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Va C&p Exam For Prostate Cancer

Know What Is At Issue In The Va C And P Exam

VA Claim Exams: Genitourinary

In earlier tips, I told you to talk only about symptoms and limitations. If you have to, have a brief statement that explains why you think your condition is service-connected. But this begs the question how do you know what will be discussed in your C& P exam? This comes back to understanding the 4 Pillars of a VA claim.

Your C& P exam will invariably involve issues in only 2 of those pillars:

Suppose your exam is for a condition that has not been service-connected. In that case, it is a good chance that it is either a nexus or a diagnostic exam.

Lets talk about the diagnostic exam. Remember that the VA has a Duty to Assist?

While I always tell Veterans not to confuse the Duty to Assist with Actual Assistance,. There is one scenario where I think the VA does a good job of assisting Veterans in their claims.

That scenario arises if you have not yet had your medical condition diagnosed in certain situations, the VA is required to send you for a Diagnostic Exam to diagnose your medical condition before a decision can be made about service connection or impairment rating. If, however, there is no reasonable possibility that the condition could be service-connected even if diagnosed, the VA does NOT have to send you for a Diagnostic Exam.

Suppose your exam is not a diagnostic exam. In that case, you can be sure that the doctor will want to talk to you about nexus and the impairment rating criteria.

What Does A Va C& p Exam Consist Of

The purpose of the C& P exam is to determine whether your condition is related to service and/or the extent of your service-connected disability. It is not much different than a doctors appointment you will answer questions about your condition and the examiner will evaluate your condition with a series of tests that will vary depending on your condition.

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Symptomatic treatment of an enlarged prostate usually involves a combination of medication and lifestyle changes. A diet rich in fruits and vegetables may be the best option if you suffer from chronic urination. It will help the body adjust to the increased size of the prostate. Also, taking regular urination intervals will help retrain the bladder to function properly. Inactivity also contributes to urine retention, and cold temperatures can increase the urge to urinate.

Invasive treatment of enlarged prostate includes medication that relieves the pressure on the urethra and bladder. However, if the condition is severe, it may require surgical intervention. If treatment is not successful, the enlarged prostate can become a potentially life-threatening disease. As the hormone levels in the body change, the enlarged prostate can lead to various complications, including urinary retention and even cancer. This is why it is critical to see a doctor for further evaluation.

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Va Rating For Prostate Cancer

Prostate cancer is listed under diagnostic code 7528 malignant neoplasms of the genitourinary system. The VA rates prostate cancer at 100% during cancer treatment and six months afterward. At the end of six months, a re-examination is required to determine a new rating. In addition, any ongoing disabilities related to cancer contribute to the VA disability rating for cancer in remission.

They brought me from being stuck at 30%. Denial after denial. Finally rated at 70%. Appealed for total and unable to work disability since 2014. Without Woods and Woods I would still be stuck at 30%.

Va Rating For Voiding Dysfunction Frequent Urination And Urinary Incontinence

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Unlike other disabilities, the VA doesnt have a specific disability rating number for voiding dysfunction, frequent urination, and urinary incontinence. Instead, these dysfunctions are listed under ratings of the genitourinary system-dysfunctions in the Schedule of Ratings . Depending on the symptoms and severity, they range from 0% to 60%.

Description
Urinating every 2-3 hours during the day or waking up to urinate two or more times each night. 10%

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Va Disability For Prostate Cancer

Prostate cancer is the 2nd most common type of cancer in men. The American Cancer Society estimates that about 1 in 8 men will be diagnosed with prostate cancer in their lifetimes.

As with other cancers, prostate cancer is caused by cells with abnormal DNA. Abnormal DNA can come from inflammation in the prostate, which can damage cell DNA, or exposure to cancer-causing material, which causes DNA mutations.

Can I Add Dependents To My Va Disability Award

Yes. You can add your spouse, dependent children, and/or dependent parents to your VA disability award, and the VA will increase your monthly compensation for each dependent.

Gregory Rada is an Air Force veteran that helps veterans nationwide receive the benefits to which they are entitled. He works with all his clients one-on-one from the start of their case to the end and never hands them off to case managers or paralegals. Learn more about his experience by clicking here.

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What Does All This Mean For Veterans With Prostate Cancer Claims

This case was a little complicated because of all the side issues of protecting effective dates, using VA forms, etc. So lets boil out the important facts for veterans trying to maximize their VA prostate cancer rating.

#1: Tell the VA every complication of your prostate cancer.

In your original claim for prostate cancer, tell the VA all of the complications of your prostate cancer even before it goes into remission.

You can tell the VA this in three ways: lay evidence, medical evidence, and expert opinions. The best course of action is to use all three tools.

If you use lay evidence, be sure to focus on the frequency, chronicity and severity of your prostate cancer complications and residuals and their impact on your earning capacity. It has been my experience over the last 13 years that lay evidence when done right is the silver bullet in your VA claim or appeal.

You can bolster your lay evidence with medical evidence showing the complications and residuals of your prostate cancer. This isnt technically necessary, but it is incredibly helpful if you can back up what you tell the VA with evidence in your medical records.

And, if you decide to use an expert opinion, present your lay evidence, medical evidence and a copy of your VA claims file being especially sure to include adverse medical opinions to the expert to ensure that his or her opinion is thorough.

#2: Dont let the VA cut you out of an earlier effective date for your prostate cancer ratings.

What Is Prostate Cancer

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Prostate cancer is a type of cancer that affects the prostate gland, which is a small walnut-shaped organ that sits beneath the bladder and in front of the rectum. Prostate cancer usually grows slowly and is initially confined to the prostate gland, where it may not cause serious harm.

Veterans are more likely to be exposed to toxic chemicals throughout their service. Agent Orange exposure and burn pit exposure are two examples of toxic exposures linked to an increased risk of prostate cancer.

Symptoms of prostate cancer dont usually appear in the early stages of the disease. When they do, they may be similar to those caused by benign prostatic hyperplasia , a noncancerous prostate gland enlargement.

Read Also: How To Tell If You Have Prostate Cancer

Questions About The Dbq

The DBQ is a relatively new form available to veterans, so there are questions about how to use it. Here are some of the most common questions about the DBQ and some general answers to those questions:

Will having my doctor fill out a DBQ really expedite my claim? While there is no statistical evidence that proves the DBQ accelerates the claims process, many veterans have reported their satisfaction with the time to process their claims.

Will the VA pay for me to see my own doctor? No. If a veteran chooses to see his own doctor for a medical evaluation instead of a reporting for a C& P exam, he is responsible for all related charges, co-pays, and travel costs. Because veterans have the option to take the DBQ to their own physician, they are also responsible for any extra charge the doctor might require for filling out this form. Asking your doctor to complete the form is the same as asking him to add support to your claim by writing a letter or provide evidence of a medical condition.

Is there a DBQ for every condition? No. However, there are over 70 DBQs that cover many medical conditions. Some DBQs are available for a specific, single condition such as prostate cancer or high blood pressure, and others can be used for related conditions. The VA provides a complete list of available forms and covered conditions. The current list defines nearly every condition that a veteran can receive compensation for.

  • The initial exam for PTSD
  • Tinnitus and Hearing Loss

Exposure And Prostate Cancer

Various forms of exposure that veterans have faced during their service have been linked to prostate cancer. Some forms of exposure do have presumptive service connection, while others do not. Therefore, depending on the form of exposure, some veterans may have an easier time becoming service-connected than others.

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Medical Conditions Covered By Dbqs

There a more than 70 DBQs covering a full range of medical conditions. Some of the DBQs are specific to a single condition , but most forms can be used for multiple conditions .

The VA has a list of all the conditions covered by DBQs, including access to the downloadable forms, on its website. While DBQs are available for the majority of conditions, there are not DBQs for the following:

  • Initial examination for PTSD
  • Prisoner of war examination protocol
  • Gulf War medical examination
  • General medical examination for compensation purposes
  • General medical examination for pension purposes

A Va Disability Benefits Questionnaire

Claims Process Archives

DBQs are downloadable forms created for veterans use in the evaluation process for VA disability benefits. DBQs are supposed to help speed the processing of claims for service-connected compensation and give veterans more control over the disability claims process.

Although veterans are able to access these forms, they cannot fill them out themselves. Instead, DBQs give veterans the option of visiting a private healthcare provider or a VA healthcare provider to get the evaluation completed.

When a veteran goes to a private healthcare provider to complete a DBQ, it is important that veterans:

  • Access the form online through the VAs website and download it
  • Have their private doctor or healthcare provider complete the form
  • Review their findings and save a copy for records and
  • Submit the form to VA.

The DBQ forms use check boxes and standardized language so that that evaluation can be completed quickly and correctly. Healthcare providers check a box next to descriptions that most accurately depict the disability in question. Overall, the use of DBQs provides veterans with an improved means to submit medical evidence to support their claims.

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Common Causes Of Service

Veterans encounter various situations and geographical locations that put them at risk for cancer development. Service-related prostate cancer occurs for two primary reasons: exposure to Agent Orange and burn pit exposure. There is also a growing body of evidence showing a connection between the contaminated water at Camp Lejeune and the later development of prostate cancer.

Tip #1 Dont Skip Your C& p Exam

Translation: You must report to your scheduled C& P exam unless you have Good Cause for missing it.

Weve heard rumors that some folks are telling veterans not to show-up to their C& P exams.

They are wrong!

Dont fall into this trap.

If you dont attend your C& P exam, the VA Rater can either make a rating decision based on your submitted evidence alone or in some circumstances deny the claim.

Pro Tip:§ 3.655 Failure to report for a VA C& P Exam. When entitlement or continued entitlement for VA disability benefits cannot be established or confirmed without a current VA examination and the claimant fails to report without good cause, the VA Rater shall act in accordance with the table below.

If the veteran fails to report for a C& P exam without good cause in connection with a: Then the VA Rater should:
Original VA disability compensation claim, orNew claim Decide the claim based on the evidence of record.
Increased evaluation claim, or
Discontinuance or termination is only finalized after due process, as provided in M21-1, Part IV, Subpart ii, 2.B. Reduction or discontinuance will not be finalized when the claimant submits evidence during the proposed reduction period justifying continuation of the benefit or indicates a willingness to report for examination.

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General Formula For Va Ratings For Prostate Cancer

Thee VA rating for prostate cancer generally works like this.

While the veterans prostate cancer is still active in the official language of the VA rating schedule, this means there is local reoccurrence or metastasis of a malignant neoplasm of the genitourinary system he will be rated 100%

Once the veterans prostate cancer goes into remission, the veteran will be rated for voiding dysfunction or renal dysfunction, whichever is predominant.

Va Rating For Prostate Cancer Residuals

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Once youve been off treatment for six months and your prostate cancer is in remission , the VA will assign a residual rating. A residual rating is given to any condition that persists after treatment has ended.

Several common residual conditions occur after veterans have recovered from prostate cancer. For example, suppose you had surgery to remove your prostate gland and are now incontinent. In that case, youll receive up to a 60 percent VA rating for prostate cancer. This is the highest residual rating for incontinence.

Urinary incontinence is also called voiding dysfunction by the VA and is rated from 20% to 60% based on these criteria:

  • 20% You wear absorbent materials and only change them once daily.
  • 40% You change absorbent materials two to four times daily.
  • 60% You wear an appliance or change absorbent materials more than four times daily.

Incontinence is one of the highest permanent ratings you can receive after your cancer is no longer active, at a 60 percent VA rating for prostate cancer.

Urinary frequency is rated from 10% to 40% based on these criteria:

  • 10% You go every two to three hours or wake up twice each night to urinate
  • 20% You go every one to two hours or wake up three to four times each night to urinate
  • 40% You go less than every hour or wake up five or more times each night to urinate

Atrophied testes are another possibility, depending on the treatment, rated from 0% to 20%. To be rated at 20%, both testes must be impacted.

Watchful Waiting

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How To Prove That Your Military Service Caused Prostate Cancer

The first step in winning your claim is to prove that your prostate cancer is linked to your time in service. The VA requires three elements to service-connect a veteran for prostate cancer:

  • A current diagnosis of prostate cancer
  • Proof of an in-service event or injury that led to your prostate cancer
  • A link that connects your service to your prostate cancer
  • The first element is pretty straightforward. However, the second and third elements can be more challenging to prove. To do so, youll need to provide evidence that your military service caused your prostate cancer.

    The good news is that if youre a Vietnam, Gulf War, or Post 9/11 veteran, the VA has paved the way for your prostate cancer to be linked automatically to your service.

    What Are The Payment Amounts For Va Disability Compensation

    When the VA approves you for disability benefits, it assigns you a disability rating. This rating is between 0 and 100 percent. The severity of your condition, as judged by the VA, determines your disability rating. The VA takes into consideration such factors as current and ongoing treatment, how your medical condition affects or limits your activities of daily living, and severity of symptoms.

    As of December 1st, 2021 the VA disability rate benefit amounts are as follows:

    • 0 percent disability rating: $0.00 per month
    • 10 percent disability rating: $152.64 per month
    • 20 percent disability rating: $301.74 per month
    • 30 percent disability rating: $467.39 per month
    • 40 percent disability rating: $673.28 per month
    • 50 percent disability rating: $958.44 per month
    • 60 percent disability rating: $1,214.03 per month
    • 70 percent disability rating: $1,529.95 per month
    • 80 percent disability rating: $1,778.43 per month
    • 90 percent disability rating: $1,998.52 per month
    • 100 percent disability rating: $3,332.06 per month

    Moreover, a disability rating of 30 percent or above qualifies you to receive additional benefits for your spouse, children, or dependent parents. The VA provides an additional monthly payment schedule for veterans who are at least 30 percent disabled and have qualified dependents.

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    What Happens If You Miss A C& p Exam

    If you miss a C& P exam, the VA Rater can either deny the claim or decide it based on the evidence of record.

    You should not miss your C& P exam unless you have Good Cause for doing so.

    Good cause means a reason that justifies your failure to report for VA C& P examination.

    The VA will generally accept any reason offered by the individual as good cause for his/her failure to report for an exam.

    Examples of good cause include, but are not limited to, illness or hospitalization of the claimant or death of an immediate family member.

    Exceptions: Good cause is not established if the claimant

    • Fails to provide any reason for failing to report, or
    • Indicates he/she did not receive notice of the examination.

    References: For more information on

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