The 2026 VA rating-schedule changes: what’s proposed for sleep apnea, tinnitus & mental health
The VA is in the middle of the most significant overhaul of its Schedule for Rating Disabilities (VASRD) in decades — and three of the most commonly claimed conditions are at the center of it: sleep apnea, tinnitus, and mental health. The proposals would lower ratings for many sleep apnea and tinnitus claims while raising them for many mental health claims. But here is the single most important fact, stated plainly: as of 2026, none of these changes are final, and the current criteria still apply to every claim. If you already have a rating, you’re protected. If you’ve been putting off a claim for one of these conditions, the timing now genuinely matters. Here’s exactly what’s proposed, what’s protected, and a checker for your condition.
1. What’s happening
The VASRD is the rulebook that assigns a percentage to every service-connected condition. The VA has been running a multi-year effort to modernize it, and the proposals drawing the most attention — and debate — cover sleep apnea, tinnitus, and mental health disorders. The stated goal is to align ratings with current medical knowledge and with the schedule’s purpose: compensating for average impairment of earning capacity. The practical effect varies sharply by condition — some veterans would see lower ratings, others higher.
2. Nothing is final yet
The proposals were published in the Federal Register in February 2022. Years later, no final rule has been issued for these conditions. Changes require the full rulemaking process — proposed rule, public comment, final rule — and once a final rule publishes, a 60-day window typically applies before it takes effect. Some observers expect possible implementation by late 2026, but delays, revisions, or cancellation are all on the table. Until then, every claim is decided under the current criteria.
3. Sleep apnea
Today, sleep apnea (Diagnostic Code 6847) assigns an automatic 50% rating if you require a breathing-assistance device like a CPAP. The proposal would replace that device-based rule with a symptom-based one:
The rationale is that if CPAP restores near-normal function, the remaining impairment is small. The effect: many veterans currently at 50% for CPAP use could receive lower ratings if they filed new claims after the change. This is proposed, not final.
4. Tinnitus
Tinnitus (Diagnostic Code 6260) is currently a standalone condition with a maximum 10% rating — and one of the most commonly claimed. The proposal would eliminate that diagnostic code and instead treat tinnitus as a symptom of the underlying condition that causes it (such as hearing loss or a traumatic brain injury), rather than a disability in its own right. For future claimants, that removes tinnitus’s value as a standalone “gateway” rating. Existing tinnitus ratings would be grandfathered. This is proposed, not final.
5. Mental health
Unlike sleep apnea and tinnitus, the mental health proposal would help many veterans. It replaces the old occupational-impairment focus with a domain-based model assessing cognition, interpersonal relationships, task completion, life activities, and self-care. Two changes stand out: a minimum 10% rating for any service-connected mental health condition (eliminating the 0% level), and removal of the requirement of “total occupational and social impairment” to reach 100% — which could make 70% and 100% ratings easier to obtain. This is proposed, not final.
6. The medication rule
Separate from the three-condition overhaul is a change that already moved: in February 2026, the VA published an interim final rule amending 38 C.F.R. § 4.10, directing that if medication or treatment reduces a condition’s symptoms, the disability is rated at that lower, treated level. After concerns from veterans service organizations and lawmakers, the VA said it would pause implementation while it reviews public comments. It’s a reminder that this area is actively in flux — and that documenting your baseline severity (what symptoms look like without treatment) is worth doing regardless.
7. You’re grandfathered — but watch increases
Existing ratings are protected — a rule change doesn’t reach back and lower them, and the 5-, 10-, and 20-year rules plus due-process requirements make across-the-board cuts highly unlikely. The catch: if you file for an increase (or otherwise reopen a condition) after new criteria take effect, the VA can re-evaluate the entire condition under the new, possibly stricter standard. So think carefully before filing an increase on sleep apnea or tinnitus once rules change — and if you have an un-filed claim for these conditions, filing while current criteria still apply preserves today’s standard for that claim.
8. Check your condition
Pick a condition to see what’s proposed, the likely direction, and your protection status.
Your condition
These are proposed changes, not final as of 2026 — current criteria still apply. General information, not legal advice or a filing recommendation. Consider a VA-accredited representative for your specific claim.
9. Frequently asked questions
Have the VA rating changes for sleep apnea, tinnitus, and mental health taken effect?
No. As of 2026, these are proposed changes to the VA Schedule for Rating Disabilities (VASRD) that have not been finalized. The VA first published the proposals in the Federal Register in February 2022, and no final rule has been issued for these conditions. The current rating criteria remain in effect for all claims, and any changes would go through the full rulemaking process — proposed rule, public comment, and final rule — with a typical implementation window of about 60 days after a final rule is published. Some observers expect possible implementation by late 2026, but delays, modifications, or cancellation are all possible.
Will my existing VA rating be reduced if the rules change?
Not automatically. Veterans with existing service-connected ratings are grandfathered under current protections — a change to the rating criteria does not by itself lower your rating. The VA stated the proposed changes would not affect evaluations of veterans currently receiving compensation. However, there’s an important caveat: if you later file for an increase, your entire condition can be re-evaluated under whatever criteria are in effect at that time, which could be the new, stricter standard. The 5-, 10-, and 20-year protected-rating rules and due-process requirements make across-the-board cuts to existing ratings highly unlikely.
What is proposed for sleep apnea ratings?
The proposal would move sleep apnea away from the current rule, where requiring a CPAP machine automatically earns a 50% rating, and toward ratings based on how much impairment remains after treatment. Under the proposed criteria, sleep apnea that is well-controlled by CPAP could be rated at 0% or 10%, with higher ratings reserved for cases where treatment is ineffective, can’t be used, or leaves serious complications. In practice, many veterans currently rated 50% for CPAP use could see lower ratings if they filed new claims after the change — which is why the timing of a new filing matters. This change is proposed, not final.
What is proposed for tinnitus ratings?
The proposal would eliminate the standalone diagnostic code for tinnitus (currently a maximum 10% rating) and instead evaluate tinnitus as a symptom of the underlying condition that causes it, such as hearing loss or a traumatic brain injury. Tinnitus is one of the most commonly claimed conditions, and this change would remove its value as a standalone “gateway” rating for future claims. Veterans already rated for tinnitus would keep their existing rating under grandfathering, but new claimants after implementation would generally not receive a separate rating for tinnitus alone. This change is proposed, not final.
Are the proposed mental health changes good or bad for veterans?
For many veterans, the proposed mental health changes are favorable. The VA has proposed a new domain-based evaluation model that assesses functioning across areas like cognition, interpersonal relationships, task completion, life activities, and self-care. It would establish a minimum 10% rating for any service-connected mental health condition (eliminating the 0% level) and remove the requirement of “total occupational and social impairment” to reach 100%, potentially making higher ratings easier to obtain. A separate rule already in effect — the medication rule — could offset some gains by rating conditions at their treated level, though the VA paused its implementation amid pushback.