We understand that applying for VA disability benefits for fibromyalgia can be overwhelming for fellow service members. We have extensive knowledge of the VA’s claims process and what they typically look for in claims.
However, it’s important to note that the VA’s regulations and procedures are subject to change, making it difficult for the average person to keep up. This is where we step in to assist veterans with service-related fibromyalgia in obtaining the disability benefits they rightfully deserve.
Fibromyalgia is a persistent musculoskeletal disorder characterized by widespread pain felt on both sides, above and below the waist. It is often accompanied by symptoms such as fatigue, and difficulty with focus and concentration, also known as “fibro fog”.
These symptoms can make it difficult for veterans to perform daily tasks, work, and take care of themselves and their loved ones. Regrettably, some veterans with fibromyalgia may have their VA disability claims denied.
How Does the VA Rate Fibromyalgia?
When it comes to fibromyalgia, it can at times be difficult to establish a proper rating due to the complexity of the condition. However, the VA does have a precedent for this, as follows:
- The severity of fibromyalgia determines the disability rating assigned by the VA, expressed as a percentage.
- To determine the rating, the VA considers:
- Medical records
- Results of VA claim exam (if applicable)
- Information from other sources, like a “buddy statement”
- Disability ratings for fibromyalgia are covered in the Code of Federal Regulations, Title 38, § 4.71a diagnostic code 5025.
- Fibromyalgia can receive a disability rating of:
- 40% for constant or nearly constant symptoms that do not respond to treatment
- 20% for episodic symptoms present more than one-third of the time, worsened by certain triggers
- 10% for symptoms requiring continuous medication
- Veterans with multiple service-related conditions have all their conditions considered to calculate a combined disability rating, which cannot exceed 100%.
Have You Been Denied VA Disability for Fibromyalgia?
Many veterans, unfortunately, face denials when filing for VA disability claims, whether due to completing the wrong form, missing a filing deadline, or having insufficient evidence to prove service-related fibromyalgia.
However, it’s crucial to understand that a claim denial does not signify the end of the road. Veterans have the right to appeal their VA disability claims, even if their initial claim was denied. Our team can assist with the appeal process and provide guidance on what a strong disability benefits application should include. Our experienced lawyers are well-versed in establishing a service-related connection and will work diligently to ensure that your application is complete and well-documented.
It’s important to recognize that decision-makers reviewing your claim have limited information about you, and we can help you navigate the process by providing the necessary information to establish your claim.
What Causes Fibromyalgia?
There are several factors that may contribute to the development of fibromyalgia in veterans. Those with a family history of fibromyalgia may be more susceptible to developing the condition. Additionally, service-related fibromyalgia may be brought on by physical trauma, psychological stress, emotional events, or an infection.
In addition to widespread pain, people with fibromyalgia may also experience tension headaches, anxiety or depression, and TMJ disorders. It’s worth noting that more women than men are diagnosed with fibromyalgia. However, some healthcare professionals believe that many men with the condition may not seek treatment for their symptoms, or that those who do seek medical attention may be undiagnosed or misdiagnosed.
To summarize, here are the most common causes of fibromyalgia with veterans.
- Family history of fibromyalgia
- Service-related physical trauma
- Psychological stress
- Emotional events
And some of the symptoms to watch out for include:
- Widespread pain
- Tension headaches
- Anxiety or depression
- TMJ disorders
Can a Service Connection to Fibromyalgia be Made for Veterans?
Service connection for all conditions is established in these ways:
- New illness or injury during active military service
- Existing illness or injury made worse during active military service
- Proof of symptoms through medical records and documentation is required
For Gulf War Veterans and Fibromyalgia, it can be established in these ways:
- Special service connection guidelines for Gulf War Veterans
- Fibromyalgia is a presumptive illness for Gulf War Veterans
- No need to prove connection between symptoms and military service
- Fibromyalgia must be at least 10% disabling and first occurred during active duty up until December 31, 2026
If you need help with your service condition for fibromyalgia, or you have already been denied, get in touch with us at VA Benefits Attorneys today.