Paths to a VA Disability Rating for Bladder Cancer: Agent Orange, Burn Pits and Other Exposures

If you’re a veteran living with bladder cancer, you may be entitled to monthly disability compensation, health care, and in some cases, Special Monthly Compensation for severe complications. Whether you qualify for presumptive service connection related to Agent Orange, burn pits or Camp Lejeune water contamination, or need to establish service connection without a VA presumptive, you have several paths available to obtain your rightful benefits.  

Bladder Cancer and Agent Orange 

For many years, limited data prevented an official recognition of the link between Agent Orange and bladder cancer. In a report issued in 2016 by the Institute of Medicine, an IOM committee charged with reviewing the health effects of Agent Orange on Vietnam veterans stated that there was “limited or suggestive evidence” to link bladder cancer to this type of herbicide exposure. This statement and other evidence led to bladder cancer being added to the VA’s list of presumptive conditions related to Agent Orange exposure. 

The association between Agent Orange and bladder cancer is still considered an area in need of research – in 2023, a nationwide study of more than 2.5 million male Vietnam veterans treated in the VA Health System found an increased risk of bladder cancer among veterans who had been exposed to Agent Orange. But now impacted veterans are able to obtain VA disability benefits for the impairment and suffering caused by their bladder cancer. See how we can help with Agent Orange exposure claims.

Burn Pits and the New Bladder Cancer Presumptive 

In January 2025, the PACT Act was expanded to include bladder cancer as a presumptive condition for burn pit exposure, recognizing the effect of the carcinogens released in burn pit smoke, some of which (like benzene and aromatic amines) have been specifically linked to bladder cancer.

If you were previously denied VA disability for this condition, the presumption will now greatly increase your chances of being rated, especially with expert assistance. At Hill & Ponton, we win 96% of the appeals we handle! Get in touch for a free evaluation of your case.

Other Paths to Service Connection 

What if your bladder cancer is not presumed service-connected? If you didn’t serve in a location or time interval covered by presumptive rules, or if your claim is based on another in-service cause, you have several ways to establish service connection:

1. Direct Service Connection

To establish a direct connection between your bladder cancer and military service, you must present: 

• A current diagnosis of bladder cancer 
• An in-service event, injury or exposure (e.g., exposure to industrial solvents, asbestos or other toxins) 
• A medical nexus linking the in-service exposure to your bladder cancer 

Example: Bladder Cancer from Asbestos Exposure

In the video below, VA attorneys Matthew Hill and Carol Ponton discuss a case where they were able to find an alternative way to establish service connection for a veteran with bladder cancer who didn’t qualify for the Agent Orange presumption.

If you were denied disability for bladder cancer, please request a free evaluation here. Our VA-accredited attorneys are highly experienced in winning appeals for veterans like you and may be able to help you, at no upfront cost.

Because asbestos is not a recognized cause of bladder cancer by the VA, you will need a strong nexus letter from a doctor (ideally an oncologist or occupational medicine specialist), and documentation of military occupation and duty locations with known asbestos use. If your asbestos exposure claim is weak, consider filing for bladder cancer as a secondary condition.

2. Secondary Service Connection

You may qualify if your bladder cancer is caused or aggravated by a service-connected condition. For example: 

• A veteran takes immunosuppressive drugs for a service-connected autoimmune disorder and develops bladder cancer as a result 
• Bladder cancer develops as a complication of treatment (e.g., radiation or chemotherapy) for another service-connected condition 

3. Service Connection by Aggravation 

If you had bladder cancer (or a pre-cancerous condition) prior to service, but your military duties worsened it, you may still qualify for VA benefits. In such cases, VA must determine that the condition preexisted service and that service permanently worsened the condition beyond its natural progression. Learn more about VA claims for preexisting conditions. 

How the VA Rates Bladder Cancer

The VA assigns bladder cancer a rating of 100% for a six month period following the end of any ”surgical, X-ray, antineoplastic chemotherapy or other therapeutic procedure”, according to Diagnostic Code 7528 for malignant neoplasms of the genitourinary system. At the end of this six-month period, the VA will assign a new rating for residuals using the criteria for voiding dysfunction or renal dysfunction, whichever is predominant. 

In other words, as long as the bladder cancer is still active, or, if the veteran is still undergoing treatment for this condition, then the 100% rating will continue. However, the rating will be reduced below 100% six months after treatments have ended and the cancer is no longer active. At that point, the VA will schedule a mandatory follow-up Compensation and Pension examination in order to determine the ongoing severity of the condition and rate it based on the remaining residuals.

What Are the Residuals of Bladder Cancer? 

Even after remission, many veterans face chronic urinary and systemic problems due to damage caused by cancer or its treatment. Common residuals include:

• Requirement for another surgery 
• Ongoing pain 
• Voiding dysfunction 
• Erectile dysfunction 

When the VA evaluates residuals, they will consider whether there is any voiding dysfunction or renal dysfunction. These health conditions may be present following bladder cancer.

For voiding dysfunction, the symptoms that count are urinary leakage, urinary frequency, and obstructed voiding. For renal dysfunction, the VA health care providers will run lab work and evaluate whether there is a decrease in kidney function. 

In our experience, the most common residual from bladder cancer tends to be voiding dysfunction. Voiding dysfunction means that there is urinary leakage or incontinence, which may require the use of an appliance or absorbent materials, such as adult diapers or pads. There may also be obstruction in urination, where too much urine is retained, which may result in frequent urinary tract infections, the need for more surgery, or the use of a catheter. There may also be abnormal urinary frequency, which causes the veteran to have to urinate several times during the day and/or several times per night. 

In addition to voiding dysfunction, some veterans may also develop erectile dysfunction.  If erectile dysfunction develops secondary to the bladder cancer, then the veteran would also be entitled to special monthly compensation for loss of use of the genital organ. 

In order to demonstrate a need for a compensable rating for bladder cancer residuals, the veteran should submit thorough and supportive medical evidence. This evidence can prove that, even though the cancer may not technically still be active, there are still residuals that do deserve compensation. 

For example, letters from the veteran’s treating doctor and lay statements from the veteran and family members, would help to establish the severity of the symptoms. Basically, any form of supportive evidence of continued residuals would greatly support the veteran’s claim that ongoing compensation for the bladder cancer residuals is warranted.

How to Win a High VA Rating 

To win or preserve your bladder cancer rating after the initial 100% rating period, strong supporting evidence is essential: 

• Medical Records: Include oncologist and urologist reports, imaging, lab tests 
• Doctor’s Nexus Letters: Especially crucial in non-presumptive claims 
• C&P Exams: Attend all exams and accurately describe your symptoms, also consider getting a private medical opinion 
• Lay Statements: Statements from you, caregivers, or family about the daily impact of residuals, describing how often you wake at night to urinate, how many pads you use daily, the emotional or social impact (e.g., embarrassment, isolation) and any inability to work or travel due to urination issues 
• Work Impact Documentation: Evidence that the cancer or its residuals affect employment (if bladder cancer prevents you from working, you can also file for TDIU, which if granted will pay at the 100% rate even if your rating is lower). 

Keep in mind that the VA sometimes underrates residuals because it fails to consider related conditions that deserve separate ratings, such as erectile dysfunction (which may qualify for special monthly compensation), chronic kidney disease or renal insufficiency (rated under a separate diagnostic code) or mental health issues due to physical complications (e.g., depression from incontinence). You can file a new claim or a secondary claim for any of these.  

Don’t Settle for an Underrated Claim

If the VA underrates you, you can request a Higher-Level Review or file a Supplemental Claim with new evidence. We recommend hiring a VA-accredited attorney to help identify legal or medical errors, draft a strong legal argument and represent you before the Board of Veterans Appeals if needed. 

Example: VA Underrates Voiding Dysfunction 

After undergoing bladder cancer surgery, you now use 4 pads per day and wake up 5 times per night. VA rates you at 20%, saying your symptoms are mild. You could: 

• Submit a new C&P exam or private urologist’s report 
• Include a lay statement explaining pad usage and nightly urination 
• File a Supplemental Claim with this evidence 

If successful, your rating could increase to: 

• 40% for frequent urination (if voiding 5+ times per night) 
• 60% or higher for incontinence with absorbent material changes 4+ times daily 

Content Reviewed by

Attorney Shelly M. Mark

Shelly is an attorney passionate about serving underserved communities, including veterans, homeless individuals, and those in need. With experience in VA disability claims and social security law, she has worked with non-profits and as an Equal Justice Works Fellow.