The Department of Veterans Affairs has proposed rewriting the diagnostic code that governs how sleep apnea is rated for VA disability compensation. The proposed rule would eliminate the long-standing 50% rating triggered automatically by a CPAP prescription and replace the entire Diagnostic Code (DC) 6847 tier structure with a treatment-effectiveness model. No final rule has been published as of this article’s date, and existing ratings would be protected if and when a final rule takes effect.
Sleep apnea is one of the most-claimed and highest-awarded service-connected conditions, so any change to DC 6847 has outsized implications. A large share of sleep apnea grants today land at the 50% level, driven almost entirely by the CPAP-prescription rule the proposed rule would remove.
How DC 6847 works under the current rule
DC 6847 — Sleep Apnea Syndromes (Obstructive, Central, Mixed) — is rated under 38 CFR § 4.97. The current rule has four tiers:
- 0% — Asymptomatic but with documented sleep disorder breathing.
- 30% — Persistent day-time hypersomnolence.
- 50% — Requires use of a breathing assistance device such as a CPAP machine.
- 100% — Chronic respiratory failure with carbon dioxide retention or cor pulmonale, or; requires tracheostomy.
The 50% tier is structured so that any veteran whose treating physician prescribes a CPAP or comparable device is entitled to that rating, regardless of how well the device controls symptoms. For background on how each level applies in practice, see our sleep apnea condition guide.
What the proposed rule would change
VA published its Notice of Proposed Rulemaking on February 15, 2022 and has continued to refine the proposal in response to public comment. Under the proposed rule, DC 6847 would have four tiers — 0%, 10%, 50%, and 100% — and the 30% tier would be eliminated. CPAP use, by itself, would no longer trigger any tier above 0%.
Side-by-side: current DC 6847 vs. proposed DC 6847
| Tier | Current criteria | Proposed criteria |
|---|---|---|
| 0% | Asymptomatic but with documented sleep disorder breathing. | Asymptomatic, with or without treatment. |
| 10% | (Not applicable — no 10% tier in current rule.) | Incomplete relief of symptoms with treatment (including CPAP). |
| 30% | Persistent day-time hypersomnolence. | (Tier eliminated.) |
| 50% | Requires use of a breathing assistance device such as a CPAP machine. | Treatment is ineffective, or the veteran is unable to use the prescribed treatment because of a comorbid condition. |
| 100% | Chronic respiratory failure with carbon dioxide retention or cor pulmonale, or; requires tracheostomy. | Treatment ineffective or unusable, and the veteran has end-organ damage such as cor pulmonale or chronic respiratory failure. |
The structural shift is what matters most: the proposed rule moves DC 6847 from a treatment-prescribed model to a treatment-effectiveness model. A veteran whose CPAP works well would, under the proposed rule, fall into the 0% or 10% tier even though the same veteran would receive 50% under the current rule.
Who is grandfathered
VA cannot reduce an existing sleep apnea rating simply because the rating schedule changes. 38 CFR § 3.951(a) provides that a readjustment to the Schedule for Rating Disabilities “shall not be grounds for reduction of a disability rating in effect on the date of readjustment” unless medical evidence establishes that the disability has actually improved. Section 3.951(b) gives even stronger protection to ratings continuously in effect for 20 or more years, which cannot be reduced absent a finding of fraud.
Applied to sleep apnea: a veteran rated at 50% under the current CPAP-trigger rule would keep that 50% rating after a final rule takes effect. Any future reduction would still require a new examination showing actual medical improvement, plus the procedural protections in 38 CFR § 3.105 (notice, opportunity to submit evidence, and a personal hearing if requested).
Why VA says it’s proposing the change
In the proposed rule’s preamble, VA argues that the current criteria reward the prescription of a treatment device rather than the residual disability the veteran actually experiences. Under the proposed framework, the rating would track functional impairment — whether the prescribed therapy works, whether the veteran can tolerate it, and whether complications such as cor pulmonale persist. VA frames this as aligning sleep apnea with the broader functional-impairment standard that governs most of the rating schedule.
What veterans should do now
The current DC 6847 criteria are still in force. If you have a documented sleep disorder and have not yet filed:
- Get a current sleep study. Polysomnography results — specifically the Apnea-Hypopnea Index — are essential evidence under both the current and proposed rules.
- File an Intent to File (VA Form 21-0966). This locks in your effective date for up to one year while you gather records. Our how to file guide walks through the steps.
- Document treatment. If you use a CPAP, save your compliance and efficacy data. If you cannot tolerate CPAP because of another service-connected condition (PTSD-related claustrophobia, sinusitis, deviated septum), get that documented in writing by a treating provider — that documentation matters under both rule sets.
- Prepare for the C&P exam. Bring your sleep study, your CPAP data, and a written description of residual daytime symptoms. See our C&P exam guide.
If you are filing sleep apnea as a secondary to PTSD, rhinitis, sinusitis, or another service-connected condition, the secondary service-connection framework is unaffected by the proposed rule. See our secondary conditions guide for the nexus requirements.
To estimate how a sleep apnea rating combines with your other conditions, use our VA disability calculator.
How to track the final rule
If a final rule is issued, it will be published in the Federal Register and codified in 38 CFR § 4.97. VA’s disability compensation portal is the authoritative source for the official effective date, transition guidance, and any operational instructions to regional offices. We will update this article when a final rule is published.
This content is for informational purposes only and does not constitute legal or medical advice. For personalized guidance on a sleep apnea claim, consult a VA-accredited Veterans Service Organization (VSO), attorney, or claims agent.
Frequently Asked Questions
Will I lose my current 50% sleep apnea rating if the proposed rule is finalized?
No automatic reduction is permitted. Under 38 CFR § 3.951(a), a change to the VA Schedule for Rating Disabilities cannot, by itself, reduce a rating already in effect. VA can only lower a protected sleep apnea rating if a future medical examination shows the disability has actually improved, and only after following the formal reduction-protection procedures in 38 CFR § 3.105. Ratings continuously in effect for 20 years or more receive even stronger protection under § 3.951(b).
When does the new VA sleep apnea rating rule take effect?
There is no effective date because there is no final rule. The proposal was published in the Federal Register on February 15, 2022 and remains in proposed form as of April 2026. VA has signaled it is still reviewing public comments. If a final rule is published, VA will announce an effective date in that final rule — and it will only apply to claims pending or filed on or after that date.
Should I file my sleep apnea claim now or wait?
Filing decisions are personal, but the practical reality is that the current DC 6847 criteria — including the 50% rating for veterans who require a CPAP — remain in force. Filing now means your claim is evaluated under the current rule, and even if the proposed rule is later finalized, an existing rating cannot be reduced solely because the schedule changed. Submitting an Intent to File (VA Form 21-0966) preserves your effective date while you gather a sleep study and other evidence.
Does the proposed rule change how sleep apnea secondary to PTSD is evaluated?
The proposed rule does not change the law of secondary service connection. A sleep apnea claim filed as secondary to PTSD, rhinitis, sinusitis, asthma, or another service-connected condition still requires a current diagnosis, the established primary condition, and a medical nexus linking the two. What would change — if the proposed rule is finalized — is the rating tier the secondary sleep apnea is assigned, because the proposed criteria measure treatment effectiveness rather than CPAP use.
What evidence does VA need under the new treatment-effectiveness standard?
If the proposed rule is finalized, claims would turn on objective evidence of how well treatment is controlling the condition. That would likely include a current sleep study (polysomnography) with Apnea-Hypopnea Index data both off and on therapy, CPAP compliance and efficacy reports from the device, treating-provider documentation of residual daytime symptoms, and medical records of any end-organ complications such as cor pulmonale or chronic respiratory failure.
Sources
Every rating percentage, diagnostic code, and dollar figure on this page is sourced from the references below. See our editorial policy for how we choose and verify sources.
- Schedule for Rating Disabilities — Special Provisions Regarding Evaluation of Respiratory Conditions; Schedule for Rating Disabilities — Respiratory System (Notice of Proposed Rulemaking) — U.S. Government Publishing Office
- 38 CFR § 4.97 — Schedule of ratings—respiratory system — U.S. Government Publishing Office
- 38 CFR § 3.951 — Preservation of disability ratings — Legal Information Institute, Cornell Law School
- VA disability compensation — U.S. Department of Veterans Affairs
- VA Is Rewriting Big Pieces of the Disability Rating Playbook — Military.com
This content is for informational purposes only and does not constitute legal or medical advice. For personalized guidance, consult a VA-accredited VSO, attorney, or claims agent.