The recently issued VA interim final rule changes how veterans' disability rates are established when medication or treatment is involved. Under the new guidelines, raters now consider how both the disease and any prescribed medications or treatments actually affect a veteran's daily life. This change shifts the evaluation process to assess how medications improve daily activities, rather than assuming how the condition would affect life without such treatment.
Previously, courts interpreted that VA examiners should rate veterans as if they were not taking medication, potentially resulting in higher hypothetical ratings than a veteran experiences in daily life. Now, the new VA rule requires ratings to reflect a veteran's day-to-day life experience, including improvements from medication. Even though these changes aim to make the system more accurate and fair, they could also mean that, in some cases, veterans may receive lower ratings if their condition improves with treatment.
Most veterans might have heard of Ingram v. Collins, a court decision that enforced ignoring medication when establishing a rating for certain disabilities. This enabled veterans to receive a higher rating than their actual experience warranted. By amending 38 CFR 4.10, the VA clarified that the process mandated by the Ingram v. Collins decision no longer governs its disability evaluations. The new rule affects more than 500 diagnostic codes and 350,000+ pending claims by:
- Ratings now will reflect reality - VA examiners look at how a veteran?s disability actually affects daily life with prescribed medication or treatment.
- Raters no longer hypothesize about "untreated" disabilities - if medication improves a veteran's condition, that improvement will be counted.
- Factuality: examiners will base the veteran's rating on their findings from the C& P exam.
Why the VA Made the Rule Effective Immediately
Typically, when federal agencies, including the VA, are about to change a rule, they must first give the public time to review and comment on the proposed change before it becomes final. It's a requirement of the Administrative Procedure Act (APA), a law designed to ensure that agencies don't implement new rules without allowing public input.
But there's an exception that allows an agency to bypass the usual public comment process and make a rule effective immediately if waiting would be "impracticable, unnecessary, or against the public interest." In this case, the VA invoked this exception to implement the rule effective February 17, 2026.
After the Ingram v. Collins court case, disability claims were at risk of being delayed or handled unfairly. In practice, the VA acted quickly to resolve the issue after the court case, stating that waiting for public comments would have caused problems. Even if the rule is already in effect, the VA is still accepting public comments for 60 days. It's an opportunity for veterans and the general public to provide feedback, and the VA may consider it in future rule updates. However, for veterans, now this means:
- As of the Federal Register publication date, the rule is already in force.
- During the 60-day comment period, observations can be submitted to regulations.gov under RIN 2900 AS49.
- Comments may influence how VA finalizes or adjusts the rule later, but they do not delay the rule's current application.
What Happens to Your Rating With the Changes
While the amendment to 38 CFR 4.10 addresses how medication is considered, existing disability ratings are not automatically downgraded simply because the new rule took effect. The change is intended to prevent "erroneous" interpretations that previously led to veterans being rated on a "worst-case" basis when they were not taking medication; it does not include automatic downgrades. Any change in rating still requires VA review and must be based on actual evidence of functional improvement or worsening. However, you may consider:
- If your rating stays the same and you do not file anything new, nothing changes for you.
- If you file a claim for a rating increase, supplemental claim, or new evidence, VA will now evaluate how your condition affects you with medication, and that could result in a lower rating if your condition is well-controlled.
- If VA schedules you for a re-evaluation exam and shows your impairment has improved with medication, then the exam itself could lead to a rating reduction.
Important: ratings are always based on the evidence provided and the VA's evaluation of functional impairment with treatment. To help veterans understand the rule, here are some conditions under which medication can improve daily functioning, for informational purposes only:
- Respiratory conditions such as asthma, COPD, chronic bronchitis, and emphysema. Medication, such as inhalers, steroids, or oxygen therapy, can improve breathing and reduce limitations in daily activities. Veterans who manage their condition well with medication may receive ratings reflecting their day-to-day functioning.
- Musculoskeletal or orthopedic conditions, such as arthritis, back pain, joint injuries, knee or hip issues. Medication supports pain management, anti-inflammatory therapy, and mobility improvements to reduce discomfort. Newly evaluated ratings may reflect actual functional limitations and could be lower than under the old standard if pain is well managed.
- Mental health conditions such as depression, PTSD, or anxiety. Medication helps through antidepressants, anti-anxiety medications, and therapy to reduce symptoms like panic attacks, insomnia, or irritability. Ratings under the new evaluation rules may take into account the true impact on work, social life, and daily functioning.
- Chronic pain syndromes such as fibromyalgia, complex pain, back, and shoulder pain. Medication, including pain pills, nerve treatments, and physical therapy, can significantly improve daily functioning. Ratings could reflect the veteran's real-life limitations.
- Cardiovascular conditions such as hypertension, heart disease, and arrhythmias. Medication helps through blood pressure pills, heart rhythm drugs, and lifestyle management to reduce fatigue and shortness of breath. New ratings may consider functional limitations during treatment, potentially differing from untreated severity.
- Diabetes: medications help stabilize blood sugar through insulin, oral drugs, and diet management to prevent complications. Ratings may reflect daily limitations with treatment.
- Sleep disorders such as insomnia and sleep apnea. Medications, including sleep aids, CPAP, and other therapies, help improve alertness, work performance, and quality of life. Ratings could reflect the actual daily functioning while using the treatment.
These are examples only and are not intended to cause worry or panic. Because every veteran's case is unique, a rating will always depend on medical evidence and VA evaluation.
Taking Action to Better Understand
Even though the new VA rule is now in effect, there are solutions that can help you understand your disability rating, safeguard your benefits, and ensure your claim accurately reflects your real-life condition.
- Check your current rating: you can look up your disability rating in your VA portal or in your VA decision letters to see which conditions are rated at what percentage. Your current rating is protected and will not automatically change under the new rule. Remember: any adjustment requires VA review based on new evidence or re-evaluation.
- Know when the new VA rule applies: pending claims you have, new claims you may file, re-evaluations requested by you or initiated by the VA.
- Submit evidence or claims if your condition has changed. If there's a worsening despite medication, or if you feel your current rating doesn't reflect your daily life, you can:
- File a supplemental claim or new claim for an increase.
- Provide medical evidence, treatment records, or statements showing your daily impairment.
- Provide feedback during the public comment period. The VA is accepting comments for 60 days following publication of the rule (RIN 2900AS49).
It's important to note that any existing rating doesn't change automatically. Any rating decrease must be based on actual medical improvement. Under 38-C.F.R.3.2500-3.2600, VA must consider all evidence submitted in new claims or supplemental claims. You can submit feedback at https://www.regulations.gov/. Document how your condition affects daily activities, even with medication, and your abilities to:
- work
- walk
- lift objects
- sleep
- manage household tasks
Assisting Veterans in Securing the Compensation They Deserve
If you're applying for compensation and receive treatment or are taking medication for a service-connected condition, this new interim final rule could directly affect how your disability rating is determined. Staying informed and up to date on the changes is the best way to understand how these updated guidelines apply to you.
You can always reach out to a trusted veterans organization, connect with a VSO, or speak with an accredited attorney who can review your specific situation. Given that even minor details about your treatment or daily limitations can significantly affect your rating at this time, seeking legal assistance may be essential. We can help by connecting you with experienced lawyers ready to assist you in securing the compensation you deserve.