Section 4.88a - Chronic fatigue syndrome(a) For VA purposes, the diagnosis of chronic fatigue syndrome requires: (1) new onset of debilitating fatigue severe enough to reduce daily activity to less than 50 percent of the usual level for at least six months; and(2) the exclusion, by history, physical examination, and laboratory tests, of all other clinical conditions that may produce similar symptoms; and(3) six or more of the following: (i) acute onset of the condition,(iii) nonexudative pharyngitis,(iv) palpable or tender cervical or axillary lymph nodes,(v) generalized muscle aches or weakness,(vi) fatigue lasting 24 hours or longer after exercise,(vii) headaches (of a type, severity, or pattern that is different from headaches in the pre-morbid state),(viii) migratory joint pains,(ix) neuropsychologic symptoms,59 FR 60902, Nov. 29, 1994