Question:

I applied for Blue Water compensation for prostate cancer and was deemed eligible. I now have an appointment to determine percentages for disability. How is percentage determined? Do they calculate that I got the cancer in 2008? Or is it just up to date they determine percentages? Thank you for your help.

Jim's Reply:

When an eligible veteran is diagnosed with prostate cancer and he timely files a claim, he'll be rated as 100% disabled on a temporary basis that will stay at 100% until such time as he is treated for the cancer. Once treatment happens the veteran will be reexamined and rated for any conditions that may exist after treatment. Those conditions are usually erectile dysfunction and leaking or urine and a sense of frequency and urgency to urinate that can upset sleep and social habits.

Assuming you've had either surgical or chemo treatment and that your PSA has reached normal levels, your rating will be determined as much as anything by the number of absorbent pads you use each day to control leakage. If you use 6 pads each day, your rating is likely to be 60%. Using 4 pads or 2 pads will rate you at 40% or 20% respectively. If you are awakened at night to urinate or if you must wear pads to sleep, that will be taken into consideration. If you suffer erectile dysfunction you'll be rated separately for a 10% SMC rating. You must emphasize that you have ED or that will be ignored.

Your rating will be effective and you'll be paid from the time that the claim was filed. You will not receive retroactive pay back to the time of your diagnosis unless you had filed a claim then, were denied and you had managed to keep the appeal open all this time. If you have filed previous claims that had been denied in the past, you should speak to a veterans law attorney before doing anything...you may be eligible for retro pay in some very limited circumstances.

If you have practiced "watchful waiting" and you haven't had any treatment, your rating should be 100% with a future exam scheduled. Many men today don't jump at treatment since prostate cancer may be very slow growing and we die with the cancer rather than of it. All too often the treatment is worse than the disease and men are avoiding any therapy at all. 

VA doesn't ever seem to accept that men choose no treatment and eventually someone will infer treatment (you took an aspirin) and you'll get a notice that since you've cured your cancer your rating is dropping. If and when this happens (and it will) you must formally file a notice of disagreement and explain that you still have cancer. Calling VA and talking won't get your rating set straight, you must file the paperwork.

Remember that during a C & P exam we don't talk about how well we're doing, we talk about our worst days. That isn't to say we should magnify any symptoms but when asked "How are you?", our reply shouldn't be, "Never better doc...I feel great!" Good luck.