Proposed Sleep Apnea Rating Changes: June 2026
Author: Jessica R. Allen, Physician
If you would like to discuss your sleep apnea case with Dr. Allen, please call (919) 849-8617 or schedule a free phone consultation at this link.
Proposed Sleep Apnea Rating Changes: What Veterans Should Know About Section 108
Veterans have been hearing a lot of discussion recently 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.
At Brightview Psychiatry Solutions, we believe veterans deserve clear, balanced, and medically grounded information. This article focuses specifically on the sleep apnea portion of the proposed legislation being discussed, commonly referred to as the Take Care of America’s Veterans Act, including S. 4744 and related House language.
This article is not legal advice, and the proposal is not the same thing as a final enacted law. However, 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 The VA Currently Rates 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% 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. For example, a veteran may receive a noncompensable rating when sleep-disordered breathing is documented but asymptomatic, a 30% rating for persistent daytime hypersomnolence, or a 100% rating for more severe complications such as chronic respiratory failure with carbon dioxide retention, cor pulmonale, or the need for a tracheostomy.
That current 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.
The proposed changes would move away from that approach.
What Section 108 Would 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:
A 0% rating would apply when sleep apnea is asymptomatic, with or without treatment.
A 10% rating would apply when treatment provides incomplete relief.
A 50% rating would apply only when treatment is ineffective or the veteran is unable to use the prescribed treatment because of a qualifying comorbid condition, and there is no end-organ damage.
A 100% rating would apply only when sleep apnea is associated with end-organ damage.
This would be a major shift. Under the current system, the medical need for CPAP can support a 50% rating. Under the proposed language, the fact that a veteran uses CPAP would not automatically mean the veteran receives a 50% evaluation. Instead, the VA would appear to 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.
If you would like to discuss your sleep apnea case with Dr. Allen, please call (919) 849-8617 or schedule a free phone consultation at this link.
Why This Matters 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.
That is why this proposal has generated concern among veterans, advocates, and organizations that serve the veteran community.
Would Existing Sleep Apnea Ratings Be Reduced?
One important point deserves careful attention: the proposed language includes a protection for compensation already in effect before the date of enactment.
In other words, 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, and veterans with existing ratings should not assume that their current compensation would automatically be reduced simply because this proposal is being discussed.
However, that does not mean the proposal is insignificant. The language appears directed at claims filed after enactment. That means 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, and future generations of service members could potentially face a more difficult rating structure for sleep apnea.
The key takeaway is this: veterans should not panic, but they should stay informed.
If you would like to discuss your sleep apnea case with Dr. Allen, please call (919) 849-8617 or schedule a free phone consultation at this link.
Service Connection Still Matters
A change in the rating schedule would not eliminate the need to prove service connection. It would affect how 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 Medical Documentation May Become Even More Important
If the proposed rating structure becomes law, the quality of medical documentation may become even more important in future sleep apnea claims.
Under the proposed language, the VA would appear to place greater emphasis 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.
If you would like to discuss your sleep apnea case with Dr. Allen, please call (919) 849-8617 or schedule a free phone consultation at this link.
Why This Proposal Is Controversial
The controversy surrounding Section 108 is not simply that it changes sleep apnea ratings. VA rating criteria can and do change over time. The larger concern is that this proposal would place specific rating-schedule changes into legislation rather than allowing VA to complete the usual regulatory process in the ordinary manner.
VA previously proposed changes to sleep apnea ratings through the regulatory process, and those proposed changes generated substantial concern. The current legislative proposal appears to revive similar concepts by directing the VA to revise the rating schedule for sleep apnea in a particular way.
For many veterans and advocates, that raises a serious policy concern: disability ratings should be based on medical evidence, functional impairment, and the lived impact of service-connected conditions—not primarily on budgetary goals or legislative offsets.
Reasonable people can debate how the VA should modernize its rating schedule. However, 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 Veterans Should Do Now
Veterans should avoid panic, but they should also avoid ignoring the issue.
If you already have a service-connected sleep apnea rating, the proposed language appears to include protection for compensation already in effect before enactment. Still, veterans should 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 your 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.
Veterans should also contact their elected representatives if they have concerns about Section 108 or any proposed change to veterans’ disability compensation. Policy decisions affecting veterans should be made transparently, with careful attention to medical evidence and the real-world impact on veterans and their families. You can look up your members of Congress here: https://www.congress.gov/members/find-your-member
The Bottom Line
The proposed sleep apnea rating changes are significant because they could alter how future VA claims are evaluated. Under the current system, a veteran who requires CPAP may qualify for a 50% 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.
For veterans, the most important message is this: do not rely on fear, rumors, or oversimplified social media summaries. Focus on evidence. Focus on diagnosis, treatment history, functional impairment, and a well-supported medical nexus when one is needed.
At Brightview Psychiatry Solutions, our role 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.
If you would like to discuss your sleep apnea case with Dr. Allen, please call (919) 849-8617 or schedule a free phone consultation at this link.
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