<aside> 💡 Chronic Fatigue Syndrome is a complex disorder characterized by extreme fatigue in veteran’s that can’t be explained by any specific medical condition. A veteran’s level of fatigue may worsen with physical or mental activity but doesn’t improve with rest. According to the Mayo Clinic, Chronic Fatigue Syndrome is a systemic exertion intolerance disease (SEID) or myalgic encephalomyelitis (ME). Sometimes it’s abbreviated as ME/CFS for VA rating purposes.

There’s no single test to confirm a diagnosis of Chronic Fatigue Syndrome. You may need a variety of medical tests (to include a blood test and lab work) to rule out other health problems and conditions that have similar symptoms to Chronic Fatigue Syndrome.

</aside>

<aside> <img src="https://s3-us-west-2.amazonaws.com/secure.notion-static.com/c825bc34-9079-4821-984c-9129ce20838d/question.png" alt="https://s3-us-west-2.amazonaws.com/secure.notion-static.com/c825bc34-9079-4821-984c-9129ce20838d/question.png" width="40px" /> The etiology (cause or origin) of Chronic Fatigue Syndrome is unknown, although there are many theories — ranging from viral infections to psychological stress to exposure of toxins and chemicals.

<aside> <img src="https://s3-us-west-2.amazonaws.com/secure.notion-static.com/02ee89fe-f68e-467f-a1ee-53e7ad248a49/asthma.png" alt="https://s3-us-west-2.amazonaws.com/secure.notion-static.com/02ee89fe-f68e-467f-a1ee-53e7ad248a49/asthma.png" width="40px" /> Signs & Symptoms Some of the more common signs and symptoms of Chronic Fatigue Syndrome in veterans include:

</aside>

</aside>

<aside> <img src="https://s3-us-west-2.amazonaws.com/secure.notion-static.com/782967a1-e0cb-4855-b7d9-abc42a204eac/no.png" alt="https://s3-us-west-2.amazonaws.com/secure.notion-static.com/782967a1-e0cb-4855-b7d9-abc42a204eac/no.png" width="40px" /> Process of Elimination A Diagnosis of Chronic Fatigue Syndrome is often made by ruling out other conditions such as:

<aside> <img src="https://s3-us-west-2.amazonaws.com/secure.notion-static.com/e7818d70-43f7-45ce-add7-f067ce698caf/bindersonshelf.png" alt="https://s3-us-west-2.amazonaws.com/secure.notion-static.com/e7818d70-43f7-45ce-add7-f067ce698caf/bindersonshelf.png" width="40px" /> Resources

Chronic Fatigue Secondary to PTSD

Comp & Pen Exam

Secondary Conditions Database (insert backlink)

Medical Research Database (insert backlink)

Webinars & Trainings (insert backlink)

</aside>

<aside> <img src="https://s3-us-west-2.amazonaws.com/secure.notion-static.com/7bec8a88-252d-4abd-ad20-166aa59cced6/Attacking_Comp_and_Pen_Exam.png" alt="https://s3-us-west-2.amazonaws.com/secure.notion-static.com/7bec8a88-252d-4abd-ad20-166aa59cced6/Attacking_Comp_and_Pen_Exam.png" width="40px" /> The Connection Between Chronic Fatigue Syndrome and Gulf War Veterans

One thing we do know is that veterans who served in Southwest Asia theater of operations are more prone to developing Chronic Fatigue Syndrome, although researchers don’t exactly know why. A 2005 study confirmed that veterans who deployed to the Persian Gulf during the 1991 Gulf War have an increased risk for Fibromyalgia, Chronic Fatigue Syndrome, Skin Conditions, and Dyspepsia. The VA has recognized medically unexplained illnesses, more commonly referred to as “Gulf War Syndrome,” and certain infectious diseases to include Chronic Fatigue Syndrome.*The chronic fatigue syndrome must have emerged during active duty in the Southwest Asia theater of military operations on or by December 31, 2021, and be at least 10 percent disabling.

A “Persian Gulf Veteran” is one who served in the Southwest Asia theater of operations during the Persian Gulf War. See 38 CFR § 3.317(e)(1). The Southwest Asia theater of operations includes Iraq, Kuwait, Saudi Arabia, the neutral zone between Iraq and Saudi Arabia, Bahrain, Qatar, the United Arab Emirates, Oman, the Gulf of Aden, the Gulf of Oman, the Persian Gulf, the Arabian Sea, the Red Sea, and the airspace above these locations. See (38 CFR § 3.317(e)(2).

The term “qualifying chronic disability” means a chronic disability resulting from any of the following (or any combination of the following): (A) an undiagnosed illness; (B) a medically unexplained chronic multisymptomatic illness that is defined by a cluster of signs or symptoms, such as: (1) chronic fatigue syndrome; (2) fibromyalgia; (3) functional gastrointestinal disorders (excluding structural gastrointestinal disease).

</aside>

<aside> <img src="https://s3-us-west-2.amazonaws.com/secure.notion-static.com/fad79e08-07c9-41d2-a3c1-0868a20df166/exam_512px.png" alt="https://s3-us-west-2.amazonaws.com/secure.notion-static.com/fad79e08-07c9-41d2-a3c1-0868a20df166/exam_512px.png" width="40px" /> VA Disability Rating Criteria for Chronic Fatigue Syndrome

According to 38 CFR, Part 4, the Schedule for Rating Disabilities, paragraph § 4.88a the diagnosis of Chronic Fatigue Syndrome for VA rating purposes requires the following:

  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 (6) or more of the following:
    1. Acute onset of Chronic Fatigue Syndrome (a sudden and unexpected outbreak or recurrence)
    2. Low grade fever
    3. Nonexudative pharyngitis (inflammation of the back of the throat called the pharynx),
    4. Palpable (able to be felt) or tender cervical (neck) or axillary lymph nodes (underarm area)
    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 pre-morbid state)
    8. Migratory joint pains
    9. Neuropsychologic symptoms (memory, mood, learning problems)
    10. Sleep disturbances </aside>

<aside> <img src="https://s3-us-west-2.amazonaws.com/secure.notion-static.com/61bea29d-bbcc-4b52-a48b-e5631aa2b9b3/exam_512px.png" alt="https://s3-us-west-2.amazonaws.com/secure.notion-static.com/61bea29d-bbcc-4b52-a48b-e5631aa2b9b3/exam_512px.png" width="40px" /> 6354 Chronic Fatigue Syndrome VA Rating Criteria

Rating
Debilitating fatigue, cognitive impairments (such as inability to concentrate, forgetfulness, or confusion), or a combination of other signs and symptoms:
Which are nearly constant and so severe as to restrict routine daily activities almost completely and which may occasionally preclude self-care 100%
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 60%
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 40%
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 20%
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 10%
Note: For evaluating this disability, incapacitation exists only when a licensed physician prescribes bed rest and treatment.
</aside>