Sleep Apnea · VA Policy

Proposed Sleep Apnea Rating Changes: August 2026

Originally published June 14, 2026. Updated August 10, 2026.

Since this article was first published, the legislation has moved but has not passed:

• June 10, 2026

  The Take Care of America's Veterans Act was introduced as H.R. 9237 in the House by Rep. Mike Bost (R-IL) and as S. 4744 in the Senate by Sen. Jerry Moran (R-KS). The package bundles more than 60 separate veterans bills, including the Major Richard Star Act and the Love Lives On Act.

• Mid-July 2026

  The House brought the bill to the floor. An attempt to send the bill back to committee failed by a single vote, and House leadership then postponed the final vote rather than proceed.

• July 29, 2026

  In the Senate, two competing efforts both failed. A request to pass the bill by unanimous consent was blocked, and an amended version proposing to replace the disability-rating offset with unobligated Department of Defense funds was also blocked.

• As of August 9, 2026

  The bill has not passed either chamber. It remains active, and sponsors have said they intend to bring it back up.

The sections below explain what the proposal would do and why it matters, with the understanding that the language could still change, advance, or fail entirely.

Introduction

Veterans have been hearing a great deal of discussion about proposed changes to VA disability ratings for obstructive sleep apnea. As with many veterans' benefits issues, the conversation online has moved quickly, and some of the information being shared is incomplete, confusing, or understandably alarming.

Brightview Psychiatry Solutions takes the position that veterans deserve clear, balanced, and medically grounded information. This article focuses on the sleep apnea portion of the legislation under discussion, the Take Care of America's Veterans Act (H.R. 9237 / S. 4744), and specifically on the provision known as Section 108.

This article is not legal advice, and a proposal is not the same thing as an enacted law. Because the proposed language could significantly affect how future VA sleep apnea claims are rated, it is important for veterans to understand what is being discussed and why medical evidence remains so important.

How Does the VA Currently Rate Sleep Apnea?

Under the current VA rating schedule, sleep apnea is evaluated under Diagnostic Code 6847. This includes obstructive, central, and mixed sleep apnea syndromes.

At present, many veterans with service-connected obstructive sleep apnea receive a 50 percent rating when their condition requires the use of a breathing-assistance device such as a CPAP machine. Other rating levels may apply depending on the severity of symptoms and complications. A veteran may receive a noncompensable rating when sleep-disordered breathing is documented but asymptomatic, a 30 percent rating for persistent daytime hypersomnolence, or a 100 percent rating for more severe complications such as chronic respiratory failure with carbon dioxide retention, cor pulmonale, or the need for a tracheostomy.

That structure has made the CPAP requirement a central issue in many sleep apnea claims. In many cases, once service connection is established and CPAP use is medically required, the rating analysis has been relatively straightforward.

These criteria remain in effect today. The proposed changes would move away from this approach, but only if and when they are enacted or finalized.

What Would Section 108 Change for Sleep Apnea?

The sleep apnea portion of Section 108 would require the VA to revise the rating schedule for sleep apnea syndrome. Instead of focusing heavily on whether a veteran requires CPAP or another breathing-assistance device, the proposed structure would focus more on whether treatment controls the condition, whether treatment provides incomplete relief, whether treatment is ineffective, whether the veteran is unable to use treatment because of another medical condition, and whether there is end-organ damage.

In plain language, the proposed structure would look like this:

This would be a major shift. Under the current system, the medical need for CPAP can support a 50 percent rating. Under the proposed language, the fact that a veteran uses CPAP would not by itself mean the veteran receives a 50 percent evaluation. Instead, the VA would look more closely at whether treatment works, whether symptoms persist despite treatment, whether another condition prevents treatment use, and whether more serious medical complications have developed.

Does Section 108 Affect Tinnitus As Well?

Yes. Section 108 addresses two conditions, not one. In addition to the sleep apnea provisions described above, the section would change how tinnitus is evaluated.

Under the current rating schedule, recurrent tinnitus generally receives a 10 percent rating. Under the proposed language, tinnitus would generally no longer receive a separate compensable rating and would instead be evaluated as a symptom of an underlying disease or injury rather than as a stand-alone disability.

Sleep apnea and tinnitus are two of the most frequently claimed service-connected conditions in the VA system, which is why this single section has drawn so much attention within a nearly 600-page package.

Would Existing Sleep Apnea Ratings Be Reduced?

One point deserves careful attention: the proposed language includes a protection for compensation already in effect before the date of enactment.

The proposal states that the revised rating schedule may not serve as the basis for reducing, discontinuing, or otherwise adversely affecting compensation that was already in effect the day before the law was enacted.

That is important. Veterans with existing ratings should not assume that their current compensation would automatically be reduced simply because this proposal is being discussed. Both supporters and critics of the bill have generally agreed on this point: the language is directed at claims filed after enactment.

That does not mean the proposal is insignificant. Future claims could be evaluated under a much different framework if this language becomes law. Veterans who have not yet filed, veterans with pending claims depending on timing, veterans whose conditions have not yet been diagnosed, and future generations of service members could potentially face a more difficult rating structure.

The key takeaway: veterans should not panic, but they should stay informed.

Is the VA's Own Rule Change Still Pending?

This is a source of considerable confusion, and it is worth separating clearly. There are two distinct tracks.

Track one is regulatory. In February 2022, the VA published a proposed rule updating portions of the VA Schedule for Rating Disabilities, including the respiratory, auditory, and mental disorders body systems. That proposal included the sleep apnea and tinnitus changes now under discussion. It went through public comment. It was never finalized. A proposed rule creates no legal obligation and changes no ratings. Until the VA publishes a final rule, the existing DC 6847 criteria govern.

Track two is legislative. Section 108 would direct the VA by statute to make changes similar to those it previously proposed by regulation.

This distinction matters for two reasons. First, supporters of the bill argue that the rating changes originated with the VA's own rulemaking rather than with this legislation, and that if those changes proceed anyway, Congress should direct the resulting savings toward veterans programs. Second, and more practically for veterans: even if the legislation fails, the regulatory track has not closed. The VA retains the ability to finalize its rule through the ordinary rulemaking process.

Veterans following this issue should watch both tracks, not just the one generating headlines.

Why Are Veterans Organizations Divided?

The veteran service organization community has split publicly over this bill, and veterans encountering conflicting messages from organizations they trust should understand why.

Organizations urging passage — including the American Legion, Wounded Warrior Project, AMVETS, the Military Officers Association of America, the Military Order of the Purple Heart, Vietnam Veterans of America, and others — signed a coalition letter in late June supporting the bill as written. Their position is that the package delivers more than 60 long-stalled priorities, that existing ratings are protected, that the rating changes originated with the VA rather than with Congress, and that the associated savings would stay within veterans programs rather than returning to the Treasury.

Organizations opposing Section 108 — including the Veterans of Foreign Wars, Disabled American Veterans, and Iraq and Afghanistan Veterans of America — support many individual provisions but object to the funding mechanism. Their position is that disability ratings should be based on medical evidence and functional impairment rather than on budgetary targets, and that Congress should not fund benefits for one group of veterans by reducing future compensation for another.

The scale of the disagreement reflects the numbers involved. VA projections cited in this debate estimate the changes could reduce disability compensation by roughly $57 billion over ten years and affect up to 1.5 million veterans over time.

Both positions are held in good faith by organizations with long records of advocating for veterans. Veterans should read the underlying bill text and the organizations' own statements rather than relying on secondhand summaries.

Why Does This Matter for Veterans?

The concern is not merely technical. Obstructive sleep apnea can have significant consequences for a veteran's daily functioning, mental health, cardiovascular health, concentration, mood, fatigue, occupational reliability, and overall quality of life.

Many veterans with sleep apnea use CPAP because their condition is serious enough to require ongoing treatment. The fact that a treatment helps does not necessarily mean the underlying condition is minor. For many veterans, CPAP use is burdensome, disruptive, uncomfortable, and only partially effective. Some veterans continue to experience fatigue, fragmented sleep, daytime sleepiness, cognitive slowing, irritability, headaches, or impaired functioning despite treatment.

From a medical perspective, the practical impact of sleep apnea should not be evaluated only by asking whether a machine was prescribed or whether oxygen levels improve on paper. A fair evaluation should consider the veteran's actual functional impairment, symptom persistence, treatment tolerance, comorbid conditions, and the broader health consequences of the disorder.

Does Service Connection Still Matter?

A change in the rating schedule would not eliminate the need to prove service connection. It would affect how the VA assigns the percentage once service connection is established.

For sleep apnea, service connection may be pursued in several ways. Some veterans argue that sleep apnea began during service, especially when there is evidence of loud snoring, witnessed apneas, choking or gasping during sleep, nonrestorative sleep, morning headaches, daytime fatigue, or sleep-related complaints during or soon after active duty.

Other veterans pursue sleep apnea as secondary to an already service-connected condition. Common examples may include PTSD, depression, anxiety disorders, insomnia disorder, chronic rhinitis, sinusitis, asthma, medication effects, or obesity as an intermediate step caused or aggravated by service-connected physical or psychiatric conditions.

This is where medical evidence becomes critical. The VA does not grant service connection for sleep apnea simply because a veteran has a diagnosis. The claim generally requires a clear medical explanation connecting the veteran's sleep apnea to service or to a service-connected condition.

A strong medical nexus opinion should explain not only what the veteran has been diagnosed with, but why the diagnosis is medically connected to service or to another service-connected condition. It should address the veteran's timeline, risk factors, symptoms, treatment history, relevant medical literature, and any alternative explanations raised by the VA.

Why Might Medical Documentation Become Even More Important?

If the proposed rating structure is enacted or finalized, the quality of medical documentation may become even more important in future sleep apnea claims.

Under the proposed language, greater emphasis would fall on treatment response. That means future evidence may need to address questions such as:

• Does CPAP or other prescribed treatment fully control the veteran's symptoms?
• Does the veteran continue to experience daytime fatigue, sleep fragmentation, cognitive impairment, mood disruption, headaches, or reduced functioning despite treatment?
• Is the veteran unable to tolerate CPAP because of another medical condition, such as panic symptoms, claustrophobia, chronic nasal obstruction, rhinitis, sinus disease, mask intolerance, dermatologic problems, or other comorbidities?
• Has sleep apnea contributed to end-organ damage or other serious complications?
• Has the veteran's sleep apnea caused or worsened psychiatric symptoms, occupational impairment, or functional limitations?

These are medical questions, not just administrative ones. Veterans may benefit from ensuring that their treating clinicians, sleep specialists, and medical opinion providers document the real-world impact of sleep apnea and the effectiveness or limitations of treatment.

Because both the legislative and regulatory tracks remain open, this documentation has value regardless of which framework ultimately applies. Contemporaneous records of persistent symptoms despite treatment, treatment intolerance, and functional limitation are useful evidence under the current criteria and would be directly relevant under the proposed criteria.

Why Is This Proposal Controversial?

The controversy surrounding Section 108 is not simply that it changes sleep apnea and tinnitus ratings. VA rating criteria can and do change over time. A larger concern raised by critics is that this proposal would place specific rating-schedule changes into legislation rather than allowing the VA to complete the usual regulatory process, and that it would do so as a funding offset for other spending.

Supporters counter that the VA had already proposed these changes years earlier, that the regulatory process may proceed regardless, and that directing the resulting savings back into veterans programs is preferable to allowing them to return to the Treasury.

Reasonable people can debate how the VA should modernize its rating schedule. Veterans' disability compensation exists to recognize the average impairment in earning capacity caused by service-connected disability. Any major change to the rating schedule should be medically sound, transparent, and fair to the veterans who will be affected by it.

What Should Veterans Do Now?

Veterans should avoid panic, but they should also avoid ignoring the issue.

If you already have a service-connected sleep apnea rating, current criteria still apply, and the proposed language includes protection for compensation already in effect before enactment. Continue to comply with treatment when medically appropriate, and continue documenting ongoing symptoms and functional limitations.

If you have sleep apnea and believe it is related to service or secondary to a service-connected condition, consider speaking with an accredited representative, veterans law attorney, or qualified medical professional about your evidence. This is especially important if your claim has not yet been filed or if a prior claim was denied.

If your sleep apnea is secondary to PTSD, depression, anxiety, insomnia, rhinitis, asthma, chronic pain, medication effects, or obesity related to service-connected conditions, your claim may require a detailed medical nexus opinion that explains the connection in a clear and medically supported way.

Verify the status before acting on anything you read online. Legislative and regulatory status can change quickly. Check Congress.gov for the current status of H.R. 9237 and S. 4744, and the Federal Register for any final rule affecting DC 6847.

Contact your elected representatives if you have concerns about Section 108 or any proposed change to veterans' disability compensation. You can look up your members of Congress at congress.gov/members/find-your-member.

The Bottom Line

As of August 2026, nothing has changed in how the VA rates sleep apnea. The Take Care of America's Veterans Act has stalled in both chambers, and the VA's 2022 proposed rule has not been finalized. Diagnostic Code 6847 continues to apply as written.

The proposal remains significant because it could alter how future claims are evaluated. Under the current system, a veteran who requires CPAP may qualify for a 50 percent rating once service connection is established. Under the proposed language, future ratings would depend much more heavily on whether treatment provides relief, whether treatment is ineffective or cannot be used because of another condition, and whether there is end-organ damage.

Existing compensation appears to be protected under the proposed language, but future claims could be affected if the proposal becomes law or if the VA finalizes its rule.

For veterans, the most important message is this: do not rely on fear, rumors, or oversimplified social media summaries. Focus on evidence — diagnosis, treatment history, functional impairment, and a well-supported medical nexus when one is needed.

The role of Brightview Psychiatry Solutions is to help veterans pursue medically grounded, evidence-based nexus opinions when psychiatric conditions, sleep disruption, service-connected disabilities, or related medical factors may support service connection. No medical opinion can guarantee an outcome, but a clear and well-reasoned medical explanation can help ensure that the VA has the evidence it needs to fairly consider the claim.

Related reading

• Sleep Apnea Nexus Letters
• Sleep Apnea Claimed Secondary to Sinusitis
• Sleep Apnea Secondary to Allergic Rhinitis
• Sleep Apnea Claimed Secondary to Obesity

This article is provided for general informational purposes and is not legal advice. Legislative and regulatory status described above reflects publicly available information as of August 9, 2026 and may change. Veterans should verify current status with primary sources or an accredited representative before making claim decisions.

Jessica R. Allen, M.D. is a licensed psychiatrist and former VA C&P examiner practicing at Brightview Psychiatry Solutions PLLC in Wake Forest, North Carolina.

Educational information only. This article is provided for general educational purposes and does not constitute medical advice, legal advice, or a treatment relationship. Reading it does not establish a physician–patient relationship with Dr. Allen or Brightview Psychiatry Solutions PLLC. No outcome in any VA claim is promised or implied; the VA determines service connection and assigns all disability evaluations. Veterans should consult their own treating providers regarding medical care and an accredited representative, agent, or attorney regarding claims. If you are in crisis, the Veterans Crisis Line is available 24/7: dial 988 and press 1, or text 838255.