Prostate cancer and VA disability benefits
Prostate cancer is a common diagnosis among veterans. Each year, about 15,000 veterans receive prostate cancer diagnoses and treatment through VA facilities. Over 200,000 veterans are prostate cancer survivors.
If you’re a veteran with prostate cancer, you may be eligible for VA disability benefits. If you’re considering filing a claim, it can be helpful to know the ins and outs of the VA’s disability claims process, so you can equip yourself with the information you need to make the process smoother.
In this article, we’ll cover:
- establishing a service connection
- the VA’s Compensation and Pension (C&P) exam
- the VA Disability Benefits Questionnaire (DBQ) for prostate cancer
- VA rating criteria for prostate cancer
Prostate Cancer: Symptoms, Diagnosis, and Prevalence in Veterans
Knowing the signs and symptoms of prostate cancer is the first step toward seeking diagnosis and treatment. Regular screening is key.
Common Symptoms of Prostate Cancer
Symptoms of prostate cancer can include:
- Painful or frequent urination
- Blood in urine or semen
- Erectile dysfunction
- Pelvic discomfort
An enlarged prostate can also be a sign of prostate cancer. Early detection is essential for more effective treatment, so regular check-ups and PSA testing are important, especially for veterans who may be at higher risk. Some research explores whether turmeric can lower PSA levels.
Prevalence in the Veteran Population
Prostate cancer is a very common diagnosis among veterans. In fact, the VA reports that prostate cancer accounts for approximately 30% of new cancer diagnoses within the VA system.
Certain factors, unfortunately, increase the risk for veterans. Exposure to Agent Orange, burn pits, and contaminated water at Camp Lejeune have all been linked to a heightened risk of prostate cancer for those who served.
Service Connection for Prostate Cancer: Establishing the Link
What is Service Connection?
To get VA disability benefits, veterans need to demonstrate a “service connection” for their prostate cancer. This means showing the VA that your cancer is related to your time in the military.
A direct service connection means proving that something that happened during your service caused or worsened your prostate cancer. This can be tough, but it’s key to receiving benefits.
Specific Service-Related Exposures and Prostate Cancer
Certain exposures during military service have been linked to prostate cancer:
- Agent Orange: Veterans who served in Vietnam or other areas where Agent Orange was used may be eligible for what’s called a “presumptive service connection.” This makes it easier to get benefits.
- Burn Pits: Evidence is growing that exposure to burn pits can lead to prostate cancer.
- Contaminated Water at Camp Lejeune: The water at Camp Lejeune was contaminated from 1953 to 1987. More and more evidence suggests this contamination increases the risk of prostate cancer.
Medical Nexus: Connecting Service to Diagnosis
A “medical nexus” is super important for proving service connection. This means getting a medical opinion from a qualified doctor stating that it’s “at least as likely as not” that your prostate cancer is related to your military service. This statement is crucial for your claim.
Preparing for the VA C&P Exam: What to Expect
The VA uses Compensation & Pension (C&P) exams to evaluate disability claims. If you’ve filed a claim related to prostate cancer, you’ll likely be asked to attend one of these exams.
Purpose of the C&P Exam
The VA requires a C&P exam to assess claims and determine the severity of your condition and how it affects your daily life. It’s really important that you attend this exam and that you’re ready to discuss your symptoms and medical history openly and honestly.
What to Bring to the Exam
Make sure you bring all your relevant medical records to the C&P exam. This includes any diagnosis reports, treatment records, and other documents related to your prostate cancer. It’s also helpful to prepare a list of your symptoms and how they impact your daily life. Document everything — from the frequency and severity of your symptoms to the treatments you’re undergoing and their side effects. Don’t forget to mention any secondary conditions that have arisen as a result of your prostate cancer or its treatment.
During the Exam
During the exam, be honest and clear about all your symptoms and how they impact your life. The examiner may conduct a physical exam, which could include assessment of your genitalia, testicles, epididymis, and prostate. However, you should know that you have the right to decline certain parts of the physical exam if you feel uncomfortable. Your comfort level is paramount, so don’t hesitate to speak up.
The Disability Benefits Questionnaire (DBQ) for Prostate Cancer
The Department of Veterans Affairs uses a standard form called the Disability Benefits Questionnaire, or DBQ, to collect data about a veteran’s medical condition. The VA relies on this information to determine a veteran’s eligibility for disability benefits and the level of compensation they should receive.
The DBQ for prostate cancer is a specific form with questions about the diagnosis, treatment, and functional effects of the disease. It’s important to understand what the VA will ask about when you complete a DBQ for prostate cancer.
Key Sections of the Prostate Cancer DBQ
The DBQ includes several sections, including:
Medical History
In this section, you’ll be asked to provide information about your diagnosis, treatment, and other relevant medical issues. You should be prepared to provide dates of diagnosis, types of treatments you’ve received (such as radical prostatectomy, radiation therapy, or hormone therapy), and any complications you’ve experienced.
Prostate Cancer-related Inquiries
This section asks about specific symptoms, such as frequent urination, incontinence, and erectile dysfunction. You should be ready to discuss how severe these symptoms are and how often they occur.
Functional Impact Assessment
This section evaluates how prostate cancer and its treatment affect your ability to perform daily activities. You’ll need to provide specific examples of how your symptoms limit your ability to work, socialize, or take care of yourself.
VA Rating for Prostate Cancer and Residual Conditions
The Department of Veterans Affairs assigns disability ratings for prostate cancer based on the severity of the condition and its impact on a veteran’s life. They use a specific code to classify prostate cancer.
Diagnostic Code 7528
The VA uses Diagnostic Code 7528 to rate prostate cancer. When a veteran is undergoing active treatment for prostate cancer, they typically receive a 100% disability rating.
Active treatment usually includes chemotherapy, radiation, or surgery, and newer treatments are being investigated, such as the potential of Orgovyx to shrink prostate size.
Residual Conditions and Long-Term Effects
After treatment, the VA may adjust the disability rating based on any lasting effects of the cancer or its treatment. These are often called “residual conditions.”
Common residual conditions include:
- urinary incontinence (loss of bladder control)
- erectile dysfunction
- frequent urination
These conditions can significantly affect a veteran’s quality of life, and they can support a continued disability rating.
Special Monthly Compensation (SMC)
Veterans who experience particularly severe residual conditions may qualify for Special Monthly Compensation (SMC), which is an additional monetary benefit.
For example, SMC-K is available if a veteran experiences the loss of use of a reproductive organ.
TDIU Benefits for Veterans with Prostate Cancer
TDIU (Temporary Disability for Individual Unemployability) provides benefits to veterans who can’t work because of service-connected disabilities. Think of it as a way to get compensated at the 100% disability rate even if your disability rating is less than 100%.
You might be eligible for TDIU if you have a combined disability rating greater than 70%. If prostate cancer (and other service-connected conditions) prevent you from holding down a job, you might qualify for TDIU benefits.
Frequently Asked Questions
What is the 70-40 rule for VA disability?
The “70-40 rule” is a common term, but it’s more of a guideline than a strict rule. It refers to situations where a veteran has one disability rated at 70% and another at 40%. Combining these doesn’t simply add up to 110%. The VA uses a combined ratings table, and depending on the specific disabilities, a 70% and a 40% rating will often result in an overall combined rating of 80%.
How to get a DBQ filled out?
The easiest way to get a DBQ completed is to ask your treating physician. If they are willing to fill it out, you can provide them with the appropriate form. Alternatively, you can be examined by a VA doctor during a Compensation & Pension (C&P) exam, and they will complete the DBQ.
What not to say at a VA C&P exam?
It’s crucial to be honest and accurate during a C&P exam. Avoid exaggerating your symptoms or making statements that are untrue. Focus on describing your current symptoms and how they impact your daily life. Don’t speculate about the cause of your condition unless you have medical evidence to support it.
How long does the VA pay for prostate cancer?
If your prostate cancer is service-connected, the VA will pay disability benefits for as long as the condition persists. The amount of compensation depends on the severity of your condition, as determined by the VA’s rating criteria.
Can a VA doctor complete a DBQ?
Yes, a VA doctor can complete a DBQ. In fact, during a Compensation & Pension (C&P) exam, the examining VA doctor will complete a DBQ as part of the evaluation process.
In Conclusion
Getting VA disability benefits for prostate cancer requires careful preparation and detailed documentation. It’s important to document any symptoms, treatments, side effects, and secondary conditions you’ve experienced so they can be considered during your Compensation and Pension (C&P) exam.
A successful claim depends on establishing a clear service connection. You’ll need to connect your prostate cancer to your time in the military. Understanding how service-related exposures might have contributed to your condition is key.
By understanding the Disability Benefits Questionnaire (DBQ), preparing for your C&P exam, and documenting everything thoroughly, you’ll increase your chances of a successful claim. Be honest and communicate clearly during your exam.