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Fibromyalgia is a chronic musculoskeletal condition characterized by the following symptoms:
- Unexplained and widespread pain throughout the body.
- Tenderness and sensitivity to touch
- Fatigue, even after sleeping for a long time.
- Insomnia
- The inability to concentrate or pay attention.
- Joint pain
- Muscle weakness and stiffness
- Migraines and headaches
- Digestive problems, including irritable bowel syndrome (IBS)
Fibromyalgia can be extremely debilitating, but it can also be difficult to diagnose. If you’re a Veteran suffering from fibromyalgia, you may be entitled to disability benefits when you meet specific requirements.
Here’s what you need to know and how Veteran Ratings can assist you in developing your claim.
Fibromyalgia in Veterans
A study on Gulf War Veterans’ health by VA found that 1990-1991 Gulf War deployment is associated with an increased risk for fibromyalgia, Chronic Fatigue Syndrome, skin conditions, and dyspepsia.
Physical trauma, psychological stress, emotional events, or infection may bring on service-related fibromyalgia. Veterans with fibromyalgia may have other related symptoms such as tension headaches, anxiety, depression, TMJ disorders, etc.
More women than men are diagnosed with fibromyalgia. Some healthcare professionals believe that many men with the condition don’t seek treatment for their symptoms or that men who go to the doctor are undiagnosed or misdiagnosed.
How the VA Rates Fibromyalgia
The VA assigns a disability rating based on the severity of a Veteran’s fibromyalgia. To determine a fibromyalgia disability rating, the VA is guided by the Code of Federal Regulations, Title 38, § 4.71a diagnostic code 5025, Disability Ratings for Fibromyalgia.
From this regulation, the VA can assign the following disability ratings:
- 40%: Constant, or nearly so, and not responsive to therapy.
- 20%: Episodic, with symptoms that are present more than one-third of the time, 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.
Disability ratings are cumulative, and Veterans can have more than one-service related condition. The VA combines these conditions into a single rating that cannot exceed 100%. For example, if you receive a rating of 50% for one condition and a fibromyalgia rating of 40%, your VA disability rating will be 90%.
How Is Service Connection Established For Fibromyalgia?
To get VA disability benefits, you must establish a service connection for your fibromyalgia.
Fibromyalgia is a Presumptive Condition for Gulf War Veterans
If you served in the Gulf War and have been diagnosed with fibromyalgia, you do not need to show a connection between fibromyalgia and military service.
The VA presumes that some health conditions, including fibromyalgia, are related to Gulf War service if the Veteran has experienced them for six or more months. The illness must have also appeared during active duty in the Southwest Asia theater of military operations by December 21, 2026, and be at least 10% disabling.
Eligible theaters of operation include:
- Saudi Arabia
- Kuwait
- Iraq
- Oman
- The United Arab Emirates
- The Gulf of Oman
- Qatar
- The Persian Gulf
- Neutral zone between Iraq and Saudi Arabia
- The Gulf of Aden
- The Arabian Sea
- The Red Sea
- Bahrain
That makes the claims and rating process much easier for Veterans who fall into this category.
Many Veterans who served in the Gulf War, Iraq, and Afghanistan were exposed to various toxic substances, including uranium, pesticides, decontamination agents, certain medications, and burn pits that released benzene and dioxin. That exposure makes it highly probable that fibromyalgia has a service-related connection, which is why it is presumptive.
If you’re not a Gulf War Veteran but still have fibromyalgia, you can still file for a disability rating with the VA, but the process is a little more complicated to link your condition in some way 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.
This can be confusing for some Veterans who want to file a claim. To help you better understand what steps to take, we suggest that you schedule a risk-free consultation with Veteran Ratings to get answers to your questions.
Secondary Conditions to Fibromyalgia
Many Veterans find their fibromyalgia leads to debilitating effects in other ways, such as IBS, sleep apnea, insomnia, migraines, chronic fatigue syndrome, and mental health conditions.
The VA recognizes fibromyalgia as a primary condition, so any secondary conditions related to it can also qualify for a disability rating. Combining these ratings can lead to a total overall rating more closely approaching a 100% maximum rating.
Veteran Ratings can help you identify these secondary conditions. Our network of experienced medical professionals can guide Veterans in gathering their necessary documents and medical reviews for the most successful outcome.
How to Get VA Benefits for Fibromyalgia
The first step is obtaining a medical diagnosis for Fibromyalgia and associated secondary conditions.
One hurdle to overcome is that fibromyalgia symptoms are routinely difficult to diagnose. Symptoms resemble those of other diseases, and some healthcare providers don’t undertake proper diagnostic testing for fibromyalgia which is not the case when working through Veteran Ratings.
Our Veteran consulting partners will guide you in gathering your documentation, including all medical records and supporting evidence, that you will submit with your disability claim.
When you work with Veteran Ratings and our consulting partners, you’ll stand the best chance for approval at the highest ratings for your primary fibromyalgia condition and any secondary conditions you apply for.
Frequently Asked Questions About VA Fibromyalgia Rating
Can I receive a VA fibromyalgia rating if I was not diagnosed during my military service?
If you served in the Gulf War and have been diagnosed with fibromyalgia, you do not need to show a connection between fibromyalgia and military service. Otherwise, you’ll need to prove a service connection to give you a chance at approval.
Can I receive a higher VA fibromyalgia rating if my condition worsens?
Yes. Veteran Ratings and our Veteran consulting partners can help with increases by providing guidance on how to submit up-to-date medical evidence that shows your disability has gotten worse.
You can appeal the decision if you receive a denial, but Veteran Ratings does not assist Veterans with this part of the process.
Denials often hinge on the fact that a Veteran hasn’t proven that their fibromyalgia isn’t service-related or they have completed forms and supporting evidence the wrong way. Again, because Veteran Ratings are experts in understanding what the VA wants, this typically does not happen when Veterans work with us as evidenced by our 95% success rate.
How long does it typically take to receive a decision on a VA fibromyalgia claim?
It depends. If you are thorough and complete with your initial disability claim submission, you could get a decision in as little as four months or so. However, if your claim is kicked back to you for more information or you’re denied outright, it could take several more months for adjudication to take place.
This is why working with Veteran Ratings and our Veteran consulting partners is critical to ensure your first submission is as complete as possible.
Can Veterans get disability benefits for fibromyalgia based on “pain alone”?
For purposes of VA disability compensation, pain alone can serve as a functional impairment for fibromyalgia and many other underlying causes. In a 2018 US Court of Appeals case, the court held that a veteran’s pain is a functional impairment that affects a veteran’s earning capacity, regardless of the disease causing the pain or lack of formal diagnosis.
To establish the presence of a disability such as fibromyalgia, a veteran must show that their pain reaches the level of functional impairment of earning capacity.
