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What is fibromyalgia, and how does the VA rate it for VA disability benefits?

As a common condition experienced among Veterans, fibromyalgia is often claimed for VA disability benefits. But what is it, and how does the VA rate it? Beyond knowing the signs of fibromyalgia and how to start your claim for the condition, it's also important to be familiar with presumptives for fibromyalgia (presumed connection to events during military service) and also pyramiding in regards to your VA disability claim.

It sounds like a lot, but we're here to break it down step by step. Keep reading as we detail what fibromyalgia is, the condition's symptoms, and everything you need to know about getting VA disability benefits for fibromyalgia:

What is fibromyalgia?

As defined by Mayo Clinic, fibromyalgia is "a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues."

Common symptoms of fibromyalgia include:

  • Bodily pain and dull aches

  • Fatigue

  • Brain fog and cognitive difficulties

Although it's a bit of a medical mystery, it's thought that fibromyalgia is caused by genetics, infections, physical events, or emotional events. Veterans who have been diagnosed in service with this condition (direct service connection) or developed the condition after an exposure from service (presumptive) have found success with service connection for this condition.

What is the VA rating criteria for fibromyalgia?

The VA's rating criteria 5025 Fibromyalgia (fibrositis, primary fibromyalgia syndrome) states the following must be present for the condition to qualify for service connection:

  • "With 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: That are constant, or nearly so, and refractory to therapy 40"

  • The above criteria must be episodic, with symptoms worsening due to environmental or emotional stressors.

  • The above criteria must be present more than one-third of the time.

What about presumptives for fibromyalgia?

With the PACT Act enacted in 2022, there can be confusion about the connection of fibromyalgia as a presumptive condition. It is still under the Gulf War (SW Asia theater) section of deployment exposures.  

Don't forget about pyramiding

If you've never heard of pyramiding: this principle asserts that no two conditions or symptoms can be rated twice. So, in the case of fibromyalgia, symptoms such as bodily pain and fatigue can only be rated once, under fibromyalgia if that's the claim you decide to file.

Two different conditions can have overlapping symptoms, which makes it tricky to figure out which symptoms adhere to which condition. We wrote an entire blog about pyramiding here.

Are you looking for expert medical documentation?

Whether you need a Nexus Letter, DBQ, chart review, or assistance to figure out where to start – we can help you. Schedule a chart review or review the other ways we can help you here. Getting the VA disability benefits you deserve starts with a strong claim backed by compelling documentation. Get started with us today.

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