Infectious and immune system · 38 CFR 4.88b
Infectious and Immune Conditions and VA Disability
This group covers infections, immune disorders, and the chronic illnesses that can follow them. Some are tied to where you served. The VA rates many of them at 100 percent while the disease is active, then rates whatever it leaves behind. Gulf War and Southwest Asia veterans have special rules here, because several of these illnesses are presumptive.
Patriot Path handles the medical side of these claims. Our physicians write the nexus letters and independent medical opinions that connect an infection, its lasting effects, or a chronic illness to your service. The fee is a flat $1,500, and the first consultation is free.
Medically reviewed by the Patriot Path Medical Team
Licensed MD reviewers • Last updated: June 2026
Conditions in this system
These are the infections and immune conditions veterans claim most. Full guides are on the way.
- Chronic fatigue syndromeGuide in progress
Long-term exhaustion that rest does not fix. A Gulf War presumptive, rated on how much it limits your daily life.
DC 6354
- HIV-related illnessGuide in progress
Rated on your immune markers, symptoms, and any related infections.
DC 6351
- TuberculosisGuide in progress
Rated at 100 percent while active, then on what it leaves in the lungs or elsewhere.
DC 6311
- MalariaGuide in progress
Rated at 100 percent during an active attack, then on residuals like liver or spleen damage.
DC 6304
- Q feverGuide in progress
A Southwest Asia presumptive. Rated while active, then on lasting effects, which can include chronic fatigue.
DC 6331
- BrucellosisGuide in progress
A Southwest Asia presumptive infection, rated while active and then on what remains.
DC 6316
How the VA rates infectious and immune conditions
Most infections follow the same pattern. While the disease is active, the VA often rates it at 100 percent. Once it clears, that rating drops, and the VA rates whatever the infection left behind under the body system it harmed, like the lungs, the liver, or the nerves.
A few conditions work on their own scale. Chronic fatigue syndrome is rated on how often it forces you to rest and how much it cuts into your daily life. HIV is rated on your immune markers and symptoms. These do not clear, so they are rated on their current severity.
The biggest point for Gulf War veterans is presumption. The VA presumes a link to service for chronic fatigue syndrome and for a set list of Southwest Asia infections. When a condition is presumptive, you do not have to prove what caused it.
Connecting an infectious or immune condition to service
There are a few ways to tie one of these conditions to your service:
- Direct. The infection was diagnosed in service, or its records show the exposure that caused it. Lasting effects trace back to that illness.
- Presumptive (Gulf War). Chronic fatigue syndrome and infections like Q fever, brucellosis, malaria, and West Nile are presumptive for Gulf War and Southwest Asia veterans (38 CFR 3.317). The VA accepts the link, so you do not have to prove the cause.
- Secondary. An infection or its treatment caused a new problem (38 CFR 3.310). Organ damage that follows an infection is a common example.
For a direct or secondary claim, the VA needs a current diagnosis, an in-service cause, and a medical opinion linking them (38 CFR 3.303). That opinion has to clear the “at least as likely as not” standard, a 50 percent or better chance. That standard is the benefit-of-the-doubt rule under 38 U.S.C. 5107(b), carried out in 38 CFR 3.102. A nexus letter is that linking opinion.
Frequently asked questions
Is chronic fatigue syndrome a VA disability?
Yes. Chronic fatigue syndrome is rated under Diagnostic Code 6354, from 10 to 100 percent, based on how often it limits your activity and forces rest. For Gulf War veterans it is presumptive, so the VA accepts the link to service without proof of cause.
Which infections are presumptive for Gulf War veterans?
The VA presumes service connection for a set list under 38 CFR 3.317, including brucellosis, Q fever, malaria, West Nile virus, nontyphoid salmonella, shigella, and Campylobacter jejuni. Tuberculosis and visceral leishmaniasis can be presumed any time after service. Dates and locations of service matter, so check your eligibility.
How does the VA rate an infection that already cleared?
While the infection is active, it is often rated at 100 percent. After it clears, the VA rates what it left behind under the affected body system. Liver, lung, nerve, or joint damage from an old infection can each carry its own rating.
Can I claim HIV as a service connection?
Yes. HIV-related illness is rated under Diagnostic Code 6351, based on your immune markers, symptoms, and any related infections. As with any direct claim, it needs a diagnosis, an in-service link, and a medical opinion connecting them.
Do I need a nexus letter if my illness is presumptive?
Often no. If your condition is on the presumptive list and you meet the service requirements, the VA accepts the link. For a non-presumptive infection or a secondary condition, a nexus letter is usually what decides the claim.
A service-related infection or chronic illness?
Tell us what you are dealing with. The first consultation is free, and we will tell you straight whether a nexus letter can strengthen your claim.
Sources & regulatory references
- VA disability compensation (VA.gov) https://www.va.gov/disability/
- 38 CFR 4.88b, Schedule of ratings, infectious diseases, immune disorders and nutritional deficiencies (eCFR) https://www.ecfr.gov/current/title-38/section-4.88b
- 38 CFR 4.88a, Chronic fatigue syndrome (eCFR) https://www.ecfr.gov/current/title-38/section-4.88a
- 38 CFR 3.317, Persian Gulf veterans presumptive (eCFR) https://www.ecfr.gov/current/title-38/section-3.317
- 38 U.S.C. 5107, Benefit of the doubt (Cornell LII) https://www.law.cornell.edu/uscode/text/38/5107
- Gulf War illness and Southwest Asia (VA.gov) https://www.va.gov/disability/eligibility/hazardous-materials-exposure/gulf-war-illness-southwest-asia/