ptsd "fibromyalgia" Secondary Claims Or Not? Headaches, Ibs, Sleep Disturbance

[BlastDaddy]

Could anyone tell me what could be considered a secondary claim for a diagnosis of Fibromyalgia?

OR, Should these be stand alone claims?

I am 40% for Fibromyalgia and was considering filing a secondary claim.

PTSD 50%

Tinnitus 10%

Currently 70%

NOD still pending.

My S&W DR. say's my insomnia,IBS and headaches could be from fibromyalgia. The VA has scheduled me for a sleep study for the sleep disturbances.

As far as the headaches I have two ways to pursue them. Although I did not complain while on active service I did have them annotated on my out-processing physical. I have also been treated for the from the VA. They prescribe both Samaritan for the onset of migraines and Topiramate twice daily for headaches. The S&W doctor also says the fibromyalgia could cause the headaches. But this is also a presumptive illness/ undiagnosed illness.

IBS, Irritable Bowl Syndrome. Is it a stand alone or considered under the fibromyalgia initial diagnosis? Could I claim it under the SWA presumptive illness since they have diagnosed me with it and treat me with medications for it.

Dadgumit.. I don't know. I have all these and was told to get on here and check with the forum. My VSO said I would be pyramiding and could not do it but after reading I have mixed reviews and have looked for a new VSO.

Lets start here.

[Vync]

Fibromyalgia

Remember that Fibromyalgia is a diagnosis of exclusion. Lots of symptoms, but no exact cause. Diagnosis fibro.

A sleep study is a definite next step. I can tell you this from personal experience. I was sent for a sleep study and they found that the CPAP machine not only relieved my sleep apnea, but it also reduced (not eliminate) symptoms associated with my fibro. I recall my doc saying that there is an alpha wave pattern that is present in some patients who have fibro, but goes away when they are on CPAP or BIPAP. It might not be the same situation for everyone. If you can keep the mask on all night, it might help.

Although I am not SC for fibro or insomnia, I am SC for migraines and IBS. My SC for both of those is actually secondary to my SC TMJ pain, so I can't tell you if they could be related to fibro.

Headaches/Migraines

Having headaches marked on your exit physical helps, but having actual treatment records showing a headache as part of the complaint actually helps more. Were you treated by a physician for the condition within 12 months leaving the service, even by the VA? If you are, the medical records can really help your claim. The 12 month window after leaving active duty is a key presumptive period. Please keep in mind that that topiramate can have some funky side effects. I took it for a few weeks and it completely jacked up my sense of taste. That doesn't happen to everyone, but if it happened to you that would be the first thing I would consider.

IBS

If the conditions are part of the SWA presumptives and you have them, definitely file claims for them. I believe IBS is in that list.

Pyramiding

It depends on the diagnostic code and the actual problem. I was initially awarded separate claims for GERD and constipation. Years later I had a DRO request in and they actually 'corrected' my claim and merged the two together under the pyramiding rule, but i ended up with a higher percentage due to increased severity of my symptoms. I am not sure how fibro could be considered pyramiding because it can actually impact every system and muscle. It would seem unfair to have fibro treated as a wildcard pyramiding factor. Definitely keep researching this. You can also go to the VA web site and search BVA appeals. It is a tricky search process, but you could see if other people had the same problem and how they ended up being rated. It might take a lot of time, but is very much worth it. There is no guarantee that you will end up with the same results, but it gives you an idea of the possibilities.

VSO
Regardless of VSO, you are ultimately responsible for your claim. No VSO is perfect. One person could have great luck with a specific VSO and others have horrible luck. I was with DAV and got great advice until my rep retired. I also was with my state/county VSOs and got mixed results. They told me I could not win a specific claim, but I actually did. I showed them my results and they asked how I won. I told them I did a lot of research and had a lot of help from the great folks at the Hadit web site.

IMO Jargon
From what you wrote, you said the doc mentions that the fibro 'could' cause headaches. The VA sees the word 'could', by itself, like it does 'possible', 'probably', or 'might', which usually means means game over. I had one doc who said my condition possibly is secondary to another SC condition. I asked them if they believed it was a 50/50 chance. They said yes. I then asked them respectfully if they could document it in my records using specific jargon. I showed them copies of my specific treatment records (from the Army, VA, and other docs) that had key details highlighted to save time. They wrote that they reviewed the records from the Army, VA, and other named docs dated (whatever date) and felt that my (secondary condition) was 50%/50% as least as likely as not caused by my (primary condition). The doc could not say with 100% scientific medical certainty, but felt comfortable with the 50/50 chance because it 'could' be related and it didn't leave him feeling pressured. The key is sometimes having your doc merely phrase things in jargon the VA recognizes. It is not a guarantee, but can really help.

Sleep Apnea/Insomnia

If your sleep study diagnosis includes sleep apnea, it might be worth considering filing for sleep apnea secondary to PTSD. You might need help from your PTSD doctor. Many, but not all, people with sleep apnea tend to be on the heavy side. Keep in mind that I have SA, but am not heavy, but when anxiety strikes I eat anything in sight. Eating and gaining weight can linked to anxiety/PTSD. It could be a long shot, but the rating for sleep apnea with CPAP is a single 50% rating. Claiming insomnia secondary to PTSD might be a option because all that stress and anxiety that you are enduring is likely to be easily attributed to many sleepless nights. Keep in mind that sleep apnea and insomnia would likely be considered pyramiding by the VA, but they would at grant you the higher percentage of the two conditions.

NOD

You don't have to tell us, but I assume your NOD is for being lowballed on one of your ratings or for an unlisted condition that the VA denied. If you are trying to get a higher rating for tinnitus, it probably won't happen because the VA caps that condition at 10%.

Your Combined Rating
50% + 40% + 10% comes out to 73% according to the Service Connected Disabilities Calculator here on hadit. I noticed that you show your rating at 70%. Let's presume that you do file for IBS under the SWA presumptive and get approved for an additional 10% rating. Your new rating 50% + 40% + 10% + 10% would come out to 75.7%, which would round up and give you an 80% rating. I would recommend you seriously consider filing, at least for IBS.

I hope this information helps you out. Keep in mind that I am not an expert, but am trying to help answer your questions and give some examples of what I have encountered. I wish you the best of luck with your claims.

[BlastDaddy]

Vync,

I plan on filing I just don't know how I'm going to file. IBS will be a stand alone it looks like. The sleep disorder will depend on the results of my study after I spend the night and have the test done.

As far as the NOD, No it's not on the tinnitus. It's on the PTSD. I guess I should be grateful I received 50% permanent with no chance of remission. But my VSO and I felt different. Even afterwards I spiraled downhill with two suicide attempts and hospitalizations. I'm doing much better now with proper treatment and medications and constant care.

Within time I will file for my TDIU. Right now I can't due to the company I'm with has me in a position that allows me to show when I want. My position is a self made one. This is due to I'm part of a profit share company. I will have to sell out my shares to be unemployed.

[Vync]

You probably have quite a number of medical treatment records. What I recommend you do is go through them and look for anything that can help contribute to each specific claim. Don't forget that if you are given medications to treat a SC condition, it is possible to get the side effects of those meds SC if they rise to a 10% level. Keep in mind that a lot of the psychotropic medications you might be given for treatment of mental health conditions can have some rather odd side effects.

From what you indicated, you likely need to be higher than 50%.

Check with your VSO about the TDIU. In your condition you could probably go for extended periods without actually being able to legitimately work. Not sure how the VA would view profit sharing type employment.

[mariajohnson]

According to a recent study women who complained of sleep problems were at an increased risk of developing fibromyalgia than women who didn’t have sleep issues. According to the researchers, chances of a woman to acquire fibromyalgia increases with age and severity of sleep problems. It established a profound association between sleep problems and fibromyalgia.

[augoldminer]

"Remember that Fibromyalgia is a diagnosis of exclusion. Lots of symptoms, but no exact cause. Diagnosis fibro."

Research is showing that as many as 45% of people DXed with fibro really have small fiber polyneuropathy.

You need to be tested for small fiber polyneuropathy.

If you have small fiber polyneuropathy you will be treated better as its a disorder tht can be proved.

Many doctors do not really believe in fibro even VA doctors.

And none of the test done by the VA to DX fibro will show small fiber polyneuropathy.

There are only two main test for SFPN.

One is a skin punch test.

And the other a simple eye test know as corneal confocal microscopy,

http://www.technologythejournal.com/news/breaking-news-04.pdf

[63SIERRA]

I was told by a rater that the VA is looking alot more closely at sleep disturbances and fibro having connections