Diagnostic Code 6354 · 38 CFR §4.88b
Chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME/CFS), is a complex condition characterized by profound fatigue that is not improved by rest and is worsened by physical or mental exertion. Diagnosis requires the fatigue to persist for six months or more and to significantly reduce activity levels. CFS is particularly relevant for Gulf War veterans, as it is recognized as a qualifying medically unexplained chronic multi-symptom illness under 38 CFR 3.317.
| Rating | Criteria |
|---|---|
| 10% | Symptoms 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% | Symptoms that are nearly constant and restrict routine daily activities by less than 25 percent of the pre-illness level, or symptoms that wax and wane resulting in periods of incapacitation of at least two but less than four weeks total duration per year. |
| 40% | Symptoms that are nearly constant and restrict routine daily activities to 50 to 75 percent of the pre-illness level, or symptoms that wax and wane resulting in periods of incapacitation of at least four but less than six weeks total duration per year. |
| 60% | Symptoms that are nearly constant and restrict routine daily activities to less than 50 percent of the pre-illness level, or symptoms that wax and wane resulting in periods of incapacitation of at least six weeks total duration per year. |
| 100% | Symptoms that are nearly constant and so severe as to restrict routine daily activities almost completely and which may occasionally preclude self-care. |
CFS diagnosis requires new onset of debilitating fatigue severe enough to reduce daily activity to less than 50 percent of the pre-illness level for at least six months, plus exclusion of other conditions. You also need six or more qualifying symptoms. For Gulf War veterans, evidence of service in Southwest Asia plus the diagnosis may be sufficient under the presumptive framework.
Yes. CFS qualifies as a medically unexplained chronic multi-symptom illness under 38 CFR 3.317 for veterans who served in the Southwest Asia theater of operations.
Keep a detailed daily activity journal documenting what you do each day compared to what you did before CFS onset.
Yes. CFS can be claimed secondary to conditions that cause chronic sleep disruption, immune dysfunction, or prolonged physical stress.