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“The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.”

Chronic Fatigue Syndrome (CFS)

                         *24242 PROGRAM OPERATIONS MANUAL SYSTEM

                            Disability (DI, Part 4)


DI 24515.075 Evaluation of Specific Issues - Chronic Fatigue Syndrome (CFS)


DI 24515.075


                                 A. BACKGROUND

Chronic Fatigue Syndrome (CFS), previously known as Chronic Epstein-Barr Virus Syndrome, and also currently called Chronic Fatigue and Immune Dysfunction Syndrome, is a systemic disorder consisting of a complex of variable signs and symptoms which may vary in duration and severity. The etiology and pathology of the disorder have not been established. Although there are no generally accepted criteria for the diagnosis of cases of CFS, an operational concept is used by the medical community. There is no specific treatment, and manifestations of the syndrome are treated symptomatically.




CFS is characterized by the presence of persistent unexplained fatigue and by the chronicity of other symptoms. The most prevalent symptoms include episodes of low-grade fever, myalgias, headache, painful lymph nodes, and problems with memory and concentration. These symptoms fluctuate in frequency and severity and may be seen to continue over a period of many months. Physical examination may be within normal limits.

Individual cases must be adjudicated on the basis of the totality of evidence, including the clinical course from the onset of the illness, symptoms, signs, and laboratory findings. Consideration should be given to onset, duration, severity and residual functional capacity following the sequential evaluation process.


                                  C. PROCEDURE

 Enter listing code 688 in item 26 of the Form SSA-831-U3 and item 34 of Forms SSA-832-U3/833-U3 whenever the case involves an allegation or diagnosis of CFS.