Fibromyositis
Fibromyositis is a VA-ratable condition under diagnostic code 5025 in the Musculoskeletal Diseases category. Maximum rating: 40%.
Rating Criteria
| Rating | Criteria |
|---|---|
| 40% | 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 |
| 20% | 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 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% | 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 require continuous medication for control |
Important Notes
Fibromyalgia (DC 5025) is characterized by widespread musculoskeletal pain and tender points. Associated symptoms may include: fatigue, sleep disturbance, stiffness, paresthesias (tingling/numbness), headache, irritable bowel symptoms, depression, anxiety, or Raynaud's-like symptoms (cold sensitivity in extremities). 'Refractory to therapy' means symptoms persist despite continuous treatment including medication, physical therapy, or other therapeutic interventions. The 40% rating requires symptoms to be constant or nearly constant AND unresponsive to treatment.
Filing Tips
Pro Tip: The VA won't connect the dots for you. That's your job. Build the paper trail before you file.
Gather medical evidence showing a current diagnosis of this condition.
Document in-service events, injuries, or exposures that caused or aggravated this condition.
Consider a nexus letter from a medical professional linking your condition to service.
Review the rating criteria for DC 5025 to understand what symptoms warrant higher ratings.
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