Fibromyalgia is a complex and often misunderstood condition characterized by chronic non-articular pain, generalized tender points, and a range of associated symptoms. For veterans seeking disability compensation, understanding what to expect during the compensation and pension (C&P) exams related to fibromyalgia is crucial. Let’s see the key aspects of fibromyalgia, the specific considerations for veterans, and a detailed walkthrough of the C&P exam process.
Understanding Fibromyalgia
Fibromyalgia, as defined by the American Academy of Family Physicians, is an idiopathic chronic pain syndrome with generalized tender points. It is a multi-system disease accompanied by symptoms such as sleep disturbances, fatigue, headaches, morning stiffness, paresthesias, and anxiety. The diagnosis is based on the presence of widespread pain for at least three months and at least 11 tender points among specific anatomical sites. While there’s no specific guideline for treatment, a multi-dimensional approach involving patient education, cognitive behavioral therapy, exercise, physical therapy, and pharmacologic therapy may be effective.
Veterans with Fibromyalgia
Fibromyalgia is a condition for which many veterans file claims, and it is often linked to chronic multisystem illnesses seen in those who have served in various operational areas. Gulf War veterans serving from 1991 to the present are particularly noted to develop the condition at times. Additionally, mental health conditions such as PTSD, depression, and other disorders can exacerbate fibromyalgia symptoms.
What to Expect in a C&P Exam
Preparing for the Exam
If you file a claim for fibromyalgia, you will likely receive a packet detailing the scheduled C&P exam. This packet will provide information about the examining doctor, their specialty, and the location of the exam. It’s common for veterans to research the examining doctor’s background to better understand their expertise.
The Disability Benefit Questionnaire
During the C&P exam, the examiner will likely use a Disability Benefit Questionnaire (DBQ) to gather information. This form, available on va.gov, covers various aspects related to fibromyalgia. It includes personal details, information about the examiner, and questions about the diagnosis, symptoms, and treatments.
Key Questions in the DBQ
Diagnosis and Medical History
- Diagnosis of Fibromyalgia: The form will ask if you have a diagnosis of fibromyalgia, including the date of diagnosis and any other relevant diagnoses.
- Medication and Treatment: Details about continuous medication for symptom control and any ongoing treatment for the condition.
Symptoms and Impact
- Symptoms Checklist: The examiner will inquire about widespread musculoskeletal pain, stiffness, muscle weakness, fatigue, sleep disturbances, paresthesias, headaches, depression, anxiety, and other symptoms.
- Frequency of Symptoms: Questions about the episodic or constant nature of symptoms and their impact on daily life.
Physical Examination
- Tender Points: The examiner will assess specific tender points in the body, checking for tenderness and trigger points.
Functional Impact
- Occupational Impact: How fibromyalgia affects your ability to perform occupational activities like lifting, walking, and sitting.
- Assistive Devices: Whether you use any assistive devices like a wheelchair, braces, or crutches.
Ratings and Compensation
The DBQ information, along with other medical evidence, is used by raters and adjudicators to determine the appropriate disability rating. Fibromyalgia is currently rated under diagnostic code 5025 in the 38 Code of Federal Regulation. Ratings range from 10 to 40, depending on the severity and impact on daily life. Continuous medication for control results in a 10% rating, while constant symptoms refractory to therapy can lead to a 40% rating.
Conclusion
Understanding what to expect in a fibromyalgia C&P exam is vital for veterans navigating the disability claims process. By familiarizing yourself with the DBQ and the specific criteria used for ratings, you can better prepare for the examination and potentially streamline the claims process. Remember, while the information provided here offers insights, individual experiences may vary, and consulting with a Veterans Service Officer or legal professional can provide personalized guidance based on your unique situation.
Also read: Depression and Veterans Disability
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Leveraging an extensive network of licensed independent medical professionals, all well-versed in the medical professional aspects of the VA claims process, we review the necessary medical evidence to incorporate in our reports related to your VA Disability Claim.
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