Prostate Cancer rating pending


Hi Jim:

My husband is a Viet Nam Vet, a victim of Agent Orange. He has several disabilities as a result, one being diabetes with neuropathy with a total rating of 100% when added together, and the other being Prostate Cancer, rated at 100% by itself. Obviously with their calendar of percentages, without the prostate cancer, it would be around 80 to 85%. They have been reviewing his Prostate Cancer rating since January 7. It keeps saying pending. But it also said they would have a decision by Jan 27. it is now March. My husband has undergone radiation treatment and now is undergoing a series of injections including hormones and chemo. That ends in 2020. He was also recently started on a drug called Casodex (another type of chemo drug) due to the fact that his PSA started rising again. We took all the papers from his doctor to the VA when he had his scheduled exam visit, but they did not want them. Just his PSA levels. They scanned nothing in.

I hesitate to upload any documents because it says it may take longer if you submit new paperwork. They aren't asking for any at this time.

My husband was not eligible for surgery or seeds or any other type of treatment except the one he is on due to the high grade of his prostate cancer. My question then I guess is can the VA make this disability permanent? They told my husband if his PSA keeps rising, all they can do is keep giving him the chemo to keep the cancer at bay. As long as he is still diagnosed with prostate cancer, not cured, don't they have to keep giving him the compensation at 100%? Could it be made permanent? The proof letter says you are considered to be totally and permanently disabled....why then would they ask for a re-examination?

Jim's Reply:

This is pretty typical of how VA manages a chronic cancer condition. VA rates all service connected cancer as 100% temporary. They assume that everyone will get treated and all cancer will be cured after treatment. Once the cancer is gone they re-examine the veteran and the temporary 100% "recuperation" rate falls to a lower rating that is supposed to reflect any disabling conditions caused by treatment.

Prostate cancer is rated at 100% and after surgery or radiation or both, the veteran is rated at 40% or 60% for incontinence and ED. The "cure" is all about the PSA and if it rises the vet can seek the 100% temporary rating again. The same pattern is seen with service connected lung cancer and other agent orange presumptive conditions. In your veterans case, he's already 100% rated and that is a permanent rating. Then he has a temporary 100% rating for prostate cancer. You didn't mention it but that he has  two 100% ratings tells me he should be receiving the "housebound" benefit even if he isn't technically housebound. Ultimately the VA will require that he be scheduled for a "future exam" until one of the contract examiners calls an end to it by making statements about the permanence of his condition. Unless and until that happens, he has little choice but to follow along with the routine so he won't lose the benefit. At examinations stress that his PSA is rising and that he should be receiving the housebound benefit...don't accept less.