Learn the VA Rating Scale for Service-Related Fibromyalgia

Fibromyalgia is a chronic condition that’s characterized by tenderness and pain in the muscles, tendons, and other soft tissue. Often, there is unexplained, widespread pain throughout the body that can last for long periods of time. Along with this pain, fibromyalgia sufferers have “trigger points” that are painful to the touch or when pressure is applied to those areas. These trigger Fibromyalgia on a Green Computer Screen With an Exclamation Pointpoints are most commonly found on the top of the shoulders, front sides of the neck, between the shoulder blades, back of the head, upper chest, and outer elbows.

Fibromyalgia is a condition that affects approximately five million adults, but studies show that veterans, particularly those who served in the Gulf War, are more frequently diagnosed with fibromyalgia that non-Gulf War veterans and civilians. While it’s not necessary for Gulf War veterans to prove a service connection to receive disability benefits for this condition from the United States Department of Veterans Affairs (VA), a 10 percent disabling rating is needed to receive any type of benefit. Additionally, a veteran’s fibromyalgia symptoms must meet two criteria: they must have initiated while on active duty in the Southwest Asia theater of military operations or by December 21, 2016.

This theater of operations includes the following locations, along with the airspace above them:

  • Saudi Arabia
  • Kuwait
  • Iraq
  • Oman
  • The United Arab Emirates
  • The Gulf of Oman
  • The Persian Gulf
  • The neutral zone between Iraq and Saudi Arabia
  • The Gulf of Aden
  • The Arabian Sea
  • The Red Sea
  • Bahrain
  • Qatar

If you suffer from fibromyalgia, you may be eligible for VA Disability benefits. However, the VA application process can be complicated and sometimes frustrating, so you may want to hire a legal expert to help you. 

Additional Symptoms

Fibromyalgia can come on suddenly or gradually. If the onset happens quickly, it is usually due to a trauma or physical injury. Fibromyalgia can also be brought about by infections or exposure to chemicals or drugs. It is common for people with fibromyalgia to experience fatigue and trouble sleeping, along with these other symptoms:

  • Tenderness in the jaw and face
  • Sensitivity to certain types of foods, odors, bright lights, and noise
  • Migraine headaches and tension
  • Tingling or numbness in the feet, hands, legs, or arms
  • Feelings of anxiousness or depression
  • Abdominal pain
  • Problems with memory and the ability to concentrate
  • The feeling that the hands and feet are swelling when they are not
  • A decreased tolerance for exercise

How Fibromyalgia Is Diagnosed and Rated

To diagnose fibromyalgia, a doctor will give a physical exam where he tests the sensitivity of the patient’s trigger points. There must be widespread pain that has lasted over three months in 11 of the 18 possible points. The patient must feel pain above and below the waist and on both sides of his body. If the evaluation and diagnosis are made by a rheumatologist, the patient’s fibromyalgia will be rated under diagnostic code 5025.

If a veteran suffers from widespread pain and tender points—with or without accompanying fatigue, stiffness, headache, sleep disturbance, and other symptoms—he will be rated in the following way:

  • 10 percent. This rating is given if the symptoms require continuous medication to control them.
  • 20 percent. This rating is given if the symptoms are episodic but present more than one-third of the time, with “exacerbations often precipitated by environmental or emotional stress or overexertion.”
  • 40 percent. This rating is given if the symptoms are constant, nearly constant, and are resistant to therapy.

It’s important to note that you can suffer from other conditions along with fibromyalgia. If this is the case, it’s unlikely that you’ll win a claim for fibromyalgia until you’ve received treatment for the other condition, it’s been stabilized for six months, and still your fibromyalgia continues.

We Can Help

The attorneys at Cuddigan Law help veterans obtain the disability benefits they deserve. We understand compensation for conditions like fibromyalgia, and we assist veterans because we respect and appreciate the sacrifice and service they’ve made to our country.

If you’re a veteran who experiences flare-ups of widespread pain, stiffness, and trigger-point tenderness in various areas of your body, you may be eligible for VA Disability benefits for your FM condition, and we want to help. Or if you’ve applied and were denied benefits, call Cuddigan Law at (402) 933-5405. We’ll schedule an appointment to discuss your eligibility for compensation.

 

Sean D. Cuddigan
SSA and VA Disability Attorney in Omaha, Nebraska