How Does the VA Rate Fibromyalgia Disability?

How Does the VA Rate Fibromyalgia Disability?

Many Veterans deal with the chronic pain, fatigue, and depression of fibromyalgia as a result of their military time. As a result, many ask how does the VA rate fibromyalgia disability.

Although the cause of fibromyalgia is unknown at this time, a combination of genetic and environmental factors may cause this neurological condition. Potential environmental impacts include trauma (both physical and emotional), psychological stress, infections, and exposure to certain chemicals. 

Since Veterans are often exposed to many dangerous environmental factors, those diagnosed with fibromyalgia may receive benefits from the Veterans Administration (VA).

Before applying for these benefits, let’s look more closely at fibromyalgia and how the VA rates fibromyalgia disability claims.

Common Symptoms of Fibromyalgia

Since fibromyalgia is difficult to diagnose, it wasn’t always considered a qualifying disability under VA rules. However, according to the tenth version of the International Classification of Diseases (ICD) maintained by the World Health Organization, the diagnosis of fibromyalgia ICD 10 falls under the category of chronic widespread pain.

The VA now accepts fibromyalgia as a compensable disability, but sometimes the only way to diagnose the condition is to eliminate all other possible conditions that share the same basic symptoms.

Some of the most common symptoms and concerns people with fibromyalgia face include:

  • Chronic and widespread moderate to severe painful sensations
  • Debilitating pain and sensitivity resulting from even mild contact
  • Extended pain responses that last beyond what others experience
  • Ongoing fatigue, insomnia, and waking from sleep unrefreshed
  • Lower abdominal pain and cramping
  • Impaired concentration and memory
  • Migraine headaches
  • Depression
  • General hypersensitivity
  • Digestive issues such as IBS
  • Long-term, chronic pain can negatively affect your sleep, leading to headaches and concentration problems. Most people with severe pain are limited in movement and cannot exercise, causing a negative cycle of pain and inactivity.

    How is Fibromyalgia Treated?

    Common treatment for fibromyalgia addresses symptoms through multidisciplinary approaches. Aerobic and strengthening exercises may relieve symptoms, while medications can help manage the condition. Antidepressants can also improve quality of life.

    Fibromyalgia pain often stems from trigger points on the body that react upon contact. These trigger points can occur anywhere, but the neck, back, and shoulders, along with the areas on the limbs, are the most common trigger spots sufferers point to.

    How Can I Obtain VA Benefits For My Fibromyalgia?

    Diagnosis of Fibromyalgia

    Before you can apply for VA benefits, you need a fibromyalgia diagnosis from an accredited medical professional. This diagnosis can come from a rheumatologist (someone who specializes in arthritis and inflammatory or immune-related conditions), a general practitioner, or the doctor who performs your Compensation and Pension (C&P) exam for the VA. 

    Prove a Service Connection

    Once you have a solid diagnosis, you must connect it to your military service. Simply being a Veteran with a diagnosed condition is not enough to qualify for VA benefits. You must show your time in the military caused the condition.

    Here are three ways you might connect your fibromyalgia to your military service:

    1. You received your diagnosis during your active service
    2. You had an existing condition or injury that your active service aggravated and caused the fibromyalgia
    3. You are a Gulf War Veteran

    Because the Gulf War exposed many military members to harmful chemicals, pesticides, burn pits that released benzene and dioxin, and decontamination agents in Iraq and Afghanistan, the VA does not require proof of a service-connected diagnosis. Instead, when Gulf War Veterans receive a fibromyalgia diagnosis, the VA considers it a presumptive condition, meaning the VA automatically connects it to their military service.

    Receive a Disability Rating

    VA disability ratings are found in the Code of Federal Regulations. Fibromyalgia ratings fall under Title 38 §4.71a Diagnostic Code 5025.

    Disability ratings for fibromyalgia usually fall into one of three VA disability rating categories:

    • 10 percent disabled – The Veteran needs continuous medication to control pain
    • 20 percent disabled – Pain is episodic, present more than one-third of the time, and often triggered by stress or overexertion
    • 40 percent disabled – Nearly constant pain that does not respond to therapy

    Veterans with qualifying fibromyalgia claims can receive medical treatment through the VA to help relieve their pain and other symptoms. To qualify for disability benefits, the VA must rate you at least 10 percent disabled due to your fibromyalgia. 

    Depending on which rating category you qualify for, your disability benefits will vary. If you have another service-related condition, the VA can combine all qualifying conditions into a single rating, but the total amount cannot exceed 100 percent disability.

    Veterans’ dependents and survivors may also qualify for VA benefits. To learn more about these benefits, you could reach out to the VA or, for more personalized service, contact an experienced VA benefit lawyer to discuss your situation. 

    If You Suffer From Fibromyalgia and Need VA Benefits, Trust Berry Law to Help

    The dedicated legal team at Berry Law understands the complicated nature of dealing with fibromyalgia every day. We also know how complex the VA benefits system is. We focus our legal practice on helping Veterans receive the care and treatment they need. When your life changes because of your military service, we are ready to go to battle to protect your legal rights.

    At Berry Law, over 20 percent of our legal team personally served in the military, and almost 100 percent of our staff have at least one immediate family member who served or is currently serving our country. We are Veterans serving Veterans since 1965. You can trust that we’ll fight for you and help you receive the benefits you deserve. 

    To learn more about how to bring a disability claim and how the VA may rate your fibromyalgia claim, call us at (888) 883-2483 or complete our online contact form to speak with one of our compassionate and skilled legal professionals.

    ptsd attorney john berry
    VA Disability Attorney, John Berry
    Berry Law

    The attorneys at Berry Law are dedicated to helping injured Veterans. With extensive experience working with VA disability claims, Berry Law can help you with your disability appeals.

    This material is for informational purposes only. It does not create an attorney-client relationship between the Firm and the reader, and does not constitute legal advice. Legal advice must be tailored to the specific circumstances of each case, and the contents of this blog are not a substitute for legal counsel.

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