VA C&P Exams for Prostate Cancer
C&P exams can be incredibly stressful for veterans. Having to attend a C&P exam for prostate cancer can add to that stress, so it is helpful to know what to expect. If you are a veteran who may need to attend a prostate cancer C&P exam soon, then continue reading to learn all about the exam process.
What is Prostate Cancer?
Prostate cancer occurs when the cells grow out of control in the prostate gland. The prostate gland is below the bladder and behind the seminal vesicles, which make most of the fluid for semen. The prostate itself also “makes some of the fluid that is part of semen.”
Most forms of prostate cancer are adenocarcinomas. Adenocarcinomas can develop from gland cells. Multiple types of other cancers may start in the prostate, however. These include small cell carcinomas; neuroendocrine tumors; transitional cell carcinomas; and sarcomas. Often, prostate cancer grows slowly, but some forms can grow quickly and spread.
Symptoms of Prostate Cancer
A person suffering from prostate cancer may experience some or all of the following symptoms:
- Difficulty urinating, specifically increased urge to urinate or weak urinary stream;
- Bloody urine or semen;
- Erectile dysfunction;
- Hip, back, or chest pain;
- Weakness or numbness; and
- Loss of bladder or bowel control.
How is Prostate Cancer Diagnosed?
Prostate cancer can usually be found through screening. Early prostate cancer usually does not cause symptoms, so screening can be crucial for detection.
Tests to detect and diagnose prostate cancer can include:
- Physical examinations;
- PSA blood tests;
- Prostate biopsies;
- Imaging tests;
- Genetic testing;
- Transrectal ultrasounds;
- MRIs;
- PET scans;
- Bone scans; and
- CT scans.
Once the condition has been diagnosed, doctors will usually come up with a treatment plan. The treatment plan could vary depending on the severity of the cancer; the health and age of the veteran; and more.
Treatment methods can include:
- Surgery;
- Radiation therapy;
- Cryotherapy;
- Hormone Therapy;
- Chemotherapy;
- Immunotherapy; and
- Targeted therapy.
How Does VA Rate Prostate Cancer?
Once service connection is established, VA rates prostate cancer based on whether it is active. If the prostate cancer is active, then VA should automatically assign a temporary 100 percent disability rating.
However, if the cancer goes into remission following a treatment plan, then VA will evaluate each residual of the cancer and rate them based on severity.
Common Residuals of Prostate Cancer
Common residuals can include:
- Frequent urination – The rating criteria for urinary frequency ranges from 10% to 40% disabling depending on the amount of time between voiding.
- The 10% rating requires “daytime voiding interval between two and three hours, or; awakening to void two times per night.”
- To qualify for the 40% rating, then there must be “daytime voiding interval less than one hour, or; awakening to void five or more times per night.”
- Urinary Incontinence – Urinary incontinence is rated under 38 CFR 4.115a Ratings of the genitourinary system — dysfunctions under Voiding Dysfunction and includes ratings from 20% to 60% disabling. The ratings are dependent on how often a veteran needs their absorbent materials changed due to their incontinence. Absorbent materials include adult diapers or pads, and to be eligible for the 60% rating, absorbent materials must be changed four or more times per day.
- Erectile Dysfunction – Erectile dysfunction is a common residual of prostate cancer. VA will only grant 0% for erectile dysfunction unless there is deformity with loss of erectile power. However, a grant of service connection for erectile dysfunction deems a veteran eligible for Special Monthly Compensation (SMC) level k for the loss of use of a creative organ.
These are just a few common residuals, and some veterans may experience additional residuals. Presence and severity vary from person to person.
What is a C&P Exam?
Compensation and Pension (C&P) Examinations are medical exams ordered by VA to evaluate the conditions a veteran is claiming for disability compensation. Exams can be performed by a VA doctor or a VA-contracted doctor.
With prostate cancer, the exam may be ordered to evaluate whether the veteran currently has prostate cancer, or to assess residuals.
Initial C&P Exam for Prostate Cancer
The first C&P exam for prostate cancer that a veteran may have to attend will likely be to confirm the prostate cancer diagnosis. This usually happens once a claim for VA disability benefits for prostate cancer has been filed.
This exam may use some of the testing methods mentioned above to confirm the veteran’s diagnosis of prostate cancer. If the veteran’s diagnosis is confirmed, then they should receive a temporary 100 percent rating for their cancer.
C&P Exams Following Cancer Remission
After six months, following the successful completion of a treatment program, VA will usually request that the veteran attend another C&P exam. This is done to assess any residuals of the cancer that may be present.
During this exam, the examiner may ask questions relating to urinary continence; erectile dysfunction; scars; or other residuals. Some of the questions may include:
- Do you have any scars?
- Are your scars painful?
- Do you experience any urinary incontinence?
- Do you need to wear urinary pads? How many per day?
- Does your need to urinate interrupt your sleep in the middle of the night?
- Do you experience frequency/urgency with your need to urinate?
- Do you have an intermittent stream when you urinate?
- Do you have any burning or pain during urination?
- Do you experience erectile dysfunction?
Tips for Prostate Cancer C&P Exams
Now we will get into some are some tips to help you during your prostate cancer C&P exam.
Make Sure You Attend Your Exam
Attending your prostate cancer exam is vital. VA places a lot of weight on these exams and adjudicating your claim. If VA requests an exam to confirm your prostate cancer diagnosis, then you need to attend for VA to confirm your diagnosis and then assign the 100 percent rating.
If VA requests an exam to evaluate the residuals of your prostate cancer, then you should attend so that VA can assess the residuals and, hopefully, assign the correct corresponding rating.
If you do not attend an exam, then it will most often result in a claim denial. If you cannot attend an already scheduled exam, or accidentally missed an exam, then you should contact VA as soon as possible to reschedule it. We have seen countless veterans receive a denial of benefits because they did not attend their scheduled exam.
When VA is scheduling you for an exam, they will usually contact you via phone or mail you a letter. As such, it is very important to ensure that VA has your most up-to-date contact information. If you move or change phone numbers, then you should contact VA as soon as possible so that you do not miss any communications from them.
Know What the Purpose of Your Exam Is Before You Attend
Understanding what the purpose of your exam is can also help to eliminate egregious stress prior to your exam.
For example, if you currently have prostate cancer, then understanding that the purpose of your exam is to confirm your diagnosis can be helpful. Once these tests have been completed, VA should assign a 100 percent rating for your prostate cancer.
If the purpose of your exam is to evaluate the residuals of prostate cancer, then it is important to come prepared to talk about the residual symptoms and conditions that you experience. Knowing what you are being examined for is the best way to be prepared to describe the true impact of your symptoms.
Be Honest About Your Symptoms
Being honest about the residual symptoms and conditions you experience is very important during C&P exams for prostate cancer, or any condition for that matter.
This openness can be challenging, as prostate cancer and its residuals can be difficult to talk about due to the intimate nature of the condition. Some may find it embarrassing to talk about urinary incontinence or erectile dysfunction, but it is crucial that you do talk about them to receive the VA disability rating you deserve.
You should also not downplay the severity of your condition or symptoms. It is best to make sure you accurately state how your residuals affect you. While you may be tempted to downplay the number of urinary pads you use in a day, for example, it is very important that you accurately represent the residuals of prostate cancer that you experience so that you can receive the most accurate rating.
Bring a Companion to Your Exam
In most exams, you can bring someone to accompany you. Bringing someone with you can be a major asset for several reasons.
Often, a spouse or family member will have a different insight into a veteran’s condition than the veteran themself. While veterans often understate their symptoms during exams, a spouse or family member may be better suited to help accurately capture how the veteran’s symptoms affect them daily.
Additionally, if a spouse or family member helps care for the veteran, then they may have additional insights too.
Bring Notes
If you think that you may have difficulty remembering certain aspects of your symptoms, like how many urinary pads you use in a day or how many times you wake up in the night to urinate, then writing them down in a small notebook may be helpful to you. You could also keep a list of notes on your cell phone so that you may easily access them during the exam.
Know Your Options Following an Exam
After your exam, you should request a copy of the examiner’s report. To do this, you can send a letter requesting it to your Regional Office.
Once you obtain this information, you should review the exam to ensure that it adequately represents what you reported to the examiner.
If your C&P exam results are unfavorable, such as the examiner reported that you did not have any residual symptoms, then there are ways to overcome it. Accredited representatives can be a very helpful option, as they can obtain private medical opinions to counter the VA exam.
How to Get Accredited Representation to Help with An Appeal for Prostate Cancer or Its Residuals
If you need the help of an accredited representative to fight your appeal for VA disability benefits for prostate cancer or its residuals, then the talented veterans’ advocates at Chisholm Chisholm & Kilpatrick may be able to help.
We can help you gather medical evidence and lay statements to build your appeal. We have helped veterans with these appeals before and we may be able to help you too. Call our office today for a free case evaluation at (800) 544-9144.
