Related to fibromyalgia

[invisible]

I just recieved my determination for Fibromyalgia. They listed it as a disability, denied SC, but in the notes listed enviromental hazard. What does this mean? I wasn't expecting to be approved, since at the last moment, my primary PCM declined to fill out the Questionaire. Just wondering if anyone had any insight. Out of all the labs they took, the odd one was the Epstein Barr. I am not sure if that is to confirm, rule out FM... IDK. Thanks in advance for any insight!

fibromyalgia

Not Service Connected

Environmental Hazard in Gulf War

[k5one]

Upload your denial on here, after covering the personal information.  That will give us more to go on, and we may be able to give you more useful advice.  

[Vync]

Relative equipoise should hopefully address the SA vs. Fibro problem with fibro being a presumptive. Being deployed to the gulf and having fibro should be a rubber stamp approval.

[invisible]

I know that the primary reason is because my Primary care MD refused to fill out the DBQ related. The notes he did make were sub-par, which I didn't realize until it was too late. And he stated things like my IBS being managed when I continued to have problems, its just that he said there was nothing really that could be done. He was thorough during appts, I guess he just lacks annotating it in notes. The Rheum MD I saw today believes that it is highly likely I do have fibro but ordered lots of tests to rule out other things before she says it definitively. It is a little complicated because I have SC and established degen. arthritis.  It seems like they (VA) is using my Epstein barr results against me, even though in interpretation, tests just show that I have had mono it in the past. I tested neg to an acute infection, but positive to the parts that point to a past infection and antibodies. It must be convient to use something like mono, which most people have had in their life.

Since this whole debackle, I have decided to make appointments with specialists related to all my issues, and never to assume that they are accurately noting what I complain of or what they say and do in the appointment. I had an ortho and rhuemotogy and am scheduled for an MRI, and just had x-rays done both yesterday and today. It will be documented by the time I appeal.

What does bother me is that I complained about stuff related to muscle and joint pain in the military, fatigue, etc esp to my nurse case manager in the WTU which I know is noted, along with in my MEB evaluation... not to mention physical therapy etc, etc.  I am waiting on getting a new copy of my full medical file, and I will go page by page and make folders for each condition and fill each folder with stuff related to each condition. 

I don't see how a physical examination should be abnormal, when you cannot "see" FM like...say rheum arthritis where there is swelling, but I digress.

Edited November 10, 2015 by invisible

[Vync]

I think your rheumatologist will be able to unscrewup your fibromyalgia denial.

You have a solid grasp on having mono antibodies and an active infection. The C&P exam text would help clarify the C&P doctor's justification of denying, which I assume he attributed to mono. If you had an active infection, I would understand - but not having one should mean approval (in my opinion). Once your rheumatologist finishes ruling everything out and has you officially diagnosed, ask for a statement clarifying the fibro is from gulf service, not from epstein-barr antibodies because you do not test positive for that. Also, his opinion would outweigh that of the generic C&P doctor.

They are pretty much gaming the exclusion criteria for the "there must be no other cause" part...

Eligibility Requirements

• Qualifying undiagnosed illnesses or diagnosable chronic disability patterns, that appeared either during a qualifying period of active service or prior to December 31, 2016, must meet the following conditions:
  • There must be no other cause for your disability or illness than service in the Southwest Asia theater of military operations.
  • your disability existed for 6 months or more, AND
  • If your disability or illness did not appear during active duty in the Southwest Asia theater of military operations, then it must have appeared prior to December 31, 2016, to a degree that is at least 10-percent disabling (for VA rating purposes).

The disability must be one or more of the following:

• Undiagnosed illnesses. These are illnesses that may include but are not limited to: abnormal weight loss, fatigue, cardiovascular disease, muscle and joint pain, headache, menstrual disorders, neurological and psychological problems, skin conditions, respiratory disorders, and sleep disturbances.
• Diagnosable functional gastrointestinal disorders. Functional gastrointestinal disorders are a group of conditions characterized by chronic or recurrent symptoms that are unexplained. These disorders may include but are not limited to irritable bowel syndrome, functional dyspesia, functional vomiting, functional constipation, functional bloating, functional abdominal pain syndrome, and functional dysphagia.
• Diagnosable Chronic Fatigue Syndrome
• Diagnosable Fibromyalgia

 

 

 

 

[Guest]

The crazy one here, there is no known cause for fibromyalgia but there are theories that fibromyalgia is linked to either some types of injuries, some types of infections or some types of severe stress related conditions.  It really does not matter it seems that you fit all the categories.  Due to the fact that you had noted in your SMRs/STRs fatigue, muscle pain, digestive problems, depression, and an infection should be enough for your doctor to diagnose fibromyalgia.  This is just crazy the lack of back bone your PCP chose not to help you.  I will admit when I was in the military I fell and injured my spine and it is well documented in my records but VA denied my claim stating that my spine disorder was acute and not chronic but once again my rheumatologist did a bone scan and found that I was having spasm down my entire spine which can only be seen by injecting a small amount of radioactive dye and then doing a scan. He linked my spine condition to my injury in the military. I was awarded service connection back to my original date of claim.  It appears that you have all the evidence you only need current diagnosis to link your conditions.  The really great thing about fibromyalgia is that all the conditions can be separated and rated individually without pyramiding.  You can claim all of them and that will push you overall combined rating up. They (VA) really p*ssed me off and that is when I started reading 38 CFR part 3 and 4.  My VA rheumatologist told me I should be getting 100% and I didn't have a clue of what he was talking about so I did my research/homework and finally got rated 100% scheduler. Shame on VA they are still playing their games but you have the ammo you need to take then down

Best wishes

[invisible]

Here is what is on ebenefits- blue button, I did complain of pain and flinching, and I have significant crepedation...which was remarked by her first. This is why I refuse to be treated at the VA primarily, I know less is more, most be the directive to VA md's concerning documenting pt's issues. Another thing is that I was told that the appointment was related to FM only, but it was listed as a general gulf war exam. I mentioned IBS, TMJ, all the other stuff and how much of it flares worse together and that was not noted. And I told her that I have a 3.4 right now, but that I am failing a science class right now because its just too much- I am taking A&P 2 which is a super intense course and I am overwhelmed. And that the school I am transfering back to, I had failed chem for the same reason, so the institutional gpa there is worse... I do well in the social sciences where I naturally do well even if I do not open the textbook. I told her I have hardly any energy and do what I can for my kids but beyond that, I sit becuase I hurt and do not have the energy. And that sometimes I either do not go to class or cannot focus due to the discomfort. I copy and pasted the pertinent, and left out labs. She also said that I had no symptoms... but it doesn't surprise me that in one appointment a Rheumy said it is highly likely I have FM, but the VA doc says no, and didn't even do anything near or similar in physical exam to what was done today. The labs taken today were related to arthritis and other rheum conditions and reg blood work- and the VA did epstein barr and reg blood. I swear they do it that way on purpose, or I am just paranoid.

 

Describe the history (including onset and course) of the Veteran's
fibromyalgia condition:
Reports that she has been treated for nerve pain/fibromyalgia.
Medications are Gabapentin Baclofen and Cymbalta, no side effects
from
medication. Diagnosed by her PCP Dr. Sam Peng, private practice.
Stated he has refused to complete the DBQ paperwork because it is to
confusing. Diagnosed 9 months ago. She has no swelling of joints but
feels as though they are swollen, no diagnosis of Epstein Barr virus
or mononucleosis, no history of lyme's disease, thyroid disease
nor
connective tissue disease. She requires no power scooter, crutches,
cane or walker, to aid in walking. States has he has 2 children 2.5
and 4 years, she does what she has to do for them and sit down.
Currently unemployed but is a full-time student, major is occupation
therapy assistant, with plans to transfer back to Georgia Perimeter
College, for Associates degree in Psychology to Currently taking a
full load, no problems with attending class, she has lack of focus
and
energy but she has ADD, GPA 3.2. Pain is located " it is a chain
reaction, lower back and radiates to the hips and buttock to lower
legs, numbness and tingling aggravated by certain positions and
driving for long distances, her neck pain radiating to shoulders,
sensation of knotted rubber bands deep inside, ultimately pain is
described as a shooting and pinching pain in the joints and deep
muscles and knots, pain is 6/10 good day, bad day 8.5-9/10. The
medication does help to provide some relief. When her pain increases

she has other problems with TMJ, IBS and headaches. She does have
sleep apnea, which is allowing her to get more rest.

 

The veteran has claimed a disability pattern of fibromyalgia, associated

with the environmental hazards of South west Asia (Iraq).

Fibromyalgia a diagnosable chronic multi-symptom illness with a partially explained etiology. It is less likely as not

that

the claimed condition, is a disability pattern that is associated with a

specific exposure to Southwest Asia environmental hazards, medical

literature does not provide evidence to support claim.

Service treatment records, document veteran complained of fatigue with

decreased libido, requested Implanon birth control removal. Diagnosis is

absent from DOD records, Altoona and Wilkes Barre Pennsylvania VA

records.

Atlanta VA medical records have no diagnosis or treatment for

fibromyalgia. Highland Rivers progress notes document no initial

assessment of fibromyalgia 8/21/2015; however, on return visit 8/25/2015,

it is documented veteran has stated VA sent her for Cymbalta 30mg, for

fibromyalgia. Fibromyalgia is a diagnosis, after a medical evaluation has

been completed, the records are silent a medical evaluation, to rule

other

disease states. Current labs are normal, except for a positive Epstein

Barr Virus (EBV), which has some co-existing symptoms of fibromyalgia but

transmission is usually through infected saliva. It is less likely as not

the veteran incurred fibromyalgia during active duty service, etiology of

diagnosis is unknown at this time, this is a self-reported diagnosis, no

records were presented from Dr. Sam Peng's office, further comments

would

be speculative.

 

The veteran was able to complete range of motion of her upper and lower

extremities, without complaints of pain, weakness, fatigability, or

incoordination. There are no current range of motion measurements

available during an exacerbation and this examiner has had no contact

with the patient during a flare-up; this provider cannot determine or

accurately estimate the degree of functional loss of this joint without

resorting to mere speculation.