Chronic Fatigue Syndrome (CFS/ME)
Chronic Fatigue Syndrome (CFS/ME) is rated under 38 CFR 38 CFR § 4.88a, DC 6354, Diagnostic Code 6354, from 0% to 100% based on the frequency and functional severity of symptoms. The maximum 100% rating requires: Which are nearly constant and so severe as to restrict routine daily activities almost completely and which may occasionally preclude self-care. Most claims establish the 0% or 10% rating before reaching the top tier.
Rating schedule — DC 6354 at a glance
- Minimum rating
- 0%
- Maximum rating
- 100%
- Rating tiers
- 6
- CFR section
- 38 CFR § 4.88a, DC 6354
- Body system
- Infectious Diseases
- Secondary conditions
- 1
Lowest schedular rating available
Full schedular disability
0%, 10%, 20%, 40%, 60%, 100%
Part 4 rating schedule
Mapped in our database
What are the VA rating criteria for Chronic Fatigue Syndrome (CFS/ME)?
Diagnosis of CFS established but symptoms controlled by continuous medication.
Note: Diagnosis requires CDC criteria: unexplained fatigue >6 months, plus 4 or more of 8 symptoms. Service connection frequently granted for Gulf War veterans. No 10% tier exists under 38 CFR § 4.88a.
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
Note: Diagnosis requires CDC criteria: unexplained fatigue >6 months, plus 4 or more of 8 symptoms. Service connection frequently granted for Gulf War veterans.
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
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
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
Which are nearly constant and so severe as to restrict routine daily activities almost completely and which may occasionally preclude self-care
“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”
Which conditions are commonly secondary to Chronic Fatigue Syndrome (CFS/ME)?
View 1 secondary condition linked to Chronic Fatigue Syndrome (CFS/ME)
Medical rationale, evidence strength, and filing tips — rated under 38 CFR § 3.310
Common Questions About Chronic Fatigue Syndrome (CFS/ME) VA Ratings
What is the VA rating range for Chronic Fatigue Syndrome (CFS/ME)?
The VA rates Chronic Fatigue Syndrome (CFS/ME) under Diagnostic Code 6354 at 0%, 10%, 20%, 40%, 60%, 100%. The minimum 0% rating requires: Diagnosis of CFS established but symptoms controlled by continuous medication.. The maximum 100% rating requires: Which are nearly constant and so severe as to restrict routine daily activities almost completely and which may occasionally preclude self-care.
Which 38 CFR diagnostic code does the VA use for Chronic Fatigue Syndrome (CFS/ME)?
The VA rates Chronic Fatigue Syndrome (CFS/ME) under Diagnostic Code (DC) 6354, governed by 38 CFR 38 CFR § 4.88a, DC 6354. The diagnostic code establishes the specific rating tiers and severity criteria the VA examiner applies.
What is the difference between a 0% and a 100% rating for Chronic Fatigue Syndrome (CFS/ME)?
A 0% rating requires: Diagnosis of CFS established but symptoms controlled by continuous medication.. A 100% rating requires: Which are nearly constant and so severe as to restrict routine daily activities almost completely and which may occasionally preclude self-care. The difference typically reflects the frequency, severity, or functional impact of the condition as documented in medical records and C&P examination findings.
Can Chronic Fatigue Syndrome (CFS/ME) qualify for TDIU (Total Disability Individual Unemployability)?
Veterans rated for Chronic Fatigue Syndrome (CFS/ME) may qualify for TDIU if the condition — alone or in combination with other service-connected disabilities — prevents substantially gainful employment. A single disability rated at 60% or higher (or multiple disabilities combining to 70%, with one at 40%) can support a TDIU claim under 38 CFR § 4.16.
What evidence do I need to establish service connection for Chronic Fatigue Syndrome (CFS/ME)?
Service connection for Chronic Fatigue Syndrome (CFS/ME) requires three elements: (1) a current diagnosis of the condition, (2) an in-service event, injury, or disease, and (3) a medical nexus linking the current diagnosis to that in-service occurrence. A nexus letter from a treating or independent medical examiner is the most reliable nexus evidence.
Which conditions are commonly secondary to Chronic Fatigue Syndrome (CFS/ME)?
Chronic Fatigue Syndrome (CFS/ME) is associated with 1 documented secondary condition. Secondary conditions caused or aggravated by a service-connected disability are ratable under 38 CFR § 3.310. See the secondary conditions page for the full list with medical rationale and evidence strength ratings.
What is the C&P exam like for Chronic Fatigue Syndrome (CFS/ME)?
A Compensation & Pension (C&P) exam for Chronic Fatigue Syndrome (CFS/ME) uses a Disability Benefits Questionnaire (DBQ) specific to the body system involved. The examiner documents the frequency, severity, and functional impact of your symptoms. Bring all relevant treatment records and be prepared to describe your worst-day symptoms — the examiner rates your condition based on the full clinical picture, not a single visit.
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