What Do I Have To Do To Get The 40% Cap On Fibromyalgia Increased To 100%?

[fuzzywhitt]

What can I do to get the 40% cap on Fibromyalgia increased to 100%?

[luvHIM]

What can I do to get the 40% cap on Fibromyalgia increased to 100%?

I have an established diagnosis of Fibromyalgia as secondary to Ankylosing Spondylitis. But, in answer to your question, I filed all of the manifested conditions diagnosed and treated to date as secondary to the Fibromyalgia separately because they can all be rated separately (e.g., migraine/tension headaches; chronic fatigue syndrome, irratible bowel syndrome, etc.) The thing is your doctor needs to also show the conditions as separately manifested but "due to" the Fibromyalgia.

The only two conditions that appear in my SMR's and VAMR that I have not filed a claim on is anxiety/depression "due to" (as stated in my VAMR) chronic pain. I will wait on the decision for the pending claim and appeal before I consider filing a claim.

Hope this helps some because, unfortunately, the VBA regs are what they are. I know the cap for Fibromyalgia is 40% and there is no other way to get an increase to 100% without filing a claim for other manifested conditions secondary to the Fibromyalgia.

Others may have something different to say, hopefully someone else will respond to your thread.

[Pete53]

You have to ask and the Fibro must keep you from holding a job. Since you already are 40% you should be on your way.

[fuzzywhitt]

I have tried to claim IBS, headaches, bilateral shoulder, hips, and knee bursitis as separate and distinct from Fibromyalgia...I was told by the person deciding my claim, that under their regs..they can not separate them. I want to know how to change their regs. Do I go to my Congressman or Senator or what? Who writes the regs?

[luvHIM]

I have tried to claim IBS, headaches, bilateral shoulder, hips, and knee bursitis as separate and distinct from Fibromyalgia...I was told by the person deciding my claim, that under their regs..they can not separate them. I want to know how to change their regs. Do I go to my Congressman or Senator or what? Who writes the regs?

The following link is from the BVA archives for 2007 and this is an example of a denial, which also ties into what Pete53 indicated regarding your ability to work or not:

www.va.gov/vetapp07/files3/0720397.txt

The following link relates to a claim that granted migraine headaches as secondary to Fibromyalgia and tension headaches:

www.va.gov/vetapp07/files1/0708498.txt

I am presuming that your other noted conditions are "diagnosed conditions" and that you are currently being treated for them...is this correct? If I am correct in my presumption, what reasoning did the VA give for denying those claims on a separate basis?

It is obvious that not all claims are adjudicated the same way because if you read through the BVA cases (just to get some idea of how claims are being awarded and what causes them to be denied), some are awarded and some are not.

Have you requested or filed a claim for an extrascheduler review for increased rating?

I hope there are others with this condition that can be of more help to you. My Fibromyalgia condition, as I already stated, is secondary. But I still requested a rating of 40% (or maximum for Fibromyalgia).

[fuzzywhitt]

the headaches, depression, and IBS are all symptoms of Fibromyalgia..Therefore, will not be rated separately, but will be included with my Fibromyalgia rating. The bilateral bursitis is part of the muskuloskeletal system and can't be separated, but is included with the Fibromyalgia rating. I was scheduled for a BVA hearing before a Judge, to see if they could separate the bursitis, since I had at least four doctors tell me that bursitis is separate and distinct and has nothing to do with Fibromyalgia. I was told that the DRO looked up the regs and that the Judge would not be able to separate the conditions, the way the regs are written.

Fibromyalgia is now recognized world wide as a potentially totally debilitating condition. That is why, I want to find out how to get the 40% increased.

Thank you for your comments.

[john999]

If you have major depression due to chronic pain disorder that disables you from work that should get you TDIU. Fibro is not a mental disorder. This really sounds like some cute BS from the VA.