ME/CFS Disability Benefits for Veterans
A lot of people don’t believe veterans when they say they have Chronic Fatigue Syndrome because it’s a rule-out condition. It’s often diagnosed after ruling-out things like HIV/AIDS, mental health conditions, other health problems that could be affecting sleep, and simple insomnia. Since it is that type of condition, it can be hard to get a clear chronic fatigue syndrome disability rating.
Treatment for CFS is just as tricky as the diagnosis. Sometimes you can be prescribed painkillers or anti-depressants — often treating the most notable symptoms that might be causing it. Exercise, physical therapy, and counseling might also be ordered, but again that is to treat the symptoms that surround the sleep difficulties.
- ME/CFS Disability Benefits for Veterans
- What is the VA Disability Rating for Chronic Fatigue Syndrome?
- Chronic Fatigue Syndrome VA Disability Ratings
- Does Chronic Fatigue Make you Feel Incapacitated?
- How do you Prove Your Chronic Fatigue Syndrome is Service-Connected?
- Persian Gulf Vets and Chronic Fatigue Syndrome
- Less Severe Symptoms of CFS/ME that Still Get a VA Rating
- Even the VA is Still Learning About Chronic Fatigue Syndrome
- An Example from an Actual VA Disability Appeal for CFS Benefits
What is the VA Disability Rating for Chronic Fatigue Syndrome?
If you follow most Google searches, you’ll find results talking about 38 CFR § 4.88a. Government documents as recent as February of 2019 call those documents “outdated terminology to refer to this complex disease.” That shows that you want to be sure to work with a disability lawyer that keeps up on the current events and changes with VA disability law! Until the government updates their outdated diagnostic criteria, we work within the system to get chronic fatigue VA benefits for the symptoms that can be diagnosed.
38 CFR § 4.88b Puts Chronic Fatigue Syndrome in a category with infectious diseases, immune disorders, and nutritional deficiencies. Its schedule number is 6354. They currently define it as “Debilitating fatigue, cognitive impairments (such as inability to concentrate, forgetfulness, confusion), or a combination of other signs and symptoms.” The level of these symptoms is what decides the level of your rating.
Chronic Fatigue Syndrome VA Disability Ratings
|Nearly constant symptoms and so severe that you can’t do routine daily activities. You can’t even take care of yourself, your health needs, or your social needs.||100% Rating|
|If the symptoms reduce your daily activities to less than 50% of what they were before you were sick. This level also has symptoms come and go but wipe you out at least 6 weeks out of the year total.||60% Rating|
|Nearly constant but only restrict your daily routine to 50%-75% of what it was before. If you total about 4 weeks per year of being down, you are in this category.||40% Rating|
|If you are down for 2-4 weeks out of a whole year and your daily activities are only about a fourth of what they used to be, you’re in this Chronic Fatigue Syndrome Disability rating.||20% Rating|
|If your symptoms come and go but can mostly be controlled by continuous medications and you’re only down for a total of a couple of weeks out of the year, you are at this level.||10% Rating|
Does Chronic Fatigue Make you Feel Incapacitated?
Sometimes associated with myalgic encephalomyelitis, chronic fatigue symptoms usually show up the day after a lot of exertion or concentration. Beyond aches and pains that come from getting old, ME/CFS is the next level of weakness, pain, and inability to go about your regular daily activities. While you might feel incapacitated, the VA only considers you incapacitated if you require bed rest and treatment from a doctor. If you “just can’t get out of bed” they may not consider you incapacitated. When you fill out your claim for chronic fatigue syndrome VA disability benefits, make sure you document the days you were stuck in bed. Keep a list of the days that you called the doctor if you can, and be prepared to list it all out when you go for your C&P Exam.
Achy joints, exhaustion, and other flu-like symptoms are some of the core symptoms of Chronic Fatigue Syndrome. Veterans with written documentation of the days when the symptoms hit will have a stronger case. Getting disability benefits for chronic fatigue syndrome is harder than getting the diagnosis, so mark down every incapacitated day on your calendar as soon as you can.
How do you Prove Your Chronic Fatigue Syndrome is Service-Connected?
Since doctors are still trying to figure out what it really is, it is hard to diagnose myalgic encephalomyelitis / chronic fatigue syndrome. This can also make it tricky to prove to the BVA that it was caused by your time in the service (service-connected). Again, focus on the symptoms and their effects on your daily life to convince them that you need disability. You want to show evidence that before or during your service you didn’t get exhausted after moments of intense physical or mental activity. Lay statements from school teachers, coaches, friends and neighbors can help paint the picture of what your life was like before you were a soldier.
You can also show medical records of things that you talked to your doctor about in the days after you were discharged, or even during service. Various viral infections, aches and pains, deteriorated immune system, and swollen lymph nodes are all symptoms that could point to CFS. If you went to the Persian Gulf anytime during your tour, you may be presumptively rated for Gulf War Syndrome, which includes symptoms of Chronic Fatigue Syndrome and Fibromyalgia.
Persian Gulf Vets and Chronic Fatigue Syndrome
If you served in Afghanistan, Iraq, or anywhere else around the Persian Gulf, you might be eligible for additional claims. There are a lot of vets that came home from the Persian Gulf with symptoms of fibromyalgia, rheumatoid arthritis, and irritable bowel syndrome. This combination is being called “Gulf War Syndrome” and carries its own rating. This is why it is so important that you work with a professional VA disability lawyer on your case. A VA rating for one set of symptoms might exclude you from getting a higher rating for those same symptoms if they point to a different disability.
Fibromyalgia/chronic fatigue syndrome disability cases that aren’t for troops from the Persian Gulf must be handled differently than those that might be Gulf War Syndrome. To get the highest rating for all of your disabilities, call us and ask our caseworkers about your claim. You can ask all of the questions you want for free at (866)232-5777 and we won’t charge you anything unless we win your case. If you are unable to work, you should call us immediately so we can work on getting you 100% or TDIU benefits.
Less Severe Symptoms of CFS/ME that Still Get a VA Rating
Some other symptoms that point to CFS are a consistent sore throat without mucus or phlegm. This would be from rough breathing while you are trying to sleep. You can also have swollen lymph nodes and consistently sore muscles. Aches and pains and a deteriorated immune system all come from a lack of sleep, so the more you can show those symptoms with medical evidence, the better your chance at getting disability for chronic fatigue syndrome.
You want to make sure you are clear with your doctor when it comes to your diagnosis. Your doctor will try to treat the symptoms or even recommend occupational therapy, exercise, and lifestyle changes to mitigate your symptoms. Some people can find recovery from their Chronic Fatigue Symptoms as is runs its course over a few years. If you find that your symptoms aren’t changing and it is having an effect on your mental health, be sure to make that clear to your doctor and to the VA.
Even the VA is Still Learning About Chronic Fatigue Syndrome
CFS could be part of a bigger VA disability claim for a higher rating. This official document from the VA talks about CFS being part of a MUCMI claim. A Medically Unexplained Chronic Multisymptom Illness is something that is affecting many soldiers after they come home from the Persian Gulf and other recent conflicts. If you have enough symptoms that point to a MUCMI VA claim, then we’ll present that to the VA instead of just trying to win your claim for chronic fatigue syndrome.
Our staff talks every day with veterans with hard-to-prove disabilities. We know how to work with you, your spouse, and the VA to get you a fair and just hearing. We can even help you appeal a denial and fight for an earlier effective date in case the VA tried you cheat you out of back pay.
An Example from an Actual VA Disability Appeal for CFS Benefits
This statement from the VA shows what they consider ‘incapacitated’ and give a hint on what you should claim and when you apply:
“As such, to warrant a 40 percent rating, the Veteran would have to display symptoms that were “nearly constant and restrict routine daily activities to 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.” 38 C.F.R. § 4.88b, Diagnostic Code 6354 (2014). While the Veteran does claim that his symptoms of fatigue, inability to concentrate, forgetfulness, and confusion are “nearly constant,” he has also claimed that his routine daily activities were restricted by about 30 percent of the pre-illness level. The Veteran has not claimed incapacitation by his symptoms, nor has he produced any evidence of physician-prescribed bed rest for his symptoms. As such, the Veteran does not qualify for a 40 percent disability rating under Diagnostic Code 6354.”
The 3 main symptoms are more like classifications by the CDC: 1. Extreme fatigue after doing a normal task. 2. Symptoms that get worse after heavy mental or physical activity, not just ‘always tired.’ 3. Still being tired after a full night’s sleep.
Sort of. You still have to apply, but you fall into a category of ‘Presumptive Rating’ so that it is a little easier to get benefits when you apply. You still have to go through the same application process and prove that you served in the Gulf.
No, you can still be active and only have occasional bouts of fatigue and still get VA Benefits for CFS. While one in four people that have CFS is bed-bound or at least house-bound, many people lead 50% normal lives and receive a check from the VA for their CFS benefits.