Chronic Fatigue as a Condition for VA Disability Compensation and Benefits

Fatigue and military service usually goes hand in hand. Most military veterans recognize the symptoms of fatigue because they were exposed to it as an active duty servicemember during times of high operational tempo or deployment. Sometimes the mission and the sense of belonging to a team compelled us to push through feeling extremely tired or minor injuries. The VA recognizes fatigue as a condition eligible for a rating and compensation, but this chronic fatigue is much more severe and long lasting than what we might have experienced during periods of active duty service or combat.

The VA recognizes fatigue as a condition for a disability rating for certain symptoms related to chronic fatigue that are similar to more prolonged illness, such as Chronic Fatigue Syndrome (CFS). Chronic Fatigue Syndrome is much more severe than just being tired or feeling worn out. According to a book available through the National Institutes of Health, it is a condition of “continuing, debilitating fatigue, which is made worse by even mild exercise.”[1]  One cannot simply cure it by resting, although rest would likely be part of a treatment plan prescribed by a physician.

The VA defines Chronic Fatigue Syndrome as:

  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 or more of the following:
    • acute onset of the condition,
    • low grade fever,
    • nonexudative pharyngitis,
    • palpable or tender cervical or axillary lymph nodes,
    • generalized muscle aches or weakness,
    • fatigue lasting 24 hours or longer after exercise,
    • headaches (of a type, severity, or pattern that is different from headaches in the pre-morbid state),
    • migratory joint pains,
    • neuropsychologic symptoms,
    • sleep disturbance.

(38 C.F.R. § 4.88a(a))

A veteran could obtain this type of rating through application for service-connected disability. Remember that to obtain service-connected disability the veteran must show 1) a current disability, 2) an occurrence of an injury or event while in service, and 3) a nexus or link between the current disability and that in-service event. 

Another way, for Gulf War era veterans, is through a presumptive condition. Presumptions, with the proper evidence, can simplify the steps and evidence needed for typical service-connected disability.  In order to qualify for this presumptive service connection, you must show the you (1) SERVED IN THE QUALIFYING AREA, (2) DURING THE QUALIFYING PERIOD, and (3) HAVE SOME OF THE SYMPTOMS TO A DEGREE OF AT LEAST 10%. 

  • AREAS – The qualifying areas for this presumption are Iraq, Kuwait, Saudi Arabia, any 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.[2]
  • PERIOD – The first eligibility for this was created by congress in 1994 and has been updated ever since. It spans service from August 2, 1990 through the present to extend to December 31 of 2026.
  • SYMPTOMS – If you have a diagnosis of CFS, you need to show “debilitating fatigue, cognitive impairments (such as inability to concentrate, forgetfulness, or confusion), or a combination of other signs and symptoms [w]hich 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.” (38 C.F.R. § 4.88(b), diagnostic code 6354). If you do not have a diagnosis, you would need to show multiple symptoms listed above 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.

[1] Amit Sapra, Priyanka Bhandari; Chronic Fatigue Syndrome. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan. Available at:

[2] See 38 C.F.R. §3.317(e)(2) and VA Training Letter 10-01 (Feb. 4, 2010).

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