Chronic Fatigue Syndrome — VA Rating Guide

The rating ladder

What the VA looks for at each percentage.

How to describe it (and win the rating)

• Document the total number of weeks of incapacitation per year, since duration of incapacitating episodes drives several tiers (10%: 1–<2 wks; 20%: 2–<4 wks; 40%: 4–<6 wks; 60%: ≥6 wks).
• Per the regulatory note, a period of incapacitation means a period during which a physician has prescribed bed rest and treatment — get provider-prescribed bed rest documented in the record.
• Quantify the restriction of routine daily activities as a percentage of pre-illness level, because tiers hinge on precise ranges (20%: <25% restriction; 40%: 50–75% level; 60%: <50% level).
• Establish a pre-illness baseline of daily activity to make the percentage-of-restriction comparison meaningful.
• Note whether symptoms are 'nearly constant' versus 'wax and wane,' as this determines which prong of the criteria applies.
• For the 10% tier, document if symptoms are controlled by continuous medication.

Evidence that helps

• Diagnosis of chronic fatigue syndrome meeting the diagnostic criteria referenced in the rating schedule
• Physician-prescribed bed rest and treatment records establishing incapacitating episodes
• Calendar or log documenting total weeks of incapacitation per year
• Clinical documentation of debilitating fatigue
• Documentation of cognitive impairments (inability to concentrate, forgetfulness, confusion)
• Assessment quantifying restriction of routine daily activities as a percentage of pre-illness level
• Medication list showing continuous medication used to control symptoms (relevant to 10% tier)
• Evidence regarding ability to perform self-care (relevant to 100% tier)

Next steps

Related conditions & secondary claims

Conditions medically linked to Chronic Fatigue Syndrome — each can be worth a separate or secondary claim:

• Fibromyalgia — CFS and fibromyalgia are both Gulf War presumptive conditions and frequently co-occur.
• IBS — Functional GI illness like IBS is part of the same Gulf War symptom cluster.

Common questions

What is the VA disability rating for chronic fatigue syndrome?

The VA rates chronic fatigue syndrome under 38 CFR diagnostic code 6354. The rating tiers are: 10% — Debilitating fatigue, cognitive impairments (such as inability to concentrate, forgetfulness, confusion), or a combination of other signs and 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 the symptoms are controlled by continuous medication.; 20% — Debilitating fatigue, cognitive impairments, or a combination of other signs and symptoms that are nearly constant and restrict routine daily activities by less than 25 percent of the pre-illness level; or the symptoms wax and wane, resulting in periods of incapacitation of at least two but less than four weeks total duration per year.; 40% — Debilitating fatigue, cognitive impairments, or a combination of other signs and symptoms that are nearly constant and restrict routine daily activities to 50 to 75 percent of the pre-illness level; or the symptoms wax and wane, resulting in periods of incapacitation of at least four but less than six weeks total duration per year.; 60% — Debilitating fatigue, cognitive impairments, or a combination of other signs and symptoms that are nearly constant and restrict routine daily activities to less than 50 percent of the pre-illness level; or the symptoms wax and wane, resulting in periods of incapacitation of at least six weeks total duration per year.; 100% — Debilitating fatigue, cognitive impairments, or a combination of other signs and symptoms that are nearly constant and so severe as to restrict routine daily activities almost completely and which may occasionally preclude self-care.. Your exact percentage depends on the severity documented in your records and C&P exam.

How much VA disability compensation is chronic fatigue syndrome?

Monthly pay depends on your assigned rating percentage and your dependents, not the condition alone. Chronic Fatigue Syndrome can be rated from 10% to 100%. Use the free US Vet Help disability calculator for your exact 2026 monthly amount.

What evidence do I need for a chronic fatigue syndrome VA claim?

Evidence that helps includes: Diagnosis of chronic fatigue syndrome meeting the diagnostic criteria referenced in the rating schedule; Physician-prescribed bed rest and treatment records establishing incapacitating episodes; Calendar or log documenting total weeks of incapacitation per year; Clinical documentation of debilitating fatigue; Documentation of cognitive impairments (inability to concentrate, forgetfulness, confusion); Assessment quantifying restriction of routine daily activities as a percentage of pre-illness level; Medication list showing continuous medication used to control symptoms (relevant to 10% tier); Evidence regarding ability to perform self-care (relevant to 100% tier).

How do I get the correct rating for chronic fatigue syndrome?

To be rated accurately: Document the total number of weeks of incapacitation per year, since duration of incapacitating episodes drives several tiers (10%: 1–<2 wks; 20%: 2–<4 wks; 40%: 4–<6 wks; 60%: ≥6 wks).; Per the regulatory note, a period of incapacitation means a period during which a physician has prescribed bed rest and treatment — get provider-prescribed bed rest documented in the record.; Quantify the restriction of routine daily activities as a percentage of pre-illness level, because tiers hinge on precise ranges (20%: <25% restriction; 40%: 50–75% level; 60%: <50% level).; Establish a pre-illness baseline of daily activity to make the percentage-of-restriction comparison meaningful.; Note whether symptoms are 'nearly constant' versus 'wax and wane,' as this determines which prong of the criteria applies.; For the 10% tier, document if symptoms are controlled by continuous medication..