Fibromyalgia
Widespread musculoskeletal pain with tender points, often with fatigue, sleep problems, and stiffness. VA rates it 10, 20, or 40 percent based on how constant the symptoms are and whether they respond to treatment.
Presumptive condition — Gulf War Illness (38 CFR 3.317) - Southwest Asia service
Fibromyalgia is one of the named medically unexplained chronic multisymptom illnesses presumed service-connected for veterans with qualifying service in the Southwest Asia theater of operations (Gulf War era), if it manifests to at least 10 percent.
How the VA rates it
Rated under DC 5025 on 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. Widespread means pain on both left and right sides, above and below the waist, affecting both the axial skeleton (neck, chest, spine, low back) and the extremities. The maximum schedular rating is 40 percent, reserved for symptoms that are constant or nearly constant and refractory to (not helped by) therapy.
Rating criteria by percentage
Rated up to 40%Symptoms that are constant, or nearly so, and refractory to therapy.
Symptoms that are episodic, often triggered by environmental or emotional stress or overexertion, present more than one-third of the time.
Symptoms that require continuous medication for control.
Secondary condition strategy
Commonly claimed secondary to this
Conditions veterans often develop from this one — each can be its own rating under 38 CFR 3.310.
- Major Depressive Disorder — Depression frequently accompanies fibromyalgia; a separate rating requires a distinct diagnosis with symptoms beyond those already counted in the 5025 rating.
- Irritable Bowel Syndrome — IBS commonly co-occurs and is separately ratable when independently diagnosed, though IBS-type symptoms are also listed within the fibromyalgia criteria (watch for double-counting).
- Migraines — Chronic headaches co-occur with fibromyalgia and can be rated separately when diagnosed as migraine with distinct prostrating attacks.
This is often secondary to
If you already have one of these service-connected, it may support connecting this condition.
- PTSD — Some veterans successfully claim fibromyalgia as aggravated by or secondary to PTSD given the recognized link between chronic stress physiology and central pain sensitization; medical nexus opinion is essential.
Evidence that strengthens this claim
- Get a formal fibromyalgia diagnosis (rheumatology is ideal) documenting widespread pain and tender points; vague chronic pain notes are often rated lower or denied.
- Show treatment resistance: records of medications, physical therapy, and other treatments tried and failed are what separate 40 percent from 20 percent.
- Gulf War veterans: highlight Southwest Asia service dates in the claim; fibromyalgia is presumptive under 38 CFR 3.317 and does not require an in-service diagnosis.
- Keep a symptom diary showing how often symptoms are present; present more than one-third of the time is the 20 percent threshold.
Rating rules to know
The 5025 rating already accounts for associated fatigue, sleep disturbance, headache, IBS symptoms, depression, and anxiety, so separately rating those same symptoms is pyramiding. Separate ratings require distinct diagnoses with symptoms beyond those compensated under 5025.
Related diagnostic codes
More musculoskeletal conditions
Lumbosacral Strain (Low Back Strain)
Chronic strain of the low back muscles and ligaments, one of the most commonly claimed VA disabilities. VA rates it on how far you can bend and move your low back, not on how much it hurts.
Rated up to 100%
Limitation of Knee Flexion
The most commonly rated knee disability: how far you can bend the knee. Ratings run 0 to 30 percent based on measured flexion, with a 10 percent floor for a painful knee under the painful-motion rule.
Rated up to 30%
Degenerative Arthritis (Osteoarthritis)
Wear-and-tear arthritis confirmed by X-ray. VA rates it through the motion limits of each affected joint, with a 10 percent floor for a painful arthritic joint even when motion is nearly normal.
Rated up to 20%
Cervical Strain (Neck Strain)
Chronic strain of the neck muscles and ligaments. VA rates it on how far you can move your neck under the same spine formula used for the low back, with neck-specific degree thresholds.
Rated up to 100%
Degenerative Disc Disease (DDD)
Wear-and-tear breakdown of the spinal discs and joints, in the low back or neck. VA rates it on measured spinal motion under the same formula used for back and neck strain.
Rated up to 100%
Plantar Fasciitis
Inflammation of the tissue band supporting the arch, causing heel and arch pain. VA gave it its own diagnostic code in 2021, rated 10 to 30 percent based mainly on whether treatment provides relief.
Rated up to 40%
Disclaimer: Valor Rating is not affiliated with the U.S. Department of Veterans Affairs. This content is for educational purposes only and does not constitute legal or medical advice. Always review your documents carefully before submitting to the VA. For official guidance, consult an accredited VSO, claims agent, or attorney.