Fibromyalgia is a reality that faces many brave men and women who have served our country. While the Department of Veterans Affairs does cover benefits for Fibromyalgia, obtaining these benefits can be quite challenging for our veterans.
Luckily, this is changing, and our veterans, particularly Gulf War veterans, have seen increasing success in obtaining their VA benefits for Fibromyalgia. If you’re looking at potentially filing for VIA benefits due to Fibromyalgia, you’ll want to know the VA disability rating for the condition.
How Does the VA rate Fibromyalgia?
Like many service-related disabilities, the VA rates Fibromyalgia on a rating scale based on the severity of the condition. To determine your fibromyalgia rating, the VA will look at:
- Your medical records
- The results of your VA claim exam should you be required to take one
- Any additional information you choose to provide, such as a buddy statement
The VA disability ratings for Fibromyalgia are contained in the Code of Federal Regulations, Title 38, § 4.71a diagnostic code 5025. Disability ratings for Fibromyalgia will be assessed as 40%, 20%, or 10%.
- 40%: Constant, or nearly so, and not responsive to therapy.
- 20%: Episodic, with exacerbations often precipitated by environmental or emotional stress or overexertion, and are present more than one-third of the time.
- 10%: Require continuous medication for control.
It’s important to note that disability ratings are cumulative, and veterans can have more than one-service related condition. When assessing disability ratings, the VA combines these conditions into a single rating that cannot exceed 100%.
For instance, if you receive a spinal fusion disability rating of 50% and a fibromyalgia rating of 40%, your VA disability rating will be 70%.
What is Fibromyalgia?
Fibromyalgia is a neurological condition that causes widespread, unexplained musculoskeletal pain. These sensations are believed to be caused by irregularities in how the brain and spinal cord process pain signals from your central nervous system.
It can create painful sensations ranging from moderate to extreme, debilitating pain stemming from even the slightest touch. It can also cause painful responses to last significantly longer, such as if you bump your head or twist your ankle.
Pain caused by Fibromyalgia most often occurs in what are called “trigger points,” such as the:
- Neck
- Shoulders
- Back
- Hips
- Arms
- Legs
What are the Symptoms?
In addition to widespread pain throughout the body, Fibromyalgia also causes a host of other symptoms, such as:
- Tenderness
- Sensitivity to touch
- Impaired memory and concentration
- Fatigue
- Sleep loss
- Migraines and headaches
- Digestive problems like irritable bowel syndrome (IBS)
Many of these symptoms can be directly attributed to the amount of pain those that suffer from fibromyalgia experience. Long and unpredictable bouts of pain could negatively impact your ability to fall and stay asleep, making it difficult to concentrate or leading to chronic headaches.
Another issue for those dealing with Fibromyalgia is that due to how common these symptoms are among other illnesses, Fibromyalgia can be rather difficult to diagnose.
How is Fibromyalgia Diagnosed?
As stated, Fibromyalgia is a challenge for practitioners to diagnose. This isn’t just due to how common symptoms are but also because there aren’t any lab or medical tests that can detect them. Instead, fibromyalgia diagnoses are typically made by assessing a compilation of systems and ruling out other possible conditions.
While Fibromyalgia falls under rheumatology, it doesn’t need to be diagnosed by a rheumatologist. However, while any practitioner can diagnose it, those with specific training may not feel comfortable doing so. It’s worth knowing that Fibromyalgia can also be diagnosed during your C&P exam at the VA.
What Causes Fibromyalgia?
Diagnosing Fibromyalgia is further complicated because it has no known direct cause. However, researchers have identified some possible links. It is now believed that repeated nerve stimulation causes changes in the brain and spinal cord of people with Fibromyalgia coinciding with increases in particular chemicals in the nervous system that signal pain.
The biggest factors that have been identified are:
- Repetitive injuries
- Physical and emotional trauma
- Stress
- Infections
- Genetics
There are also certain risk factors of note with Fibromyalgia. Women are far more likely to suffer from Fibromyalgia. Also, if you have rheumatoid arthritis, lupus, or osteoarthritis, you are more likely to develop Fibromyalgia.
How Do I Get VA Benefits for Fibromyalgia?
The first step is obtaining a medical diagnosis for Fibromyalgia. As stated earlier, this can come from any practitioner, not just a rheumatologist, and can also be diagnosed during a C&P exam at the VA. Your condition could qualify you for benefits from the VA.
The second step is establishing a service-related connection for your Fibromyalgia. Like all VA benefits, you will need to be able to link your condition in some way to your military service.
There are three ways to connect Fibromyalgia to your military service.
- If you were diagnosed while actively enlisted in the armed forces, you would have a service-related connection to Fibromyalgia.
- You can make a case for an “aggravated” connection by tying it to an existing illness or injury that was made worse during your time on active duty.
- If you are a Gulf War veteran, you already have a presumptive connection.
Many veterans who served in the Gulf War, Iraq, and Afghanistan were exposed to various chemical exposure, uranium, pesticides, decontamination agents, certain medications, and burn pits that released benzene and dioxin. The exposure makes it highly probable that Fibromyalgia has a service-related connection.
Because Gulf War veterans were found to have significantly higher rates of Fibromyalgia, they are given a presumed service-related connection if they receive a fibromyalgia diagnosis. In addition to receiving a diagnosis, to receive benefits, Gulf War veterans must also:
- Be rated at least 10%
- Have occurred anytime during their active duty up to Dec. 31, 2026.
Have Questions About VA Ratings for Fibromyalgia?
Due to the nature of the condition, obtaining a fibromyalgia diagnosis is enough of a challenge. Connecting your condition to your service and obtaining benefits shouldn’t add to that challenge, but it often does. While improvements have been made, such as the presumptive connection for Gulf War veterans, veterans from more recent eras haven’t been as lucky.
Our veterans deserve the benefits they have earned, and the team at Hill & Ponton stands behind them. If the VA has denied your claim, rejected your service-related connection, or received a lower rating than you think you deserve, we’re here to help. If you know your potential rating (listed above), you can utilize our compensation calculator below to determine your potential benefits, and contact our team for more information.
