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23.4 Chronic Fatigue Syndrome
Chronic Fatigue Syndrome (CFS) is a controversial diagnosis which relates to a cluster of symptoms, most often arising following a viral infection. It is assumed the condition is caused or at least triggered in some way by that viral infection, but this has not been conclusively demonstrated. CFS has several synonyms including 'Post Viral Fatigue Syndrome' and 'myalgic encephalitis'.
There is widespread agreement within the medical profession that there is no specific diagnostic test for CFS and that it does not represent a single specific disease. The diagnosis is one of exclusion i.e. by eliminating all other disorders which might produce similar symptoms. The cause of the condition is unknown and there is much disagreement about what it constitutes.
Claims for the contraction and aggravation of CFS need to be examined with great care. Regardless of other submissions, it is essential that specialist medical evidence be sought from a qualified immunologist or other specialist in the field.
Delegates have two readily available sources of reference available to them. These are the Defence Compensation Instruction (DCI) no.17 dated December 1997 and the VEA SOP 24/2003. Whilst DCIs are no longer legally current the guidance provided by DCI 17 is still accepted RCG policy and is preferred, in this case, to the SOP. The observation at para 18 of the DCI still holds i.e.:
It is most unlikely that claims for CFS, including its aggravation, will succeed unless it can be established that the causal infection has been contracted in the workplace and is clearly linked to an epidemic of the same infection...
Note that DCI 17 cited case law to support the view that acceptance of CFS aggravation claims should be examined with some care:
The case of Swanson and Comcare (1996) (No Q94/3 — 96) involved a claim that the employee's work environment (mainly the air conditioning and formaldehyde 'off gassing' from furniture) aggravated his CFS. His symptoms were non-specific, being stated as fatigue, difficulty concentrating, skin rashes, poor memory and abdominal pains.
The AAT affirmed, in unequivocal terms, Comcare's decision to reject liability. Its conclusions were reached after looking at medical evidence indicating that CFS is an unknown condition for which there are no diagnostic tests. Further, there was nothing to suggest that Mr Swanson was suffering from an organic disease.