If you have a VA disability rating for sleep apnea, tinnitus, PTSD or another mental health condition, the criteria VA uses to rate it have not changed in 2026. The overhaul proposals VA published in February 2022 are still proposals, not law, and as of Oct. 28, 2026, no final rule for those conditions has appeared in the Federal Register.
The one change VA did make this year lasted 10 days. A rule that would have lowered ratings for veterans whose medication controls their symptoms took effect Feb. 17 and was rescinded Feb. 27. Here is what each piece means, where it stands, and what protects the rating you already have.
The 10-day medication rule, start to finish
On Feb. 17, 2026, VA published an interim final rule titled “Evaluative Rating: Impact of Medication” in the Federal Register (91 FR 7118). It rewrote 38 CFR 4.10, the section that tells examiners how to judge functional impairment. The new text said examiners would not “estimate or discount” improvements from medication or treatment, and that if medication lowered the level of disability, the rating would be based on that lower level.
In plain English: a veteran whose back pain is manageable only because of daily prescription medication could be rated on the medicated condition, not the underlying injury. That reversed how the courts have told VA to handle conditions whose rating criteria do not mention medication. In Jones v. Shinseki (2012), the U.S. Court of Appeals for Veterans Claims said VA cannot count the relief from medication against a veteran when the diagnostic code does not list medication as a factor. In Ingram v. Collins, 38 Vet. App. 130 (2025), the same court applied that principle to musculoskeletal conditions rated on range of motion. VA said its rule was a response to Ingram.
The rule took effect the day it was published, without the usual comment period first. Veterans groups and members of both parties objected quickly. VA halted enforcement on Feb. 19, and on Feb. 27 it published a final rule rescinding it, effective immediately. The rescission restored the prior text of 38 CFR 4.10. VA noted that it does not settle the legal questions still before the courts, so the issue could return through new rulemaking or a court decision.
What VA has proposed for sleep apnea, tinnitus and mental health
The rating schedule, formally the VA Schedule for Rating Disabilities, has 15 body systems. In testimony to the House Veterans’ Affairs Committee on Jan. 14, 2026, Nina Tann, executive director of VA’s Compensation Service, said 11 had been updated. The four left are mental disorders, respiratory, ear, and neurological conditions and convulsive disorders. Proposed rules are out for all four. VA told lawmakers it expected to finalize them by the end of fiscal year 2026, which ended Sept. 30. That date passed without a final rule.
The proposals veterans ask about most are from Feb. 15, 2022:
- Sleep apnea. Today, a veteran who needs a CPAP machine is rated 50 percent. The proposal would rate sleep apnea on how well treatment works: 0 percent if treatment leaves no symptoms, 10 percent if treatment helps but does not fully work, and higher ratings when treatment fails or cannot be used.
- Tinnitus. Today, tinnitus can carry its own 10 percent rating. The proposal would end the standalone rating and evaluate tinnitus as part of the condition causing it, such as hearing loss.
- Mental disorders. The mental disorders proposal would replace today’s symptom list with five areas of functioning: cognition, relationships, task completion, navigating environments, and self-care. It would also set a 10 percent minimum for any service-connected mental disorder, ending the 0 percent rating.
Congress has also looked at the sleep apnea and tinnitus changes. The Take Care of America’s Veterans Act, H.R. 9237, would write parts of them into law and use the savings for other veterans benefits. It has not passed. Stucci Media covered the bill’s other provisions in our report on the Take Care of Veterans Act and combat-injured retirees.
The rules that protect a rating you already have
A new rating schedule does not, by itself, cut existing ratings. Several regulations stand between a schedule change and your monthly payment:
- 38 CFR 3.951(a). A readjustment of the rating schedule is not grounds to reduce a rating in effect on the date of the change unless an examination shows your condition actually improved.
- 38 CFR 3.951(b). A rating held continuously for 20 years or more cannot be reduced below that level except for fraud.
- 38 CFR 3.957. Service connection in effect for 10 years or more cannot be severed except for fraud or a lack of the required service.
- 38 CFR 3.344. Ratings in place for five years or more get extra stability. VA has to show sustained improvement, not a single better day at an exam.
- 38 CFR 3.105(e). Before any reduction that lowers your payment, VA must send a proposal, give you 60 days to send evidence, and let you request a hearing.
The practical result: veterans rated today under current criteria keep the current criteria’s protection. The people most affected by any future change are veterans who file after it takes effect.
What this means for you
If you are thinking about filing for sleep apnea, tinnitus or a mental health condition, file an Intent to File now on VA.gov or with VA Form 21-0966. It holds your effective date for one year while you gather evidence, and compensation is generally paid back to that date if your claim is granted. Claims are decided under the rules in effect when VA decides them, so the intent to file does not freeze today’s criteria, but it does protect your back pay.
At every exam, tell the examiner what you take and how you function without it. Describe flare-ups, the hours before a dose, and what your days looked like before treatment started. Never stop or skip a prescribed medication to show how bad a condition is.
If you got a decision between Feb. 17 and Feb. 27, 2026, read the reasons section. If the examiner or rater credited your medication against you on a condition whose criteria do not mention medication, you can file a Supplemental Claim or request a Higher-Level Review. You have one year from the date on the decision letter.
If you receive a proposed reduction, check how long the rating has been in place against the 5, 10 and 20-year rules above, send evidence within the 60-day window, and ask for a hearing within 30 days of the notice to keep payments at the current rate while VA decides.
Get free help. Accredited representatives at veterans service organizations such as the American Legion, VFW, DAV and your county veterans service office handle claims at no charge. You can confirm anyone’s accreditation through VA’s Office of General Counsel search tool before you sign anything. And read every decision letter line by line; VA’s own accuracy numbers show why that matters, as Stucci Media reported in our look at VA’s record claims year and the accuracy questions behind it.
Watch the calendar for your payment, too. Social Security’s 3.6 percent cost-of-living increase for 2027 sets the benchmark for VA disability compensation, though the VA increase still requires its annual act of Congress. Details are in our September inflation and COLA report.
How we will keep this page current
This explainer will be updated when VA publishes a final rule for any of the four remaining body systems, when a court rules on the medication question, or when Congress acts on H.R. 9237. Each update will carry a date at the top. For the rest of our benefits coverage, see the Stucci Media Veterans hub.
Rocci’s Take
The medication rule told veterans that doing what their doctors asked could cost them their rating, and it took a loud response from veterans to kill it in 10 days. I am not against modernizing a rating schedule that dates to 1945, but changes this big belong in the open, with comments heard first and existing ratings protected. Until VA publishes final rules, file your intent to file, keep your medical records tight and do not let rumors make your decisions.
Frequently Asked Questions
Did VA change disability ratings in 2026?
No final change to the rating criteria for sleep apnea, tinnitus or mental disorders took effect in 2026. The only change, a rule on how medication affects ratings, took effect Feb. 17, 2026, and was rescinded Feb. 27, 2026.
Is the VA medication rule still in effect?
No. VA rescinded the interim final rule on Feb. 27, 2026, and restored the prior wording of 38 CFR 4.10. Under court decisions such as Jones v. Shinseki and Ingram v. Collins, VA should not count the relief from medication against you when the rating criteria do not mention medication.
Will my 50 percent sleep apnea rating be reduced if the new rules take effect?
A schedule change alone is not grounds for a reduction under 38 CFR 3.951(a). VA would have to show actual improvement through an examination and follow the notice and hearing rules in 38 CFR 3.105(e).
When will the new mental health rating criteria start?
VA has not announced a date. It told Congress in January 2026 that it expected to finalize the remaining body systems by Sept. 30, 2026, and that target passed without a final rule.
Should I file my claim now or wait?
Many advocates recommend filing an Intent to File now, because it holds your effective date for one year. Talk with an accredited representative about the timing that fits your condition and evidence.
Sources
- Department of Veterans Affairs, “Evaluative Rating: Impact of Medication,” interim final rule, 91 FR 7118, Feb. 17, 2026
- Department of Veterans Affairs, “Rescission of Interim Final Rule, Evaluative Rating: Impact of Medication,” FR Doc. 2026-03940, Feb. 27, 2026
- Nina Tann, VA Compensation Service, statement to the House Veterans’ Affairs Subcommittee on Disability Assistance and Memorial Affairs, Jan. 14, 2026
- Department of Veterans Affairs, “Schedule for Rating Disabilities: Mental Disorders,” proposed rule, Feb. 15, 2022
- Stars and Stripes, VA halts enforcement of rating rule, Feb. 19, 2026
- Newsweek, Veterans bill faces key VA deadline, Sept. 1, 2026
- Title 38, Code of Federal Regulations, sections 3.105, 3.344, 3.951, 3.957 and 4.10
Rocci J. Stucci is the founder and CEO of Stucci Media and host of The Rocci Stucci Show.
