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Veterans Law

2022 VA Proposed Updates: Mental Health, Sleep Apnea, and Tinnitus

Jenna Zellmer

March 23, 2022

Updated: November 20, 2023

2022 VA Proposed Updates: Mental Health, Sleep Apnea, and Tinnitus

On February 15, 2022, VA announced some proposed changes to the way it rates some disabilities, such as some respiratory, auditory, and metal 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.

What are the Proposed Updates?

The VA proposed updates include the following:

  • Changes to the evaluative rating criteria for sleep apnea, with updates corresponding to developments in medical knowledge to rate 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.
  • Changes to the way mental health conditions are evaluated by analyzing the condition overall (or more holistically) to focus 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.

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 the musculoskeletal system.

Each bodily 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 for purposes of receiving VA disability compensation.

VA Proposed Updates to Sleep Apnea, Mental Health, Tinnitus VA Ratings

Sleep Apnea Rating Changes

The number of veterans receiving compensation for sleep apnea, or interrupted breathing during sleep, has risen sharply in recent years.  In the 2020 Annual Benefits Report 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, 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 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 upon how symptomatic the condition remains after treatment

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.

Tinnitus Rating Changes

Similarly, veterans diagnosed with tinnitus 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 VA proposed updates, 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, which is a high-pitched ringing caused by damage to the ears.

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.

Mental Health Rating 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.

Under the new rules, conditions like anxiety, depression or PTSD would be evaluated based on how they affect veteran’s ability to perform everyday functions, with even mild impairment available for compensation.

The proposed rules for mental health conditions would increase the minimum disability rating from 0 to 10 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.

In addition, rather than assigning an evaluation based on the number and type of symptoms present, VA would implement new criteria to evaluate mental disorders based on how impactful the disability is across five domains of impairment: cognition, interpersonal interactions and relationships, task completion, life activities and navigating environments, and self-care.

The goal of 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 Could These Updates Help Veterans?

According to VA, incorporating modern medical data into the rating criteria can help provide a more accurate assessment of disabilities and how they can impact earning capacity.  This, in turn, would allow for more accurate compensation for service-connected disabilities.

How Will These Changes Impact Veterans’ Monthly Compensation?

Currently, veterans can receive anywhere from $171.23 for a 10 percent disability rating to $3,737.85 for a 100 percent rating.

Proposed changes to the VA disability ratings system could mean lower payouts for veterans with sleep apnea and tinnitus in the future, but higher 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 significant financial ramifications.

When Will These Changes Be Implemented?

As of now, VA officials do not have a planned implementation date for the ratings changes.

The public has 60 days (until April 18, 2022) to provide feedback on the proposals before any final deadlines can be set.  Comments can be submitted electronically using this website.

More details on where to submit comments and who to contact can be found here.

About the Author

Bio photo of Jenna Zellmer

Jenna joined CCK in January of 2014 as an appellate attorney, was named Managing Attorney in September of 2019, and now serves as a Partner at the firm. Her law practice focuses on representing disabled veterans at the Court of Appeals for Veterans Claims and the Court of Appeals for the Federal Circuit.

See more about Jenna