Fibromyalgia and VA Disability Compensation

Fibromyalgia and VA Disability Compensation

What is Fibromyalgia?

Fibromyalgia is a condition characterized by widespread musculoskeletal pain usually accompanied by sleep, memory and mood issues, and fatigue. 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. The VA also notes that it must affect both the axial skeleton and the extremities.

There is no known cause of fibromyalgia but it more often occurs in women and can be triggered by physical or psychological trauma such as a motor vehicle accident, or by some infections.

It is believed that people with fibromyalgia have an increased level of chemicals in their brain that over-activate neurotransmitters which signal pain in the brain.

 

How Does the VA Rate Fibromyalgia?

38 C.F.R. 4.71(a) diagnostic code 5025 lists the VA’s rating criteria for fibromyalgia and includes ratings from 10% to 40% disabling. Each rating begins with the prerequisite that there be “widespread musculoskeletal pain and tender points, with or without associated fatigue, sleep disturbances, stiffness, paresthesias, headache, irritable bowel syndrome, depression, anxiety, or Raynaud’s-like syndrome.” From there, each rating has its own requirements.

The lowest rating, 10%, requires that the veteran take continuous medication for the control of their fibromyalgia. For the 20% rating, the VA requires that the symptoms listed above be “episodic, with exacerbations often precipitated by environmental or emotional stress or by overexertion, but that are present more than one-third of the time.” Finally, for the 40% rating, the highest VA rating for this condition, the veteran’s symptoms must be “constant, or nearly so, and refractory to therapy.”

 

Is Fibromyalgia a Presumptive Condition?

In short, no. The VA does not consider fibromyalgia to be presumptively related to Agent Orange or ionized radiation exposure, or exposure to contaminated water at Camp Lejuene. However, veterans of the Persian Gulf War who develop fibromyalgia may be entitled to service connection. Under the VA’s regulation for qualifying disabilities for Persian Gulf War veterans, fibromyalgia is “a medically unexplained chronic multisymptom illness that is defined by a cluster of signs or symptoms.” The VA may grant service connection for a Persian Gulf War veteran’s fibromyalgia. If you are a veteran who served in the Southwest Asia theater of operations and have been diagnosed with fibromyalgia, our office may be able to assist you with your VA claim.

Category: Veterans Law

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