Jump to content
Using an Ad Blocker? Consider adding HadIt.com as an exception. Hadit.com is funded through advertising, ad free memberships, contributions and out of pocket. ×
  • 0

Possible Nod - Questions Fibromyalgia


onrope
This thread is over 365 days old and has been closed.

Please post your question as a New Topic by clicking this link and choosing which forum to post in.

For almost everything you are going to want to post in VA Claims Research.

If this is your first time posting. Take a moment and read our Guidelines. It will inform you of what is and isn't acceptable and tips on getting your questions answered. 

 

Remember, everyone who comes here is a volunteer. At one point, they went to the forums looking for information. They liked it here and decided to stay and help other veterans. They share their personal experience, providing links to the law and reference materials and support because working on your claim can be exhausting and beyond frustrating. 

 

This thread may still provide value to you and is worth at least skimming through the responses to see if any of them answer your question. Knowledge Is Power, and there is a lot of knowledge in older threads.

 

spacer.png

Question

I just posted my success story in that forum. To recap, I have been awarded 80% total.

I was granted 0% for Fibro. Reason is this as stated on my award letter.

We have assigned a non-compensable evaluation for your fibromyalgia, claimed as joint pain based on: Widespread musculoskeletal pain.

Widespread pain means pain in both left and right sides of the body, that is both above and below the waist, and that effects both the axial skeleton and the extremities.

A higher evaluation of 10 percent is not warranted unless the evidence shows *Widespread musculoskeletal pain and tender points, with or without associated fatigue, sleep disturbance, stiffness, paresthesias, headache, irritable bowel symptoms, depression, anxiety or Raynauds like symptoms that require medication for control.

I have complained of all the problems to my PCP and the C&P doctor (who was actually a PA not a doctor.) My DBQ for the fibro has been attached to make the reading of this post easier. The only issue I can se is that the reason I was only granted 0% was because I wasn't receiving treatment or therapy for it. Reason I have not received therapy is that no one would diagnose me with anything. I am pasting this portion.

b. Is continuous medication required for control of fibromyalgia symptoms?
[ ] Yes [X] No
c. Is the Veteran currently undergoing treatment for this condition?
[ ] Yes [X] No
d. Are the Veteran's fibromyalgia symptoms refractory to therapy?
[ ] Yes [X] No
3. Findings, signs and symptoms
-------------------------------
Does the Veteran currently have any findings, signs or symptoms attributable
to fibromyalgia?
[X] Yes [ ] No
a. Findings, signs and symptoms (check all that apply):
[X] Widespread musculoskeletal pain
b. Frequency of fibromyalgia symptoms (check all that apply):
[X] Present more than one-third of the time
c. Does the Veteran have tender points (trigger points) for pain present?
[X] Yes [ ] No
[X] All bilaterally
Thoughts?...suggestions?

fibro DBQ.txt

Link to comment
Share on other sites

2 answers to this question

Recommended Posts

  • 0
  • Content Curator/HadIt.com Elder

Hiya Onrope,

In my opinion, you should have received a 20% rating. The "criteria for 10%" quoted by the VA is just a basic description of fibromyalgia itself quoted directly from 5025 (below).

Look at the areas highlighted in BOLD below:

§4.71a Schedule of ratings—musculoskeletal system

5025 Fibromyalgia (fibrositis, primary fibromyalgia syndrome)
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 are constant, or nearly so, and refractory to therapy 40
That are episodic, with exacerbations often precipitated by environmental or emotional stress or by overexertion, but that are present more than one-third of the time 20
That require continuous medication for control 10
Note: 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 the axial skeleton (i.e., cervical spine, anterior chest, thoracic spine, or low back) and the extremities.

Your DBQ has this checked:

b. Frequency of fibromyalgia symptoms (check all that apply):

[X] Present more than one-third of the time

The Medical History section of your attached DBQ mentions:

"It comes and goes, there is no pattern to it"
-- episodic


"When I try to do any exercise like running or anything I makes me scream in pain"
-- overexertion

Because this was very recent, I recommend filing a reconsideration. If they drag their feet and the reconsideration timer starts running out, you should file an NOD.

Keep in mind that a potential future rating increase to 40% means that it is near constant "and" refractory to therapy. Refractory basically means that whatever therapy has been tried does not work.

One more thing... Because the VA rater messed up this rating, it is possible that they might have messed up other ratings. Look over your award letter and carefully compare it with the rating criteria.

Good luck!

  • Like 1
Link to comment
Share on other sites

  • 0

Thanks for the reply.

Because this was very recent, I recommend filing a reconsideration. If they drag their feet and the reconsideration timer starts running out, you should file an NOD

Keep in mind that a potential future rating increase to 40% means that it is near constant "and" refractory to therapy. Refractory basically means that whatever therapy has been tried does not work.

One more thing... Because the VA rater messed up this rating, it is possible that they might have messed up other ratings. Look over your award letter and carefully compare it with the rating criteria.

Good luck!

I thought the same. But I also realize I have just been DX'd with the issue and need to participate in therapy in order to determine the full gravity of this disability. It's been very debilitating but was attributed by my PCP to age. It'll be good to move forward with treatment.

As you stated about the other ratings. I was denied for contentions of headaches. I will post the DBQ when I get to a computer. But the reason was because there was no history in my SMR and no presumptive condition was mentioned.

My fear is that a 20% rating from a monetary standpoint does nothing for me. My other fear is what if a mistake was made for my other positive ratings and I get reduced.

So I am real worried as what I should do anything or just be satisfied with my outcome.

Edited by onrope
Link to comment
Share on other sites

  • veterans-crisis-line.jpg
    The Veterans Crisis Line can help even if you’re not enrolled in VA benefits or health care.

    CHAT NOW

  • Advertisemnt

  • question-001.jpegLooking for Answers? Here are tips for finding the answers you seek.

     

    All VA Claims questions should be posted on our forums. To post, you must register. Registration is free. You can register for a free account here.

     

    You can read the forums without registering.

     

    Tips on posting on the forums.
     

    1. Post a clear title like ‘Need help preparing PTSD claim’ or “VA med center won’t schedule my surgery” instead of ‘I have a question.
    2. Knowledgeable people who don’t have time to read all posts may skip yours if your need isn’t clear in the title. I don’t read all posts every login and will gravitate towards those I have more info on.
    3. Use paragraphs instead of one massive, rambling introduction or story. Again – You want to make it easy for others to help. If your question is buried in a monster paragraph, there are fewer who will investigate to dig it out.

     

    Leading to:

     

    Post straightforward questions and then post background information.

     

    Examples:
     
    • A. I was previously denied for apnea – Should I refile a claim?
      • Adding Background information in your post will help members understand what information you are looking for so they can assist you in finding it.
    • I was diagnosed with apnea in service and received a CPAP machine, but the claim was denied in 2008. Should I refile?
       
    • B. I may have PTSD- how can I be sure?
      • See how the details below give us a better understanding of what you’re claiming.
        • I was involved in a traumatic incident on base in 1974 and have had nightmares ever since, but I did not go to mental health while enlisted. How can I get help?

     

    This gives members a starting point to ask clarifying questions like “Can you post the Reasons for Denial from your claim?” etc.

     

    Note:

     

    • Your first posts on the board may be delayed before they appear as they are reviewed.
    • This process does not take long.
    • Your first posts on the board may be delayed before they appear as they are reviewed. The review requirement will usually be removed by the 6th post. However, we reserve the right to keep anyone on moderator preview.
    • This process allows us to remove spam and other junk posts before hitting the board. We want to keep the focus on VA Claims, and this helps us do that.
  • Most Common VA Disabilities Claimed for Compensation:   

    tinnitus-005.pngptsd-005.pnglumbosacral-005.pngscars-005.pnglimitation-flexion-knee-005.pngdiabetes-005.pnglimitation-motion-ankle-005.pngparalysis-005.pngdegenerative-arthitis-spine-005.pngtbi-traumatic-brain-injury-005.png

  • Advertisemnt

  • VA Watchdog

  • Advertisemnt

  • Ads

  • Can a 100 percent Disabled Veteran Work and Earn an Income?

    employment 2.jpeg

    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

×
×
  • Create New...

Important Information

{terms] and Guidelines

<——>