VA Rule Change: How Medication Can Affect Your Disability Rating (38 CFR 4.10)

📅 Feb 17, 2026 • ⏱️ ~13 min read • By Bruce Goren, USAF (Ret. Feb 2026)
Quick Answer: VA's new rule (38 CFR 4.10, effective Feb 17, 2026) clarifies that disability ratings reflect your actual functional impairment with your current treatment—not a hypothetical unmedicated baseline. Document what you still cannot do even when medication helps. Do not stop taking prescribed medication to influence ratings. Focus on describing real functional limitations: work capacity, household tasks, activity restrictions, and flare-up patterns.

There is a new VA rule change that a lot of veterans are hearing about… and most of the explanations online are either panic fuel or vague enough to be useless.

This post explains what changed, what it means in plain English, and what you can do right now. It is not legal advice and it is not medical advice. If you have a claim pending or you are mid-appeal, talk to an accredited VSO, accredited agent, or VA-accredited attorney for guidance specific to your case.

Short version: VA issued an interim final rule effective February 17, 2026 amending 38 CFR 4.10 to clarify that ratings should reflect the actual functional impairment you experience, and that the ameliorative effects of medication should not be estimated or discounted at the time of the disability exam.

What changed on February 17, 2026

On February 17, 2026, VA published an interim final rule titled "Evaluative Rating: Impact of Medication" (RIN 2900-AS49). The summary section explains the purpose plainly: VA is amending 38 CFR 4.10 to correct judicial interpretations VA believes misconstrued the role of medication and treatment in evaluating functional impairment.

Official source (Federal Register via GovInfo):

What this means in normal human language

Before this change, a common legal argument in many disability contexts was basically:

"Do not penalize a veteran because medication makes symptoms look less severe."
In other words… the rating should reflect the underlying condition, not the polished-up version created by treatment.

There is long-standing case law and commentary around when VA can consider medication relief. Many explanations summarize it like this: VA generally cannot base the rating on medication relief unless the rating criteria for that condition explicitly discuss medication effects. If you want background on that older framework, these are helpful reads:

Now, with the amended 38 CFR 4.10, VA is explicitly saying that disability ratings should reflect the actual level of functional impairment you experience and that it should not require examiners to estimate a hypothetical "unmedicated baseline" at the time of the disability exam.

If you want to read a commentary take that sparked a lot of discussion, this is the article you referenced. It is not an official source, but it is a decent summary of what many people are worried about:

Who might be affected

This rule matters most for conditions where medication can noticeably improve day-to-day function. Think "symptoms are still there, but the meds make me functional enough to survive a workday."

Practical examples (not an exhaustive list):

Concrete Examples: What This Looks Like for Specific Conditions

Example 1: Chronic Back Pain

Veteran takes daily NSAIDs, muscle relaxers, and gets quarterly steroid injections. Pain goes from 8/10 unmedicated to 4/10 with treatment.

What matters for rating: Even at 4/10 pain, veteran cannot stand more than 20 minutes, cannot lift over 15 lbs, experiences flare-ups 2-3 times monthly requiring bed rest, and has difficulty sleeping. These functional limitations should be documented and rated, not dismissed because "medication helps."

Example 2: PTSD/Anxiety

Veteran takes SSRIs and anxiety medication. Symptoms are improved but not eliminated.

What matters for rating: Even with medication, veteran experiences panic attacks 1-2 times weekly, avoids crowds and public places, has difficulty maintaining employment due to anxiety triggers, and has strained family relationships. Medication makes life manageable but significant occupational and social impairment remains.

Example 3: Migraines

Veteran takes daily preventive medication plus abortive medication for breakthrough migraines. Frequency reduced from 12/month to 4/month with treatment.

What matters for rating: Still experiences 4 prostrating migraines monthly requiring dark room and inability to function. Misses work 4-6 days per month. Even on "good" days, has chronic low-grade headache affecting concentration. This functional impact should be rated despite medication reducing frequency.

Important: This does not mean "stop taking your meds to get a higher rating." Please do not do that. That is a health decision, and it is not worth gambling your safety for paperwork.

What you should do now (without panicking)

1) Make sure your records describe your function, not just your diagnosis

Medical notes often include shorthand like "stable" or "well-controlled." Clinically, that can be true… and also completely unhelpful for explaining how your condition still impacts your daily life.

If medication takes you from "8/10 pain" to "4/10 pain," that is improvement. But 4/10 pain that still limits standing, sleep, lifting, stairs, or driving is still impairment. Records that include specifics are more useful than records that just say "doing well."

2) Document what is still limited even when treatment helps

3) Track medication side effects separately

The rule is about beneficial effects on the rated condition. Medication can also cause side effects that create their own functional problems. If you have side effects, track them and discuss them with your provider so they are documented.

4) If you want to comment on the rule, note the deadline

The interim final rule states that comments must be received by April 20, 2026. The document directs commenters to submit through regulations.gov under RIN 2900-AS49. See the official PDF for details.

5) Understand what to say (and not say) at C&P exams

C&P examiners now evaluate your function with your current treatment. Here is how to communicate effectively:

Good functional language (use this):

Vague medical language (avoid this):

Key principle: Describe what you cannot do, not just what hurts. VA rates functional impairment, not pain levels alone.

6) Know when to get professional help

You should consider working with a VSO, accredited agent, or VA-accredited attorney if:

Resources for finding accredited representatives:

What About Pending Claims and Established Ratings?

If you have a claim pending right now

The rule is effective February 17, 2026. If your C&P exam is scheduled on or after this date, the new interpretation may be applied. Make sure your exam includes detailed functional limitations even with treatment.

If you have an established rating

Existing ratings are not automatically changed by this rule. However, if VA schedules a reexamination in the future, the new framework will likely apply. Continue documenting functional limitations in your ongoing medical care.

If you are in the middle of an appeal

Talk to your VSO or representative about how this rule might affect your case. The Board of Veterans' Appeals and courts will apply the regulation in effect at the time of their decision.

How to Document Functional Limitations in Medical Records

The best documentation happens during routine medical care, not just at C&P exams. Here is how to ensure your records reflect reality:

At Primary Care and Specialty Appointments

Keep Your Own Symptom Log

Medical records often lag behind reality. Keep a simple log:

Bring this log to appointments and C&P exams. It provides objective patterns over time.

The Big Picture: What VA Is Actually Trying to Do

The rule change is not designed to arbitrarily lower ratings. According to the Federal Register document, VA's stated goal is to correct what it views as judicial misinterpretation of how medication effects should be evaluated.

The core principle: ratings should reflect the veteran's actual functional status at the time of evaluation, with consideration of the effects of treatment the veteran is receiving.

This is not the same as saying "medication cures everything, so no rating." It means: document what you still cannot do even when treatment helps, because that is the impairment VA should be rating.

Common Misconceptions About This Rule

Misconception 1: "VA can now lower my rating just because I take medication"

Reality: VA rates functional impairment. If you have significant functional limitations despite medication, those limitations should still result in an appropriate rating. The rule clarifies evaluation methodology, not a mandate to reduce ratings.

Misconception 2: "I should stop taking medication before my C&P exam"

Reality: This is dangerous and unnecessary. Describe your function with your prescribed treatment regimen. If medication side effects create additional functional problems, document those separately.

Misconception 3: "This only affects mental health conditions"

Reality: The rule applies to all conditions where medication or treatment affects functional capacity—musculoskeletal, neurological, cardiovascular, GI, respiratory, etc. Any condition where treatment improves symptoms but impairment remains.

Misconception 4: "My existing rating will automatically change"

Reality: Existing ratings are not automatically reevaluated. The rule applies to examinations conducted on or after the effective date. However, routine reexaminations scheduled in the future will use the new framework.

How this fits into the bigger separation timeline

If you are still active duty, you have one big advantage… time. The best outcomes usually come from consistent documentation, not last-minute heroics.

Two companion posts that help you plan the "boring but important" parts:

📅 Keep VA Tasks and Documentation on Your Timeline

OutProcessed helps you place VA prep tasks, medical documentation reminders, and separation deadlines in one place… so this does not become a last-minute scramble.

Build My Timeline →

Frequently Asked Questions

What is the VA medication rule change 38 CFR 4.10?

Effective February 17, 2026, VA amended 38 CFR 4.10 to clarify that disability ratings should reflect actual functional impairment experienced by the veteran, and that ameliorative effects of medication should not be estimated or discounted at the time of disability examination. In simpler terms: your rating is based on how you actually function with your current treatment, not what your function might be without medication.

Does this rule mean VA will lower my disability rating if I take medication?

Not automatically. The rule clarifies how functional impairment is evaluated, not a directive to reduce ratings. If you take medication but still have significant limitations in work, household tasks, or daily activities, those limitations should still be captured in your rating. The key is documenting what remains impaired despite treatment.

Should I stop taking my medication to get a higher VA rating?

Absolutely not. Never stop prescribed medication for rating purposes. This is dangerous to your health and not worth the risk. Instead, ensure your medical records document the functional limitations you still experience even with medication—pain levels, activity restrictions, work limitations, flare-up frequency, and medication side effects that create their own problems.

How should I prepare for a C&P exam under the new medication rule?

Describe your actual daily function with your current treatment regimen. Be specific about what you cannot do or can only do with difficulty: how long you can stand/sit, lifting limits, distance you can walk without pain, sleep disruption, days of work missed, household tasks you cannot perform. Mention medication side effects as a separate issue. Bring a written summary of functional limitations and flare-up patterns covering the past year.

Does this rule affect existing disability ratings or only new claims?

The rule is effective February 17, 2026 and applies to evaluations conducted on or after that date. Existing ratings established before this date are not automatically changed. However, if you have a pending claim, appeal, or future reexamination scheduled on or after February 17, 2026, the new interpretation may be applied during those evaluations.

Can I submit comments on this rule?

Yes. VA published this as an interim final rule, which means it is effective immediately but VA is accepting public comments until April 20, 2026. Comments can be submitted through regulations.gov using RIN 2900-AS49. Check the Federal Register document for specific submission instructions.

What if my C&P exam report does not reflect my actual limitations?

You can submit additional evidence including: personal statement describing functional limitations in detail, buddy statements from people who witness your limitations, medical records from your treating providers showing ongoing symptoms and restrictions, and symptom logs documenting flare-ups and activity limitations. Consider working with a VSO or accredited representative to ensure this evidence is properly submitted.

How do medication side effects fit into disability ratings?

Medication side effects that cause functional impairment can be relevant to your rating but are typically evaluated separately from the ameliorative effects on the primary condition. For example, if PTSD medication reduces anxiety but causes fatigue that affects work capacity, the fatigue should be documented. Some side effects may warrant separate ratings if severe enough.

Should I work with a VSO or attorney on this?

If you have a pending claim, appeal, or are facing a rating reduction, working with an accredited VSO, agent, or attorney is advisable. They can help ensure your functional limitations are properly documented and presented, especially under the new evaluation framework. Free VSO representation is available through organizations like DAV, VFW, American Legion, and others.

Final thoughts

This rule change is real, recent, and worth understanding. It is also not a reason to spiral.

The core idea you should take from this is simple: your records should reflect how your condition impacts your daily function, even when treatment helps. If that is true, you are in a much better position no matter how policy shifts in the future.

About the author: Bruce Goren is an Air Force member retiring in February 2026. He built OutProcessed after seeing how scattered and confusing the separation process can be.