VA Diagnostic Code 5025Fibromyalgia (fibrositis, primary fibromyalgia syndrome)
Rated from 10% to 40% under § 4.71a. Here is what the VA requires at each level.
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What each rating requires
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- 40%
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
- 20%
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 episodic, with exacerbations often precipitated by environmental or emotional stress or by overexertion, but that are present more than one-third of the time
- 10%
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 require continuous medication for control
Notes on this code
These notes are part of the regulation. They change how the levels above are applied.
- 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.
Fibromyalgia VA Disability Rating (Diagnostic Code 5025)
Understanding how the VA rates fibromyalgia under 38 CFR § 4.71a
What This Condition Is
Fibromyalgia — also referred to as fibrositis or primary fibromyalgia syndrome — is rated by the VA under Diagnostic Code 5025, within the Musculoskeletal System.
The condition is characterized by widespread musculoskeletal pain and tender points. It may occur with or without a range of associated symptoms, including:
- Fatigue
- Sleep disturbance
- Stiffness
- Paresthesias (tingling or "pins and needles" sensations)
- Headache
- Irritable bowel symptoms
- Depression
- Anxiety
- Raynaud's-like symptoms
What "Widespread Pain" Means
Under the VA's guidance, widespread pain means pain that is present:
- On both the left and right sides of the body, and
- Both above and below the waist, and
- Affecting both the axial skeleton (the cervical spine, anterior chest, thoracic spine, or low back) and the extremities.
Available Rating Levels
The VA assigns one of three rating levels for fibromyalgia, based on how constant the symptoms are and how they respond to treatment.
| Rating | What It Reflects |
|---|---|
| 40% | Widespread musculoskeletal pain and tender points (with or without the associated symptoms listed above) that are constant, or nearly so, and refractory to therapy (not responsive to treatment). |
| 20% | Widespread musculoskeletal pain and tender points (with or without the associated symptoms) 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. |
| 10% | Widespread musculoskeletal pain and tender points (with or without the associated symptoms) that require continuous medication for control. |
What the VA Looks For
When rating fibromyalgia under Diagnostic Code 5025, the VA considers:
- The presence of widespread musculoskeletal pain and tender points, as defined above.
- Whether associated symptoms (fatigue, sleep disturbance, stiffness, paresthesias, headache, irritable bowel symptoms, depression, anxiety, or Raynaud's-like symptoms) are present — though these may be present or absent at any rating level.
- How persistent the symptoms are — for example, whether they are constant or nearly constant, episodic but present more than one-third of the time, or controlled with continuous medication.
- How the symptoms respond to treatment — including whether they are refractory to therapy or require continuous medication for control.
- Whether exacerbations are triggered by environmental or emotional stress or by overexertion.
This information summarizes the VA rating criteria for fibromyalgia under 38 CFR § 4.71a, Diagnostic Code 5025. It is provided for general educational purposes and does not guarantee any particular rating outcome.
These criteria are a rendering of § 4.71a, diagnostic code 5025. The official version is the one that governs your rating.
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