Citation Nr: A26008564 Decision Date: 01/29/26 Archive Date: 01/29/26 DOCKET NO. 251009-596037 DATE: January 29, 2026 ORDER Entitlement to an effective date of October 29, 2021, but no earlier, for the grant of service connection for fibromyalgia, to include joint pain, is granted. Entitlement to an initial disability rating in excess of 40 percent for fibromyalgia, to include joint pain, is denied. FINDINGS OF FACT 1. The date of claim for entitlement to service connection for fibromyalgia, to include joint pain, is October 29, 2021, and entitlement arose no later than this date. 2. The Veteran is in receipt of the maximum schedular rating for fibromyalgia for the entire period on appeal. CONCLUSIONS OF LAW 1. Entitlement to an effective date of October 29, 2021, but no earlier, for the grant of service connection for fibromyalgia to include joint pain have been met. 38 U.S.C. §§ 5107(b), 5110; 38 C.F.R. §§ 3.102, 3.155, 3.156, 3.400. 2. The criteria for entitlement to an initial disability rating in excess of 40 percent for fibromyalgia, to include joint pain, have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.21, 4.3, 4.7, 4.71a, Diagnostic Code 5025. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the Army from June 2003 to August 2003 and from July 2004 to August 2008, with additional periods of service in the National Guard. The Board thanks the Veteran for her service. The rating decision on appeal was issued in October 2024 and constitutes an initial decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies. In the October 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the October 15, 2024, agency of original jurisdiction (AOJ) decision on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801. If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) (within a year of this decision for the effective date claim) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claims, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. With respect to the claim for an increased initial rating for fibromyalgia, the period on appeal runs from March 2, 2023, the currently assigned effective date of service connection, to October 17, 2024, the notification date of the rating decision on appeal. 1. Entitlement to an effective date prior to March 2, 2023, for the grant of service connection for fibromyalgia, to include joint pain. The Veteran contends that she is entitled to an effective date of October 29, 2021, for the grant of service connection for fibromyalgia. Except as otherwise provided, the effective date of an evaluation and award of compensation based on an original claim, a claim reopened after final disallowance, or a claim for increase will be the date of receipt of the claim or the date entitlement arose, whichever is later. 38 U.S.C. § 5110; 38 C.F.R. § 3.400. If a claim for disability compensation is received within one year after separation from service, the effective date of entitlement is the day following separation or the date entitlement arose. 38 C.F.R. § 3.400(b)(2). If a claim is continuously pursued it will be considered filed as of the date of the first claim in the continuously pursued chain, not the date the most recent request for review was received. 38 C.F.R. §§ 3.400, 3.2500(c). Continuous pursuit of a claim can be achieved by timely and properly filing an appropriate review option, including a supplemental claim, within one year of an AMA decision. 38 C.F.R. § 3.2500(c). The concept of continuous pursuit is only applicable with respect to AMA decisions. 38 C.F.R. § 3.2500(h). The reference above to "the date entitlement arose" for effective date purposes is not defined in the current statute or regulation. The U.S. Court of Appeals for Veterans Claims (Court) has interpreted it as the date when the claimant met the requirements for the benefits sought; this is determined on a "facts found" basis. See 38 U.S.C. § 5110 (a); see also McGrath v. Gober, 14 Vet. App. 28, 35 (2000). Here, the Veteran submitted a claim for service connection for fibromyalgia on October 29, 2021, which was denied in an April 2022 rating decision. The record does not show any earlier informal or formal claims for service connection for fibromyalgia. In July 2022, the Veteran submitted a VA Form 20-0996, Decision Review Request: Higher-Level Review, listing the April 2022 rating decision. Entitlement to service connection was again denied in a July 2022 higher-level review decision, to which the Veteran filed a Supplemental Claim in July 2023. The claim was denied in an October 2023 rating decision and an additional Supplemental Claim was submitted in September 2024, resulting in the October 2024 rating decision on appeal. The Board therefore finds that the claim initially filed on October 29, 2021, was continuously pursued within the meaning of 38 C.F.R. § 3.2500(c). The date of claim is therefore October 29, 2021. With respect to the date entitlement arose, in the rating decision on appeal, service connection for fibromyalgia was granted on a presumptive basis as a medically unexplained chronic multisymptom illness (MUCMI) under 38 U.S.C. § 1117. The Veteran is a Persian Gulf veteran. See January 2023 VA Memo; 38 C.F.R. § 3.317(e). Service connection may be granted for a Persian Gulf veteran with objective indications of a qualifying chronic disability, including a MUCMI, that became manifest to any degree at any time. 38 U.S.C. § 1117(a)(1). Prior to the enactment of the PACT Act, such qualifying chronic disability must have become manifest either during active military, naval, or air service in the Southwest Asia theater of operations, or to a degree of 10 percent or more not later than December 31, 2026. 38 U.S.C. § 1117(a)(1); 38 C.F.R. § 3.317(a)(1). As the date of claim predates the PACT Act, the Board must determine whether the Veteran's fibromyalgia manifested to a compensable degree to assign an effective date prior to August 10, 2022, the effective date of the PACT Act. The earliest fibromyalgia diagnosis of record is from October 2023. See October 2023 VA rheumatology note. That record noted a history of multiple joint pain with an initial rheumatology consult in August 2022 noting further work-up was needed. The August 2022 record was noted to be concerning for autoimmune disease due to polyarthralgia and a positive ANA of 1:80. Earlier VA treatment records during the appeal period also noted reports of pain in various joints, including the neck and shoulders. The Veteran reported a long history of diffuse joint and muscle pain dating back to 2013 that has been attributed to fibromyalgia. See October 2024 VA examination report. She also required continuous medication for control of her fibromyalgia symptoms, the requirement for a 10 percent rating for fibromyalgia under 38 U.S.C. § 4.71a, Diagnostic Code 5025. Id. The Board will therefore resolve all doubt in the Veteran's favor and find that she had fibromyalgia during the entire period on appeal and that this disability manifested to a compensable degree. As such, the assignment of an effective date of October 29, 2021, the date of claim, for the grant of service connection is warranted, and the claim is granted. 2. Entitlement to an initial disability rating in excess of 40 percent for fibromyalgia, to include joint pain. The Veteran contends that she is entitled to a higher disability rating for her service-connected fibromyalgia. The Board notes that the Veteran is in receipt of the highest schedular rating under DC 5025 for the entire period on appeal. 38 U.S.C. § 4.71a. Neither the Veteran nor her representative has identified any basis for a higher rating, to include an extraschedular basis. See Doucette v. Shulkin, 28 Vet. App. 366 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). Moreover, as fibromyalgia is specifically listed in the rating schedule, rating by analogy under another Diagnostic Code is not appropriate. See Copeland v. McDonald, 27 Vet. App. 333, 336-37 (2015). Based on the foregoing, the weight of the evidence is against the assignment of a higher initial rating for fibromyalgia. Thus, the benefit-of the doubt rule does not apply and an initial rating in excess of 40 percent for fibromyalgia is not warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. M. C. GRAHAM Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Alvarez, D.A. 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.