VA evaluates fibromyalgia using the frequency, persistence, treatment response, and medication control of widespread symptoms.
Plain-language summaries explain the text; they do not decide whether any level applies.
Widespread musculoskeletal pain and tender points, with or without associated symptoms, that are constant, or nearly so, and refractory to therapyPlain-language summary
Symptoms are constant or nearly constant and do not respond to therapy.
Widespread musculoskeletal pain and tender points, with or without 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 timePlain-language summary
Symptoms are episodic but present more than one-third of the time.
Widespread musculoskeletal pain and tender points, with or without associated symptoms, that require continuous medication for controlPlain-language summary
Continuous medication is required to control the qualifying symptoms.
38 CFR § 4.71a, DC 5025 · Effective May 7, 1996 · Reviewed Jul 24, 2026