0% for CFS

[Lavish]

From e-benefits and speaking with an American Legion rep, it looks like the VBA has rated me 0% SC for CFS effective 2015.  I thought the ratings for CFS had to be 10, 20, 40, 60, or 100.  As of 2015, I am rated 50% for MDD w/ anxiety, and 40% for Fibro.   As of 2020, I am 100% for MDD w/ anxiety.   They are trying to screw me out of back pay and SMC.   

I did a C&P exam in August for CFS and Gulf War Illness.  I was hoping they would rate me for all of the many other issues that I have since the examiner did DBQs on them, but definitely the headaches, which I was denied for back in May.

I have so many issues that have been documented by the VA.  How can they rate me at 0% for CFS and nothing for GWI?   I know they are trying to lump the fatigue in with the Fibro and MDD, but there are a WHOLE lot of other issues related to CFS that isn't included in the MDD and Fibro award.  I didn't think I would need to file a supplemental again for the headaches and other issues, since the examiner did DQBs for 20 different things - I "thought" VA would list them as secondary to the CFS or something, but I guess that was wishful thinking. 

[Lavish]

On 10/31/2021 at 10:47 PM, pwrslm said:

I think that CFS can be rated under fibrosis, or it may be considered pyramiding. Chronic fatigue is a symptom of fibrosis from what I understand. I would read the decision letter and see if this is what they explain. Zero % would be a correct rating to prevent pyramiding, that is what they did with me 2 times now.

You mean Fibromyalgia, not Fibrosis, right?

[pwrslm]

I did.

 

thanks

[Lavish]

I got my decision for the CFS with the 0% rating, which states the below:

REASONS FOR DECISION

Service connection for chronic fatigue syndrome. Service connection for chronic fatigue syndrome has been established as directly related to military service. (38 CFR 3.303, 38 CFR 3.304)

A noncompensable evaluation is assigned from April 26, 2015, the date VA received your claim. Since you continuously pursued and appealed your claim for benefits the effective date is the date the claim was received. (38 CFR 3.2500 and 38 CFR 3.2501, 38 CFR 3.400)

We have assigned a 0 percent evaluation for your chronic fatigue syndrome based on: • A diagnosed disability with no compensable symptoms

Note: In every instance where the schedule does not provide a zero percent evaluation for a diagnostic code, a zero percent evaluation shall be assigned when the requirements for a compensable evaluation are not met. {38 CFR §4.31}

A higher evaluation of 10 percent is not warranted for chronic fatigue syndrome (CFS) unless the evidence shows:

• Debilitating fatigue, cognitive impairments (such as inability to concentrate, forgetfulness, confusion), or a combination of other signs and symptoms controlled by continuous medication; or

• Debilitating fatigue, cognitive impairments (such as inability to concentrate, forgetfulness, confusion), or a combination of other signs and symptoms which wax and wane but result in periods of incapacitation of at least one but less than two weeks total duration per year. (38 CFR 4.88a, 38 CFR 4.88b)

I'm sure the 0% rating is due to cognitive impairments (such as inability to concentrate, forgetfulness, confusion) is because these are already rated in my MDD disability.  HOWEVER, a Gulf War Medical Exam was also requested with the CFS C&P exam and the Dr. did 20 different DBQs as part of the Gulf War exam, but it doesn't appear that ANY of those were reviewed - even though "General Medical Gulf War" exam is listed in the evidence section.

My concern is that headaches, fatigue, joint pain, sleep disturbances (which DBQs were done on as part of the Gulf War Exam) were not considered - and they aren't listed as part of my MDD disability rating and shouldn't be listed separately from my Fibro rating. 

What do ya'll think?

[El Train]

Well the DBQ for Fibro covers a lot of the same things as CFS if you look at it (headaches, fatigue, joint pain, sleeplessness).  They could lump all those symptoms into your Fibro and MDD rating and probably have.  You got max for Fibro.  If you were to trade your Fibro for CFS, do you think it would be higher than the 40%?  I'll go out on a limb and say 'You will not get rated for both'.  Especially being 100% for a mental condition.  I know how bad you want the CFS.  I did too.  Especially with a diagnosis putting me at the 60% level, but it didn't happen.  I got 100% for a mental condition with TBI & 40% for Fibro.  I'm not putting that in jeopardy. I got 10% for headaches due to the TBI.

Think about what you could loose by trying to gain the CFS rating.   Bottom line, you do you.  Keep us updated.

[Lavish]

46 minutes ago, El Train said:

Well the DBQ for Fibro covers a lot of the same things as CFS if you look at it (headaches, fatigue, joint pain, sleeplessness).  They could lump all those symptoms into your Fibro and MDD rating and probably have.  You got max for Fibro.  If you were to trade your Fibro for CFS, do you think it would be higher than the 40%?  I'll go out on a limb and say 'You will not get rated for both'.  Especially being 100% for a mental condition.  I know how bad you want the CFS.  I did too.  Especially with a diagnosis putting me at the 60% level, but it didn't happen.  I got 100% for a mental condition with TBI & 40% for Fibro.  I'm not putting that in jeopardy. I got 10% for headaches due to the TBI.

Think about what you could loose by trying to gain the CFS rating.   Bottom line, you do you.  Keep us updated.

I'm not even really concerned about the CFS rating - although, I do have both CFS and Fibro, which I know will be hard to rate with the MDD.   However, my main issue is with the headaches that I've had also for over 30 years and have been denied several times.   I feel that the headaches should have been rated since a DBQ was done for them AGAIN under the Gulf War Exam.  But BVA didn't even address the headaches, joint paint, sleep issues, or any of the other DBQs that were done.  I feel they should have at least given a reason for WHY they rated 0% for CFS, other than just saying I'm diagnosed with it without any compensable symptoms - they need to go say HOW they determined no compensable symptoms.  If it's because the other symptoms have been rated under my other disabilities they should say that.  But, they didn't and can't say that because many of the other conditions haven't been rated under my other disabilities. 

[pacmanx1]

1 hour ago, Lavish said:

I feel that the headaches should have been rated since a DBQ was done for them AGAIN under the Gulf War Exam.  But BVA didn't even address the headaches, joint paint, sleep issues, or any of the other DBQs that were done.

Even though you had a Gulf War exam if you did not file a claim for these separate issues the VA/BVA will not necessarily rate them. After my Gulf War Exam, the VA denied my claims and I filed separate claims and then the VA rated and granted my claims for headaches 50%, Sleep Apnea 50%, Fibromyalgia 40%, GERD/IBS 30% and Mood Disorder 30%. The effective dates were not far off so I am not concern about the effective dates other than I have one issue on appeal because I thought/think I should get a better effective date.