Question:

You responded to a vet in 2018, “There will be C&P exams and VA will attempt to lower the watchful waiting rating but it will stay in place if you're diligent in monitoring VA efforts.” I just filed my claim as I was diagnosed with non aggressive prostrate cancer in Feb, 2020. We are not planning treatment for now. Monitor every six months. Another biopsy. How will the VA try to lower rating. I am being seen for this by a private sector. I served in Vietnam 1965-66 USAF. Thank you for what you do. 

Jim's Reply:

When the Vietnam veteran is diagnosed with prostate cancer the condition is presumed to be service connected because of exposure to agent orange. The rating received is 100% and that rating is temporary as VA assumes every veteran will receive treatment and that every treatment will cure the cancer.

Once treatment occurs the veteran no longer has cancer the 100% rating will fall to reflect any residual effects of treatment like frequency and urgency of urination or erectile dysfunction.

The veteran who chooses watchful waiting won't have any treatments to cure the cancer so the rating should remain at 100% until a treatment is initiated. 

However, the VA is so set in believing that every vet will choose treatment that they will often enough lower the rating because they assume treatment happened, not because it happened. Typically this will happen after a telephone C&P and the veteran will receive a letter proposing to lower the 100% benefit because of a successful treatment that never happened. When this occurs a prompt appeal will usually set it right...back to 100%.