Fibromyalgia VA Rating 

For veterans diagnosed with fibromyalgia, managing symptoms like pain and fatigue can feel like a never-ending battle. The VA recognizes the impact of this condition and offers disability compensation based on its severity. If you’re a veteran dealing with fibromyalgia, understanding how the VA rates this condition is crucial to securing the benefits you deserve. 

How the VA Rates Fibromyalgia 

The VA uses specific criteria to assign a disability rating for fibromyalgia, ranging from 10% to 40%, based on the frequency and severity of symptoms. 

5025 Fibromyalgia (fibrositis, primary fibromyalgia syndrome): 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: 

• 40% Rating: That are constant, or nearly so, and refractory to therapy 
• 20% Rating: That 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 
• 10% Rating: That require continuous medication for control 

VA Note: Widespread pain means pain in both the left and right sides of the body, that is both above and below the waist, and that affects both the axial skeleton (i.e., cervical spine, anterior chest, thoracic spine, or low back) and the extremities. 

Need help filing your VA disability claim for fibromyalgia? Request our free VA claims guide, packed with expert tips on how to navigate the process. 

Is Fibromyalgia a Presumptive Condition? 

Yes, fibromyalgia is considered a presumptive condition for Persian Gulf War veterans, meaning that veterans who served in the Southwest Asia theater of military operations do not need to prove a direct connection between their service and their fibromyalgia to qualify for VA disability compensation. According to 38 CFR § 3.317, veterans can receive compensation for fibromyalgia if the condition: 

• Became manifest during active service in the Southwest Asia theater or within a designated timeframe after service, no later than December 31, 2026. 
• Is rated at least 10% disabling. 

This presumption applies to Gulf War veterans because fibromyalgia is classified as a medically unexplained chronic multisymptom illness (MUCMI). This classification means that the condition is characterized by overlapping symptoms, including fatigue, widespread pain, and disability that are disproportionate to physical findings and have an inconsistent demonstration of laboratory abnormalities. 

PACT Act and Gulf War Veterans 

The PACT Act has further ensured that Gulf War veterans diagnosed with fibromyalgia are eligible for benefits beyond the original deadline of December 31, 2026, voiding the requirement for the condition to manifest by that date. Veterans who have fibromyalgia and served in the Southwest Asia theater of operations are eligible for VA disability compensation without needing to prove direct causation between their military service and their condition. 

Objective Signs and Symptoms of Fibromyalgia 

According to 38 CFR § 3.317, veterans with objective indications of fibromyalgia, such as persistent muscle pain, sleep disturbances, and cognitive dysfunction, are eligible for compensation, as these symptoms can be independently verified by a physician or through non-medical indicators. For compensation purposes, fibromyalgia is considered chronic if it has existed for six months or more or exhibits episodes of improvement and worsening over a six-month period. 

Getting VA Disability for Fibromyalgia 

Veterans seeking a VA disability rating for fibromyalgia must provide: 

• Diagnosis: Medical documentation confirming a fibromyalgia diagnosis. 
• Evidence: Records showing symptoms began or worsened during military service. 
• Nexus: A medical opinion linking fibromyalgia to military service or a service-connected condition. 

Service Connection for Fibromyalgia 

There are several ways to establish a service connection for fibromyalgia: 

Direct Service Connection 

Fibromyalgia may be directly linked to your military service. Although the exact cause of fibromyalgia is unknown, it is often associated with injuries, infections, or stress, all of which are common during military service. Medical evidence from a doctor can help connect your condition to specific incidents during your time in the military. 

Secondary Service Connection 

Fibromyalgia can be connected as a secondary condition to other service-connected disabilities. For example, if you have PTSD, depression, lupus, rheumatoid arthritis, or ankylosing spondylitis and later develop fibromyalgia, you may be eligible for compensation. In such cases, a medical link between the primary condition and fibromyalgia is needed. 

Aggravation of Pre-existing Fibromyalgia 

If you had fibromyalgia before joining the military, but your service worsened the condition, you may qualify for compensation due to aggravation. 

Common Secondary Conditions Linked to Fibromyalgia: 

• Irritable Bowel Syndrome (IBS): Up to 70% of fibromyalgia sufferers also have IBS. The two conditions share overlapping symptoms like pain, sleep issues, and stress-related flare-ups. 
• Chronic Fatigue Syndrome: Many veterans with fibromyalgia also have chronic fatigue syndrome, sharing symptoms like sleep disturbances and widespread pain. Both conditions can qualify for VA compensation. 
• Post-Traumatic Stress Disorder (PTSD): PTSD and fibromyalgia are often linked. Veterans who develop both conditions may be eligible for VA compensation for each. 
• Anxiety and Depression 
• Migraines and other types of headaches 

By ensuring you document these conditions and their relationship to your military service, you can strengthen your claim for VA disability compensation. 

Winning a 60% VA Disability Rating for Fibromyalgia with Debilitating Fatigue: Case Example 

In this case, a veteran who served in the U.S. Army from September 1988 to August 1991 and February 1994 to September 1996 sought a higher initial disability rating for his service-connected fibromyalgia. Initially rated at 40%, the veteran appealed for a higher rating, which led to a detailed review by the Board of Veterans’ Appeals. 

The Board initially upheld the 40% disability rating for fibromyalgia but later granted a 60% disability rating effective February 17, 2010, due to the development of debilitating fatigue that severely impacted the veteran’s daily activities. 

Key Factors That Contributed to Winning the Claim:

• Constant, Refractory Symptoms: The veteran’s fibromyalgia symptoms, including widespread musculoskeletal pain and tender points, were constant and unresponsive to therapy. Despite multiple treatment attempts, the symptoms persisted at a severe level, justifying the 40% rating initially assigned. 
• Development of Debilitating Fatigue: By February 17, 2010, the veteran’s condition had worsened to include debilitating fatigue that reduced his daily activity level to less than 50% of what it was before the illness. This significant impact on his life warranted an increase to a 60% rating under the criteria for chronic fatigue syndrome. 
• Comprehensive Medical Documentation: The veteran’s case was supported by thorough medical records, including VA examinations that documented the severity and persistence of his symptoms. These records demonstrated the extensive impact of fibromyalgia and fatigue on his ability to function daily. 
• Functional Limitations: Despite the 40% rating being the maximum for fibromyalgia under its specific diagnostic code, the additional diagnosis of chronic fatigue syndrome allowed for an increased rating. The evidence showed that the veteran’s condition was severe enough to meet the criteria for a higher rating due to the added impact of fatigue. Also, under VA Regulations, VA is required to give the veteran the higher rating when two or more conditions have the same or similar symptoms and cannot be rated individually.  

This case highlights the importance of detailed medical evidence and the consideration of all symptoms and related conditions when seeking a higher VA disability rating. Veterans with similar cases should ensure that their medical records accurately reflect the full extent of their condition and its impact on their daily life. 

My Claim Was Denied, What Can I Do? 

If your VA disability claim for fibromyalgia is denied, you have options: 

1. File an Appeal with the Board of Veterans Appeals: Submit this within one year of receiving the VA’s decision. 
2. Request a Higher-Level Review: Ask for another review of your claim by a senior VA official. 
3. File a Supplemental Claim: Include new and relevant evidence to support your case. 

How to Increase the VA Rating for Fibromyalgia 

If you believe your current VA disability rating for fibromyalgia is too low, you can file for an increase by submitting: 

• New Medical Evidence: Documentation showing worsening symptoms. 
• Functional Impact: Proof that fibromyalgia is significantly impacting your daily life. 
• Secondary Conditions: Additional claims for secondary conditions related to fibromyalgia, such as chronic fatigue syndrome. 

Think your VA rating is too low? Contact us for a free consultation to see how we can help increase your rating. 

Fibromyalgia and Unemployability 

Fibromyalgia can lead to severe physical pain that many veterans find challenging to control. It often appears alongside other conditions that can further complicate everyday tasks such as sleeping or interacting socially. 

As a result, maintaining steady employment can become incredibly difficult for veterans with severe fibromyalgia. Those who are unable to work due to their service-connected conditions may qualify for Total Disability based on Individual Unemployability (TDIU), which provides compensation for veterans unable to hold gainful employment.