Fibromyalgia is rated as a single condition based on how constant and treatment-resistant the widespread pain and associated symptoms are, not on a joint-by-joint basis.
Common Filing Mistake
Because fibromyalgia symptoms overlap heavily with depression, anxiety, and IBS, it's sometimes claimed as several separate conditions instead of one fibromyalgia claim, which can lead to confusing, conflicting evidence rather than one clear, well-supported claim.
Diagnostic Codes
- DC 5025Fibromyalgia (fibrositis, primary fibromyalgia syndrome)
Rating Criteria
| Rating | Criteria |
|---|
| 40% | Symptoms that are constant, or nearly so, and refractory (resistant) to therapy |
| 20% | Symptoms that are episodic, with exacerbations often triggered by environmental or emotional stress or overexertion, present more than one-third of the time |
| 10% | Symptoms that require continuous medication for control |
Special Rules
- "Widespread pain" specifically means pain in both the left and right sides of the body, both above and below the waist, affecting both the axial skeleton (neck, chest, upper/lower back) and the extremities.
- Associated symptoms considered include fatigue, sleep disturbance, stiffness, paresthesias, headache, irritable bowel symptoms, depression, anxiety, and Raynaud's-like symptoms.
Sourced from 38 CFR §§ 4.71a / 4.130. This is a reference aid, not a rating decision, your actual rating depends on the medical evidence in your specific case and your C&P exam findings. Rules can be amended, verify current text at eCFR.gov or with an accredited VSO before relying on this for a specific claim.