Prostate cancer is the second leading cause of male cancer-related deaths. Veterans who served in Vietnam are now reaching their mid-60’s, which is the age at which prostate cancer is usually diagnosed. This means that we are seeing in influx of prostate cancer cases. Roughly eight million men in the US served in Vietnam. And according to recent studies, almost 1.4 million men are predicted to develop prostate cancer in their lifetime. A 2013 study conducted at the Portland VA Medical Center and Oregon Health and Science University found that Veterans exposed to Agent Orange are not only at higher risk for prostate cancer, but they are more likely to have aggressive forms of the disease.
Agent Orange, as we have discussed in previous blog posts, has been found to cause many serious health problems. The VA has recognized fourteen different diseases and cancers as being related to Agent Orange exposure. These conditions are considered “presumptive diseases,” meaning that the VA will grant service-connection for these conditions as long as the veteran was in Vietnam. Prostate cancer is one of the diseases on this presumptive list. Research as shown that Agent Orange was contaminated with the toxin 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) as a by-product of chemical manufacturing, and that this toxin is a suspected cause of cancer.
The VA has established a rating system for prostate cancer, based upon the severity of the symptoms. This is rating system falls under genitourinary conditions (38 CFR. §4.115a) Prostate cancer is rated according to voiding dysfunction or urinary tract infection (whichever is more severe).
In the instances that surgery is required for prostate cancer, the VA will also award a temporary 100% rating post-surgery. The VA will schedule a follow-up exam at a VA medical center about six months after the surgery (sometimes this exam falls almost a year after the surgery) in order to determine whether or not the 100% rating is still warranted. If there is no metastasis, the VA will then rate the residuals according to voiding dysfunction or renal dysfunction (whichever is predominant), which usually comes to 10% (38 C.F.R. § 4.115b, DC 7528 (2013). Court cases have determined that the VA can reduce the 100% rating only after the cessation of surgical, X-ray, antineoplastic chemotherapy or other therapeutic procedure. The term “therapeutic” according to DC 7528 is interpreted as the procedures to cure cancer and the disease.
When the VA decides to cease the 100% temporary rating, or reduce a current rating, they will send the veteran a notice of proposed reduction of benefits. The letter will most likely give the veteran a deadline to respond. If the veteran is still experiencing disabling symptoms of prostate cancer, and believes that he is still entitled to the current rating, he should have his doctor fill out the Form 21-0960J-3, Disability Benefits Questionnaire for Prostate Cancer. This form, completed by the doctor, would serve as evidence that the veteran is entitled to the current rating.