VA Proposed Changes: Mental Health, Sleep Apnea, and Tinnitus (2025 Update)
CCK Law: Our Vital Role in Veterans Law
On February 15, 2022, VA announced proposed changes to the way it rates some disabilities, such as some respiratory, auditory, and mental health conditions. These proposed changes would “enable VA to incorporate modern medical data and terminology” into the new criteria and, in theory, make it easier for veterans to establish service connection and reach rating criteria eligibility. As of 2025, these updates have not been implemented by VA, but we still expect to see them in the near future.
This article will guide you through the proposed changes as well as provide the latest information on the new VA mental health rating effective dates in 2025.
Highlights of this article include:
- Descriptions of the proposed updates VA may be implementing
- When to expect the new VA mental health rating effective dates, as well as those for tinnitus and sleep apnea
- Explorations of the impact these updates will have
- And more
What is VASRD?
The VA Schedule for Rating Disabilities (VASRD) contains the disabilities for which veterans can be rated, divided into 15 different categories depending on the bodily system to which the disability pertains.
For example, there are separate categories for the digestive system, respiratory system, and musculoskeletal system.
Each body system then lists diagnoses that can occur within that system with its corresponding diagnostic code, a four-digit code that corresponds to the disability.
The rating schedule explains how disabilities will be rated in severity, which determines VA disability compensation.
VA is in the process of a multi-decade review of the entire Schedule.
What Are the Proposed Updates to Sleep Apnea, Mental Health, and Tinnitus?
Some of the most-discussed of VA’s proposed updates include the following:
- Changing the rating criteria for sleep apnea to now be based on responsiveness to treatment.
- No longer rating tinnitus as its own condition, but rather evaluating tinnitus as a symptom of the underlying disease that causes it.
- Changing the way mental health conditions are evaluated by focusing on how the condition impacts cognition, interpersonal relationships, task completion, life activities, and self-care.
- Additionally, VA proposes to include a 10 percent minimum evaluation for having one or more service-connected mental health conditions, as well as no longer requiring that the veteran experience “total occupational and social impairment” to be rated at 100 percent.
Sleep Apnea VA Rating Changes
The number of veterans receiving compensation for sleep apnea, or interrupted breathing during sleep, has risen sharply in recent years. In one of the recent Annual Benefits Reports released by VA, sleep apnea was the most prevalent respiratory condition in all service-connected veterans.
Under the current rating schedule, VA issues ratings at 0, 30, 50, and 100 percent for sleep apnea, even if treatments are effective at dealing with the condition.
Currently, if a veteran uses a CPAP machine, they will receive a 50 percent rating. If the proposed changes were to take effect, this would no longer be the case.
With the proposed VA sleep apnea rating changes, veterans could receive a 0 percent rating for asymptomatic sleep apnea, even if symptoms are fully treated by a CPAP machine or other treatment, for the first time. Ratings would then increase based on how symptomatic the condition remains after treatment.
These updated criteria would be as follows:
- 100 percent – Treatment ineffective (as determined by sleep study) or unable to use treatment due to comorbid conditions; and with end-organ damage
- 50 percent – Treatment ineffective (as determined by sleep study) or unable to use treatment due to comorbid conditions; and without end-organ damage
- 10 percent – Incomplete relief (as determined by sleep study) with treatment
- 0 percent – Asymptomatic with or without treatment
Under these criteria, veterans would receive ratings of 10 percent or higher “only when treatment is either ineffective or the veteran is unable to use the prescribed treatment due to comorbid conditions.”
This would allow VA to formally acknowledge a veteran’s condition without requiring any compensation if the condition is easily managed with treatment.
VA Tinnitus Rating Changes
Similarly, veterans diagnosed with tinnitus—a high-pitched ringing sound in the ears—would need to meet a higher standard in order to receive higher levels of disability compensation.
Currently, if a veteran has service-connected tinnitus, they will receive a 10 percent rating.
Under the proposed VA tinnitus rating changes, tinnitus would need to be related to non-compensable hearing loss or another service-connected disability (e.g., TBI) in order to get a rating.
More than 1.5 million veterans are currently receiving disability benefits for tinnitus, making it one of the most common VA disability claims.
VA officials noted that these changes would likely reduce the number of veterans qualifying for disability ratings of 10 percent or more.
However, VA also stated that the number of veterans who have the condition entered into their case files for future reference would not change.
VA Mental Health Ratings Changes
VA studies have estimated that as many as one in every eight veterans may suffer from PTSD or related mental health issues, but outside experts have said the requirements for proving impairment under the current system remain difficult.
VA’s new mental health ratings changes would increase the minimum disability rating from 0 to 10 percent, and allow veterans the chance to earn mental health ratings of 10, 30, 50, 70, or 100 percent. The rule would also get rid of a dated part of VASRD that prevents a veteran from getting a 100 percent rating for a mental health condition if they are able to work.
Under the new rules, conditions like anxiety, depression, or PTSD would be evaluated based on how impactful the disability is across five domains of impairment. These domains are:
- Cognition – Which would assess a veteran’s mental processing involved in gaining knowledge and comprehension. These processes include, but are not limited to, memory, concentration, attention, goal setting, speed of processing information, planning, organizing, prioritizing, problem solving, judgment, decision making, or flexibility in adapting when appropriate.
- Interpersonal interactions and relationships – Which would assess a veteran’s ability to effectively interact with other people in both social and occupational settings and participate in society. This domain includes both informal (social, associational, etc.) and formal (coworkers, supervisors, etc.) relationships.
- Task completion – Which would assess a veteran’s ability to manage task-related demands. This domain includes, but is not limited to, the following types of activities: Vocational, educational, domestic chores, social, or caregiving.
- Life activities and navigating environments – Which would assess a veteran’s physical and mental ability to go from place to place. This domain includes, but is not limited to, the following: leaving the home, being in confined or crowded spaces, independently moving in surroundings, navigating new environments, driving, or using public transportation.
- Self-care – Which would assess a veteran’s ability to take care of himself or herself. This domain would include, but would not be limited to, the following types of activities: Hygiene, dressing appropriately, or nourishment.
Veterans will receive a score from 0 to 4 based on the number of affected domains and how severely their mental disorder hampers function in that domain. These scores correspond to the following criteria:
- 0 = “None” – “No difficulties” associated with the domain.
- 1 = “Mild impairment at any frequency; or moderate impairment that occurs less than 25% of the time.” These represent “slight difficulties in one or more aspects” of the domain that “do not interfere with tasks, activities, or relationships.”
- 2 = “Moderate impairment that occurs 25% or more of the time; or severe impairment that occurs less than 25% of the time.” These represent “clinically significant difficulties in one or more aspects” of the domain “that interfere with tasks, activities, or relationships.”
- 3 = “Severe impairment that occurs 25% or more of the time; or total impairment that occurs less than 25% of the time.” These represent “serious difficulties in one or more aspects” of the domain “that interfere with tasks, activities, or relationships.”
- 4 = “Total impairment that occurs 25% or more of the time.” This represents “profound difficulties in one or more aspects” of the domain “that cannot be managed or remediated; incapable of even the most basic tasks within one or more aspects” of the domain; “difficulties that completely interfere with tasks, activities, or relationships.”
Once these scores are all tallied, veterans will receive disability ratings of 10, 30, 50, 70, or 100 percent, depending on the scores they received in each domain. The criteria for each rating are as follows:
- 100 percent rating – Assigned if a score of 4 is given in one or more domain; or if a score of 3 is given in two or more domains
- 70 percent rating – Assigned if a score of 3 is given in one domain; or if a score of 2 is given in two or more domains
- 50 percent rating – Assigned if a score of 2 is given in one domain
- 30 percent rating – Assigned if a score of 1 is given in two or more domains
- 10 percent rating – Assigned as the minimum rating for any diagnosed, service-recognized mental disorder
Overall, VA’s goal with these changes is to better recognize the impact of mental health on individuals’ well-being “by placing greater emphasis on a disabled veteran’s ability to function in the work setting, rather than focusing on symptoms alone.”
How Will These Changes Impact Veterans’ Monthly Compensation?
As of 2025, veterans can receive anywhere from $175.51 for a 10 percent disability rating to $3,831.30 for a 100 percent rating.
Proposed changes to the VA disability ratings system could mean lower average payouts for veterans with sleep apnea and tinnitus in the future, but higher average payouts for veterans facing mental health challenges like post-traumatic stress disorder and depression.
Importantly, for veterans currently receiving disability benefits for one of these conditions, the changes will not take away any existing benefits or lower their disability rating.
In some cases, veterans might even see their ratings increased based on the changes, if the new rules end up more advantageous to their health situation.
On the other hand, veterans who apply for benefits in the future will see a different set of standards applied to their cases, which could result in significantly different compensation.
When Will These Changes Be Implemented? (2025 Update)
As of December 2025, VA has not yet implemented these proposed changes nor announced dates for when they will come into effect. Many observers now believe that their implementation will take place in mid-2026.
Upon finalization and approval, there will be a 60-day grace period before any of these updates actually take effect. Any claims filed during or before this period will be able to use the criteria that are most favorable.
If you are interested in learning more about these updates, consult this document from the Federal Register.
What Should Veterans Do to Prepare for These Updates?
Depending on whether or not these updates will be beneficial to your VA claim, there are two courses of action you can take to prepare for their implementation. Nicholas Briggs, an Accredited VA Claims Agent with CCK Law, explains what to do depending on your circumstance:
- If the updates are unfavorable to your claim – “One thing you can always do is file your claim as soon as possible, either by filing a complete claim for an increased rating or just notifying VA of your intent to file a claim. As long as you file a complete claim within a year of your intent to file, VA is going to use that intent to file date as the date of your claim. And as long as that date is before the change in the regulations, your claim will still be eligible for consideration under the original rating criteria.”
- If the updates are beneficial to your claim – “If these changes do go into effect and the new ratings are more favorable to you, then it might benefit you to file an increased rating claim. This is because you could be entitled to an increase based solely on how those changes are applied to your current disability picture.”
Need Help Filing for an Increased Rating? Contact CCK Law
It can be complex and slow to file for an increased disability rating with VA. Fortunately, partnering with a knowledgeable, VA-accredited attorney can make the claims process more manageable and better your chances of securing the benefits you deserve.
If you are looking to potentially increase your disability rating, then reach out to CCK Law at (800) 544-9144 or by contacting us online for a free case evaluation.
