Fibromyalgia Flare-Up

[desertstorm]

I haven't posted in a while but I would like to ask a question. I am currently service connected for fibromyalgia at 20% and irritable bowel syndrome at 10%. I have filed for a NOD for both conditions which is currently with the DRO at the Regional Office in St. Pete, Tampa. I had a terrible flare-up of fibromyalgia and had to go to the emergency room two days May 5th and 6th. Today I called the 1-800 number and told the representative that I wanted the emergency room notes to be submitted as new evidence in support of my NOD. I also have had to go to the emergency room for fibromyalgia other times throughout the appeal process. My question is, if I have continued to have flare-ups and the current medication I am taking for fibromyalgia is not helping, will this warrant an increase in percentage? They lowballed me from the beginning because I met the medical requirements for a 40% rating. I'm wondering if they will send me to have another C & P exam. Any thoughts or comments are appreciated.

[Berta]

This is the way VA rates fibro and you should send(with proof of mailing) using a 21-4148 as a cover sheet to explain what evidence is enclosed and refer them to their decision date and to your NOD-

copies of Anything that could help warrant the higher rating.

“Fibromyalgia with 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 requires

continuous medication for control warrants a 10 percent rating.

When the symptoms of fibromyalgia are episodic, with the

exacerbations often precipitated by environmental or emotional

stress or by overexertion, but are present more than one-third of

the time, a 20 percent rating is assigned.

A 40 percent rating,

the maximum rating available for fibromyalgia under Diagnostic

Code 5025, is warranted when fibromyalgia is constant, or nearly

so, and refractory to therapy. "Widespread pain" means pain in

both the left and right sides of the body that is both above and

below the waist, and that affects both axial skeleton (i.e.,

cervical spine, anterior chest, thoracic spine, or low back) and

the extremities. 38 C.F.R. § 4.71a, Diagnostic Code 5025.

http://www.va.gov/vetapp10/files4/1038171.txt