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UPDATE: The VA Halts Enforcement of Medication Rule
On Feb 19, 2026, VA Secretary Doug Collins issued a public statement that the VA is halting enforcement of the interim final rule, “Evaluative Rating: Impact of Medication.” The VA will continue to collect public comments.
This means that, as of now, the amended interpretation of 38 CFR §4.10 described below is not being applied in disability rating decisions. We will continue monitoring official guidance and update this article as new information becomes available.
On February 17, 2026, the Department of Veterans Affairs (VA) amended 38 CFR §4.10, the regulation governing functional impairment in disability ratings.
Several headlines have framed this as a major shift in VA disability policy. The reality is more measured.
Under the new rule, VA ratings must reflect how a veteran functions with medication or treatment in effect, rather than estimating how severe the condition would be without treatment.
The rule took effect immediately on February 17, 2026, through an interim final rule published in the Federal Register. The public comment period runs through April 20, 2026.
This analysis is based on the regulatory text, the Federal Register notice, and input from VA rating specialists.
Summary of Key Points
- The VA amended 38 CFR §4.10 to require ratings based on treated functional impairment.
- Examiners may no longer estimate severity without medication.
- The rule does not automatically reduce existing VA ratings.
- Longstanding VA rating protections and due process requirements remain in place.
Table of Contents
What Changed vs. What Did Not Change
| What Changed | What Did Not Change |
| VA ratings must reflect functioning with medication in effect | Existing VA ratings are not automatically reduced |
| Examiners cannot speculate about untreated severity | 5-, 10-, and 20-year protection rules remain |
| Rule effective February 17, 2026 | Due process is still required before reductions (38 CFR §3.105) |
| Applies to evaluation of functional impairment under §4.10 | Fraud remains the only exception to 20-year protection (38 CFR §3.951(b)) |
| Change applies for all new VA claims/increases filed | Already processed claims/increase will not be reevaluated automatically to apply this rule |
What Exactly Does 38 CFR §4.10 Now Require?
38 CFR §4.10 addresses “functional impairment” in the VA rating schedule.
Under the amended rule:
- VA disability evaluations are based on how the condition affects ordinary conditions of daily life, including employment.
- The evaluation reflects the body as a whole, an organ system, or the psyche.
- Functional impairment must be assessed with treatment or medication in effect.
- Examiners are not permitted to provide hypothetical opinions about untreated severity.
The VA states this change ensures ratings reflect actual earning-capacity impairment and eliminates what it describes as “medical speculation.”
Why Did the VA Make This Change?
In the Federal Register notice, the VA explained that certain court decisions required consideration of how severe a disability would be without medication. The VA stated that this created inconsistency and required speculative analysis.
The VA cited recent case law, including Ingram v. Collins, as part of the background.
According to the VA, the amendment:
- Promotes consistency across disability evaluations
- Aligns ratings with actual functioning
- Removes hypothetical severity estimates
Does the New VA Rule Automatically Lower Disability Ratings?
No.
The amendment to 38 CFR §4.10 does not automatically reduce existing ratings.
Any reduction (which would mostly only apply to new claims/increase claims that were filed and being processed as of the publication date) must still follow regulatory safeguards, including:
- Due process under 38 CFR §3.105
- Evidence of sustained improvement
- Stabilization protections under the 5-year rule
- Service-connection protection after 10 years
- VA rating protection after 20 years under 38 CFR §3.951(b)
>> Learn How to Punch Back Against a Proposed VA Rating Reduction (step-by-step)
Does This Affect Veterans Rated 100% P&T?
Veterans rated 100% Permanent and Total are generally in a stable position.
If a VA rating has been in place for 20 years, it can’t be reduced except in cases of fraud (38 CFR §3.951(b)).
However, filing for a VA disability increase or seeking new claims can reopen aspects of a file for review.
Many experienced adjudicators advise veterans to carefully weigh risks before pursuing additional claims when already rated 100% P&T.
The rule itself does not automatically reopen protected ratings.
How Could This Rule Impact Pending or Future Claims?
For veterans with claims in process or considering filing:
- The VA will evaluate functional impairment with medication or treatment in effect.
- Being prescribed medication does not automatically mean the condition is fully controlled.
- Residual symptoms, side effects, and ongoing limitations remain relevant.
- Clear documentation of how a condition affects your daily life and employment is essential.
If filing for an increase, understand that the VA may review your disability picture in full. Any reduction still requires evidence of sustained improvement and must follow due process procedures.
What Types of Conditions Could Be Most Affected?
Conditions in which medication significantly alters symptoms may receive closer functional evaluation. Examples could include:
- Mental health ratings
- GERD ratings
- Asthma ratings
Note: This does not mean a VA rating will automatically decrease. It means examiners must assess real-world functioning while treatment is in place.
Why Are Some Veterans Organizations Concerned?
Several Veterans Service Organizations (VSOs) have raised concerns that:
- Veterans may be disadvantaged if medication partially controls symptoms.
- “Controlled” does not always mean “no impairment.”
- The interim final rule took effect before the comment period concluded.
This reflects an ongoing debate about how disability should be measured when treatment reduces but does not eliminate impairment.
Quick Recap
The February 17, 2026 amendment to 38 CFR §4.10 requires the VA to rate disabilities based on treated functional impairment rather than hypothetical untreated severity, while leaving existing rating protections fully intact.
Conclusion
The new VA medication rule is a regulatory clarification, not a sweeping rollback of benefits.
It changes how functional impairment is evaluated under 38 CFR §4.10. It does not automatically reduce ratings, reopen protected awards, or eliminate due process protections.
What it does do is increase the importance of clearly documenting ongoing limitations — even when treatment is prescribed.
As always, informed and strategic decisions matter when filing VA claims or pursuing VA rating increases.
FAQs | Frequently Asked Questions
What is 38 CFR §4.10?
38 CFR §4.10 is the regulation that governs how the VA evaluates functional impairment when assigning disability ratings.
Does this new medication rule apply to existing VA disability ratings?
It applies to evaluations moving forward, but it does not automatically reduce existing ratings.
Can the VA reduce my rating if medication helps my condition?
A reduction requires evidence of sustained improvement and must follow due process under 38 CFR §3.105. The rule does not eliminate those protections.
Is the VA medication rule a law passed by Congress?
No. It is a regulatory amendment issued by the VA through an interim final rule published in the Federal Register.
Are 100% P&T ratings protected from the VA medication rule?
VA ratings in place for 20 years are protected from reduction except in cases of fraud under 38 CFR §3.951(b).
Is the VA medication rule permanent?
The rule was issued as an interim final rule. However, as of February 19, 2026, the VA has announced it is halting enforcement of the rule while continuing to collect public comments.
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Quality Assurance Team
The Quality Assurance (QA) team at VA Claims Insider has extensive experience researching, fact-checking, and ensuring accuracy in all produced content. The QA team consists of individuals with specialized knowledge in the VA disability claims adjudication processes, laws and regulations, and they understand the needs of our target audience. Any changes or suggestions the QA team makes are thoroughly reviewed and incorporated into the content by our writers and creators.
About the Author
Eric Webb
Eric has written and worked in the field of Veterans Disability since 2020 and enjoys writing educational content for the veteran population. His prior work has been published in the Official Journal of the American College of Sports Medicine (ACSM). He holds a Degree in Health and Exercise Science.
