Veterans and lawmakers want the Department of Veterans Affairs to rescind a regulation published Feb. 17 that would have VA required medical examiners to consider the effectiveness of treatments or medication on a disability when determining a compensation rating.
VA Secretary Doug Collins promised Thursday that the department would not enforce the controversial rule, but it remains on the books. The legal limbo has alarmed veterans, advocacy groups and lawmakers who say the proposal must be revoked to guarantee it won’t be followed.
The rule stipulated that VA medical examiners base ratings evaluations on a veteran’s actual level of impairment during every day life.
If treatment lowered the level of disability, the associated rating would be based on the lowered disability level, according to the rule.
VA officials said the regulation rule formalized a practice that has been in place since 1958 and deemed it necessary because the VA faces reconsidering 350,000 claims decisions and retraining its medical examiners as a result of the 2025 Ingram v. Collins ruling.
Without it, they said, the department would see “an overall increase in compensation expenditures based on disability level that veterans are not actually experiencing.”
But veterans saw the announcement, which sidestepped the standard regulatory process, as a betrayal. As of Tuesday, more than 18,000 veterans, family members and organizations had commented on the regulation in the Federal Register, with many calling for its immediate rescission.
“Our nation should never balance its budget on the backs of those who have stood to defend it,” Disabled American Veterans National Commander Coleman Nee said during a hearing Tuesday. “No veteran should be penalized for taking the medication they need to survive.”
More then 20 lawmakers from the House and the Senate, namely Democrats and independents, wrote Collins Tuesday requesting the rule be revoked. They argued that leaving it on the books is causing veterans to “confront the unnecessary dilemma of continuing life-improving treatment for their conditions.”
“Medications help improve function and mask symptoms, but they do not eliminate the impacts of living with musculoskeletal disability, mental health conditions, spinal cord injuries and other health conditions,” wrote members of Congress, including the ranking Democrats on the House and Senate Veterans Affairs Committees, Rep. Mark Takano of California and Sen. Richard Blumenthal of Connecticut. “This rule forces veterans into an impossible choice: follow their prescribed treatment plan or risk losing their benefits.”
VA Deputy Secretary Paul Lawrence said Sunday that the VA had withdrawn the rule, although no revocation has been published in the Federal Register.
Speaking at the DAV’s Mid-Winter Conference in Arlington, Virginia, Lawrence affirmed Collins commitment to abandon the regulation.
“Candidly, we have no intention of ever doing anything or talking about it ever again,” Lawrence said.
But Lawrence also expressed disappointment in veterans’ reaction to and interpretation of the regulation, decrying any insinuation that VA leadership would use the regulatory process to cut benefits.
“If you look at our words and actions, we would never do that,” Lawrence said. “In our first year in office, we have processed more disability claims, we have granted more disability than ever, ever, ever in such a short period of time and so in that sense, we were just disappointed.”
Nee said veterans have concerns over any changes at the department — especially those done without input from veteran service organizations — because the VA faces a “defining crossroads,” needing to modernize without the “dismantling, fragmentation and gradual erosion” of the system.
“Acknowledging flaws is not the same as abandoning the mission. Calls to dismantle or significantly privatize the VA are often framed as pragmatic solutions offering veterans choice by shifting care to the private sector. On the surface, this may sound reasonable. In practice, it risks hollowing out the only healthcare system in this country that is purpose built for veterans,” Nee said.
In addition to the rule remaining on the books, the VA has filed an appeal to a decision in Ingram v. Collins, one of the court cases that decided the VA must discount the positive impact of medication when assigning disability ratings.
In the rule, VA officials said the department concluded that the Ingrams decision and previous rulings have “misconstrued the role of medication and treatment in evaluating functional impairment.”
Basing a disability rating without considering the effect of medication or treatment is “an unquantifiable, hypothetical, unwarranted standard that would compensate veterans for a level of disability they are not actually experiencing,” VA officials said.
Veterans organizations are in Washington, D.C. over the next several weeks lobbying Congress to support their legislative priorities, which for many include passage of a bill that would allow medically retired service members to collect their Defense Department retirement pay and VA disability compensation without offsets, improvements to the disability claims process and laws safeguarding veterans from companies that collect large fees from veterans for assistance with their claims.
Rita Graham, policy director for the Service Women’s Action Network, said her organization would like to see expanded fertility treatments for women veterans at the VA, improved research on the effects of military service on women — including toxic exposures — and recognition that women have served honorably in combat for a decade.
She added that the uproar over last week’s rule provided an opportunity for improved dialogue between groups like SWAN and the VA.
“SWAN would like to appreciate the VA’s reversal of the interim final rule on medication and disability ratings and hope this will lead to more transparency and congressional oversight for all future regulatory changes,” Graham said.
Patricia Kime is a senior writer covering military and veterans health care, medicine and personnel issues.
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