Chronic Fatigue Syndrome

Your doctor will complete VA Form 21-0960Q-1 (Chronic Fatigue Syndrome DBQ) after examining you. This walkthrough helps you prepare them. The DBQ is a standardized questionnaire; your doctor's answers directly determine your VA rating. Brief them on these specific points before the exam so nothing important is missed or underdocumented.

Common mistakes

• ×Asking your doctor to just "fill out the VA form" without briefing them - an uninformed completion is often generic and leads to lower ratings.
• ×Bringing the DBQ to a provider who has never seen you before - your treating physician who knows your history will write the most credible documentation.
• ×Going to the exam and waiting for the doctor to ask questions - come prepared with specific examples of your worst days and functional limitations.

These are the key clinical questions from the Chronic Fatigue Syndrome DBQ. Help your doctor understand what each question is asking and give them concrete examples for your situation. Print this section and bring it to the appointment. 1. Are debilitating fatigue symptoms nearly constant? WHY IT MATTERS: Constant symptoms warrant higher (40%) rating TIPS: Describe fatigue that is not relieved by rest 2. What are the associated symptoms? WHY IT MATTERS: At least 6 of 10 specified symptoms must be documented TIPS: Report: low-grade fever, sore throat, lymph node pain, muscle/joint pain; Also: generalized weakness, headaches, sleep disturbance; Also: neuropsychological complaints, sensitivity to bright light 3. Do symptoms restrict routine daily activities? WHY IT MATTERS: Restriction level determines between 20% and 40% rating TIPS: Describe specific activities you can no longer do or must limit

Common mistakes

• ×Not documenting at least 6 of the specified associated symptoms
• ×Failing to quantify restriction of daily activities
• ×Not bringing treatment records showing ongoing care

VA raters use the Chronic Fatigue Syndrome DBQ to determine your disability rating. The most important rating factors for this condition are: 1. 10%: Symptoms controlled by continuous medication 2. 20%: Nearly constant, restrict routine activities by less than 25% 3. 40%: Nearly constant, restrict routine activities to 50-75% of pre-illness level 4. 60%: Restrict routine activities to less than 50% 5. 100%: So severe as to restrict activities almost completely For each factor, give your doctor specific examples from your daily life so they can document accurately (not generically).

Common mistakes

• ×Minimizing cognitive symptoms

Authority

• 38 CFR 4.1 - Functional impairment as the basis for rating.

Preparation checklist for the Chronic Fatigue Syndrome DBQ exam: 1. Track daily activity levels and limitations for 3+ months 2. Document all associated symptoms with frequency 3. Quantify what percentage of normal activities you can maintain 4. Bring treatment records showing continuous care Remember: Describe your WORST days, not your average days. VA raters evaluate the full range of your disability including its worst manifestations.

Common mistakes

• ×Describing your best days or average functioning instead of your worst - VA rates the full range of disability.
• ×Minimizing symptoms out of stoicism or pride - accurate documentation is not exaggeration; it is honesty.
• ×Not mentioning secondary symptoms, side effects, or additional conditions the doctor may not ask about.