What to Expect in a Chronic Fatigue Syndrome C&P Exam | VA Disability

In this video Leah provides insights into Chronic Fatigue Syndrome (CFS) in veterans and the related VA disability Compensation and Pension (C&P) exam process. She explains that CFS is often a diagnosis of exclusion and may be difficult to assert in the presence of conditions like sleep apnea or hypothyroidism. Leah discusses the potential for service connection of CFS, including direct connections from active duty diagnosis, secondary connections to other disabilities, or links to Gulf War exposures. During the C&P exam, veterans encounter a Disability Benefits Questionnaire (DBQ) covering symptoms, history, and impact of CFS. The DBQ includes questions on symptom severity, exclusions of other conditions, cognitive impacts, and incapacitation periods.
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About:
At Prestige Veteran Medical Consulting, a veteran-owned company, we specialize in Independent Medical Opinions (IMOs) known as Nexus letters.
The purpose of this channel is to empower YOU, the veteran, to take charge of your medical evidence and provide you with valuable educational tools and research to guide you on your journey.
Understanding the unique challenges veterans face our commitment lies in delivering exceptional service and support.
Leveraging an extensive network of licensed independent medical professionals, all well-versed in the medical professional aspects of the VA claims process, we review the necessary medical evidence to incorporate in our reports related to your VA Disability Claim.
Prestige Veteran Medical Consulting is not a law firm, accredited claims agent, or affiliated with the Veterans Administration or Veterans Services Organizations. However, we are happy to discuss your case with your accredited VA legal professional.
⚠️ DISCLAIMER
This video is not medical or legal advice and should not be substituted for advisement from your VSO, accredited agent, or Attorney.
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[@BLR653]

I found your video after a nightmare C&P exam where I did not have my doctor fill out the DBQ ahead of time. Lesson learned. Doctor was extremely adversarial and couldn't be bothered to look through my 300 page medical file. Was unbelievable. Refused to order testing for me. You covered a lot of what they want to see; sleep study, thryroid testing, cmb and cmp, and vitamin testing. I had 3 of the 4 tests done but they won't help you order anything. I will definitely be looking to your services once I get all my testing done and ducks in a row. Many of us with CFS have been gas lit by the medical community for a long long long time. It gets old.

[@prestigeveteranmedical]

I am sorry to hear about your experience. Best of luck to you and thank you for watching

[@siddkid3169]

Your honesty is awesome. THANKS! This is great information at the moment veterans.

[@prestigeveteranmedical]

Big hugs my friend thank you for your encouragement as always!!

[@combatdouglas1306]

Cannot wait.

[@prestigeveteranmedical]

Go to bed sir 🥰

[@clemp3010]

I was in the gulf in those areas for presumtive. I was diagnosed with cfs and fibro in the early 2000s, followed by sleep apnea. The sleep apnea is what got me discharged in 2008. I haven't worked since i got out. I use a cpap 100%. i also have hypothyroidism controlled with medication. I have my c&p next week, but now I'm even more worried and depressed after seeing this video. My wife says i have ruined her life because i can't do anything.😢

[@prestigeveteranmedical]

I am sorry to hear this sir. Keep your spirits up and best of luck to you with this.

[@shanehess8950]

Another great video , shared with my other veterans . Trying to get them to the hundo club like myself .

[@prestigeveteranmedical]

Thank you for watching and sharing friend!!

[@anitagonzalez8129]

Great video, thank you for this information. Do you have any videos on C&P for radiculopathy of lower extremity?

[@prestigeveteranmedical]

Hey! I actually have one scheduled for January 2nd on that topic!

[@robertpalos564]

Just had my C&P exam last week, we will see how they rate it…I’ve been deployed 3 times and was exposed to the burn pits, and have all these symptoms, I already did a sleep study, they said I don’t have sleep apnea, I got blood work, they said I wasn’t anemic, so this is the only thing I can think of that is wrong with me…hopefully they give me the rating I deserve

[@prestigeveteranmedical]

Best of luck to you and keep us posted!

[@robertpalos564]

Still waiting on a decision :/

[@prestigeveteranmedical]

@@robertpalos564 sorry to shear this sir

[@robertpalos564]

@@prestigeveteranmedical hopefully soon 🤞🏽🤞🏽

[@user-ym9wb2mk5e]

@@robertpalos564Did they decide? Been waiting for 4 months now on mine, even with a DBQ from my RA doc.

[@titaniumbowlingball4258]

I have very well controlled sleep apnea near 100% compliance w/cpap I have documented Persian Gulf Exposure(s) to deployments 1993, 1995 and denied chronic fatigue I have chronic fatigue also have a max fibromyalgia rating,

[@prestigeveteranmedical]

I am sorry to hear this!! Thank you for watching

[@joshperez525]

I have severe ptsd anxiety and depression, would CFS likely be associated with that as a secondary? I’m also a gulf war vet with deployment time in the middle east. I always thought my fatigue and inability to sleep was due to ptsd.

[@prestigeveteranmedical]

It just depends on your case. Many people would attribute your fatigue to your mental health condition as you mentioned rather than a separate condition but you never know

[@flashfloodninja]

I've got MDD/Anxiety rated. I'm going to be filing for migraines because they're kicking my ass, and OSA if the home test comes back as positive, but at this point I'm not hinging much on OSA because I have no idea how to SC it properly and it would honestly be a lot easier to get my fatigue sorted out w/ OIF presumptive. I'm actually lowkey hoping the OSA comes back as negative because I don't want the VBA to have a reason to deny the fatigue issue.

[@prestigeveteranmedical]

That makes sense. Best of luck to you and thank you for watching!

[@flashfloodninja]

@@prestigeveteranmedical Related question. CFS seems to have illnesses that can disqualify it, but those same illnesses can be one of the six requisite symptoms? In my case, I have MDD, which in theory could cause fatigue, but CFS lists neuropsychological effects as a symptom to qualify for CFS. I'm confused!

[@prestigeveteranmedical]

@@flashfloodninja So from a medical perspective to actually meet the diagnostic criteria for the condition all other causes of fatigue must be ruled out as this is a diagnosis of exclusion essentially. I hope that makes sense.

[@josephcelestine1945]

This should take you to 90% but if you also have CFS, you can only go to 100% if your CFS is at 100%. Now if your CFS is at 60% you would need another rating at 10% to get to 100%. Just wanted to share as it seems we suffer the same. But I've already been rated for Anxiety/Migraines, now I'm filing for CFS because I'm showing the symptoms of CFS.

[@CoachKen10]

Great video!

[@prestigeveteranmedical]

Thanks for watching!!

[@u.duanespence2768]

Is chronic fatigue a gulf war presumptive?

[@prestigeveteranmedical]

It is quite frequently rated and service connected as a presumptive to GWS

[@u.duanespence2768]

@@prestigeveteranmedical I was granted sleep apnea but they never responded to GWS, as if it doesn't exist on the claim, no denial, no response.

[@prestigeveteranmedical]

@@u.duanespence2768 You may want to follow up with a VSO or accredited claims agent

[@katannanat]

I’ve been diagnosed with chronic fatigue and sleep apnea. The sleep apnea treatments (CPAP) machine doesn’t improve my chronic fatigue. Does that matter as far as my claim?

[@prestigeveteranmedical]

Generally speaking if you have sleep apnea and require a CPAP the rating is 50% even if it does not improve symptoms

[@eQuariuz]

What was the process you took for the Chronic Fatigue Diagnosis?

[@katannanat]

@@eQuariuz my doctor diagnosed me with it and I’ve spent years ruling out all other possibilities.

[@eQuariuz]

@@katannanat I wonder what the Difference between that and Fibromyalgia is...?

[@TexasMade903]

​@ eQuarius That's the same thing I'm trying to figure out as well. The symptoms seem the same. I got a diagnosis for fibromyalgia.

[@williamlast5657]

I am connected for migraines and I am a gulf war vet. I am fighting to get sleep apnea as a secondary to PTSD. Based on it being presumptive to gulf war vets should I try for chronic fatigue?

[@prestigeveteranmedical]

Many medical professionals would state that having a diagnosis of sleep apnea would exclude CFS as a legitimate diagnosis. It is important to follow up with your treating doctor on that of course.

[@RArensbach]

I just filed for this as a presumptive condition for gws as I was in the gulf of Oman and syria area. In my medical record notes they mention fatigue multiple times. will this help my claim?

[@prestigeveteranmedical]

It just depends. They will likely want to do a workup to see if there is an underlying cause for the fatigue rather than it falling into the category of a medically unexplainable illness

[@christianvandyne9899]

How did your claim come out?

[@tysworld8928]

What’s your opinion on cfs secondary to Guillan barre syndrome?

[@prestigeveteranmedical]

Unrelated. CFS is a diagnosis of exclusion not caused by another condition

[@SFCGIJOE-kl5mw]

I am currently active duty 22 years and recently diagnosed with Multiple Sclerosis. I feel helpless right now. I had my first c&p this morning for Tinnitus and hearing loss and just concerned about the outcome. This process has been very stressful and my anxiety levels are through the roof...which has produced more frequent flare ups. My fatigue levels are just crazy....I literally feel numb from being so tired. That concerns me because I don't want the examiner to feel like I'm malingering. I don't know what to do.

[@prestigeveteranmedical]

I am sorry to hear this sir. I would recommend just trying to be as straightforward about this as possible with the examiner and I am sure they will understand.

[@Bdi22322]

Thank you for the info. I’m a gulf war veteran and a cancer survivor, Hodgkin’s Lymphoma. I recently had my Lymphoma service connected with the signing of the Pact Act. I’m in remission so it’s 0% for being a non-active disease. I went through both chemo and radiation at the VA hospital, but I have had a lot of the symptoms of chronic fatigue since treatment. My question is can I put in a secondary condition of CFS due to Hodgkin’s Lymphoma?

[@prestigeveteranmedical]

I am so sorry to hear this sir! You may want to follow up with a legal professional like a VSO regarding the administrative side of claims filling. Best of luck to you and keep us posted!

[@Bdi22322]

@@prestigeveteranmedical Ok. Thank you for your help Ma’am.

[@prestigeveteranmedical]

@@Bdi22322 you bet! Thank you for watching!

[@pabloenriquechavesmonsalve4786]

I have all those but was stationed in Okinawa during the Gulf war.

[@prestigeveteranmedical]

Oh wow! I am sorry to hear this!

[@matthewellis5681]

I’m service connected at 0% for Fatigue status post heat intolerance injury. What should some of my next steps be just looking for some help thanks.

[@prestigeveteranmedical]

Hey sir I am sorry to hear this. Have you tried linking up with a local VSO?

[@christianvandyne9899]

Greetings, what do you think my odds are with connecting chronic fatigue secondary to hypothyoridism. IOF vet here. Thank you!

[@prestigeveteranmedical]

Fatigue is a know symptom of hypothyroidism so it is likely just part of that particular rating. Best to follow up with a legal professional

[@tbone9603]

Do you help Vietnam Veterans?

[@prestigeveteranmedical]

Yes sir we assist all veterans.

[@Tucker22.]

70 % PTSD. Can I secondary it to that? I'm not a gulf War veteran.

[@prestigeveteranmedical]

You can always file anything at any time that you believe is related to your service

[@army96261]

Hey thanks for the info. I've been researching this a lot because I'm getting ready to submit a claim. Can you help me understand if I have everything? I have DD214 showing service in Iraq giving me presumptive status I have a diagnosis from a neurologist here in the Philippines because I'm waiting for my wife to get her green card which should hopefully be this month or early next month so we are planning on returning to the US in May 2024 I also asked the doctor to complete a DBQ for CFS and he did so I have that. I am planning on writing a buddy statement in support of my claim. I'm planning on having my wife write a buddy statement in support of my claim. Is that everything? Can I submit that stuff and be good? Thanks. Also the doctor ordered a bunch of tests because he said it was a diagnosis of exclusion so he ordered blood tests, urine tests, ultrasounds, xray's, and a 2d echo. Should I include those results or no need? He wrote in the DBQ that those tests were ordered and checked.

[@prestigeveteranmedical]

Hey sir every case is different so it is really hard to say. Are you working with a VSO? Not sure if there are any over there but I would assume so. That may be a helpful resource

[@Thebwaller07]

I’m 10% tinnitus, 20% shoulder injury, 20% lower back. I’m diagnosed with sleep apnea at home and in las studied. I’m a in theater gulf war vet. I see a psychiatrist. I’m on meds for ADHD and OCD and I take sleep meds. I nap at least 4 times a day for 20 to 30 minutes. I’m exhausted all the time. I was Navy Special Warfare. If my psychiatrist will not write me a connection what can I do?

[@prestigeveteranmedical]

Hey sir you can ask your regular doctor if you would like. Also nexus letters are not required you can just go to the C&P exam

[@Thebwaller07]

@@prestigeveteranmedical thank you

[@NickMeechoovet]

I've been diagnosed with hypersomnia (post active duty). Can chronic fatigue syndrome concurrent with hypersomnia? And can they both be service connected from a humvee accident resulting in a concussion?

[@prestigeveteranmedical]

The two diagnoses would essentially conflict with one another. It is possible to have fatigue as a residual of a head injury but that would not be hypersomnia or CFS but you will want to talk to your doctor about your specific issues

[@douglaspieper]

I am currently service connected for PTSD and MDD at 70%. Will a rating for CFS increase my rating or will it be lumped together with the PTSD and MDD?

[@prestigeveteranmedical]

It just depends on the specifics of your case.

[@josephcelestine1945]

Yes, depending on the scope and degree, you can get 60% to 100% CFS, depending on the intensity. However, if you get 60% for CFS, you will raise your 70% to 90% not 100%. However, if your CFS is at an extreme severity, you can get 100% CFS. To get to 100% with CFS at 60% you would need another rating at least 10%. Assuming you already have 70% PTSD and MDD.

[@user-ym9wb2mk5e]

If you have already been TERA conceded, and do a pact act supplemental with a civi docs DBQ, is a C&P exam required? My original denial stated I needed a current diagnosis, which I now have and submitted.

[@prestigeveteranmedical]

It just depends on the person reviewing the evidence. Best of luck

[@user-ym9wb2mk5e]

@@prestigeveteranmedical Thanks! C&P exam was the usual, got talked over and just walked through a couple of DBQ questions that I had to keep correcting her "assumptions" on. I am assuming she was just going over my personal RA Doc's DBQ, but who knows. Whole thing was rushed, but at least she wasn't argumentative or combative like the last one I had.

[@prestigeveteranmedical]

oh boy. Well keep us posted on the outcome!@@user-ym9wb2mk5e

[@user-ym9wb2mk5e]

@@prestigeveteranmedical So they refused to use the DBQ again after filing a supplemental after that exam. They apparently can’t read their own regs; 38 CFR 3.159. They are doing this to a lot of vets now…. A nurse practitioner DBQ apparently outweighs a personal physician who’s been treating the patient for years and who wouldn’t risk their license for a VA claim…. Yep, makes sense.

[@prestigeveteranmedical]

I am so sorry to hear this sir. Best of luck to you and thank you for watching @@user-ym9wb2mk5e

[@combatdouglas1306]

Smart and beautiful.

[@prestigeveteranmedical]

😍😍😍

[@corndog9482]

How likely would it be for me to be rated for CFS if I am already rated for MDD + Insomnia with SAD/GAD at 70%? I was also deployed in those specified locations in the Middle-East, and I have other symptoms outside of those conditions I mentioned that I am already rated for, such as IBS, prostrating headaches, extreme fatigue for 24hrs+ after physical or mental activities, etc... that I have not yet been rated for. Thank you!

[@prestigeveteranmedical]

I am not sure sir. Often times examiners state that fatigue is a symptoms of things like mental health conditions rather than a separate condition. You may want to follow up with a legal professional on this

[@corndog9482]

@@prestigeveteranmedical When you say a "legal professional", do you mean an entity like Hill & Ponton?

[@prestigeveteranmedical]

There are many types of accredited legal professionals to include attorneys. The VA has an accreditation search tool that you can look for this type of assistance. I also have a video showing how to search with that tool @@corndog9482

[@corndog9482]

@@prestigeveteranmedical Thank you. Is it the video titled "How to find a VA accredited legal representative! Its important!" where you speak about the accreditation list?

[@prestigeveteranmedical]

Yes sir @@corndog9482

[@aaronrocks365]

What if you've already got treatment for Sleep Apnea (using an ASV for over 2 years) and Prolactinoma and endocrine issues resolved. Is CFS still able to be diagnosed/connected to service if I am still having fatigue despite my treatment?

[@prestigeveteranmedical]

That just really depends on the person interpreting the evidence. Most people would assume there to be a residual level of fatigue in some people even with adherence to treatment

[@aaronrocks365]

@@prestigeveteranmedical So should the fatigue fall in as a secondary condition to Sleep Apnea?

[@prestigeveteranmedical]

No it would not be a separate secondary condition. It is a symptom of the disorder itself and is already factored into to the rating of sleep apnea. To draw a parallel, if someone was rated for allergic rhinitis and they had a runny nose because of it they would not get a separate rating for that because it is part of the symptoms they are already rated for. I hope this clarifies @@aaronrocks365

[@aaronrocks365]

@@prestigeveteranmedical Makes sense. Thanks for the quick response!

[@prestigeveteranmedical]

You bet thank you for watching!!@@aaronrocks365

[@StarterAcademy]

I am rated for TBI. Would this exclude me?

[@prestigeveteranmedical]

I do not believe so sir

[@combatdouglas1306]

SMC-T?

[@StarterAcademy]

@@combatdouglas1306 No.

[@prestigeveteranmedical]

@@combatdouglas1306 👌

[@combatdouglas1306]

@@StarterAcademy so how you rated for tbi? What is your rating for?

[@eoe8525]

Wait

[@prestigeveteranmedical]

👍👍👍

[@jayp8124]

I'm rated for sleep apnea, can also claim CFS? or is it related ?

[@prestigeveteranmedical]

It is my opinion that those are very difficult to show coexisting

[@jayp8124]

@@prestigeveteranmedical So your saying I can claim CFS then?

[@prestigeveteranmedical]

@@jayp8124 You can always claim anything at anytime that you believe is related to your service. I personally do not believe this is a good case from a medical perspective for the reasons I discussed in my video

[@jayp8124]

@@prestigeveteranmedical ok thanks for the feedback.

[@prestigeveteranmedical]

@@jayp8124 You are very welcome thanks for watching

[@splurge4006]

is afghanistan not on that list ?

[@prestigeveteranmedical]

No it is not