Goonie

OK, that's what I thought since they refused to split it out. I didn't want to over-complicate the original post so I'm hoping folks can help me with the next steps related to this. First question, does this mean they shouldn't combine a favorable C&P exam finding for IBS with the fibromyalgia? I read some of the appeals cases and in one the judge was explaining that since the condition was maxed without factoring a secondary condition, the secondary condition should be rated separately. I don't have the exam report yet but I think I got a C&P examiner that was trying to help because he said he was and he told me he put the number of IBS episodes at the highest number the form would allow him to. He also asked why I hadn't submitted for headaches or an increase on my anxiety yet. If it turns out he was being disingenuous it would be terrifying because he seemed so genuinely nice. Service connection should not be an issue, the symptoms are noted in the decision quoted and I had repeated stomach issues in my service record, the IBS is just a lot worse now. Next, question, should I refiled the neck, carpal tunnel, and cubital tunnel secondary to a service connected shoulder issue (right shoulder impingement, 10%)? In my most recent C&P exam the examiner noted that the pain in my arm was likely due to my shoulder and I think that's why I got one of those letters saying, "we invite you to file a supplemental claim for right upper extremity cubital tunnel and carpal tunnel syndrome." The shoulder is also unstable and oddly enough it was my counselor talking to me about exercise that pointed out it may be the source of my neck aggravations. When I told him I strained the hell out of my neck a few times when I was trying to use swimming for exercise he brought up the shoulder and when he explained it (turned out he was a big swimmer, swim team at Ohio State and stuff) his explanation made perfect sense because my shoulder is unstable. When I use my right arm a lot of muscles are trying to compensate for the instability, hence possible neck strain. If there's a chance this could somehow drop my fibromyalgia rating, my overall stiffness and pain has gotten significantly worse in general with pain and tension basically everywhere, so I could include that in my statement in support of claim. Does that make sense? Any significant risk in filing? I have a supplemental claim pending with IBS and some other issues, might get bumped to 100% (the IBS might be the ringer) as is, but I feel like should go ahead and file the neck/cubital tunnel/carpal tunnel claim. Would having additional conditions above and beyond the 95% make the VA more likely to declare it P&T? Thank you so much for responses so far!

I've also posted this over at PEB forums and I'd really like to get a clear answer because I think understanding what they mean in how this is written will be very helpful. So this is reproduced verbatim in text and format from a 2012 decision letter based on only my service records. In the heading, it says "(to include claim of neck condition...)," does that mean the neck condition could be rated at some % but they combined it or subsumed it with fibromyalgia to raise that rating to 40% and avoid pyramiding? What about the things listed under "Additional symptom(s) include:"? Were the combined somehow or are they just noting other symptoms? Thank you in advance!