---
title: "DC 6354 - Chronic fatigue syndrome (CFS)"
diagnostic_code: "6354"
body_system: "Infectious Diseases, Immune Disorders and Nutritional Deficiencies"
cfr_section: "§ 4.88b"
canonical: "https://veteranai.co/va-rating-schedule/infectious-and-immune/6354-chronic-fatigue-syndrome"
source: "https://www.ecfr.gov/current/title-38/section-4.88b"
updated: "2026-07-21T20:33:20.701971Z"
---

# DC 6354 - Chronic fatigue syndrome (CFS)

Rated under § 4.88b. Body system: Infectious Diseases, Immune Disorders and Nutritional Deficiencies.

## Rating criteria

| Rating | Criteria |
| --- | --- |
| 100% | 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 |
| 60% | 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 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 |
| 40% | 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 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 |
| 20% | 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 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 |
| 10% | Debilitating fatigue, cognitive impairments (such as inability to concentrate, forgetfulness, or confusion), or a combination of other signs and symptoms: 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 |

## Notes

- Note: For the purpose of evaluating this disability, incapacitation exists only when a licensed physician prescribes bed rest and treatment.

# Chronic Fatigue Syndrome (CFS) — VA Disability Rating Guide

**Diagnostic Code 6354 · 38 CFR § 4.88b**
*Body system: Infectious Diseases, Immune Disorders and Nutritional Deficiencies*

## Understanding Chronic Fatigue Syndrome

Chronic fatigue syndrome (CFS) is rated by the VA under Diagnostic Code 6354. When evaluating this condition, the VA focuses on the presence of **debilitating fatigue**, **cognitive impairments** (such as an inability to concentrate, forgetfulness, or confusion), or a **combination of other signs and symptoms** — and, importantly, how much these symptoms interfere with your daily life.

Two key concepts run through every rating level:

- **How constant your symptoms are** and how much they restrict your routine daily activities compared to your pre-illness level.
- **Periods of incapacitation**, when symptoms wax and wane. Under this diagnostic code, **incapacitation exists only when a licensed physician prescribes bed rest and treatment.**

## Rating Levels

The VA assigns a disability percentage based on the severity, constancy, and impact of your symptoms:

### 100%
Symptoms that are **nearly constant and so severe** as to restrict routine daily activities almost completely, and which may occasionally preclude self-care.

### 60%
Symptoms that 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.

### 40%
Symptoms that 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.

### 20%
Symptoms that 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.

### 10%
Symptoms that **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.

## What the VA Looks For

When rating CFS under Diagnostic Code 6354, the VA considers:

- The presence of **debilitating fatigue, cognitive impairments, or a combination of other signs and symptoms.**
- Whether symptoms are **nearly constant** and how much they **restrict routine daily activities** relative to your pre-illness level.
- Whether symptoms **wax and wane**, and the **total duration of incapacitation** over the course of a year.
- Whether symptoms are **controlled by continuous medication.**

> **Important note on incapacitation:** For the purpose of evaluating this disability, incapacitation exists **only when a licensed physician prescribes bed rest and treatment.**

Source: https://www.ecfr.gov/current/title-38/section-4.88b