Fatigue is something nearly every veteran experiences at one point or another—but chronic fatigue is far more than just feeling tired. It’s a debilitating condition that can significantly affect a veteran’s ability to function, work, and maintain relationships. Despite this, chronic fatigue is often misunderstood or overlooked in the VA disability system.
In this post, we’ll explore how chronic fatigue can qualify for VA compensation both as a standalone condition and as a secondary condition to other service-connected issues. If you’re constantly exhausted despite rest, this blog may shed light on a path toward the benefits and recognition you deserve.
What Is Chronic Fatigue?
Chronic fatigue is a medical condition characterized by persistent, unexplained tiredness that doesn’t improve with sleep or rest. It’s important to distinguish chronic fatigue from just being “worn out.” With chronic fatigue, veterans often experience:
Exhaustion lasting more than six months
Impaired short-term memory or concentration
Unrefreshing sleep
Muscle and joint pain without swelling
Sore throat or tender lymph nodes
Post-exertional malaise (worsening symptoms after physical activity)
When these symptoms meet specific criteria, a veteran may be diagnosed with Chronic Fatigue Syndrome (CFS), also referred to as Myalgic Encephalomyelitis (ME/CFS).
Can You File a VA Claim for Chronic Fatigue?
Yes—veterans can file a claim for Chronic Fatigue Syndrome (CFS) under VA Diagnostic Code 6354, listed in 38 CFR § 4.88b. CFS is considered a medically unexplained chronic multisymptom illness (MUCMI) and is presumptively service-connected for certain veterans, especially those who served in the Gulf War.
However, you can also file for chronic fatigue as a secondary condition to an already service-connected disability.
VA Disability Ratings for Chronic Fatigue Syndrome
The VA uses a tiered rating system for CFS, primarily based on the severity and frequency of symptoms. Here’s how it breaks down:
| Rating | Criteria |
|---|---|
| 100% | Symptoms are nearly constant and so severe that they restrict daily activities almost completely. |
| 60% | Symptoms are nearly constant and restrict routine activities to less than 50% of normal. |
| 40% | Symptoms result in routine activity reduced to 50-75% of normal. |
| 20% | Symptoms are episodic but occur at least once per week and cause moderate impairment. |
| 10% | Symptoms are episodic but less frequent, causing mild impairment. |
To qualify, symptoms must be documented in medical records for at least six months and not explained by another condition.
Who Qualifies for Presumptive Service Connection?
The VA grants presumptive service connection for CFS if you meet these criteria:
Served in the Southwest Asia theater of military operations during or after August 2, 1990
Symptoms manifested during service or became disabling to a compensable degree within a specific period after service
The condition has persisted for six months or more
No other diagnosis can fully explain the symptoms
This includes service in:
Iraq
Kuwait
Saudi Arabia
Afghanistan (in certain circumstances)
If you qualify, the burden of proof is lower—meaning you don’t need to prove direct causation between your service and your condition.
Chronic Fatigue as a Secondary Condition
Even if you don’t qualify for presumptive service connection, you may still be eligible if your chronic fatigue is secondary to a service-connected disability.
Common primary conditions that lead to chronic fatigue include:
PTSD – The constant state of alertness and poor sleep associated with PTSD often results in chronic exhaustion.
Depression or anxiety – Both can significantly impact energy levels and sleep quality.
Sleep apnea – A major cause of unrefreshing sleep, which can result in severe daytime fatigue.
Fibromyalgia – Often coexists with CFS and shares overlapping symptoms.
Autoimmune diseases – Conditions like lupus or rheumatoid arthritis can induce fatigue due to inflammation.
Real-World Scenario: A Veteran’s Journey
Case Study:
Sergeant Alicia served in Kuwait during the Gulf War. After leaving service, she developed ongoing fatigue, memory fog, and muscle aches. Doctors couldn’t explain her symptoms through blood tests or scans. Eventually, she was diagnosed with Chronic Fatigue Syndrome.
Because of her Gulf War service, her condition was presumed service-connected. She was awarded a 60% rating, which increased her total compensation and made her eligible for additional support services, including vocational rehab.
This is not uncommon—and it’s proof that chronic fatigue claims can succeed when approached correctly.
Evidence You Need for a Successful Claim
To win a chronic fatigue claim, especially without a presumptive connection, you’ll need solid documentation. Here’s what works:
1. Medical Diagnosis
The VA requires a confirmed diagnosis of CFS from a licensed provider. Vague notes about “tiredness” aren’t enough.
2. Symptom Journal
Track your daily energy levels, how long it takes to recover from activity, and how fatigue affects your life. A simple spreadsheet or journal can go a long way.
3. Lay Statements
Friends, family, or coworkers can write buddy letters describing your behavior, how fatigue has changed you, and what they observe.
4. Nexus Letter (for Secondary Claims)
If you’re linking chronic fatigue to another condition, your doctor needs to provide a nexus opinion stating it is “at least as likely as not” that your fatigue stems from the service-connected issue.
Tips for the C&P Exam
You’ll likely be scheduled for a Compensation & Pension (C&P) exam after filing. Here’s how to prepare:
Be honest about your limitations—don’t downplay symptoms out of pride.
Emphasize how often symptoms occur and how long they last.
Bring your symptom journal.
If you’re fatigued after the exam, note that—post-exertional malaise is a key symptom.
Common Mistakes to Avoid
Not documenting symptoms consistently – Gaps in care can be used to deny your claim.
Failing to rule out other causes – If the VA thinks another condition explains your fatigue, they may deny your claim.
No link to service – Without a direct, secondary, or presumptive connection, your claim will likely be rejected.
Chronic Fatigue and Total Disability Individual Unemployability (TDIU)
If your chronic fatigue prevents you from maintaining substantial gainful employment, you may be eligible for TDIU. Even with a 60% rating, if your condition affects your ability to work, the VA may pay you at the 100% level.
Final Thoughts: Don’t Brush Off Chronic Fatigue
Chronic fatigue is not “just being tired.” It can be a disabling medical condition that deserves recognition and compensation—especially when it stems from or is worsened by your military service.
Whether you qualify through presumptive service, a secondary connection, or direct evidence, the path to benefits is available. With the right medical support and documentation, you can build a strong case and secure the assistance you deserve.
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