WASHINGTON — The Department of Veterans Affairs has issued a rule that changes how disability ratings are evaluated when a condition is controlled by medication — and it’s raising real questions among veterans who rely on those ratings for compensation and healthcare.
The new regulation, effective February 17, 2026, clarifies that VA disability ratings must reflect how a veteran actually functions in real life — including the effects of medication and treatment.
In simple terms: if medication improves your symptoms, VA will rate you based on how you function while taking it, not on how bad things would be if you stopped.
That shift may sound technical. It isn’t.
For many veterans, disability percentage isn’t just a number. It determines monthly compensation, healthcare priority, dependent benefits, and in some cases, access to additional federal and state programs. So this change deserves a clear explanation.
Last year, a federal court ruled that VA examiners should consider how severe a condition would be if left untreated. That meant disability evaluations might have required estimating what symptoms would look like without medication. VA has now rejected that interpretation. Under the new rule, examiners evaluate your condition as it actually exists during the examination — meaning they consider how you function while receiving treatment. VA says this aligns with the purpose of disability compensation: paying for actual impairment in earning capacity, not hypothetical scenarios.
To put it plainly, imagine you have service-connected migraines. Before treatment, you had four completely prostrating headaches per week. With medication, you now have one per week. Under the new rule, your rating reflects the once-per-week level because that’s your current, treated reality.
Or consider PTSD. Without medication and therapy, you might struggle to leave the house. With consistent treatment, you’re maintaining employment and relationships. Your evaluation reflects how you function while treated, not what might happen if you stopped.
The same applies to chronic back pain. Without anti-inflammatory medication, bending is nearly impossible. With treatment, your range of motion improves. The examiner measures what they observe — not a hypothetical worst-case scenario without medication.
That is the core shift.
But here’s the part veterans are quietly asking about.
If disability ratings reflect how well treatment controls symptoms, does that create pressure to remain untreated to protect a higher rating?
Because percentage thresholds matter.
Veterans rated 50 percent or higher qualify for top-tier VA healthcare priority, which generally eliminates copays for service-connected treatment and medications. Dropping below 50 percent can affect that status. At 30 percent and above, veterans receive additional compensation for dependents. At 100 percent Permanent and Total, veterans unlock major benefits like CHAMPVA eligibility for dependents and access to various state-level programs. When a rating drops below one of those lines, the impact can extend beyond a monthly payment.
That’s why some veterans worry this rule could feel like being penalized for getting better.
Would this actually incentivize veterans to stay in pain? It’s a fair concern to raise — but it’s not that simple. VA examiners don’t evaluate a single snapshot in isolation. They review treatment history, medical records, and long-term symptom patterns. Suddenly stopping medication before an exam does not automatically establish sustained severity. More importantly, stopping prescribed medication can cause serious harm, especially for conditions like PTSD, heart disease, seizures, diabetes, or chronic pain. Medical professionals strongly caution against altering treatment solely to influence a disability evaluation.
Still, the psychological pressure veterans feel when benefits are tied to percentage thresholds is real. The structure of the system makes that concern understandable, even if intentionally avoiding treatment is not a safe or effective strategy.
For veterans rated 100 percent Permanent and Total, this rule does not automatically change anything. You are not scheduled for routine reexaminations. Your file is not reopened simply because this regulation exists. Reductions still require a formal proposal, a 60-day response period, evidence of sustained improvement, and compliance with long-standing five-, ten-, and twenty-year protection rules. However, if a veteran voluntarily reopens their file by filing a new claim or seeking additional benefits, the updated standard would apply during that review. That distinction matters.
VA says it acted because the prior court ruling would have required examiners to speculate about untreated severity across hundreds of diagnostic codes and potentially re-adjudicate more than 350,000 pending claims. The department issued this as an interim final rule, meaning it took effect immediately while public comments are still being accepted. VA argues it is preserving consistency and preventing what it describes as speculative evaluations. Critics will likely argue the rule shifts leverage away from veterans whose conditions are successfully managed by treatment.
What this rule does is clarify that medication effects are considered during evaluations and apply that standard to new and ongoing adjudications. What it does not do is automatically reduce existing ratings, eliminate rating protection rules, trigger mass reexaminations, or require veterans to stop treatment.
For veterans currently filing claims, especially for conditions heavily controlled by medication, this change matters. For veterans with stable ratings who are not reopening their cases, there is no immediate action required.
The broader debate remains unresolved. Should disability compensation reflect untreated severity, or actual lived, treated impairment? VA has made its position clear. Ratings reflect how you function in real life, including the benefits of treatment. For veterans and service members navigating the system, understanding that distinction is critical.
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