How To Establish A Service Connection For An Enlarged Prostate
Establishing a service connection for an enlarged prostate is extremely difficult because the root cause of this condition is unclear, making it difficult to directly or proximately link this disability to an injury or disease in service.
For example, the VA denied a disability claim where a veteran tried to prove a secondary service connection for their BPH, arguing that this disability is a result of his primary service-connected diabetes. The VA found that there is no medical correlation between BPH and diabetes and denied the claim.
The Nexus Letter is like the missing link to a successful VA disability compensation claim. In this video, one of our veterans disability lawyers explains the importance of the Nexus Letter.
Therefore, a veteran needs to submit strong medical evidence with their disability claim to prove that their BPH is either a direct result or secondary result of their military service.
A veteran can submit:
- Medical records showing that they have been diagnosed with BPH.
- Service treatment records showing that they were treated for BPH or a prostate-related injury during service.
- Lay evidence that confirms the veteran developed BPH or a prostate-related injury in service. This can include statements from your co-workers, spouses, family members, etc.
- Doctor reports validating that a connection exists between their enlarged prostate and an injury or disease they suffered during service.
Vietnam Veterans & Prostate Cancer
Veterans who served in Vietnam are now reaching their mid-60s, which is the age at which prostate cancer is usually diagnosed. This means that we are seeing an influx of prostate cancer cases.
Roughly eight nine million men in the US served during the Vietnam War with approximately 2.7 million Americans serving in Vietnam. And according to recent studies, almost 1.4 million men are predicted to develop prostate cancer in their lifetime. A 2013 study conducted at the Portland VA Medical Center and Oregon Health and Science University found that Veterans exposed to Agent Orange are not only at higher risk for prostate cancer, but they also have an increased risk for more aggressive forms of the disease.
Agent Orange, as we have discussed in previous Agent Orange blog posts, has been found to cause many serious health problems. The VA has found sufficient evidence of an association with certain conditions so they have recognized fourteen different diseases and type of cancer as being related to Agent Orange exposure. These conditions are considered presumptive diseases, meaning that the VA will grant service-connection for these conditions as long as the veteran was in Vietnam. Some other diseases on this list include non-Hodgkins lymphoma , soft tissue sarcoma, porphyria cutanea tarda, multiple myeloma, and ischemic heart disease.
How Does Va Calculate The Disability Rating For My Cancer
VA uses ratings tables published in the Code of Federal Regulations to rate medical conditions. The disability rating given by VA in the rating decision should depend on your particular type of cancer and the severity of it. Some examples of ratings tables for the different types of cancer are discussed below.
Chronic B-cell Leukemias
Leukemia is rated using diagnostic code 7703. Leukemia should be rated at 100% when it is in the active treatment phase.
|With active disease or during a treatment phase||100|
|Otherwise rate as anemia or aplastic anemia , whichever would result in the greater benefit.|
|Note: The 100 percent rating shall continue beyond the cessation of any surgical, radiation, antineoplastic chemotherapy or other therapeutic procedures. Six months after discontinuance of such treatment, the appropriate disability rating shall be determined by mandatory VA examination. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of §3.105 of this chapter. If there has been no recurrence, rate on residuals.|
Six months after treatment is completed, there should be a mandatory VA examination and additional ratings should be based on residuals if there has been no recurrence.
Hodgkins disease is rated using diagnostic code 7709. Hodgkins disease should be rated at 100% when it is in the active treatment phase.
Individual Unemployability & Special Monthly Compensation
For Blue Water Navy veterans who are finally able to take advantage of the presumption of service connection for prostate cancer based on Agent Orange exposure, it is important to make sure that the VA has rated your condition correctly and has not reduced your benefits if you are still entitled to them. It is also important to apply for a secondary service connection for any conditions that are caused by your prostate cancer. You should also apply for Total Disability Rating based on Individual Unemployability if your prostate cancer prevents you from obtaining and maintaining a gainful occupation. If you are unable to work because of prostate cancer, it is important to file a claim for individual unemployability with the VA, not only so you receive benefits at the 100 percent rate, but so you can receive Special Monthly Compensation as well.
Combined Rating System For Veterans With Multiple Disabilities
Veterans with multiple disabilities use the combined rating system.
To use the combined rating system, arrange the disabilities in order by severity and locate the intersect of the two numbers on the table below.
The VA rounds the final figure to the nearest to 10 percent.
If the Veteran has more than two disabilities, find the combined value for the first two, without rounding, and repeat with the third disability. Once you have a final number, round to the nearest 10%.
For example, if disability 1’s rating is 40% and disability 2’s is 20%, the combined rating is 52%. That figure gets rounded to the nearest 10%, making the disability rating 50%.
For a three-disability example, if disability 1’s rating is 60%, disability 2’s rating is 30%, and disability 3’s rating is 20%, we first find the rating of 1 and 2. The rating of 1 and 2 comes out to be 72. We then take the first combined rating and find the intersect with disability 3. The final number comes out at an even 80% rating.
Are There Separately Compensable Va Ratings For Prostate Cancer
The concept of separate evaluations that are separately compensable was a big part of the Courts decision in Bailey v. Wilkie.
So what is a separately compensable VA rating? Specifically, this term commonly refers to the VAs practice of rat a single disability under multiple diagnostic codes without pyramiding. Basically, this means that in addition to the VA ratings for the voiding and renal dysfunctions after prostate cancer goes into remission, you can get a separate rating for certain residuals that is then combined with the prostate cancer ratings and paid separately. I dont want to go into depth on the concept of separate ratings in this post, and I will cover them in another post. You can also learn a little more about separate ratings in the Veterans Courts 2019 precedent Morgan v. Wilkie, 31 Vet. App. 162 .
With that background, lets dive into the Bailey appeal.
In this case, the veteran was diagnosed with prostate cancer in March 2013 and filed a claim to service-connect it a month later. Within a couple months, the VA granted service connection for prostate cancer and awarded a totally disabling 100-percent prostate cancer rating while the veteran was undergoing treatment.
When the veterans prostate cancer went into remission about a year later, the VA reduced his rating to 60-percent based on the predominant symptom of voiding dysfunction.
The Veterans Court weighed in on the scope of VA ratings for prostate cancer.
#2 Mental Health Conditions
Many veterans suffer from significant mental health issues that may be service connected for VA disability benefits.
In fact, nearly every veteran we speak to is suffering from mental health symptoms whether they realize it or not.
In addition, mental health conditions are easy VA disability claims to get approved.
There are 31 ratable mental health conditions under the law, but five of them are most common in veterans:
- Adjustment Disorder
- Somatic Symptom Disorder
Mental health conditions are high-value claims, which we define as a disability condition that has a high likelihood of getting rated at 30% or higher on their own.
In 2022, mental health conditions can be rated from 0% to 100, with breaks at 10%, 30%, 50%, and 70%.
According to the most recent VBA report to congress, a whopping 92.1% of disabled veterans rated for a mental health condition are rated at 30% or higher.
44.2% of veterans with a service connected mental health condition are rated at 70% or higher; the average VA rating for mental health is 70%.
Additionally, mental health conditions qualified the veteran for a 30% disability rating 21.9% of the time, a 50% disability rating 26.0% of the time, a 70% disability rating 30.9% of the time, and a 100% rating 13.3% of the time.
Post Traumatic Stress Disorder is an easy VA claim to get approved if you Have a medical diagnosis of PTSD in a medical record and Have a valid PTSD stressor event that can be verified.
Fully Developed Disability Claims
The next fasted option is the Fully Developed Disability Claims program.
The primary difference between the FDDC program and filing a standard claim is the Veteran must provide all evidence upfront and certify there’s no additional evidence needed to make a claim decision.
At a minimum, the Veteran should provide:
- All military personnel records on the condition, and
- All service treatment records on the condition, and
- All private medical records on the condition, and
- All VA health records or supplementary information about related VA health records that the VA can request on your behalf
If the VA requires additional information, the claim typically gets removed from the FDDC program and is processed as a standard claim.
Standard Va Disability Claims
With standard VA disability claims, the VA gathers evidence and compiles all supporting documents.
If the VA is unable to obtain a needed document, they may require your help. When help is required, it typically applies to documents not held by a federal agency, such as private medical records, employer information, and documents from state or local governments.
As with all claims programs, be prepared to provide your DD214 , service treatment records, VA medical records, and private medical records about your claim. Those needing help applying for their VA disability claim may also work with an accredited attorney, claims agent, or Veterans Service Officer .
What Are The Current Presumptives
Below are the categories of veterans who have presumptives established.
If a veteran is diagnosed with chronic diseases, such as arthritis, diabetes, or hypertension, within one year of their release from active duty, the VA will presume that the conditon originated during military service.
Vietnam Veterans and Agent Orange
If a Vietnam Veteran has any of the following conditions, the VA will presume that the condition was caused by exposure to Agent Orange.
- Hodgkin’s Disease
- Pellagra and any other nutritional deficiency
- Peripheral Neuropathy, except where directly related to infectious causes
More information can be found at the VAs American Former Prisoners of War Website. In addition, the White River Junction VA Medical Center has a Former Prisoner of War Coordinator.
- White River Junction Former Prisoner of War Coordinator – 687-8387, extension 5362
Veterans exposed to radiation from atomic weapons, fallout, and nuclear reactors also have presumptive conditions. There are 21 different types of cancers related to exposure to radiation. We recommend any veteran who was exposed to radiation and later develops cancer to apply for Disability Compensation. For more information, visit the visit the VAs Office of Public Health and Environmental Hazards Website.
Gulf War Illness
- Chronic Fatigue Syndrome
Decision Ready Claims Program
The fastest method of applying is through the VA’s Decision Ready Claims program. This program requires you to work with an accredited Veterans Service Organization but generally processes claims in 30 days or less.
As of now, the only types of claims the DRC program processes are:
- Conditions that began during, or caused by, service
- Conditions that are believed to be caused by military service with no direct evidence
- Conditions caused or made worse by a service-connected disability
- A current disability claim that is medically proven to have gotten worse
- Claims for eligible surviving spouses
- Claims for service members with less than 90 days before separating from the military
There are additional restrictions for filing under the DRC program. Those applying can consult their VSO to determine if the DRC program is right for them.
How To Determine Your Disability Compensation
To determine your disability compensation, you need to file a claim with VA. The VA rates your disability by severity after reviewing every piece of evidence in your claim.
You may only receive compensation for a single diagnostic code per condition, even if that condition satisfies more than one diagnostic code. However, those with more than one condition may receive additional compensation based on the combined rating system.
You may receive additional compensation if:
- You have very severe disabilities or loss of limb
- you have a spouse, children, or dependent parents
- you have a seriously disabled spouse
Note: If you have more than one child or your spouse receives Aid and Attendance benefits , be sure to include the figures from the “Add” row.
Did you know: Veterans can use their disability income in conjunction with their VA loan benefits. Speak with a home loan specialist to see how much you can afford.
What Is A Presumptive
When veterans with similar experiences have higher rates of certain types of illnesses, the federal government may create a presumptive for that illness. By doing so, they presume that the illness was caused by the military service.
This is easier to understand by looking at an example. It was discovered that veterans who were exposed to Agent Orange have a statistically greater likelihood for developing prostate cancer. Since Agent Orange was used widely in Vietnam, and any veteran who served in or around Vietnam was likely exposed to Agent Orange, the VA will presume that any prostate cancer found in a Vietnam Veteran was caused by Agent Orange. This decreases the burden on the veteran, as they dont have to prove that they were exposed to Agent Orange or that their prostate cancer was a result of Agent Orange.
For more information on the environmental hazards that have contributed to many of the current presumptives, visit the visit the VAs Office of Public Health and Environmental Hazards Website.
Va Disability Rating For Enlarged Prostate
A disability rating is a percentage that the VA uses to score the severity of a condition and determine the amount of compensation that a veteran should receive for living with the effects of this disability.
The VA determines which rating system they will use based on the diagnostic code assigned to that disability. VA diagnostic code 7527 is the code assigned to prostate gland injuries, infections, etc. This code provides that these types of injuries should be rated under the voiding dysfunction or urinary tract infection rating system, based on whichever symptoms are predominant.
BPH is categorized under diagnostic code 7527. Therefore, the VA disability rating applied to this condition would be either under the voiding dysfunction or UTI rating system.
Denied Va Disability Benefits For Prostate Cancer
VA disability claims for prostate cancer, specifically stemming from exposure to military burn pits, may be denied by VA because there is no presumption of exposure. However, if your claim for prostate cancer was denied, you still have options for appealing the decision.
The accredited VA disability attorneys at CCK may be able to help you secure VA disability benefits for your prostate cancer. Contact our office today for a free consultation.
Is A 100% Rating Permanent
No. The VA awards temporary total ratings for veterans whose conditions need additional support for a limited time, like for a 3-month convalescent period after surgery. All 100% ratings are not considered permanent unless it is medically unlikely for the condition to ever improve. In these cases, the VA will declare the condition Permanent and Total .
About The Va Disability Rating System
Veterans with a disability that developed or worsened while serving in the military or due to military service may be eligible for Service-Connected disability pay.
Conditions covered by these benefits typically include:
- Physical disabilities including hearing loss, chronic back pain, asthma and cancers caused by contact with toxic chemicals.
- Mental disabilities including anxiety, post-traumatic stress disorder , depression and traumatic brain injury .
Find a complete list of covered conditions here.
For every disability claim, the Department of Veterans Affairs assigns a severity rating ranging from 0-100%. This rating moves in 10% increments, is based on service treatment records, VA medical records, and private medical records directly relating to the disability.
For Veterans with more than one disability, the VA uses the combined rating table to calculate your disability percentage.
What Is The Disability Rating For Urinary Tract Infection
A is an infection that can affect any part of your urinary system. This occurs when your urine is contaminated by bacteria that enter your bladder. This condition can lead to pain in your pelvic area and the frequent urge to urinate, etc.
The disability rating for a UTI is:
- 10% if you need long term drug therapy, if you are hospitalized once or twice per year and/or receive occasional intensive management of your symptoms.
- 30% if you have recurrent infections leading to more than two hospital visits yearly and/or receive constant intensive management of your symptoms.
The VA will decide which rating system is predominant and should apply to the veterans condition based on the medical evidence the veteran submits with their claim or a VA examination.
In one public VA disability case, a veteran had a medical history of having one UTI, but recurring complaints of symptoms under the voiding dysfunction system. The VA ranked voiding dysfunction as the veterans predominant condition and calculated their disability rating based on that system.
Here one of our VA disability lawyers goes over the questions Woods and Woods, The Veterans Firm, is often asked about veterans disability claims and appeals.
If I Have A Presumptive Condition Should I Still Get The Assistance Of A Service Officer To Apply For Disability
Yes. Having a presumptive will make the application easier, but we still recommend veterans retain an accredited service officer to assist them.
- American Legion Veteran Service Officer – 296-5166
- Disabled American Veterans Veteran Service Officer – 296-5167
- Veterans of Foreign Wars Veteran Service Officer – 296-5168
- Vietnam Veterans of America – 283-3164
- State of Vermont Veteran Service Officer Program – 666-9844
Medical Evidence And Supporting Documentation Are Critical
To maximize your chances of winning your VA claims, medical evidence and supporting documentation should be an important part of your VA claim strategy.
If youre still on active duty, get your butt to the doctor, and have your injuries or conditions documented in your military medical records. Do this now and dont wait until youve left the military.
If you are out of the service, and already a veteran, work with your private doctor to diagnose your condition, and document the severity of your symptoms in either VA or private medical records.
Its important for you to write strong personal statements to support each disability youre claiming before the VA.
It can also be helpful to have a friend, relative, coworker, or veteran you served with write a VA Buddy Letter as a first-hand witness to the event or injury that caused your disability.
Va Benefits Provide For My Family
My main concern is for my family. I had been worried about how they will continue on if Im not here. But I got back benefits from the date my Alpha advocate filed the claim. I got a lot of money. And Im getting a special monthly compensation for being house bound, as well as medical aid and attendance when I need it. My 100 percent rating also gets my wife tax-free survivor benefits of $1,154 a month. Thats another thing I didnt know about survivor benefits )
I cant say it enough. I really appreciate everything my Alpha advocate has done for me and my family. I am so grateful. Leon
Note: Exposure to the killer herbicide Agent Orange has been found to have caused many serious conditions in veterans who stepped foot on Vietnam soil during the Vietnam War. Prostate cancer is one of those conditions. Find out more in the Wartime Veterans section of this Web site.
An appeal was not required for this initial claim; therefore, no fee was paid to Alpha for winning the most in compensation benefits possible for this veteran. The Advocates fee is subject to review by the VAs Office of the General Counsel . The VA/OGC generally considers a fee of 20% of the retroactive award as a reasonable payment and we agree. Subject to the review of the OGC, and only if we win an appeal, your Alpha Advocate will be paid a one time fee of 20% of your retroactive award.
List Of Atomic Veterans Presumptive Conditions
This applies to Atomic Veterans exposed to ionizing radiation and who experienced one of the following:
- Participated in atmospheric nuclear testing
- Occupied or were prisoners of war in Hiroshima or Nagasaki
- Served before Feb. 1, 1992, at a diffusion plant in Paducah, Kentucky, Portsmouth, Ohio or Oak Ridge, Tennessee
- Served before Jan. 1, 1974, at Amchitka Island, Alaska
For Atomic veterans, the VA considers the following conditions to be presumptive:
- All forms of leukemia, except chronic lymphocytic leukemia
- Cancer of the thyroid, breast, pharynx, esophagus, stomach, small intestine, pancreas, bile ducts, gall bladder, salivary gland, urinary tract, brain, bone, lung, colon or ovary
- Bronchioloalveolar carcinoma
- Lymphomas, other than Hodgkins disease
- Primary liver cancer, except if there are indications of cirrhosis or hepatitis B
Prostate Cancer Common Among Veterans
Prostate cancer is the second most common type of cancer for male veterans after skin cancer. There are over 200,000 prostate cancer cases in the United States every year. African-American veterans are at an even greater risk for developing prostate cancer than the average population. About one-in-six men will be diagnosed with prostate cancer in their lifetime.
The good news is that nearly 100% of men diagnosed with early stage prostate cancer are still alive nearly five years after diagnosis. Prostate cancer grows very slowly, often causing no symptoms until its in an advanced stage. Most veterans with prostate cancer die of other causes and many veterans with prostate cancer never know they had it.
How Does Va Rate Prostate Cancer
Upon establishing service connection, the rates prostate cancer depending on if it is active. If the cancer is active, the VA should automatically assign a 100% disability rating. If the cancer goes into remission, the VA will evaluate each residual of the cancer and rate them based on the severity.
These are some common residuals of prostate cancer and their ratings.
These are just a few common residuals and some veterans may experience additional residuals. Presence and severity vary from person to person.
Vietnam Veterans Need To Know About Va Benefits
When I got sick and could no longer work, my wife and I were really getting nervous. Bills were piling up and, though we have health insurance from her job, it didnt cover everything. It really was by chance that I found out I could get help from the VA because Im a Vietnam veteran. I dont know why I didnt think of it. I suspect that there are many Vietnam veterans who are seriously sick and dont know that their conditions could have been caused because they were in Vietnam. They need to know that they can apply for financial help, and get it, like I did.