Citation Nr: 21072150 Decision Date: 12/02/21 Archive Date: 12/02/21 DOCKET NO. 16-58 125 DATE: December 2, 2021 ORDER Service connection for fibromyalgia is granted. FINDING OF FACT Resolving all reasonable doubt in the Veteran's favor, her fibromyalgia symptoms began during active service and have continued since. CONCLUSION OF LAW The criteria for service connection for fibromyalgia are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from February 1985 to July 1991 in the U.S. Army. This matter comes before the Board of Veterans' Appeals (Board) from a September 2013 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Atlanta, Georgia. This case was most recently before the Board in June 2021, at which time the issue on appeal was remanded for further development. This case has now returned to the Board for appellate consideration. The Veteran contends that her diagnosed fibromyalgia had its onset during active service and has continued since. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Certain chronic diseases, including organic diseases of the nervous system, will be presumed related to service if they were shown as chronic (reliably diagnosed) in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service, with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013); Fountain v. McDonald, 27 Vet. App. 258 (2015); 38 C.F.R. §§ 3.303, 3.307, 3.309. The June 2021 VA examiner stated that fibromyalgia may result from sensitization of the central nervous system. As such, the Board will consider fibromyalgia an organic disease of the nervous system. The Veteran's service treatment records (STRs) show that she had many symptoms related to fibromyalgia during service, including fatigue, headaches, sleep trouble, gastrointestinal trouble, and "multiple musculoskeletal complaints of chronic nature", including heel pain, ankle pain, thigh pain, low back pain and stiffness, and neck pain and stiffness. In January 1991 she was treated for ankle pain of a different nature than she was seen originally, and she also had complaints of back and abdomen problems. She was referred for a psychological evaluation to make sure there was no overlying somatoform disorder or hypersensitivity to pain. Her psychological evaluation was normal, but the physician noted that the Veteran's symptoms might be aggravated by being placed in stressful situations. In April 1991, the Veteran testified at a Medical Evaluation Retention Board hearing that she had constant back pain that flares up when she is working hard, lifting, walking, or standing for long periods of time. She also testified that she has ankle pain when walking, standing for long periods of time, and sitting for long periods of time. In October 2007, the Veteran's medical treatment records note a long history of arthralgias and myalgias in her bilateral shoulders, neck, thighs, hips, and lower back. In March 2011, the Veteran's medical treatment records note that she was diagnosed with fibromyalgia in 2007 which manifested by long-standing diffuse myalgias and arthralgias "from bottom of feet to top of head" associated with function limiting daily fatigue, nonrestorative sleep symptoms, chronic headaches, and unexplained peripheral paresthesias. During the August 2019 VA examination, the Veteran reported that she began to have issues with body pain that was generalized throughout her time in service beginning in 1990 and her symptoms have worsened since. The Veteran is competent to report observable symptoms. Additionally, the Board finds that she is credible as her reports are consistent with the medical evidence of record. Based on the foregoing, the Board finds that the Veteran's fibromyalgia symptoms at least as likely as not began during active service and have continued since. The Board notes that VA medical opinions were obtained in October 2016, August 2019, and June 2021. The Board previously found the October 2016 and August 2019 opinions inadequate and therefore will not be considered. The Board also finds the June 2021 VA opinion inadequate for adjudication purposes. Notably, the opinion is inconsistent with the Veteran's medical history. For example, the physician noted that the Veteran's STRs do not show chronic, widespread pain both above and below the waist without an attributable cause. However, this contradicts the Veteran's STRs noting widespread pain and a referral for a psychiatric evaluation to determine whether she had a psychiatric condition contributing to her reported pain. Additionally, the physician did not consider the Veteran's medical history supporting the continuity of symptoms since service or the Veteran's contention that she had fibromyalgia during service in addition to her documented injuries. As such, the opinion is afforded little probative weight. At this time, the Board declines to remand for an additional opinion as such would resemble a fishing expedition for negative evidence, which, in view of the available medical evidence, is not necessary. Obtaining such additional evidentiary development in this instance would only result in additional delay with no benefit to the appellant. Sabonis v. Brown, 6 Vet. App. 426 (1994); VAOPGCPREC 5-04, 69 Fed. Reg. 59,989 (2004). As such, the Board finds the evidence of record is at least in relative equipoise as to whether the Veteran's symptoms during service were attributable to fibromyalgia. Accordingly, the Board will resolve reasonable doubt in favor of the Veteran and find that her fibromyalgia symptoms had their onset during active service, and her symptoms have continued since. Therefore, service connection for fibromyalgia is warranted. JOHN Z. JONES Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Kernen, Associate Counsel The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.