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Evidence checklist

Chronic Fatigue Syndrome

DC 635438 CFR § 4.88bMusculoskeletal

Evidence strength

Mark what you already have below and your evidence strength appears here.

Target
Saved locally
01

Specialist opinion

Highest value0 of 2 collected
Comprehensive medical evaluation meeting CDC diagnostic criteriaCritical

Evaluation documenting the three required symptoms: (1) profound fatigue lasting 6+ months, (2) post-exertional malaise, (3) unrefreshing sleep; plus cognitive impairment ("brain fog") or orthostatic intolerance. Other medical causes must be ruled out.

Private provider · independent opinion
Nexus opinion linking CFS to service ("at least as likely as not")Critical

A medical opinion connecting chronic fatigue syndrome to military service, including viral illness during service, immune stressors, burn pit or toxic exposure, or onset during or shortly after service.

Private provider · independent opinion
02

Treating physician

0 of 1 collected
Exhaustive laboratory and diagnostic workup ruling out other conditionsCritical

Records of laboratory testing (CBC, CMP, thyroid, ANA, ESR, HIV, EBV titers, sleep study) used to rule out other causes of fatigue. Documentation of negative workup supports the CFS diagnosis.

Your treating provider · written request
03

Treatment records

0 of 2 collected
Documentation of functional capacity and occupational impact

Records showing reduction in pre-illness activity level, inability to maintain employment, or reduced work hours due to CFS. The VA rates CFS under DC 6354 based on functional levels.

VA or private records · written request
Treatment records showing management attempts

Records of cognitive behavioral therapy (CBT), graded exercise therapy (GET), symptom management medications (sleep aids, pain management, beta-blockers for POTS), and specialist referrals.

VA or private records · written request
04

Lay statements

0 of 3 collected
Symptom diary documenting post-exertional malaise episodesCritical

A personal log tracking fatigue episodes, post-exertional malaise (worsening of all symptoms 12-48 hours after exertion), sleep quality, and cognitive difficulties. This is critical evidence for rating severity.

You or a witness · VA Form 21-4138 or 21-10210How to get this →
Buddy statement from spouse, family, or fellow service member

A written statement from someone who can describe observable symptoms and how your condition affects daily life.

You or a witness · VA Form 21-4138 or 21-10210How to get this →
Personal statement describing symptoms and functional impact

Your own written account of how this condition affects your daily activities, work, and relationships. Describe your worst days.

You or a witness · VA Form 21-4138 or 21-10210How to get this →
05

Benefits questionnaire

0 of 1 collected
Completed DBQ Chronic Fatigue SyndromeCritical

Standardized form capturing fatigue severity, post-exertional malaise, sleep disturbance, cognitive symptoms, and functional activity level.

Provider-completed · VA DBQ formHow to get this →
06

Service records

0 of 1 collected
Service treatment records (STRs)Critical

Military medical records showing in-service treatment, complaints, or injuries related to this condition.

NPRC / milConnect · SF-180
Condition guideRating criteria and what VA looks forC&P exam prepWhat the examiner will askBuddy statement builderGuided VA Form 21-10210

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