Chronic fatigue syndrome

VA rates chronic fatigue syndrome (CFS) under diagnostic code 6354 based on how severely your debilitating fatigue, cognitive impairments — such as inability to concentrate, forgetfulness, or confusion — or a combination of other signs and symptoms affect your daily life. The rating scale has five levels: 100%, 60%, 40%, 20%, and 10%.

The 100% rating applies when symptoms are nearly constant, restrict routine daily activities almost completely, and may occasionally prevent you from caring for yourself. The 60% rating applies when nearly constant symptoms restrict your routine daily activities to less than 50 percent of your pre-illness level, or when symptoms wax and wane and cause at least six total weeks of incapacitation per year. The 40% rating applies when symptoms restrict daily activities from 50 to 75 percent of your pre-illness level, or cause at least four but fewer than six total weeks of incapacitation per year. The 20% rating applies when symptoms restrict daily activities by less than 25 percent of your pre-illness level, or cause at least two but fewer than four total weeks of incapacitation per year. The 10% rating applies when waxing and waning symptoms cause at least one but fewer than two total weeks of incapacitation per year, or when symptoms are controlled by continuous medication. For rating purposes, incapacitation exists only when a licensed physician has prescribed bed rest and treatment.