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VA rating schedule, diagnostic code 6354
Chronic fatigue syndrome (CFS) is a condition the VA recognizes with its own official definition in the rating rules. Under VA's standards, a diagnosis of CFS requires new onset of debilitating fatigue that is severe enough to cut your daily activity to less than 50 percent of your usual level for at least six months, the ruling-out of other illnesses that could cause similar symptoms (through history, physical exam, and lab tests), and six or more specific signs such as low-grade fever, generalized muscle aches or weakness, fatigue lasting 24 hours or longer after exercise, headaches different from before, migratory joint pains, sleep disturbance, or neuropsychologic symptoms. Meeting this definition is how the VA establishes the condition for rating purposes.
The VA rates CFS under diagnostic code 6354. It is rated at 10, 20, 40, 60, or 100 percent. What drives a higher percentage is how constant and severe the symptoms are and how much they restrict your routine daily activities, plus how many weeks per year you are "incapacitated." For example, the 100 percent level describes symptoms that are nearly constant and so severe they almost completely restrict daily activities and may sometimes prevent self-care, while lower levels describe symptoms that restrict activity less or that wax and wane with fewer weeks of incapacitation. One important detail: for this code, the VA counts a period as "incapacitation" only when a licensed physician has prescribed bed rest and treatment, so keeping medical records of those orders matters.
There is also an exposure pathway that can change how service connection works. For veterans who served in the Persian Gulf (Southwest Asia theater), the VA treats CFS as one of the "medically unexplained chronic multisymptom illnesses" that can be presumed connected to service under its Gulf War rules, alongside fibromyalgia and certain functional gastrointestinal disorders. Under those rules the disability generally must appear during qualifying service or become at least 10 percent disabling by December 31, 2026, and not be attributable to a known diagnosis. When this presumptive pathway applies, it can ease the usual requirement to prove a direct medical link ("nexus") between the condition and service.
This is educational information about how the VA's rules generally work — it is not legal advice or a VA decision about any individual claim.
Grounded in federal regulations and VA guidance, independently reviewed June 2026. Educational information, not legal advice or a VA determination.
Across 7,198 real Board appeals for Chronic fatigue syndrome
A denial is often not the end either — remands (shown below) are sent back for more development and can still end in a grant. These are historical outcomes, not a prediction of your case.
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Among the appeals that were granted or partly granted, the most common ways Chronic fatigue syndrome was linked to service:
In appeals where Chronic fatigue syndrome was the only condition decided and the Board granted it, the rating most often assigned was:
These appeals involved a recognized exposure — which can mean the link to service is presumed, with no nexus to prove:
The Veteran's claims for service connection for chronic fatigue syndrome, IBS with GERD, and OSA were denied. The claim for OSA was granted due to the receipt of new evidence showing a current disability.
The Veteran's service connection claims for various conditions were granted effective from July 1, 2020.
The Veteran's PTSD and associated conditions are granted effective from November 15, 2024.
The Board has granted service connection for allergic rhinitis, finding that the Veteran's symptoms worsened during service and are related to his military service. Service connection was denied for chronic fatigue syndrome due to lack of evidence meeting all criteria for diagnosis.
The Veteran's claim for service connection for sleep apnea was granted with an effective date of January 26, 2022. His claim for chronic fatigue syndrome remains pending.
The Veteran's claim for a TDIU was granted with an effective date of May 3, 2016. The decision is based on the Veteran's service-connected disabilities including his CFS and adjustment disorder.
Jump to the decisions from a specific year.
New decisions are added every week, and older years are actively being backfilled — a year that looks thin or missing here (especially 2011–2017) is a gap in our library, not in the Board’s decisions.
Veterans appealing Chronic fatigue syndrome often look at outcomes for these too:
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This is general information, not legal advice. For advice about your own situation, talk to a VA-accredited representative — many help for free.