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bluejay6 |
Chronic Fatigue Syndrom vs Fibromyalgia |
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Has anyone been granted service connection for BOTH Fibromyalgia AND Chronic Fatigue Syndrome??? If so, what were the percentages you were awarded? Thanks Jay
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cruiser |
Re: Chronic Fatigue Syndrom vs Fibromyalgia | #1 | ||
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I could be wrong but I don't really believe that you can legitimately carry both of these diagnoses at the same time. In fact, many if not most doctors consider them to be the same thing and don't really differentiate between them. I think this is probably because they share almost all of the same symptoms and the diagnosis is largely based on subjective complaints rather than laboratory diagnostic tools.
If you read the VA regulations you will see that the requirements for a diagnosis of these conditions are very similar with the primary difference being that CFS includes some additional symptoms not noted in fibromyalgia. I think what most docs do is diagnose fibromyalgia unless you have the additional symptoms of CFS and in those cases they change the diagnosis to CFS. I don't know how one could assign separate disability evaluations for them. Cruiser |
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bluejay6 |
Re: Chronic Fatigue Syndrom vs Fibromyalgia | #2 | ||
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Cruiser,
Thank you for the reply, but that leads me to my next question--If the VA has Chronic Fatigue Syndrome, Fibromyalgia and IBS listed now as presumtive conditions to GWS then that allows me to believe that all 3 conditions are seperate and can be rated as such. Your thoughts/opinions??? |
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cruiser |
Re: Chronic Fatigue Syndrom vs Fibromyalgia | #3 | ||
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Regardless of whether or not the regulations prohibit separate evaluations, the fact is that the same symptom cannot be attributed to more than one condition. That is called pyramiding and it is prohibited.
For example, if a separate evaluation is granted for IBS, the symptoms of IBS cannot be considered when evaluating one of the other conditions even though those conditions have the same symptoms as IBS. Something like joint and muscle pain can only be considered one time even though it is a central part of both CFS and fibromyalgia. If the Rating Specialist tried to assign separate evaluations for fibromyalgia and CFS I suspect the only way to do it would be to assign a 0 percent for the fibromyalgia and then evaluate all the symptoms under CFS since that would likely provide a higher evaluation. But like I said, I doubt that a doctor will say that you have both fibromyalgia and CFS at the same time. I have no doubt that both diagnoses appear in many folks records, but this is usually due to docs not agreeing on the diagnosis rather than them saying that you have both conditions. It is common to see fibromyalgia diagnosed and then later changed to CFS, but not both at the same time. Cruiser |
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bluejay6 |
Re: Chronic Fatigue Syndrom vs Fibromyalgia | #4 | ||
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Cruiser,
Thank you for the information--I do have both diagnosed in my records by VA doctors and am currently rated for the fibromyalgia and a claim pending for the Chronic Fatigue which was denied years ago but has since been approved to be reopened with new evidence presented. It will be interesting to see how this comes about. The CDC have both these listed as seperate conditions and even states so that they can co-exist at the same time. Of course, I presented this to VA. Like I said, will be interesting to see how this plays out. |
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RATnaCAGE1 |
Re: Chronic Fatigue Syndrom vs Fibromyalgia | #5 | ||
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I have a 20% rating for Fibromyalgia and a 10% rating for CFS so it is possible. Also, if you do a detailed search on BVA appeal decisions, you will find a few, not many but a few where the board granted service connection for both. My Rheumatoligist was very adamant about separating the two conditions in my progress notes over the last few years. I have pasted the rating criteria below for the two conditions:
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% _________________________________________________ 6354 Chronic Fatigue Syndrome (CFS): Debilitating fatigue, cognitive impairments (such as inability to concentrate, forgetfulness, confusion), or a combination of other signs and symptoms: Which are nearly constant and so severe as to restrict routine daily activities almost completely and which may occasionally preclude self-care... 100% Which are nearly constant and restrict routine daily activities to less than 50 percent of the pre-illness level, or; which wax and wane, resulting in periods of incapacitation of at least six weeks total duration per year...60% Which are nearly constant and restrict routine daily activities to 50 to 75 percent of the pre-illness level, or; which wax and wane, resulting in periods of incapacitation of at least four but less than six weeks total duration per year...40% Which are nearly constant and restrict routine daily activities by less than 25 percent of the pre-illness level, or; which wax and wane, resulting in periods of incapacitation of at least two but less than four weeks total duration per year...20% Which wax and wane but result in periods of incapacitation of at least one but less than two weeks total duration per year, or; symptoms controlled by continuous medication...10% Note: For the purpose of evaluating this disability, the condition will be considered incapacitating only while it requires bed rest and treatment by a physician. For VA purposes, a diagnosis of CFS must meet both of the following criteria: New onset of debilitating fatigue that is severe enough to reduce or impair average daily activity below 50 percent of the patient's pre-illness activity level for a period of 6 months, and other clinical conditions that may produce similar symptoms must be excluded by thorough evaluation, based on history, physical examination, and appropriate laboratory tests. It must also meet six or more of the following ten criteria: Describe in detail: 1. Acute onset of the condition: 2. Low grade fever: 3. Nonexudative pharyngitis 4. Palpable or tender cervical or axillary lymph nodes: 5. Generalized muscle aches or weakness: 6. Fatigue following lasting 24 hours or longer after exercise: 7. Headaches (of a type, severity or pattern that is different from headaches in the premorbid state: 8. Migratory joint pains: 9. Neuropsychologic symptoms: 10. Sleep disturbance: _________________________________________________ In my case, I first filed a claim for Fibromyalgia due to widespread musculoskeletal pain and trigger points. After it was approved, I filed for CFS. I met at least six of the required criteria above for CFS without having to include numbers 5 and 8 which are symptoms of Fibromyalgia and the CFS claim was also approved. Rat........ |
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RATnaCAGE1 |
Re: Chronic Fatigue Syndrom vs Fibromyalgia | #6 | ||
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Here are a couple BVA decisions that grant Fibromyalgia and Chronic Fatigue Syndrome as separate conditions.....
www.va.gov/vetapp03/files/0311614.txt www.va.gov/vetapp06/files4/0626724.txt RATnaCAGE
Helo Gunner USMC |
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bluejay6 |
Re: Chronic Fatigue Syndrom vs Fibromyalgia | #7 | ||
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Rat,
Thanks for the BVA case information! Will make great reading. FYI--my case is currently still at appeal awaiting a decision. All information has been given and the file is actually sitting on someones desk, so hope it wont be much longer. I reviewed my c-file and noticed a comment by someone reference the "pyramiding" issue, so I know it's being considered. Will post with results whenever that may be. Thanks again for the info. Jay |
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Santosha1 |
Re: Chronic Fatigue Syndrom vs Fibromyalgia | #8 | ||
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Rat,
Thanks for the info on the BVA.... Q |
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Rickz245 |
#9 | |||
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Articles in the AMA say that they are two distinct critters (because of the specific tenderpoints with fibro) but that for all practical purposes they are
treated as one and the same because they are so similar. Still, as a matter of medical fact, dual diagnosis does occur.
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pgwvet |
#10 | |||
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When you go back into how the law came about, you will see why we have yCFS, FM and IBS listed under gulf war illness. The CDC and NAH was asked what was on
the VA book that was also closely resemble GWI. this gave the doctors an out since most do not like to say undiagnosed when trying to find something wrong with
us.
It was already addressed about not comping twice on the same alment VP National Gulf War Resource Center http://www.ngwrc.org Veterans Helping Veterans since 1995 |
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Santosha1 |
Ratings for /CFIDS and FMS | #11 | ||
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I have both illness and have been rated 40% for FMS and 60% for CFIDS...they are separate disease processes...CIFDS, IMHO, being the worst of the two. CFIDS
is an illness which affects the immune system, the endocrine system, gastro system, the nervous system, cognitive functioning, memory impairment, swollen
glands, fevers, and it's the only illness I know of that worsens with exercise. They are now researching the effect on the heart. There are a whole host
of other health problems that come with this illness...one of the few websites I go to for up-to-date research information on the debilitating illness is
http://www.cfids.org/default.asp If you've been recently diagnosed, please pay homage to the diagnoses (give it it's due) because it doesn't
mean your just exhausted, which is what I thought...it means your body, your entire physical being is going haywire...it is debilitating.
I would also like to point out both FMS and CFIDS were recognized when I applies for SSDI... These illness are not one in the same... Take care, Susanne
Last Edited By: Santosha1 07/18/08 07:14:39.
Edited 1 time.
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Rickz245 |
#12 | |||
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Medical Studies also indicate that 70% of people with Fibro also have CFS.
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