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Denied Fibro Because Of Joint Pain

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Draggin'

Question

I have been denied fibromyalgia by the DRO because:

  • "You noted a complaint of pain in various joints, however, you were show to have specific diagnoses related to these complaints to include bilateral ankle sprains, bilateral plantar fascitis, bilateral wrist tendonitis, bilateral shoulder strains, bilateral patellofemoral syndrome of the knees, right foot first metatarsal degenerative joint disease and talonavicular degenerative changes of the left foot."

Not that they found me service connected for all of these little diagnosis...but anyway...

My argument (below) is that fibromyalgia has more symptoms than joint pain. If awarded...What are the odds of them trying to lump in already awarded things that could be associated with fibro For example:

Right ankle sprain 10% (see above considered joint pain)

Left knee patellofemoral syndrome 10% (considered joint pain)

Right Shoulder Strain 10% (considered joint pain)

Lumbosacral Strain 10%

Migraines 0% - I'm willing to throw this one in under fibro

(By the way I am most likely appealing the amounts on all of these as well-separate from fibro.)

Here's my argument:

Although there is an explainable diagnosis for joint pains. There is still a plentiful amount of unexplained widespread pain and other symptoms of fibromyalgia that have existed for six months or more.

The medical documentation will show complaints of fibromyalgia symptoms, including:

Unexplained weight gain or loss

Headaches & migraines

Back pain

Vision changes, including rapidly worsening vision

Morning stiffness

Diffuse swelling

Fatigue

Sleep starts (falling sensations)

Twitchy muscles at night

Restless Leg Syndrome

Teeth grinding (bruxism)

Loss of libido

Chronic neck pain from stiffness & excessively tight neck muscles

Pain in both legs including muscle cramping, aching and stiffness

Bloating & nausea

Abdominal cramps

Irritable bowel syndrome

Poor balance and coordination

Hemorrhoids

Also personal documentation will confirm the following:

Sensitivity to odors

Cravings for carbohydrate and chocolate

Directional disorientation

Thanks Draggin'

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My wife has it too, and I tell you, she has to take pills to go asleep and take pills to get up out of bed. Not to mention the other dozen pills she takes during the day! I was wondering Draggin if you have sleep apnea? Her Dr say's that it's also caused by fibromyalgia. She has to wear the CPAP machine. It's like being married to a person with alzheimers. She's very bad with memories. So yes Draggin your right, there is alot more to it than just pain!

!!!BROKEN ARROW!!!

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No Pete, I have not been diagnosed. I'm going to see Rheumatologist or Neurologist or something. Nothing when it comes to records or actual treatment will progress until I do. Last the doctor checked, there was no reason for my back pain, and I was sent away for 6 months.. To the specialists it is. Sure sounds good though. Although I know sounds good means nothing without an actual condition.

You partly answered my question in someone else's post. Where you said that fibromyalgia "is a multi-symptom disorder and each condition can be rated separately." You also mentioned that it's hard to diagnose.

I sort of felt teased by the DRO's mention of maybe having fibro, but then not because my joint pain was explained. So I thought, well, what about all of this other stuff. What would they say to all of that? "Oh we didn't think about all of that, OK percentage granted"...or...Laugh and say I have not been diagnosed? or schedule an actual C&P exam?

Feel free to laugh along, I'll consider it laughing with me.

If I appeal with this, and a diagnosis does not come by the time of my hearing...will anything bad happen besides a denial?

Thanks

Draggin

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I'm not trying to be a pain...I am a bit confused by something the VA says concerning presumptive conditions. I do understand that they presume that a condition will be considered service connected, not necessarily that they will presume you have the condition. I see that they say "diagnosed" in the first sentence...

But later one under Gulf War Veterans the VA mentions "Undiagnosed Illness" a couple of times. I do see where they say medically unexplained. I can take undiagnosed to mean either undiagnosed or not medically explained. Couldn't the inclusion of the word "undiagnosed" negate the need to have a diagnosis in order to be awarded?

  • VA presumes that specific disabilities diagnosed in certain veterans were caused by their military service. VA does this because of the unique circumstances of their military service. If one of these conditions is diagnosed in a veteran in one of these groups, VA presumes that the circumstances of his/her service caused the condition, and disability compensation can be awarded.
    Later it says

    • Gulf War Veterans (Undiagnosed Illness)
    • Served in the Southwest Asia Theater of Operations during the Gulf War with condition at least 10 percent disabling by 12/31/11. Included are medically unexplained chronic multi-symptom illnesses defined by a cluster of signs or symptoms that have existed for six months or more, such as:
    • · chronic fatigue syndrome
    • · fibromyalgia
    • · irritable bowel syndrome
    • · any diagnosed or undiagnosed illness that the Secretary of Veterans Affairs determines warrants a presumption of service connection
    • Signs or symptoms of an undiagnosed illness include: fatigue, skin symptoms, headaches, muscle pain, joint pain, neurological symptoms, respiratory symptoms, sleep disturbance, GI symptoms, cardiovascular symptoms, weight loss, menstrual disorders

Am I grasping at straws or does this mean something?

Draggin'

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My wife has it too, and I tell you, she has to take pills to go asleep and take pills to get up out of bed. Not to mention the other dozen pills she takes during the day! I was wondering Draggin if you have sleep apnea? Her Dr say's that it's also caused by fibromyalgia. She has to wear the CPAP machine. It's like being married to a person with alzheimers. She's very bad with memories. So yes Draggin your right, there is alot more to it than just pain!

Sorry to hear about your wife's condition.

I do believe I have sleep apnea. Unfortunately, the sleep doctor/clinic was incredibly backed up and could not get me in for a sleep study for 12 months. They never did schedule one. The sleep doctor I see at the VA is a problem for me, he's very frank and uses scare tactics, he's just a creepy and uncomfortable person to be around. Trying to find away around seeing him. Wife says I stop breathing every once in a while. This has been reported to the doctors.

I have insomnia. And once asleep I always have a hard time waking up, period. If they had a way to help me with that, it would be amazing! I recently missed too much college and assignments, GI BILL is at risk...not sure what to do.

Draggin'

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Draggin,

Yes I know this will be a play on words but this is the game veterans have to play with VA. You will need fribromyalgia diagnosed, it could be diagnosed as fibromyalgia or it could be diagnosed as an undiagnosed fibromyalgia or diagnosed as fibromyalgia with no specific etiology. The bottom line is a doctor must say that you have this condition.

In reference to your sleep study, I suggest that you ask the sleep clinic or your (PCP) Primary Care Provider for an in-home sleep study where they will mail you the equipment and it records your sleep for several days and then you mail it back to the sleep clinic.

Hope the best

Edited by pete992
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