- Section 108 of H.R. 9237 would rewrite VA’s rating criteria for sleep apnea and tinnitus, but only for claims filed after enactment — existing disability ratings are not reduced by the bill itself.
- The provision is projected to save an estimated $57 billion over 10 years and could eventually affect up to 1.5 million veterans filing future claims.
- Under current VA rules, sleep apnea requiring a CPAP machine generally receives a 50% rating; Section 108 would replace that with a four-tier scale running from 0% to 100% based on treatment effectiveness.
- The Veterans of Foreign Wars, Disabled American Veterans, and Iraq and Afghanistan Veterans of America oppose Section 108; the American Legion supports the broader bill, including the disability-rating provision.
- The bill also carries the Major Richard Star Act, which would extend full concurrent receipt to an estimated 52,000+ combat-injured Chapter 61 retirees with fewer than 20 years of service.
- As of this writing, neither H.R. 9237 nor its Senate companion, S. 4744, has passed either chamber; a July 2026 House floor vote was postponed.
- What Section 108 Actually Changes
- Why Lawmakers Are Using Disability Ratings as a Funding Offset
- Who Is Protected and Who Could Be Affected
- Where Veterans Service Organizations Stand
- The Precedent Concern
- What Else Is Inside TCAVA
- Where the Bill Stands Now
- Frequently Asked Questions
A nearly 600-page veterans bill has split the country’s largest veterans service organizations over a single, 20-page section. H.R. 9237, the Take Care of America’s Veterans Act, bundles more than 60 previously introduced veterans proposals, including the long-sought Major Richard Star Act. But Section 108, which would change how VA rates future sleep apnea and tinnitus claims, has become the sticking point that stalled the bill in both chambers.
This article lays out what Section 108 says, who supports and opposes it, and what it would and would not do to disability compensation, based on the bill text and statements from the organizations involved.
What Section 108 Actually Changes
The disagreement centers largely on Section 108, which would direct the VA to change its disability-rating criteria for sleep apnea and tinnitus. Under the VA’s current schedule, recurrent tinnitus generally receives a 10% rating. Sleep apnea may receive a 50% rating when a veteran requires a breathing-assistance device such as a CPAP machine.
Under H.R. 9237, sleep apnea would be rated at 0% when it is asymptomatic, with or without treatment; at 10% when treatment provides incomplete relief; at 50% when treatment is ineffective or cannot be used because of another qualifying medical condition and there is no end-organ damage; and at 100% when there is end-organ damage. In practice, that means a veteran who currently would qualify for 50% simply by needing a CPAP machine could instead be rated based on how well the treatment controls symptoms.
The tinnitus changes work similarly, moving away from a standalone rating tied to the diagnosis itself and toward criteria that weigh functional impact more heavily. Critics describe the changes as significantly reducing or eliminating future compensation for many veterans with tinnitus, largely ending the standalone 10% rating, and for sleep apnea by tying ratings to treatment effectiveness, often dropping CPAP users to 0% or 10%.
Why Lawmakers Are Using Disability Ratings as a Funding Offset
Congressional budget rules require new mandatory spending to be paid for, and TCAVA carries a real price tag. Congressional budget laws require new spending to be offset by spending cuts elsewhere, and that’s where TCAVA’s Section 108 comes in. In order to pay for these badly needed provisions, lawmakers proposed removing disability ratings for sleep apnea, which has become much cheaper and easier to manage thanks to new at-home medical device technologies, and tinnitus, which is hard to prove and, rightly or wrongly, has been singled out by the media as a source of veteran benefit abuse.
House Veterans’ Affairs Committee Chairman Mike Bost has defended the approach as the only realistic path to getting the Major Richard Star Act, which has stalled for years over its own cost, through both chambers. Bost argued the offsets were necessary in order for the bill to be taken up by the Senate, saying “We’ve sat and looked at these over and over and again,” and noting the House has previously passed some of these bills only to see them die in the Senate for lack of an offset.
Who Is Protected and Who Could Be Affected
The bill’s supporters and critics agree on one core fact: nobody’s current monthly check drops the day the bill is signed. Section 108 has not become law, and the proposed changes would not reduce existing VA disability ratings solely because the legislation passed — the immediate impact would instead fall on veterans filing future claims under the new criteria. Supporters emphasize that existing ratings would be protected.
The size of the future impact, however, is significant. The VFW said a VA analysis estimated that the changes could reduce future disability-compensation payments by approximately $57 billion over 10 years and affect up to 1.5 million veterans, though those figures describe compensation that might otherwise be paid under current rating rules and do not represent money being removed from existing veterans’ monthly payments.
One group draws particular concern: people who haven’t filed yet. The VFW is concerned about veterans who have not yet filed claims, those whose conditions have not yet been diagnosed, veterans whose conditions may worsen over time, and service members now in harm’s way who could later seek compensation. There’s also a murkier category — veterans who file to increase an existing, unrelated rating. Rep. Mark Takano, the House Veterans’ Affairs Committee’s ranking Democrat, has argued the protection for current ratings is narrower than it sounds: “[The] bill can and will lead to cuts for those who already have service-connected disability ratings for sleep apnea or tinnitus,” he said, “because any time a veteran applies for a rating increase or for a new rating for some other condition, the VA can and does review previous ratings, sometimes even lowering them.”
Where Veterans Service Organizations Stand
The dispute has not split along party lines so much as along organizational lines within the veterans’ advocacy world. The Veterans of Foreign Wars, Disabled American Veterans and Iraq and Afghanistan Veterans of America are among the organizations that have spoken against the legislation as currently written. VFW National Commander Carol Whitmore put the objection plainly: “The VFW strongly opposes the Take Care of America’s Veterans Act as currently drafted because it asks future disabled veterans to bear the cost of expanding benefits through changing the VA rating schedule for tinnitus and obstructive sleep apnea.”
Disabled American Veterans has raised a similar objection focused on the practical effect for individual claimants. DAV says Section 108 would effectively eliminate the stand-alone disability rating for many future tinnitus claims and significantly reduce compensation for many veterans with sleep apnea who use a CPAP or other treatment device.
The American Legion has taken the opposite position, backing the bill as a whole. The American Legion supports the broader Take Care of America’s Veterans Act and says the proposed rating changes came from VA’s earlier rating schedule rewrite effort, not from the bill itself. The Legion also argues that, if VA rating schedule savings happen, the bill keeps those savings inside veterans programs instead of sending them back to broader Treasury priorities.
A separate survey suggests rank-and-file veterans are similarly divided on the specific provision even while broadly supporting the larger package. A Mission Roll Call survey found 70.5% support TCAVA overall, while just 29.8% support the controversial Section 108 provision as proposed. Yet even among respondents opposed to the Section 108 rating changes, 52.3% still supported TCAVA overall.
The Precedent Concern
Beyond the dollar figures, VFW leadership has framed its objection as a structural one about how disability ratings get set in the first place. In an interview with Military.com, VFW Executive Director Ryan Gallucci warned that a provision changing how future sleep apnea and tinnitus claims are rated could establish a precedent for Congress to intervene directly in how veterans’ disabilities are valued.
That argument rests on the idea that the VA Schedule for Rating Disabilities exists to reflect medical evidence, not budget math. The Veterans Affairs Schedule for Rating Disabilities exists to reflect medical evidence and functional impairment, not to generate savings for unrelated legislative priorities, yet Section 108 would codify proposed rating changes for tinnitus and sleep apnea specifically to offset the cost of other provisions. A related concern is that the offset pits one group of disabled veterans’ future compensation against another program’s cost. The VFW is also concerned that projected reductions in Title 38 disability compensation are being used to finance provisions like the Major Richard Star Act to address separate Title 10 military retirement obligations.
What Else Is Inside TCAVA
Section 108 sits inside a much larger bill, and most of its 60-plus provisions are not controversial on their own. The package’s headline item is concurrent receipt reform for combat-injured medical retirees. Its centerpiece is the Major Richard Star Act, a bill that would allow veterans who were forced to retire early due to a combat injury to collect their full military retirement pay in addition to VA disability benefits. That change would end the pay offset for an estimated Chapter 61 medical retirees with under 20 years of service, of whom approximately 54,000 combat-injured veterans are currently affected by this concurrent receipt gap.
The rest of the bill, per the official table of contents on Congress.gov, covers survivor benefits, caregiver support, education programs, claims-processing reforms, and improvements to VA disability examinations. Introduced by House Veterans’ Affairs Committee Chairman Rep. Mike Bost and Senate Veterans’ Affairs Committee Chairman Sen. Jerry Moran, the legislation combines more than 60 previously introduced bipartisan veterans’ bills into a single omnibus package, seeking to modernize VA, expand benefits for veterans and families, improve survivor benefits, and strengthen caregiver support.
Where the Bill Stands Now
Despite months of negotiation, TCAVA has not passed either chamber of Congress. DAV said it was relieved that the Take Care of America’s Veterans Act was not brought up for a final vote in July 2026, while stating it remained determined to work with VSO colleagues and Congress to enact the Major Richard Star Act and other critical veterans bills this year.
An alternative funding path has also surfaced and stalled. Senate Republican leadership blocked an effort by Senate Veterans’ Affairs Committee Ranking Member Richard Blumenthal to pass an amended version of the bill that would have replaced the disability-rating offset with a portion of $75 billion in unobligated Department of Defense funds appropriated under H.R. 1. Blumenthal argued the alternative avoided pitting veterans against each other: “It would utilize unspent Department of Defense funds from H.R.1, the so-called Big Beautiful Bill, to cover the entire cost of the bill. It’s the only offset proposal for the Take Care of Veterans Act that has garnered bipartisan support, and it is the one that doesn’t pit some veterans against other veterans.”
The American Legion, meanwhile, continues pushing for a Senate vote. The House vote was postponed; however, the Senate is still pushing forward and is planning to vote on TCAVA, and the Legion says it’s more important than ever for veterans to contact their senators. Until a reconciled bill passes the House, passes the Senate in identical form, and is signed into law, Section 108’s rating changes remain proposed, not enacted.
Frequently Asked Questions
No. Every version of the bill that has moved through committee applies the new rating criteria only to claims filed after the law takes effect, not to compensation you are already receiving. The bill text explicitly protects existing ratings from being reduced solely because the rating schedule changed. Your risk under Section 108 as written would only arise if you file a brand-new claim, or in some cases a claim to increase an existing rating, after the effective date.
That’s a reasonable question to bring to an accredited Veterans Service Officer, since your filing date, not your decision date, would determine which rating schedule applies if Section 108 becomes law. Under current rules, recurrent tinnitus generally receives a 10% rating, and under the proposed language that standalone rating would largely disappear for future claims. Nothing about filing earlier guarantees a faster VA decision, but the law in effect on your filing date is the relevant fact here, so timing matters if the bill advances.
Congressional budget rules require new mandatory spending to be offset, and the Take Care of America’s Veterans Act bundles more than 60 bills, including the long-stalled Major Richard Star Act, which needed a funding source to move in the Senate. Lawmakers who support Section 108 argue the projected savings from modernizing sleep apnea and tinnitus ratings stay inside veterans programs rather than going back to the general Treasury. Critics, including the VFW and DAV, argue that using future disability compensation as a budget offset is fundamentally different from other savings mechanisms, since it comes directly out of what disabled veterans would otherwise be paid.
The American Legion supports the broader bill and frames Section 108 differently than the VFW does, arguing the rating changes originated in VA’s own earlier schedule review rather than in the legislation itself, and that keeping any resulting savings inside veteran programs is preferable to losing them to unrelated federal priorities. The VFW, DAV, IAVA, and Paralyzed Veterans of America dispute that framing and oppose the provision. Both organizations agree the underlying package, including the Major Richard Star Act, has broad merit; they disagree specifically on financing it this way.
This is one of the murkiest parts of the debate, and it’s worth asking directly if you have a pending claim once a final version is enacted. The clearest language in the bill protects compensation already in effect before enactment, but claims still in the adjudication pipeline on the effective date raise questions the bill text doesn’t fully resolve on its own, which is exactly the kind of detail an accredited VSO or attorney can walk through against the final statutory language.
No. As of this writing, the House postponed a floor vote on H.R. 9237 in July 2026 after failing to build consensus, and the Senate has not passed its companion bill, S. 4744. The Senate blocked an amendment from Ranking Member Richard Blumenthal that would have replaced the Section 108 offset with unspent Department of Defense funds. Nothing in Section 108 affects any veteran’s rating unless and until a final, reconciled version passes both chambers and is signed into law.
Yes, potentially. The VFW has specifically flagged concern for service members currently serving who might later seek compensation for sleep apnea or tinnitus, since the rating schedule in effect on your future filing date, not your current service date, would govern how VA rates the claim. If Section 108 passes before you file, your claim would fall under the new four-tier sleep apnea structure and the revised tinnitus criteria rather than the rating schedule in effect today.
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