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Secondary Condition Claim · VASRD 6354

Chronic Fatigue Syndrome (CFS) Secondary to Impairment of the Scapulohumeral Muscles (Shoulder Fixation)

A condition caused or aggravated by an already service-connected disability can be granted its own service connection as a secondary condition under 38 CFR § 3.310. Here's how that works for Chronic Fatigue Syndrome (CFS) when it develops after Impairment of the Scapulohumeral Muscles (Shoulder Fixation).

Why Chronic Fatigue Syndrome (CFS) Is Linked to Impairment of the Scapulohumeral Muscles (Shoulder Fixation)

Recurring instability leads to ongoing pain

Primary condition · VASRD 5204

Impairment of the Scapulohumeral Muscles (Shoulder Fixation)

Shoulder dislocation or fusion causes pain and limits arm movement.

Secondary condition · VASRD 6354

Chronic Fatigue Syndrome (CFS)

CFS causes persistent fatigue not improved by rest and worsened by physical or mental activity.

Chronic Fatigue Syndrome (CFS) VA Rating Tiers

The VA rates Chronic Fatigue Syndrome (CFS) the same way whether it's claimed directly or as secondary to Impairment of the Scapulohumeral Muscles (Shoulder Fixation) — severity of Chronic Fatigue Syndrome (CFS) itself determines the percentage.

RatingCriteria
100%You can’t perform any regular activity due to extreme fatigue.
60%You're only able to function about half the time due to fatigue.
40%Significant exhaustion that limits what you can do most days.
20%Chronic tiredness that limits your lifestyle and function.
10%Occasional fatigue that interferes with daily tasks.

Example combined rating

20% Impairment of the Scapulohumeral Muscles (Shoulder Fixation) + 40% Chronic Fatigue Syndrome (CFS) = 52%

The VA combines ratings with Table I of 38 CFR 4.25, not simple addition — 20% and 40% combine to 52%, not 60%. These figures are illustrative; your actual rating for each condition depends on your own evaluation.

Evidence for a Chronic Fatigue Syndrome (CFS) Secondary Claim

  • VA physician diagnosis of CFS
  • Labs ruling out other causes
  • Personal logs of fatigue patterns
  • C&P exam documenting activity limits

Common questions about Chronic Fatigue Syndrome (CFS) secondary to Impairment of the Scapulohumeral Muscles (Shoulder Fixation)

Can Chronic Fatigue Syndrome (CFS) be service-connected as secondary to Impairment of the Scapulohumeral Muscles (Shoulder Fixation)?
Yes. Under 38 CFR § 3.310, a condition that is caused or aggravated by an already service-connected disability can be granted secondary service connection. Recurring instability leads to ongoing pain You'll need a current Chronic Fatigue Syndrome (CFS) diagnosis and a medical nexus opinion linking it to your service-c…
What VA rating can I get for Chronic Fatigue Syndrome (CFS) as a secondary condition?
Chronic Fatigue Syndrome (CFS) is rated under VASRD diagnostic code 6354 using the same criteria whether it's a direct or secondary claim: possible ratings are 100%, 60%, 40%, 20%, 10%. The rating depends on the severity of Chronic Fatigue Syndrome (CFS) itself, not on the severity of Impairment of the Scapulohumeral…
How does a secondary Chronic Fatigue Syndrome (CFS) claim affect my combined VA rating?
The VA doesn't add ratings together. Using the official combined-ratings formula (38 CFR 4.25): a 20% rating for Impairment of the Scapulohumeral Muscles (Shoulder Fixation) combined with a 40% rating for Chronic Fatigue Syndrome (CFS) (example figures) produces a combined rating of 52%, not 60%. Approving Chronic Fat…
What evidence do I need to service-connect Chronic Fatigue Syndrome (CFS) as secondary to Impairment of the Scapulohumeral Muscles (Shoulder Fixation)?
Strong evidence for the underlying Chronic Fatigue Syndrome (CFS) diagnosis includes: VA physician diagnosis of CFS; Labs ruling out other causes; Personal logs of fatigue patterns; C&P exam documenting activity limits. For the secondary link itself, a nexus letter from a treating provider explaining how Impairment of…

Primary condition

Full Impairment of the Scapulohumeral Muscles (Shoulder Fixation) guide

Secondary condition

Full Chronic Fatigue Syndrome (CFS) guide

Estimate your combined rating

See how Impairment of the Scapulohumeral Muscles (Shoulder Fixation) and Chronic Fatigue Syndrome (CFS) combine with the rest of your service-connected conditions using the official VA combined-ratings formula.

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