does anyone know how fibromyalgia is rated? and is the IDES and DES the same thing?
a question regarding fibromyalgia
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Jason Perry
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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
Note: Widespread pain means pain in both the left and right sides of the body, that is both above and below the waist, and that affects both the axial skeleton (i.e., cervical spine, anterior chest, thoracic spine, or low back) and the extremities.
No, they are not the same. IDES= Integrated Disability Evaluation System (military makes fitness findings, VA supplies ratings). DES= Disability Evaluation System (military makes both fitness and rating decision).
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
Note: Widespread pain means pain in both the left and right sides of the body, that is both above and below the waist, and that affects both the axial skeleton (i.e., cervical spine, anterior chest, thoracic spine, or low back) and the extremities.
No, they are not the same. IDES= Integrated Disability Evaluation System (military makes fitness findings, VA supplies ratings). DES= Disability Evaluation System (military makes both fitness and rating decision).
thanks so much for your post mr perry but 1 other question, what does the board use to determine percentages? eg. medical records, narsum, profile or do they take an educated guess?
9009 Fibromyalgia [see VASRD code 5025, enclosure (8), and paragraph 9011a(5)]
9009 Fibromyalgia [see VASRD code 5025, enclosure (8), and paragraph 9011a(5)]
a. This condition shall be evaluated by a rheumatologist and meet the requirements of paragraph A5 (b), under paragraph 9011.
b. The diagnostic criteria put forth by the American College of Rheumatology must be met . Current standards shall be used for making the diagnosis.
c. If the MEB report contains fibromyalgia as a diagnosis and is not written by a rheumatologist, there must be a report of recent consultation by rheumatology.
d. Any case with a diagnosis of fibromyalgia must have a psychiatry addendum submitted with the MEB.
(5) 5025 - Fibromyalgia
(a) Fibromyalgia (also called fibrositis, myofascial pain syndrome, or primary fibromyalgia syndrome), is a syndrome of chronic, and widespread musculoskeletal pain associated with multiple tender or "trigger" points, and is often accompanied by multiple somatic complaints. It is a condition for which diagnostic criteria were formally established in 1990 (and have subsequently been revised - see the VASRD for specific guidance as it describes the specific criteria).
(b) Diagnostic criteria include the following: 1. A history of widespread pain that has been present for at least 3
months. There must be both axial skeletal pain and peripheral pain. 2. The presence of pain on digital palpation at 11 of 18 tender point
4. That diagnosis should have been made by or with the consultation of a rheumatologist, who will either be a signatory of the MEB report (with recent
consultation report included when sent to the Informal PEB) or the author of a typed addendum.
(c) A psychiatry addendum will be included.
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
Note: Widespread pain means pain in both the left and right sides of the body, that is both above and below the waist, and that affects both the axial skeleton (i.e., cervical spine, anterior chest, thoracic spine, or low back) and the extremities.
http://www.rheumatology.org/practic...0_Preliminary_Diagnostic_Criteria.pdf#search="fibromyalgia"
9009 Fibromyalgia [see VASRD code 5025, enclosure (8), and paragraph 9011a(5)]
a. This condition shall be evaluated by a rheumatologist and meet the requirements of paragraph A5 (b), under paragraph 9011.
b. The diagnostic criteria put forth by the American College of Rheumatology must be met . Current standards shall be used for making the diagnosis.
c. If the MEB report contains fibromyalgia as a diagnosis and is not written by a rheumatologist, there must be a report of recent consultation by rheumatology.
d. Any case with a diagnosis of fibromyalgia must have a psychiatry addendum submitted with the MEB.
(5) 5025 - Fibromyalgia
(a) Fibromyalgia (also called fibrositis, myofascial pain syndrome, or primary fibromyalgia syndrome), is a syndrome of chronic, and widespread musculoskeletal pain associated with multiple tender or "trigger" points, and is often accompanied by multiple somatic complaints. It is a condition for which diagnostic criteria were formally established in 1990 (and have subsequently been revised - see the VASRD for specific guidance as it describes the specific criteria).
(b) Diagnostic criteria include the following: 1. A history of widespread pain that has been present for at least 3
months. There must be both axial skeletal pain and peripheral pain. 2. The presence of pain on digital palpation at 11 of 18 tender point
4. That diagnosis should have been made by or with the consultation of a rheumatologist, who will either be a signatory of the MEB report (with recent
consultation report included when sent to the Informal PEB) or the author of a typed addendum.
(c) A psychiatry addendum will be included.
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
Note: Widespread pain means pain in both the left and right sides of the body, that is both above and below the waist, and that affects both the axial skeleton (i.e., cervical spine, anterior chest, thoracic spine, or low back) and the extremities.
http://www.rheumatology.org/practic...0_Preliminary_Diagnostic_Criteria.pdf#search="fibromyalgia"
thanks pittpan2005 i meet both criterias diagnosed by a rheumatologist and constant wide spread pain with all the symptoms associated with a 40 percent rating. Regarding the rating does the va rate both the unfitting and fitting conditions or does dod just rate the unfitting conditions.
Jason Perry
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The VA rates all conditions- the PEB then only applies the ratings from the VA of conditions they find unfitting. So, when it is all said and done you will have two ratings- one from the military and one from the VA.
thanks again mr perry.