The Proposed VA Sleep Apnea Rating Change: What It Means for Your 50%

The VA has proposed changing how it rates sleep apnea, and the change would end the automatic 50% rating that veterans now get for using a CPAP. The proposal is not final, there is no start date, and current ratings would be protected. But if you have sleep apnea and are not yet service-connected, this is a “file while the current rules are in effect” moment. Here is what would change, what is still the same, and what to do now.

The Short Version

• Today, a prescribed CPAP or similar device generally earns a 50% rating under Diagnostic Code 6847.

• The proposed rule would untie the 50% from device use and rate sleep apnea by how well treatment works instead. Many veterans who now get 50% for CPAP would fall to 10%, or 0% if treatment controls their symptoms.

• The proposed rule would also remove the 30% level.

• It is only proposed. No final rule, no effective date. Current criteria still apply, and existing ratings are expected to be grandfathered.

• If you have sleep apnea and are not yet rated, filing under the current, more favorable rules is generally the safer move.

How Sleep Apnea Is Rated Today

Right now, sleep apnea (obstructive, central, and mixed) is rated under 38 C.F.R. § 4.97, Diagnostic Code 6847, at four levels:

Current sleep apnea rating criteria (38 C.F.R. § 4.97, DC 6847)

The 50% tier is by far the most common outcome, because most veterans with obstructive sleep apnea are prescribed a CPAP. That 50% is worth around $1,100 a month for a single veteran with no dependents under 2026 rates. That is exactly the tier the proposal targets.

What the VA Wants to Change

The VA first proposed overhauling its respiratory ratings, including sleep apnea, in a proposed rule published on February 15, 2022, and revised it in a supplemental proposed rule on September 12, 2024. The core idea: rate sleep apnea by how well treatment works, not by whether a device was prescribed. Here is the proposed structure from the 2022 rule:

Proposed sleep apnea criteria (2022 proposed rule, not final):

Two changes stand out. First, the 30% tier is removed. Second, and most important, the 50% would no longer be automatic for CPAP use. A veteran whose CPAP controls symptoms would no longer land at 50% for using the device. In practice, many veterans who now receive 50% would fall to 10% (incomplete relief) or even 0% (well controlled). The 50% and 100% levels would be reserved for veterans whose treatment does not work or who cannot use it.

In plain terms, the proposal flips the logic. Today, needing treatment earns the rating. Under the proposal, treatment that works would lower it.

Why This Matters for Your 50%

Here is the part that frustrates a lot of veterans. CPAP therapy is supposed to work. That is the goal. Under the current rules, doing the responsible thing, using your prescribed device, gets you a 50% rating. Under the proposed rules, that same success could count against your rating, because well-controlled sleep apnea would be treated as less disabling.

Is the Rule Final? (No)

No, and this is the most important thing to understand. As of now, the sleep apnea change is only proposed. No final rule has been published, and there is no effective date. The tiers above are from the 2022 proposed rule; the VA issued a supplemental proposed rule in 2024 that revised parts of the package, so the exact final criteria could still change. Until a final rule appears in the Federal Register with a start date, sleep apnea is still rated under the current criteria at 38 C.F.R. § 4.97, DC 6847.

Two more points that should ease the worry for veterans who are already rated:

• Existing ratings are expected to be grandfathered. The changes are aimed at future claims, not at automatically re-rating veterans who already hold a 50%.

• The VA cannot simply reduce an established rating. Its normal rating-reduction rules still apply, which require actual, sustained improvement shown the right way before any rating can be lowered.

The One Part That Could Help You

The proposal is not all bad news. Under the proposed criteria, the 50% and 100% levels are available not only when treatment fails, but also when you cannot use the prescribed treatment because of a comorbid condition. The rule would add a note defining qualifying comorbid conditions as those that, in the opinion of a qualified medical provider, directly impede or prevent using a treatment that normally works.

In plain terms: if a separate medical condition makes it impossible for you to use your CPAP, you would not be pushed down to a low rating just because the device would work in theory. If that describes you, get the reason you cannot use your device clearly documented by your provider now, because it would matter under the new framework.

What to Do Right Now

1. If you have sleep apnea and are not yet service-connected, consider filing now. Claims are generally decided under the rules in effect at the time. The current 50% standard is more favorable than what is proposed, so waiting could mean facing tougher criteria.

2. Nail down the diagnosis. The VA wants a formal sleep study (in-lab polysomnography or a qualifying home sleep test), not just a report of snoring or fatigue.

3. Document CPAP necessity. Make sure your records clearly show the device was prescribed. Keeping your compliance and usage reports does not hurt, and it strengthens your picture if the rules change.

4. Document any reason you cannot use your device. If another condition blocks CPAP use, get that in your records now for the comorbidity exception.

5. Build the service-connection link. Most veterans are diagnosed after service, so a clear medical nexus opinion is often the deciding piece.

If You Are Filing Sleep Apnea as a Secondary Condition

Many of the strongest sleep apnea claims are secondary, meaning the sleep apnea was caused or worsened by another service-connected condition. Two common paths:

• Sleep apnea secondary to PTSD, through disrupted sleep, hyperarousal, and weight gain from medication.

• Sleep apnea through obesity as an intermediate step, where a service-connected condition drove weight gain that led to the sleep apnea. We cover this in detail in our Garner v. Tran and obesity-as-intermediate-cause guides.

Service connection is a separate question from the rating. Even with the proposed rating change on the horizon, connecting your sleep apnea to your service is step one, and it is worth doing now.

Frequently Asked Questions:

References

1. 38 C.F.R. § 4.97, Diagnostic Code 6847 (current sleep apnea rating criteria); 38 C.F.R. § 4.96 (special provisions for evaluating respiratory conditions).

2. Schedule for Rating Disabilities: Ear, Nose, Throat, and Audiology Disabilities; Special Provisions Regarding Evaluation of Respiratory Conditions; Schedule for Rating Disabilities: Respiratory System, 87 Fed. Reg. 8474 (proposed Feb. 15, 2022).

3. Supplemental Notice of Proposed Rulemaking, 89 Fed. Reg. 74162 (Sept. 12, 2024) (revised proposed criteria; not final; no effective date as of publication of this article).