A single regulatory change just reshaped how hundreds of thousands of veterans will have their disabilities rated by the Department of Veterans Affairs. On February 17, 2026, VA published an interim final rule amending 38 CFR § 4.10 — the core regulation governing how functional impairment is evaluated — to require that disability ratings reflect a veteran's condition while on medication, not what that condition would look like without it. If you're a veteran taking medication for any service-connected condition, this change affects you. And with more than 500 separate diagnostic codes and an estimated 350,000 currently pending claims in the crosshairs, the ripple effects of this rule will be felt across the entire veterans community for years to come.
To understand why this matters, you need to understand what came before.
For more than a decade, federal courts had been steadily moving toward a principle that seemed like common sense to most veterans: if medication masks the true severity of your condition, your disability rating should reflect the underlying disability — not the medicated version of it.
The reasoning was straightforward. Say you have a knee condition that, untreated, leaves you barely able to walk. Your doctor prescribes medication that brings your pain down and restores some range of motion. Under the court-driven framework, the VA examiner was supposed to look past those medication-driven improvements and rate you based on what your knee would actually be like if you weren't taking those pills. The idea was that the medication was treating the symptom, not curing the disease, and your rating should reflect the reality of the disease itself.
This interpretation was rooted in the courts' reading of 38 CFR § 4.10, the regulation that tells VA how to evaluate functional impairment. Over the years, a series of court decisions built on each other to establish and reinforce this principle. The courts reasoned that rating a veteran based on their medicated state could dramatically undercount the severity of their actual disability.
Then, in 2025, the Court of Appeals for Veterans Claims issued a landmark decision in Ingram v. Collins that took this principle even further. The court ruled explicitly that VA must ignore the beneficial effects of pain medication when rating musculoskeletal disabilities. If your knee meds brought your pain and range of motion to a manageable level, the examiner was supposed to estimate what your disability would look like without the medication and rate you there.
For veterans whose conditions were genuinely disabling but appeared well-controlled on paper thanks to medication, this line of court decisions was a lifeline. It meant higher ratings that more accurately reflected the severity of what they were actually living with. It acknowledged a truth that many veterans know intimately: just because your medication makes it possible to get through the day doesn't mean you're not disabled.
That framework is now gone.
VA added two new sentences to 38 CFR § 4.10 that fundamentally alter how disability is assessed. The key language states: "This amendment clarifies VA's longstanding interpretation of Sec. 4.10 and, in doing so, amends the text to correct judicial interpretations that VA has concluded misconstrue the role of medication and treatment in evaluating functional impairment. Specifically, this amendment clarifies that veterans should be compensated for the actual level of functional impairment they experience and, therefore, that the ameliorative effects of medication should not be estimated or discounted when evaluating the severity of a veteran's disability at the time of the disability examination".
In practical terms, this means your Compensation and Pension examiner now evaluates you as you are — on your meds, in your daily life. There are no more hypothetical assessments of what your condition would look like untreated. No more attempts to establish an unmedicated baseline. The examiner sees you, notes your current level of functioning, and that's what your rating is based on.
The previous court decisions that had been interpreting the old version of this regulation are effectively overridden. Those rulings were based on judicial interpretation of regulatory language. VA has now changed that language, and the old interpretations no longer apply.
What makes this change even more striking is how it was implemented. VA bypassed the normal notice-and-comment rulemaking process, issuing an interim final rule with immediate effect. The justification cited was "good cause" — VA argued that with 350,000 pending claims potentially affected and the risk of systemic disruption, delay was impracticable. The rule was approved by Secretary Douglas A. Collins on February 11, 2026. A public comment period was opened after the rule took effect, giving veterans and advocacy organizations a window to respond — but only after the change was already the law.
The impact of this rule varies depending on where you are in the claims process, but virtually every veteran on medication for a service-connected condition should understand how it changes the landscape.
If you're filing a new claim, your C&P exam will evaluate your condition as it currently presents, including any improvements from medication. There will be no attempt to assess a "baseline severity" without medication. What the examiner sees is what you get.
If you have a claim pending, the new rule applies immediately. There is no transition period, no grandfathering of claims that were filed under the old standard. Veterans who expected to benefit from the previous court-driven framework — who anticipated that their ratings would reflect their unmedicated condition — may now receive lower ratings than they would have just weeks ago.
If you're appealing a denied or underrated claim, the new standard will likely apply to any remanded examinations or new evidence development. If your appeal hinges on the argument that VA failed to rate your condition without considering medication effects — an argument that was strong under the old framework — that legal basis has been pulled out from under you. Talk to your representative about whether your appeal strategy needs to shift. In some cases, reframing the appeal around inadequate examination, secondary conditions from medication side effects, or other grounds may be the strongest path forward.
If you already have a rating, you can breathe a small sigh of relief: existing ratings are not automatically reopened because of this rule change. However, if you file for an increase or if your condition comes up for reevaluation, the new standard applies. This means veterans need to be strategic about when and how they seek rating increases going forward.
If your medication causes significant side effects, there's an important distinction to understand. This rule addresses medication's beneficial effects on your rated condition. It does not eliminate your ability to claim secondary conditions caused by medication side effects. If your pain medication causes weight gain, your blood pressure medication causes fatigue, your psychiatric medication causes sexual dysfunction, or your treatment regimen leads to gastrointestinal problems, those side effects may be separately service-connectable. The rule changed how VA looks at what medication does for your rated condition — it didn't change the fact that medication can create entirely new problems.
If your medication stops working or you can no longer tolerate it, your rating can be reevaluated at any time. If your condition worsens because your medication is no longer effective or because side effects force you to stop taking it, you can file for an increased rating. The examiner will evaluate you as you present at that time — which, without effective medication, may look very different from your last exam.
Under this new rule, five words in your medical records can be devastating: "well-controlled on medication."
Doctors use this phrase as clinical shorthand. It means your treatment plan is working as intended. But in the context of a VA disability claim, those words can now be read to mean your disability is minimal — even if your daily life tells a very different story.
Here's the problem. "Well-controlled" doesn't mean "no impairment." A veteran whose chronic pain is "well-controlled" on medication may still be unable to stand for more than twenty minutes, may still wake up multiple times a night, may still be unable to play with their kids or hold down a physically demanding job. The medication brought the pain from unbearable to manageable — but manageable still means limited.
Under the previous court framework, this distinction mattered less because the examiner was supposed to look past the medication's effects anyway. Now, it matters enormously. If your medical records say "well-controlled" and nothing else, a C&P examiner has little reason to rate your condition as anything more than mild.
This is why specificity in your treatment notes is more important than ever. Veterans need to work with their healthcare providers to ensure that medical records capture the full picture of their functional limitations — even when medication is helping. Instead of "pain well-controlled on medication," your records should reflect specifics: "Patient reports medication reduces pain from 8/10 to 4/10, but continues to have difficulty with prolonged standing, climbing stairs, and sleeping through the night. Unable to perform yard work or carry groceries without significant flare-ups."
The difference between those two entries could be the difference between a 10 percent rating and a 30 percent rating. Don't assume your doctor's shorthand tells the full story of your daily life. It almost certainly doesn't.
This is the question many veterans are asking, and it deserves a straight answer.
Yes — in this case, VA has the legal authority to do what it did. But the method it used is debatable, and the door is not closed on challenges.
Here's why the rule itself is likely within VA's power. The court decisions that established the "rate without medication" framework were not based on the Constitution or on an act of Congress. They were based on the courts' interpretation of VA's own regulation. When a court interprets an agency's regulation and the agency disagrees with that interpretation, the agency has a well-established legal option: change the regulation. The courts themselves acknowledged this. In earlier decisions, the court explicitly noted that because its ruling was based on regulatory interpretation, VA could override it through rulemaking.
So VA isn't defying a court order. It's using its rulemaking authority — derived from 38 U.S.C. 1155 — to rewrite the regulation the court was interpreting. Once the new version of 38 CFR § 4.10 takes effect, future cases are adjudicated under the new text. The old court interpretations become moot because they were interpreting language that no longer exists in its previous form.
It's worth noting the broader legal backdrop here. The Supreme Court's 2024 decision in Loper Bright Enterprises v. Raimondo overturned the longstanding Chevron doctrine, which had required courts to defer to an agency's reasonable interpretation of ambiguous statutes. In a post-Loper Bright world, courts no longer automatically give agencies the benefit of the doubt when interpreting the law. But this situation is different — VA isn't asking courts to defer to its interpretation of an existing regulation. It's rewriting the regulation itself. That's a power agencies still clearly have, and Loper Bright doesn't change that. However, the end of Chevron deference does mean that if veterans challenge the new rule on statutory grounds — arguing, for example, that 38 U.S.C. 1155 doesn't authorize VA to rate disabilities this way — courts will evaluate that argument independently rather than deferring to VA's reading of the statute. That's a subtle but meaningful shift in the legal landscape.
But the process is where things get legally interesting — and potentially vulnerable.
VA used an interim final rule with immediate effect, bypassing the normal requirement under the Administrative Procedure Act for public notice and comment before a rule takes effect. The justification was "good cause" under 5 U.S.C. § 553(b)(B) — the argument that 350,000 pending claims and potential systemic disruption made delay impracticable. VA also characterizes this rule as a clarification of its longstanding interpretation and policy, rather than a new substantive change.
These procedural shortcuts could be challenged. Veteran advocacy organizations or individual appellants could argue that VA overstated the urgency, that the rule is arbitrary and capricious, or that bypassing public input before implementation violated the Administrative Procedure Act.
There's another wrinkle worth watching. VA characterizes this rule as a "clarification" of existing policy — essentially arguing that it has always intended to rate based on actual functional impairment, not hypothetical unmedicated baselines. But the courts spent over a decade reading the same regulation and concluding it meant something different. Calling a substantive change a clarification is a framing choice, and courts may or may not accept that framing if the rule is challenged.
None of this means the rule won't survive. It very well might. But veterans should understand that this is not a closed door. Legal challenges are possible, and how this plays out will depend in part on whether veterans and their advocates push back — through public comments, through litigation, or both.
This is a significant change, but it's not a reason to panic. It is, however, a reason to act — thoughtfully and strategically.
Submit public comments. VA has opened a comment period following publication of the interim final rule. You can submit your comment directly at https://www.regulations.gov/docket/VA-2026-VBA-0001 — search for RIN 2900-AS49 if the direct link doesn't work. Check the docket page for the exact comment deadline, as VA is required to specify a closing date. Tell VA how this rule impacts you. Share your story. Explain what your daily life actually looks like on medication versus what your records might suggest. Public comments carry real weight in the regulatory process, especially when they come from the people directly affected. Agencies are required to consider and respond to substantive comments, and a strong showing from the veterans community can influence whether this rule is modified, strengthened, or reconsidered.
Document everything about your current condition. Make sure your medical records reflect functional impairment even if your symptoms are described as "controlled." Push for specifics in your treatment notes: what you still can't do, what still causes pain, what your daily limitations look like. Don't let "stable on medication" become the entire narrative of your disability. Ask your provider to note the difference between your medicated state and full function. A note that says "improved with medication but continues to experience significant limitations in daily activities" is far more useful than one that simply says "doing well."
Track and document medication side effects separately. If your medication causes problems of its own — and many medications do — keep a detailed log. Note the symptoms, their frequency, their severity, and how they affect your daily life. These side effects can form the basis of secondary service connection claims, and they are not affected by this rule change. Your medication may be helping one condition while creating another, and both deserve recognition.
Connect with an accredited representative. If you have a pending claim that might be affected by this change, reach out to a Veterans Service Organization, an accredited claims agent, or a VA-accredited attorney. This is new and evolving territory. The specifics of your situation — when you filed, what condition you're claiming, what evidence is in your record — all matter. An experienced representative can help you navigate the new landscape and identify the strongest path forward for your particular claim.
Don't panic about existing ratings. Your current rating is not automatically reopened because of this rule. But be thoughtful about timing. If you're considering filing for an increase, make sure your documentation is airtight before you do. Under the new standard, the evidence in your medical records at the time of your C&P exam matters more than ever.
This rule change reflects a broader tension that has been building for years in the veterans benefits system — a tension between court decisions that expand protections for veterans and agency actions that pull those protections back.
For over a decade, federal courts had been interpreting VA's regulations in ways that generally favored veterans, recognizing that medication can mask the true severity of a disability and that ratings should reflect underlying conditions. That judicial trend has now been met with a regulatory response that reasserts VA's authority to define how its own rules work.
The speed and process of this change are worth noting regardless of where you stand on the substance. An interim final rule with immediate effect, bypassing prior public comment, on a matter that VA itself acknowledges could affect over 350,000 pending claims — that's an unusual move, and it sets a precedent that veterans and their advocates should watch closely.
But precedent cuts both ways. The public comment period that is now open is a genuine opportunity. Federal agencies are required to consider public comments and respond to substantive ones. If thousands of veterans submit detailed, personal accounts of how this rule affects their lives and their claims, that creates a record — a record that matters both in the regulatory process and in any future legal challenge.
The bottom line is this: the rules have changed, and they've changed in a way that will result in lower ratings for some veterans whose conditions are managed by medication. That's a real impact on real people's lives and livelihoods. But the story isn't over. Veterans have tools available — public comments, documentation strategies, secondary claims for side effects, and the possibility of legal challenges to the rule's implementation.
The most important thing any veteran can do right now is stay informed, stay engaged, and make sure the people making these decisions hear from the people living with the consequences. Your disability rating now reflects your medicated condition, and VA examiners will no longer estimate what your disability would look like without medication. This applies immediately to all pending and future claims, with no transition period. Existing ratings are safe for now, but the new standard applies if you file for an increase or face reevaluation. Medication side effects can still be claimed separately. And the public comment period — your most direct opportunity to push back — is open now.
This is one of those moments where staying silent means accepting the status quo. If this rule affects you, make your voice heard
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