Few VA disability topics generate more questions than the proposed changes to the sleep apnea rating criteria. Veterans reasonably want to know whether the rules are changing, when, and what it would mean for them. This guide separates what is actually in effect from what has only been proposed - because the difference matters.
The short version: as of today, the current rating criteria remain in effect. The VA published a proposed rule that would revise how sleep apnea is evaluated, but a proposal is not a final rule. Until a final rule is published with an effective date, claims continue to be decided under the existing schedule.
What the current criteria say
Sleep apnea is rated under 38 CFR 4.97, Diagnostic Code 6847, at 0, 30, 50, or 100 percent. The 50 percent level generally corresponds to a prescription for a breathing-assistance device such as CPAP. Our sleep apnea VA ratings guide walks through each level in plain language.
These are the criteria raters apply today. Any article or video claiming the new rules are already in effect should be checked against the actual regulation - the eCFR text of Diagnostic Code 6847 is the authoritative source.
What the VA has proposed
The VA published a proposed rule that would revise the respiratory rating schedule, including sleep apnea. In general terms, the proposal would shift the emphasis from the treatment prescribed (such as CPAP) toward how effective treatment is for the individual veteran - a change that has drawn significant attention because it could produce very different ratings for the same condition.
Key things to understand about the proposal:
- It is a proposal, not a final rule - the VA accepted public comments and may revise, delay, or withdraw it
- Proposed rating schedules typically apply only to claims filed on or after a final rule's effective date, with protections for existing ratings
- Veterans already rated under the current criteria would generally keep their ratings; reductions would not be automatic
- No one - including us - can tell you today exactly what the final criteria will say or when they will take effect
What this means if you are considering a claim
Speculation about future rules is not a strategy. The parts of a claim that matter most - a confirmed diagnosis from a sleep study, complete treatment records, and a well-reasoned medical opinion connecting the condition to service or to a service-connected disability - are the same under any version of the rating schedule.
If you are still working out the connection question, our pillar guide on sleep apnea and VA service connection explains direct and secondary pathways, and the guides on sleep apnea secondary to PTSD and sleep apnea secondary to rhinitis cover the two most common secondary theories.
Where the evidence fits
Because rating rules may change but the need for solid medical evidence does not, the sensible first step is understanding what your records actually support. A paid medical records review can help determine whether the available evidence supports a medically defensible opinion before a nexus letter is ordered.
Patriot NEXUS Letters provides independent medical evidence, not legal representation or claim filing. We do not guarantee that a medical professional will reach a favorable conclusion or that the VA will approve any claim, and we cannot predict whether or when proposed rating changes will become final.
Where veterans start
Every case is different, and there is no obligation at any step. When veterans want to understand what their records actually support, these are the two most common starting points:
- Medical records review
A licensed physician reviews your records for a $250 flat fee and identifies which conditions the available evidence may support. The fee is refunded in full if nothing supportable is identified.
- Nexus letter
When the records support one, a licensed provider writes the medical opinion that addresses the link between your condition and your service.
How VA rating schedule changes typically move from proposal to final rule
Changes to the VA's rating schedule generally follow a formal rulemaking process: the VA publishes a notice of proposed rulemaking in the Federal Register, accepts public comments for a defined period, and then either publishes a final rule, revises the proposal and issues a new one, or declines to move forward. This process can take a long time, and there is no guaranteed timeline for when, or whether, a proposal becomes final.
Veterans should be cautious of any source claiming to know the exact date new criteria take effect before a final rule has actually been published with an effective date. The only reliable confirmation is the Federal Register notice itself and the corresponding update to the eCFR text of the regulation.
Protections against rating reductions when criteria change
Veterans already rated under the current sleep apnea criteria understandably worry about losing their rating if the schedule changes. Under 38 CFR 3.105(e), the VA generally cannot reduce an existing rating without first proposing the reduction, notifying the veteran, and allowing an opportunity to submit evidence before any reduction takes effect.
Ratings that have been in effect for five years or more may also receive additional protection under 38 CFR 3.344, which limits reductions based on a single examination unless sustained improvement is shown. These protections do not guarantee a rating will never change, but they mean a new rating schedule does not automatically or immediately lower an existing evaluation.
Effective dates and why they matter more than the rating percentage
Even if a new rating schedule is eventually finalized, the effective date rules in 38 CFR 3.400 govern when any resulting rating change would actually apply to a given veteran's benefits. In most cases, a new schedule applies prospectively to claims decided after its effective date, rather than retroactively reopening every existing sleep apnea rating in the system.
For a veteran deciding whether to file a claim now or wait, this generally means the wait itself carries more certain downside - delayed potential benefits - than upside, since there is no guarantee the eventual criteria will be more favorable for any individual veteran's specific symptoms and treatment history.
What a criteria change does not change
Proposed rating criteria affect how a service-connected condition is evaluated. They do not change the medical question of whether the condition is related to service, and they do not change the need for an interpreted sleep study and a reasoned opinion grounded in your own records.
Whatever criteria are in effect when the claim is decided, the outcome still rests on the specific evidence in the file, reviewed with independent medical judgment.
Frequently asked questions
Has the VA already changed how it rates sleep apnea?
As of this writing, no. The current criteria in 38 CFR 4.97, Diagnostic Code 6847, remain in effect. A proposed rule is not the same as a final, effective regulation.
Will a rating change take away my current sleep apnea rating?
Generally, a new rating schedule applies to claims filed on or after its effective date, and existing ratings have procedural protections against reduction under 38 CFR 3.105(e). Reductions are not automatic simply because criteria change.
Should I wait to file my claim until the new rules take effect?
There is no reliable way to predict when, or whether, a final rule will be published. Filing under the current criteria, once your evidence is ready, is generally more productive than waiting on a proposal.
Where can I check whether the sleep apnea rating criteria have changed?
The eCFR text of 38 CFR 4.97, Diagnostic Code 6847, is the authoritative source, along with any final rule published in the Federal Register.
About the medical reviewer
Dr. Joseph Zelk, DNP, FNP, BC, CBSM, DBSM
Clinic Director - Diplomate of the American Board of Sleep Medicine
Dr. Zelk is double board certified in Behavioral Sleep Medicine. He is a nationally known speaker on sleep disorders and Obstructive Sleep Apnea Syndrome (OSAS), and has been an invited expert for sleep disorder related articles for The Nurse Practitioner, the Journal of the American Academy of Nurse Practitioners, and other periodicals. He has lectured to dental sleep medicine providers nationally on home sleep testing protocols and oral appliance therapy for snoring and Obstructive Sleep Apnea.
He is active in the development of novel mandibular advancement devices to help promote the field of oral appliance therapy for OSA, and leads The Sleep Medicine Group at the forefront of both oral appliance therapy and hybrid oral appliance/positive airway pressure therapy. He has also co-developed an interdisciplinary algorithm for the treatment of difficult to treat Obstructive Sleep Apnea.
Reviewed for medical accuracy on October 1, 2026. The reviewer serves as an independent medical content reviewer only and does not provide legal advice, VA claims representation, or individual medical care through this article.