What secondary conditions are linked to Gulf War Syndrome / Undiagnosed Illness?

Common secondary conditions for Gulf War Syndrome / Undiagnosed Illness include Chronic Fatigue Syndrome, Fibromyalgia, IBS, Cognitive Impairment, Chronic Headaches. Secondary service connection is established under 38 C.F.R. 3.310 when a condition is caused or aggravated by an already service-connected disability.

What happens during a C&P exam for Gulf War Syndrome / Undiagnosed Illness?

An active infectious disease is generally rated at 100% while active; once it resolves, it is rated at 0% and you are rated on the residual disability within the affected body system (38 CFR 4.88b) - claim each residual condition. Recurrence of active infection usually must be confirmed by culture, histopathology, or other diagnostic laboratory testing - make sure that confirmation is in your record.

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Gulf War Syndrome / Undiagnosed Illness

Q: What are the VA rating percentages for Gulf War Syndrome / Undiagnosed Illness?

Gulf War Syndrome / Undiagnosed Illness (DC 6354) is rated at 10%, 20%, 40%, 60%, 100% under 38 CFR § 3.317. Signs and symptoms of CFS that wax and wane but result in periods of incapacitation of at least one but less than two weeks total duration per year, or; symptoms controlled by continuous medication.

Q: What rates 10% for Gulf War Syndrome / Undiagnosed Illness under 38 CFR § 3.317?

Under 38 CFR § 3.317 (DC 6354), a 10% rating for Gulf War Syndrome / Undiagnosed Illness requires: Signs and symptoms of CFS that wax and wane but result in periods of incapacitation of at least one but less than two weeks total duration per year, or; symptoms controlled by continuous medication.

Q: What rates 20% for Gulf War Syndrome / Undiagnosed Illness under 38 CFR § 3.317?

Under 38 CFR § 3.317 (DC 6354), a 20% rating for Gulf War Syndrome / Undiagnosed Illness requires: Signs and symptoms are nearly constant and restrict routine daily activities by less than 25 percent of the pre-illness level, or; incapacitating episodes of at least two but less than four weeks total duration per year.

Q: What rates 40% for Gulf War Syndrome / Undiagnosed Illness under 38 CFR § 3.317?

Under 38 CFR § 3.317 (DC 6354), a 40% rating for Gulf War Syndrome / Undiagnosed Illness requires: Signs and symptoms are nearly constant and restrict routine daily activities to 50 to 75 percent of the pre-illness level, or; incapacitating episodes of at least four but less than six weeks total duration per year.

Q: What rates 60% for Gulf War Syndrome / Undiagnosed Illness under 38 CFR § 3.317?

Under 38 CFR § 3.317 (DC 6354), a 60% rating for Gulf War Syndrome / Undiagnosed Illness requires: Signs and symptoms are nearly constant and so severe as to restrict routine daily activities to less than 50 percent of the pre-illness level, or; incapacitating episodes of at least six weeks total duration per year.

Q: What rates 100% for Gulf War Syndrome / Undiagnosed Illness under 38 CFR § 3.317?

Under 38 CFR § 3.317 (DC 6354), a 100% rating for Gulf War Syndrome / Undiagnosed Illness requires: Signs and symptoms are nearly constant and so severe as to restrict routine daily activities almost completely and which may occasionally preclude self-care.

Q: What evidence do I need for a Gulf War Syndrome / Undiagnosed Illness VA claim?

Key evidence for a Gulf War Syndrome / Undiagnosed Illness claim includes: Laboratory confirmation of the infection (culture, histopathology, serology, or molecular testing); Records documenting the active-disease period and treatment dates; Treatment records for each residual condition, rated within its own body system; CD4/T4 cell counts and records of constitutional symptoms or opportunistic infections (HIV); Service records establishing the qualifying exposure or in-service onset (nexus). All evidence should document both the condition and its impact on daily functioning.

DC 635438 C.F.R. § 3.317

Diagnostic Code

DC 6354

38 C.F.R. § 3.317

Rating Range

10–100%

5 severity tiers

Source

Referenced

38 C.F.R. Part 4

Gulf War Syndrome / Undiagnosed Illness is rated by the U.S. Department of Veterans Affairs under DC 6354 of 38 CFR § 3.317 across 5 severity tiers (10% / 20% / 40% / 60% / 100%). Service connection requires (1) a current diagnosis, (2) an in-service event, injury, or exposure, and (3) a medical nexus opinion linking the two under 38 C.F.R. § 3.303. This condition is frequently rated as secondary to Chronic Fatigue Syndrome or Fibromyalgia under 38 C.F.R. § 3.310.

Educational tool only. Not legal or medical advice. Not affiliated with the VA.

Overview

Medically unexplained chronic multi-symptom illness affecting Gulf War veterans. Characterized by fatigue, pain, cognitive problems, GI issues, and other symptoms without a definitive medical diagnosis. Presumptive for veterans who served in Southwest Asia theater during Persian Gulf War.

Rating Criteria

10%

Signs and symptoms of CFS that wax and wane but result in periods of incapacitation of at least one but less than two weeks total duration per year, or; symptoms controlled by continuous medication.

20%

Signs and symptoms are nearly constant and restrict routine daily activities by less than 25 percent of the pre-illness level, or; incapacitating episodes of at least two but less than four weeks total duration per year.

40%

Signs and symptoms are nearly constant and restrict routine daily activities to 50 to 75 percent of the pre-illness level, or; incapacitating episodes of at least four but less than six weeks total duration per year.

60%

Signs and symptoms are nearly constant and so severe as to restrict routine daily activities to less than 50 percent of the pre-illness level, or; incapacitating episodes of at least six weeks total duration per year.

100%

Signs and symptoms are nearly constant and so severe as to restrict routine daily activities almost completely and which may occasionally preclude self-care.

Key Evidence

—Laboratory confirmation of the infection (culture, histopathology, serology, or molecular testing)

—Records documenting the active-disease period and treatment dates

—Treatment records for each residual condition, rated within its own body system

—CD4/T4 cell counts and records of constitutional symptoms or opportunistic infections (HIV)

—Service records establishing the qualifying exposure or in-service onset (nexus)

—Complete list of prescribed medications and their side effects

C&P Exam Tips

1An active infectious disease is generally rated at 100% while active; once it resolves, it is rated at 0% and you are rated on the residual disability within the affected body system (38 CFR 4.88b) - claim each residual condition.

2Recurrence of active infection usually must be confirmed by culture, histopathology, or other diagnostic laboratory testing - make sure that confirmation is in your record.

3Identify and claim every residual (for example, arthritis, neuropathy, liver or kidney damage, or cognitive issues) - that is where most lasting compensation comes from after the active phase.

4For HIV-related illness (DC 6351), the rating turns on CD4/T4 cell count thresholds (for example, under 200, or 200-500) plus constitutional symptoms and opportunistic infections - bring your CD4 labs.

5Some infections carry presumptive long-term health effects under 38 CFR 3.317 - note any qualifying service exposure that supports the nexus.

6Report your worst days, list all medications and side effects, and describe how the illness and its residuals affect work and daily activity.

Secondary Conditions

Chronic Fatigue SyndromeMODERATE

Unexplained chronic fatigue is core symptom

FibromyalgiaMODERATE

Widespread pain is common manifestation

IBSMODERATE

GI dysfunction is a hallmark symptom

Cognitive ImpairmentMODERATE

Memory and concentration problems

Chronic HeadachesMODERATE

Persistent headaches are common

Joint PainMODERATE

Unexplained musculoskeletal pain

Respiratory ConditionsMODERATE

Burn pit and environmental exposure effects

Sleep DisordersMODERATE

Sleep disturbance is common symptom

Major Depressive DisorderMODERATE

Chronic illness causes depression

Chronic FatigueMODERATE

Hallmark symptom of Gulf War illness

FibromyalgiaMODERATE

Central sensitization from toxic exposures

IBSMODERATE

GI dysfunction common in Gulf War veterans

Cognitive ImpairmentMODERATE

Neurological effects of toxic exposure

Joint PainMODERATE

Widespread musculoskeletal symptoms

Skin ConditionsMODERATE

Dermatological manifestations

Tools

Rating Calculator →Secondaries Explorer →C&P Exam Prep →PACT Act Scanner →2026 Rates →

Sources & Editorial

Rating criteria reference 38 C.F.R. Part 4 (Schedule for Rating Disabilities). This entry has not yet undergone editorial review against the live regulation text — consult the authoritative source directly before relying on the criteria shown.

View 38 C.F.R. Part 4 on eCFR →Editorial Standards →Suggest a correction →

EDUCATIONAL TOOL ONLY. NOT LEGAL OR MEDICAL ADVICE.
NOT AFFILIATED WITH THE U.S. DEPARTMENT OF VETERANS AFFAIRS.
CLAIM RECON 2026

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