Prostate Cancer, CP Exams and Disability

Hello Jim,

I am a USN Veteran and have served for 30 years from 1956 – 1987. Currently I have a 100% disability rating associated with prostrate cancer and Agent Orange Presumptions. It is my understanding that this is a temporary rating. My local Urologist had suggested “Watchful Waiting” as my course of action and this is what I told the VA when I filed my claim. I have no intention of undergoing any therapy as I am more worried about the side effects.

The VA contacted me recently and said they had a C&P examination has been scheduled.

I believe that I read in your site that the VA accepts “Watchful Waiting” as a treatment and that I would not have been called in for another C&P examination. Although it seems that the VA has treated me fairly, I never get completely comfortable and I maintain a certain level of Paranoia. I think that many of the issues mentioned on your site keep me in that on guard position. So in summary what can I expect? How can I be rated on any residuals when in fact no action has been accomplished? I have to urinate about 20 times a day and sometimes more than 4 times in an hour. My decision is due soon and I have no idea what to expect.

Thanks and Regards


In broad terms, any veteran who is diagnosed with a cancer that is determined to be service connected is awarded a 100% disabled rating. After diagnosis, most cancers are soon treated by surgery, chemotherapy, radiation and a number of other ways thought to eliminate the cancer.

Because of the good possibility of eliminating the cancer, the rating is always assigned as a temporary one. Because everyone who is diagnosed with cancer will seek treatment...right?

Except in the event of the diagnosis of prostate cancer. Since that rating was established many years ago, the thinking of how to treat prostate cancer has done a complete 180. Many physicians and patients know that most prostate cancers are very slow growing and that often enough, the cure is much worse than the disease.

VA doesn't accept watchful waiting as a therapy or treatment. The diagnosis of a prostate cancer is usually made by (1) the PSA level rising and (2) a biopsy to confirm the cancer is present. A therapy or treatment would positively change the status of one of those tests. In the case of watchful waiting, there is no change in the test outcomes so the cancer is still there. The law says that's a 100% temporary rating.

The C & P exam is the "future examination" promised when ratings are assigned as temporary. I have worked with a number of vets who are doing exactly what you're doing. Many of those vets have the exam and then receive a letter that talks about lowering the rating due to improvements after treatment.

It's maddening when that happens and it happens a lot. It's simple to resolve with an appeal but it shouldn't happen at all.

The best advice I can offer is to submit willingly to the exams and the rest of the process. You should receive a letter telling you that your 100% temporary benefit is extended until the next required exam. The next exam should be 1 to 3 years away.

The fact is that VBA is routinely denying the 100% benefit to Vietnam veterans who have prostate cancer and who are choosing watchful waiting. This is an error by VBA. We believe that the error is due to a lack of training for raters that would allow them to understand just what watchful waiting is and why many veterans are choosing that path. The only solution for the veteran is to carefully observe every move by the VA and be ready to appeal.