Proposed — not law
Sleep Apnea: the rating change VA proposed and never made
VA published a proposal in February 2022 to rewrite how sleep apnea is rated. It was never finalized. Your claim today is still decided under the old rules — and I want you to know exactly which rules those are, and how to get sleep apnea service connected in the first place.
Nothing proposed can be claimed today. A proposed rule is VA asking the public
what it thinks about a change. It has no force. VA proposed new sleep apnea criteria on
15 February 2022. As of September 2026 VA has not published a final rule, and
38 CFR 4.97, Diagnostic Code 6847 — the section of federal regulation that rates sleep
apnea — is unchanged since 17 May 2006. If you file tomorrow, you are rated under the criteria
in the first card below. Nothing else.
Two mistakes I see, and both cost money. The first: a veteran hears about the proposal,
believes his CPAP-based 50 percent is gone, and panics into a filing he does not need. The second,
and the worse one: a veteran believes he now has to prove his treatment failed, so he never files
a sleep apnea claim at all. Neither is true. Today, needing the machine is the standard.
How VA actually rates sleep apnea right now
38 CFR 4.97, Diagnostic Code 6847. Four levels.
- 0 percent — asymptomatic, but with documented sleep disordered breathing. No symptoms, but a sleep study on record showing the breathing problem.
- 30 percent — persistent day-time hypersomnolence. In plain words: you are sleepy during the day, and it keeps happening.
- 50 percent — requires use of a breathing assistance device such as a CPAP machine. CPAP means continuous positive airway pressure, the mask and air pump you wear at night. The standard is that you need it — not that it failed you.
- 100 percent — chronic respiratory failure with carbon dioxide retention, or cor pulmonale (the right side of the heart failing because of a lung condition), or requires a tracheostomy (a surgical opening in the windpipe to breathe).
Sleep apnea is rated in the same part of the regulation as asthma and COPD, and VA does not combine ratings across those codes. See asthma, COPD and lung VA ratings.
If a doctor prescribed the machine and you use it, that is the 50 percent criterion as written
today. Do not talk yourself out of filing because of a rule that does not exist.
★ This is the rule your claim is decided under.
How VA actually rates sleep apnea right now
Way 1 — Direct service connection
The sleep apnea itself started in service, or is otherwise tied to your service.
- A current diagnosis confirmed by a sleep study. VA's own sleep apnea questionnaire says the diagnosis "must be confirmed by a sleep study," with the results on record. A doctor's guess, or a home machine with no study behind it, is not enough by itself.
- Something in service. Under 38 CFR 3.303(a), service connection means the evidence shows the disability was incurred coincident with service, or, if it existed before service, was aggravated by it. VA's general rule is the same: a current condition, and a link to what happened in service.
- Proof of the link. Symptoms written down while you served — snoring, stopping breathing at night (a bunkmate or spouse can describe it), waking gasping, daytime tiredness — are the kind of record that ties a later diagnosis back to service. Check your service treatment records and sick-call visits for them, and get a doctor's statement connecting them to the diagnosis.
Many veterans are diagnosed years after they leave. That does not end the claim, but it means the
in-service symptoms and a medical opinion carry the weight. Ask for your service treatment records
before you file.
★ Sleep study + something in service + a doctor who links them.
current diagnosissleep study
Way 2Secondary service connection
Way 2 — Secondary service connection
Sleep apnea can be service connected as a result of another service-connected condition that causes it or makes it worse.
38 CFR 3.310. Under section (a), a disability that is proximately due to or the result of a
service-connected disease or injury is service connected. Under section (b), any increase in severity
of a non-service-connected condition that is proximately due to a service-connected one, and not
just the natural progress of the disease, is service connected too. For aggravation, VA needs a
baseline: medical evidence of how bad the condition was before it got worse.
Conditions the Board of Veterans' Appeals has linked to sleep apnea in its own decisions:
- PTSD — granted where doctors' opinions tied PTSD to sleep apnea (example; example). In one case PTSD caused weight gain, and the weight gain caused the sleep apnea (example).
- Chronic sinusitis or rhinitis (long-term nasal or sinus trouble) — granted where a doctor said nasal congestion made the sleep apnea worse (example).
- Deviated septum — granted where an ear, nose and throat doctor called it a contributing factor (example).
- Asthma — granted where a VA doctor said asthma aggravates sleep apnea (example; example).
- GERD (acid reflux) — granted on aggravation in one case where severe night reflux made the veteran take off his CPAP mask (example). The Board sends these back or denies them when the doctor never addressed aggravation, so ask your doctor to address both cause and aggravation.
- Obesity, as a middle step — obesity by itself is not a disability VA compensates. But if a service-connected condition caused (or worsened) your weight, and that weight was a substantial factor in causing your sleep apnea, and the sleep apnea would not have happened without it, it can connect. That is the test the Court of Appeals for Veterans Claims set in Walsh v. Wilkie (24 February 2020); the Board applied it in this decision.
These are individual decisions, not promises. Each one turned on a doctor's written opinion
for that veteran. A condition on this list does not connect your sleep apnea automatically. It only
works if the other condition is already service connected and a doctor puts the medical reasoning
in writing.
★ Secondary needs medical evidence of cause or aggravation.
What VA said it wanted to change
Proposed only. I am describing VA's stated intent, not quoting a regulation — because VA's proposed rating table for this code is not published in full on any official source I can reach.
- The proposal would shift the focus from whether you need a CPAP to how much impairment is left after treatment.
- It laid out four levels: 0, 10, 50 and 100 percent. At 0 percent, a veteran is asymptomatic with or without treatment. At 10 percent, treatment gives incomplete relief.
- VA said it would assign 50 percent only where treatment is either ineffective, or the veteran is unable to use the prescribed treatment because of comorbid conditions — other medical conditions he also has.
- VA said it would assign 100 percent only where that is so and there is end-organ damage.
- There is no 30 percent level in that structure. The 30 percent for day-time sleepiness exists today only because the proposal was never adopted.
On "comorbid conditions." VA proposed a note defining it: conditions that, in the opinion
of a qualified medical provider, directly impede or prevent the use of a recognized treatment
normally shown to be effective. Simply disliking the mask would not be enough under that
language. On "end-organ damage" — VA never defined it in the proposal. You cannot measure
yourself against a term VA did not define, so do not try.
The document: VA Notice of Proposed Rulemaking, "Schedule for Rating Disabilities—Ear, Nose,
Throat, and Audiology Disabilities; Special Provisions Regarding Evaluation of Respiratory
Conditions; Schedule for Rating Disabilities—Respiratory System," RIN 2900-AQ72, 87 FR 8474
(15 February 2022), sleep apnea discussed at pages 8478-79.
Read it in the Federal Register.
★ A proposal is a question, not a rule.
Four and a half years, no final rule
- Proposed 15 February 2022. The public comment window closed 18 April 2022.
- VA last listed this rulemaking at Final Rule Stage in the October 2024 Unified Agenda, with a projected final action of August 2025 that passed without a rule.
- As of September 2026, no final rule. The regulation is unchanged.
The comment window is closed, so here is the next avenue. If VA ever finalizes this, the
final rule publishes in the Federal Register with its own effective date, and that document will
say who it applies to and when. Watch for it there, not on social media, and not from anybody
charging you for the news.
★ Until it publishes, it is not real.
A rule change does not just take your rating away
This is the part nobody tells you, and it is the reason not to panic.
38 CFR 3.951(a). When VA revises the rating schedule, an evaluation you already hold
cannot be reduced unless medical evidence shows your disability has actually improved. A new
table, by itself, is not evidence that you got better.
38 CFR 3.951(b). An evaluation continuously in effect for 20 years or more cannot
be reduced below that level, absent fraud.
So if you are sitting at 50 percent today because you use a CPAP, a future rule does not erase
it on its own. Keep your rating decision letter. Keep your sleep study. Keep the prescription
for the machine. Those papers are what prove where you started.
★ Hold your paperwork. It is your proof.
If a new rule would ever help you, do not sit on it
An increase under a changed rule is not automatic, and the back pay is capped.
- Under 38 CFR 3.114(a), an award based on a liberalizing change — a change that helps veterans — cannot take effect any earlier than the date that change itself takes effect.
- If you ask VA for review more than one year after the change takes effect, VA can pay you only one year back from the date of your request.
Plain version: waiting costs you months of money you will never get back. If any final rule
publishes and it would rate you higher, file the request right away.
38 CFR 3.114 is here.
And today, while none of this is law: if you have symptoms and no claim on file, file under the
current criteria. A rating you already hold is worth more than a rule you are waiting on. Bring
your spouse or whoever in the Family handles the paperwork — this is easier with two sets of eyes.
★ File on the rule that exists.
Real numbers and real pages
- VA benefits (file, check a claim, ask a question): 800-827-1000, Monday through Friday, 8:00 a.m. to 9:00 p.m. ET.
- VA health care (sleep study, CPAP, getting your treatment records): 877-222-8387, Monday through Friday, 8:00 a.m. to 8:00 p.m. ET.
- Hard of hearing: dial 711 for the relay service.
- In crisis or struggling to sleep and cope: Veterans Crisis Line, dial 988 then press 1, any hour.
- How to file a VA disability claim
- VA Form 21-526EZ, the disability claim form
- VA sleep apnea questionnaire (shows what VA looks for)
- All VA phone numbers
★ Call, or file online, before you wait on a rule.
Sources — VA's own words
- 38 CFR 4.97, Diagnostic Code 6847 (eCFR)
- 87 FR 8474, proposed rule, 15 Feb 2022 (Federal Register)
- 38 CFR 3.303, principles of service connection (eCFR)
- 38 CFR 3.310, secondary service connection and aggravation (eCFR)
- 38 CFR 3.951, preservation of ratings (eCFR)
- 38 CFR 3.114, change of law (eCFR)
- VA Sleep Apnea Disability Benefits Questionnaire (benefits.va.gov)
- VA disability compensation eligibility (va.gov)
- How to file a VA disability claim (va.gov)
- VA Form 21-526EZ (va.gov)
- VA contact numbers (va.gov)
- Walsh v. Wilkie, No. 18-0495 (U.S. Court of Appeals for Veterans Claims, 24 Feb 2020)
- Board of Veterans' Appeals decisions (va.gov): A21018009, A24002721, A25027690, 22059100, 1807552, 22056234, 1717887, 1454144, 23010030