Diagnostic code
Diagnostic Code 5025: Fibromyalgia Rating Criteria
- CFR section
- 38 CFR § 4.71a
- Rating range
- 10% to 40%
- Rating levels
- 3
- Body system
- Musculoskeletal system
The VA rates Fibromyalgia under diagnostic code 5025 in 38 CFR § 4.71a. The table below is the full set of rating criteria, from the schedule itself, with the evidence factors raters look for at each level.
DC 5025 rating criteria
| Rating | Criteria |
|---|---|
| 10% | Widespread musculoskeletal pain and tender points with or without associated fatigue, sleep disturbance, stiffness, paresthesias, headache, IBS, depression, anxiety, or Raynaud's-like symptoms that require continuous medication for control What raters look forcontinuous medication; widespread pain |
| 20% | 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 What raters look forepisodic symptoms; present 1/3+ of time; stress-triggered |
| 40% | Symptoms that are constant, or nearly so, and refractory to therapy What raters look forconstant symptoms; refractory to therapy; multiple failed treatments |
Condition guide
The rating criteria are only part of the picture for Fibromyalgia. The Fibromyalgia condition page covers service connection, common evidence problems, secondary conditions, and Board outcome patterns in depth.
What happens to Fibromyalgia appeals at the Board
Claim Raven's analysis of 953 decided Board of Veterans' Appeals cases with Fibromyalgia as the primary issue. The Fibromyalgia condition page has the full breakdown, including which evidence types are associated with better outcomes.
Method: outcomes are coded per case from the Board's published decisions, rolled up as granted (including partial grants), denied, or remanded, excluding dismissals. The dataset codes the condition on appeal, not the diagnostic code, so these numbers describe Fibromyalgia appeals generally rather than DC 5025 specifically. Board outcomes describe appealed claims, not initial decisions.
Frequently asked questions
What is VA diagnostic code 5025?
Diagnostic code 5025 is the VA rating schedule entry for Fibromyalgia, found in 38 CFR § 4.71a. The VA assigns this code when it rates the condition and applies the criteria listed on this page.
What ratings are possible under DC 5025?
DC 5025 provides ratings of 10%, 20%, 40%. The percentage depends on which criteria your medical evidence documents, not on the diagnosis alone.
What does the highest rating under DC 5025 require?
The 40% rating for Fibromyalgia requires: Symptoms that are constant, or nearly so, and refractory to therapy.