What Is Chronic Fatigue Syndrome?

Chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME), is a complicated condition that is often characterized by extreme fatigue that lasts for at least six months which cannot be explained by a different medical condition. The fatigue worsens with mental and physical activity, but is not relieved by rest. Some other symptoms common to this condition are:

  • Unrefreshing sleep
  • Dizziness that worsens with moving from lying down to sitting upright or standing
  • Difficulties with memory and concentration
  • Headaches
  • Unexplained muscle or joint pain
  • Enlarged lymph nodes in the neck or armpits

The cause of CFS remains unknown, but there are many theories as to its etiology, including viral infections or psychological stress. Some doctors believe a combination of factors could cause the syndrome, which could explain its complicated presentation. While there is no single medical test that can definitively diagnose the condition, doctors often use a variety of medical tests to rule out other health conditions that have similar problems. Due to the uncertain cause of CFS, treatment typically focuses on reducing symptom severity.

Chronic Fatigue Syndrome And Veterans

Among veterans, CFS is most commonly diagnosed in those who served during the Gulf War era. Because of the frequency with which Gulf War Veterans receive a CFS diagnosis, the VA has made CFS a presumptive condition for service connection. This means that Gulf War veterans do not have to prove a connection between their CFS and their service to qualify for VA disability benefits for the condition. The only requirements are that the veteran’s CFS must have emerged to a degree of 10 percent disabling before December 31, 2021, or during active duty in the Southwest Asia theater of military operations, for the condition to be eligible for VA disability compensation.

How The VA Rates Chronic Fatigue Syndrome

Under 38 CFR § 4.88a, the VA diagnoses chronic fatigue syndrome if the following factors are met:

  1. New onset of debilitating fatigue severe enough to reduce daily activity to less than 50 percent of the usual level for at least six months; and
  2. The exclusion, by history, physical examination, and laboratory tests, of all other clinical conditions that may produce similar symptoms; and
  3. Six or more of the following:
    1. acute onset of the condition,
    2. low grade fever,
    3. nonexudative pharyngitis,
    4. palpable or tender cervical or axillary lymph nodes,
    5. generalized muscle aches or weakness,
    6. fatigue lasting 24 hours or longer after exercise,
    7. headaches (of a type, severity, or pattern that is different from headaches in the premorbid state),
    8. migratory joint pains,
    9. neuropsychological symptoms,
    10. sleep disturbance.

After officially diagnosing the condition, the VA evaluates the severity of the veteran’s CFS under 38 CFR § 4.88b using the following disability rating schedule:

Diagnostic Code 6354: Chronic fatigue syndrome (CFS) exhibiting debilitating fatigue, cognitive impairments (such as inability to concentrate, forgetfulness, or confusion), or a combination of other signs and symptoms:

  • 100 – Which are nearly constant and so severe as to restrict routine daily activities almost completely and which may occasionally preclude self-care
  • 60 – Which are nearly constant and restrict routine daily activities to less than 50 percent of the pre-illness level; or which wax and wane, resulting in periods of incapacitation of at least six weeks total duration per year
  • 40 – Which are nearly constant and restrict routine daily activities from 50 to 75 percent of the pre-illness level; or which wax and wane, resulting in periods of incapacitation of at least four but less than six weeks total duration per year
  • 20 – Which are nearly constant and restrict routine daily activities by less than 25 percent of the pre-illness level; or which wax and wane, resulting in periods of incapacitation of at least two but less than four weeks total duration per year
  • 10 – Which 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

For the purposes of evaluating this condition, incapacitation only exists when a licensed physical prescribes bed rest treatment for the affected veteran.

Getting Help With Your Chronic Fatigue Syndrome Claim

If you are a veteran looking for assistance with your CFS claim, our veterans disability lawyers are ready to help. We have experience helping veterans with CFS get the compensation to which they are entitled. Please contact our office today for more information and a free case evaluation.