Major
I have experience boarding patients with both diagnoses but not in the same patient. From both conditions a few were returned to duty but most had notable impact on their duty performance and were found unfit. Those who were returned to duty were in managerial and leadership roles with reported lower impact on their duties. To me a boost for these folks was they were in a position to manage their duties and conditions to limit negative impact on either. Please realize fitness determinations differ based on the individual’s office, grade, rank or rating.
For cases of unfit about half of the Lupus cases were TDRL’d due to uncertainty on future exacerbations and response to therapy, the rest were permanently retired. I have not had a Lupus case separated with severance but it is possible, the lowest rating on the VASRD is 10%. I’ve only had a few patients with Fibromyalgia, maybe five. I can think of one who was permanently retired and the others were separated with severance. The rating scale for Fibromyalgia goes from 10% to 20% to 40% with the difference between 20 and 40 being pretty significant in pain and complications.
Please be mindful though of comparing yourself with others with the same diagnosis. Diseases affect everyone differently and the ratings for both diseases are based on the number and severity of exacerbations.
You can lookup both conditions under the sub forum link with the VA Schedule for Rating Disabilities and judge where you may apply. I think Lupus is under diagnosis code 6350 and Fibromyalgia is under 5025. However, I recommend you speak with your providers on what they judge an exacerbation is. I’ve had patients that felt they had several exacerbations but their provider’s count was lower (patients counted two-three exacerbations but provider felt it was one longer attack with varying severity or the exacerbation had abated and the patient was experiencing side effects of treatment not the disease itself).
To answer your last question, I’ve had patients with both conditions request a formal hearing. Overall, most felt they should have been rated for other factors in addition to Lupus or Fibro but I cannot think of any of them where the rating changed.
