Veterans should know
Fibromyalgia, a pinched nerve in the neck, Raynaud's and arthritis
Four conditions VA can pay compensation for — on their own, or as a second condition caused or worsened by something already service-connected. Here is what they are, and how I would file.
Veterans Crisis Line — dial 988, then press 1. Text 838255. Chat at
veteranscrisisline.net. TTY 711 then 988, or
1-800-799-4889. 24 hours a day, 7 days a week. You do not have to be enrolled in VA benefits or
health care to connect. I put this at the top because VA's own fibromyalgia rating rule lists depression
and anxiety among the symptoms that travel with this condition. If that is where you are right now, call
first and read the rest later.
Why this page exists. Chronic pain, a numb hand, fingers that go white in the cold, a
stiff joint — a lot of veterans carry these for years and never file, because nobody told them these
are ratable conditions. They are. I wrote this in plain words. I name a diagnostic code only where VA's own
rating schedule names it, and I send you to VA's pages so you can read it yourself. I am one veteran, not a
law firm, and nothing here is a promise about your claim.
What these four conditions are
- Fibromyalgia — widespread pain in the muscles and soft tissue along with tender points, meaning specific spots on the body that hurt when pressed. VA's rating rule defines "widespread" pain as pain on both the left and right sides of the body, both above and below the waist, affecting both the axial skeleton (the cervical spine, anterior chest, thoracic spine or low back — that is, the neck, chest and spine) and the arms and legs.
- Cervical radiculopathy — a pinched or damaged nerve root in the neck, where the "cervical" spine is the neck portion of the backbone, so the trouble shows up along whatever that nerve feeds, often down the shoulder, arm and hand.
- Raynaud's syndrome — the small blood vessels in the fingers and toes clamp down in cold or under emotional stress. VA's rating rule describes a characteristic attack as "sequential color changes of the digits of one or more extremities lasting minutes to hours, sometimes with pain and paresthesias, and precipitated by exposure to cold or by emotional upsets." Digits are fingers and toes. Paresthesias are pins-and-needles, burning or numb feelings.
- Arthritis — disease or wear in the joints. VA's rule opens by saying that "with any form of arthritis, painful motion is an important factor of disability."
Your doctor's description of your own symptoms is what matters in your file. Do not shave your symptom
list down to match a page — mine included.
★ Name it plainly. Then claim it.
Two ways in: direct, or secondary
Any of these four can be compensable if it is service-connected, or secondary to a condition already service-connected.
- Direct. The condition started in service or was caused by service.
- Secondary. 38 CFR 3.310(a): "Disability which is proximately due to or the result of a service-connected disease or injury shall be service connected." Proximately due to means your service-connected condition caused it.
- Aggravation — the part most people never hear. 38 CFR 3.310(b) also covers a condition that was not service-connected but got worse because of one that is. The increase in severity can be service-connected and paid.
For aggravation, VA compares a baseline — how bad the condition was before your
service-connected condition made it worse — against how bad it is now, and subtracts the natural
progression of the disease. So get that baseline documented in medical records. Old records showing the
milder version of the condition are worth money to you.
★ Caused it, or made it worse. Both count.
Fibromyalgia is a named presumptive
If you served in the Southwest Asia theater of operations on or after 2 August 1990, this is the most important paragraph on the page.
- 38 CFR 3.317 names fibromyalgia as a medically unexplained chronic multisymptom illness that VA presumes is service-connected. Presumes means VA accepts the connection to service without you proving it. No nexus opinion required — a nexus opinion is a doctor's statement linking the condition to service.
- The condition must have become manifest either during that service, or to a degree of 10 percent or more no later than 31 December 2026. Manifest means it showed up.
- Read that again: it is a deadline on when the illness appeared, not on when you file. If your fibromyalgia manifested to that degree years ago, you are inside the rule, and you can file later and still get the presumption. Do not let anyone rush you or sell you speed.
- Do not file too early either. 38 CFR 3.317(a)(4): "Disabilities that have existed for 6 months or more and disabilities that exhibit intermittent episodes of improvement and worsening over a 6-month period will be considered chronic."
The theater, in the regulation's own words: Iraq, Kuwait, Saudi Arabia, the neutral zone between
Iraq and Saudi Arabia, Bahrain, Qatar, the United Arab Emirates, Oman, the Gulf of Aden, the Gulf of
Oman, the Persian Gulf, the Arabian Sea, the Red Sea, and the airspace above these locations.
Afghanistan is not on that list — if that is where you served, this particular presumptive
is not your route, so file directly or as secondary instead, and ask about the exposure presumptives
that do cover your service.
38 CFR 3.317 · VA's Gulf War illness page
★ When it appeared, not when you file.
Arthritis within one year of separation
- 38 CFR 3.309(a) lists chronic diseases VA will presume are service-connected. One entry is plainly "Arthritis."
- Under 38 CFR 3.307(a)(3), the disease must have become manifest to a degree of 10 percent or more within 1 year from the date of separation from service.
- So if you separated recently and arthritis showed up in that first year, say so. You may not need to prove how it happened.
Raynaud's — know which one you have. That same list names "Raynaud's
disease", which is primary Raynaud's. This page and VA's diagnostic code 7117 are about
Raynaud's syndrome, which VA titles "also known as secondary Raynaud's phenomenon or
secondary Raynaud's." If yours is the secondary kind, the one-year chronic-disease presumptive is
not your route — go the secondary service-connection route under 38 CFR 3.310 instead. Ask your
doctor to write down which one you have.
★ One year out. Different rule.
Diagnostic code 5025
VA rates fibromyalgia under diagnostic code 5025 in 38 CFR 4.71a. A diagnostic code is the number VA uses on your decision letter to say which rule it rated you under.
- 40 percent — symptoms that are constant, or nearly so, and refractory to therapy. Refractory means treatment is not controlling it.
- 20 percent — symptoms that are episodic, with exacerbations often precipitated by environmental or emotional stress, but that are present more than one-third of the time. Episodic means it comes in bouts; exacerbations are flare-ups.
- 10 percent — symptoms that require continuous medication for control.
Tender points are part of the criteria, not a detail. The code reads "widespread
musculoskeletal pain and tender points." Ask that the tender-point examination be performed
and written into the record. If it is not documented, an element of the rule is missing from your file.
VA's own list of what travels with it, from the code's note: pain and tender points
"with or without associated fatigue, sleep disturbance, stiffness, paresthesias, headache,
irritable bowel symptoms, depression, anxiety, or Raynaud's-like symptoms." Stiffness and
paresthesias — pins-and-needles or numbness — are on VA's list. Report them.
★ Get the tender points documented.
The same symptom cannot be paid twice
This is the trap on a page like this one, and I would rather you hear it from me now than from a denial later.
- 38 CFR 4.14: "The evaluation of the same disability under various diagnoses is to be avoided … the evaluation of the same manifestation under different diagnoses are to be avoided." A manifestation is a symptom as it shows up.
- Diagnostic code 5025 already folds fatigue, sleep disturbance, stiffness, paresthesias, headache, irritable bowel symptoms, depression, anxiety and Raynaud's-like symptoms into the fibromyalgia evaluation.
- So if fibromyalgia is already rated and you then claim migraine, irritable bowel, a mental health condition or Raynaud's separately, a separate rating has to rest on a distinct diagnosis with its own symptoms — not the same complaints counted a second time.
That is not a reason to stay quiet. It is a reason to have each condition diagnosed and described on its
own terms by a provider, so the record shows what is separate and what is not. File what you actually
have.
★ Distinct diagnosis, distinct symptoms.
Diagnostic code 7117
VA's rating schedule titles this code "Raynaud's syndrome (also known as secondary Raynaud's phenomenon or secondary Raynaud's)." VA names the secondary kind itself, right in the code title. That is your support for filing it as a secondary condition.
- 10 percent — characteristic attacks one to three times a week
- 20 percent — four to six times a week
- 40 percent — at least daily
- 60 percent — two or more digital ulcers, meaning open sores on the fingers or toes
- 100 percent — ulcers plus auto-amputation, meaning tissue dies and a digit is lost without surgery
Rating turns on how often attacks happen. Keep a dated log of attacks and bring it to the
examination. Nobody can count them for you afterward.
Cold-weather injury is a separate road. If you have a history of cold injury in service, ask
about claiming cold injury residuals, diagnostic code 7122, in addition to Raynaud's. One note:
VA keeps the Cold Injury Residuals questionnaire off its public list, so a private doctor cannot fill
that one out — you will need a VA examination for it. Ask VA for the exam.
★ Count the attacks. Write them down.
The codes, and the rule that saves a 0 percent
- DC 5002 — "Multi-joint arthritis (except post-traumatic and gout), 2 or more joints, as an active process" — 100, 60, 40 or 20 percent.
- DC 5003 — "Degenerative arthritis, other than post-traumatic" — 20 or 10 percent, on X-ray evidence plus limitation of motion.
- DC 5010 — "Post-traumatic arthritis: Rate as limitation of motion, dislocation, or other specified instability under the affected joint." Post-traumatic means it followed an injury.
38 CFR 4.59, word for word: "It is the intention to recognize actually painful, unstable, or
malaligned joints, due to healed injury, as entitled to at least the minimum compensable rating for the
joint." Malaligned means the joint does not sit straight. Minimum compensable rating means the
lowest paying rating for that joint. This is the provision that most often turns a 0 percent arthritis
rating into 10 percent — but note the qualifier VA applies: due to healed injury.
What to ask your examiner to actually do, because 4.59 calls for it: test the joint for pain on
active and passive motion, weight-bearing and non-weight-bearing, and compare it to the
opposite undamaged joint. If the exam did not do that, say so in writing.
★ A painful joint is not a 0 percent joint.
Cervical radiculopathy can be rated on its own
The nerve damage can carry its own rating, based on which nerve is affected and how bad the impairment is.
- Radicular groups — DC 8510 upper, 8511 middle, 8512 lower, 8513 all radicular groups. A radicular group is a bundle of nerve roots coming out of the neck.
- Named nerves — DC 8515 median nerve, 8516 ulnar nerve.
- These are rated as mild, moderate or severe incomplete paralysis, or complete paralysis. Incomplete means the nerve still works in part.
- The percentages differ for the major (dominant) and minor extremity — your writing hand rates higher than the other one.
- One limit VA states plainly: "when the involvement is wholly sensory, the rating should be for the mild, or at most, the moderate degree." Wholly sensory means numbness and tingling with no loss of strength — so if you have weakness or a weak grip, make sure the exam measures it and does not log you as sensory-only.
Get the nerve study — an EMG or nerve conduction test, which measures how the nerve and muscle are
firing — and the neck imaging into the file. Then read the anti-pyramiding panel on this page
before you file the nerve and the neck as if they were unrelated.
38 CFR 4.124a. All the arm and leg nerve levels are on Nerve damage VA ratings.
★ Which nerve, and how bad.
What I would do, in order
- File an intent to file, VA Form 21-0966. It sets a potential effective date for your payments and gives you one year to finish the claim. Be clear on what it does not do: it does not extend or protect any presumptive period.
- Get diagnosed and get it written down. A current diagnosis by name.
- Gather the evidence. Medical records, imaging such as X-rays and MRIs, nerve studies, specialist evaluations, treatment records, prescriptions, and your own written statement.
- Consider a Disability Benefits Questionnaire (DBQ) — VA's own exam form your private doctor can complete. Public DBQs cover all four of these: Fibromyalgia, Neck (Cervical Spine), Arthritis, and Artery and Vein Conditions, which is the one for Raynaud's.
- File the claim, and go to every examination VA schedules.
Intent to file · Evidence VA needs · Public DBQs
★ Intent to file first. It is free.
Three ways back, and the clock on each
- Higher-Level Review — within one year of the decision. A more senior reviewer looks at the same evidence. No new evidence allowed.
- Board Appeal — within one year of the decision, to the Board of Veterans' Appeals.
- Supplemental Claim — no filing deadline. You can file any time with new and relevant evidence.
"No deadline" is not the whole truth on money. Under 38 CFR 3.2500, if you keep
pursuing the issue by timely filing a review option within one year, the effective date is fixed by the
date VA received your initial claim, or the date entitlement arose, whichever is later. File past that
one-year window and you keep your right to file — but you can lose back pay. File within one
year if you can.
One exception: a simultaneously contested claim — where another person is claiming the same
benefit — cannot go to Higher-Level Review. Your route there is an appeal to the Board, within 60
days.
★ One year protects your back pay.
Free help exists. Know the fee rules.
- An accredited Veterans Service Organization representative helps you free. Under 38 CFR 14.636, recognized organizations, including their accredited representatives acting as such, are not permitted to receive fees for claim work.
- Only accredited agents and attorneys may charge fees at all, and only after VA has issued notice of its initial decision on the claim.
- A fee not exceeding 20 percent of past-due benefits is presumed reasonable. A fee exceeding 33 and one-third percent of past-due benefits is presumed unreasonable. If someone hands you an agreement above that line, walk away and find somebody accredited.
- Nobody should be charging you to file an original claim. I do not charge for any of this.
Find an accredited representative at
va.gov/get-help-from-accredited-representative.
Find a VA facility at
va.gov/find-locations.
Read the rating rules yourself in the VA Schedule for Rating Disabilities, 38 CFR Part 4, at
ecfr.gov
— it is not on VA.gov, so that is where to look.
★ Free is available. Use it.
One last thing. Keep your records organized in one place, and keep a copy yourself —
do not rely on somebody else holding the only file. Bring a Family member or a caregiver to the examination
if you have trouble describing a bad day on a good day. And talk to an accredited representative about your
own claim before you file. I bring the truth, simple and to the point. I have nothing left in this world
than my word.