a presumptive condition for Gulf War veterans, meaning veterans do not have to prove that their fibromyalgia and their military service are linked. In order for Gulf War veterans to receive service-connected compensation for fibromyalgia on a presumptive basis, the following criteria must be met:
- The veteran’s fibromyalgia is at least 10 percent disabling; and
- The veteran’s fibromyalgia first appeared sometime between active duty in the Southwest Asia theater of military operations and December 31, 2021
How Does VA Rate Fibromyalgia?
VA rates fibromyalgia under 38 CFR § 4.71a, Schedule of Ratings – Musculoskeletal System, Diagnostic Code 5025. Each rating begins with the prerequisite that there be “widespread musculoskeletal pain and tender points, with or without associated fatigue, sleep disturbance, stiffness, paresthesias, headache, irritable bowel symptoms, depression, anxiety, or Raynaud’s-like symptoms.” From there, each rating has its own criteria:
- 10% – requires continuous medication for control
- 20% – the symptoms listed above are episodic, with exacerbations often precipitated by environmental or emotional stress or by overexertion, but that are present more than one-third of the time
- 40% – the symptoms are constant, or nearly so, and refractory to therapy
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