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Chronic Fatigue Syndrome VA Disability Rating
DC 6354 | 38 C.F.R. § 4.88b | M21-1, Part IV.ii.1.D
OVERVIEW
Chronic fatigue syndrome (CFS) is characterized by persistent fatigue not relieved by rest, with associated symptoms including muscle pain, joint pain, headaches, cognitive difficulties, and sleep disturbance. Rated under DC 6354. Like fibromyalgia, CFS is a presumptive condition for Gulf War veterans under 38 C.F.R. 3.317 as a medically unexplained chronic multi-symptom illness. Maximum schedular rating is 100%.
RATING CRITERIA (5 LEVELS)
100% -- Nearly constant debilitating symptoms restricting routine daily activities to less than 50% of pre-illness level, or symptoms wax and wane resulting in periods of incapacitation of at least 6 weeks total per year
Severely debilitating fatigue with major functional limitation.
60% -- Nearly constant symptoms restricting routine daily activities to 50-75% of pre-illness level, or symptoms wax and wane resulting in periods of incapacitation of at least 4 but less than 6 weeks total per year
Significant functional restriction.
40% -- Nearly constant symptoms restricting routine daily activities by less than 25% of pre-illness level, or symptoms wax and wane resulting in periods of incapacitation of at least 2 but less than 4 weeks total per year
Moderate restriction of daily activities.
20% -- Periods of incapacitation of at least 1 but less than 2 weeks total per year, or symptoms controlled by continuous medication
Mild to moderate symptoms requiring ongoing treatment.
10% -- Periods of incapacitation of at least 1 but less than 2 weeks total per year, or symptoms controlled by continuous medication
Minimum compensable rating with documented treatment.
KEY EVIDENCE TO GATHER
-Medical diagnosis of CFS using established criteria (Fukuda 1994 or IOM 2015)
-Documentation of fatigue lasting 6+ months not explained by other conditions
-Exercise testing showing post-exertional malaise
-Gulf War service records (if claiming under 38 C.F.R. 3.317 presumptive)
-Activity diary showing restriction of daily activities compared to pre-illness baseline
SECONDARY CONDITIONS (2 MAPPED)
DC 9434
CFS and depression are highly comorbid.
DC 5025
CFS and fibromyalgia frequently co-occur and share overlapping symptoms.
C&P EXAM TIPS (4)
1.Gulf War veterans: CFS is PRESUMPTIVE under 38 C.F.R. 3.317. No direct nexus to a specific event is required.
2.The rating is based on restriction of daily activities compared to your pre-illness level. Document what you USED to do versus what you can do NOW.
3.Keep a detailed activity diary showing good days and bad days, what activities you can complete, and rest requirements.
4.An incapacitating episode means symptoms severe enough to require bed rest and treatment by a physician.
RELEVANT CASE LAW
38 C.F.R. 3.317
CFS is a qualifying chronic disability for Gulf War veterans as a medically unexplained chronic multi-symptom illness.
DOLLAR IMPACT
CFS at 40% pays $795.38/mo. At 60%, $1,432.71/mo. At 100%, $3,938.58/mo. Gulf War veterans with CFS and fibromyalgia frequently reach 80-100% combined.
EDUCATIONAL TOOL ONLY. NOT LEGAL OR MEDICAL ADVICE.
NOT AFFILIATED WITH THE U.S. DEPARTMENT OF VETERANS AFFAIRS.
CLAIM RECON 2026