VA Disability Benefits for Gynecological Conditions
What Are Gynecological Conditions?
A gynecological condition is one that affects the female reproductive organs: the breasts and organs in the abdominal and pelvic area including the uterus, ovaries, fallopian tubes, vagina, and vulva. Many women experience gynecological problems in their lifetime, and some can be quite serious. Common gynecological conditions include the following:
- Cervical dysplasia – a precancerous condition of the cervix, caused by the human papillomavirus (HPV)
- Menstrual disorders – e.g., endometrial cancer, endometrial polyps, endometriosis, polycystic ovarian syndrome, dysfunctional uterine bleeding (heavy or prolonged menstrual bleeding)
- Pelvic prolapse – the pelvic organs (vagina, bladder, rectum, and uterus) are held in place by connective tissue and ligaments within the pelvis; the physical stress of pregnancy, childbirth, and the weakening of tissue can lead to the walls of the vagina breaking down.
- Chronic pelvic pain – persistent pain between the belly button and pubic bone that lasts for longer than six months
- Polycystic ovary syndrome – a hormonal disorder resulting in infrequent or prolonged menstrual periods or excess male hormone (androgen) levels; the ovaries may develop numerous small collections of fluid and fail to regularly release eggs
- Uterine fibroids – benign tumors that develop in the uterus most typically during the childbearing years
- Urinary incontinence – the involuntary leakage of urine
Women veterans who are coping with a gynecological condition may be entitled to VA disability benefits if the condition is due to their time in service.
VA Adds Gynecological Conditions to Rating Schedule in May 2018
In September 2017, VA began updating its Schedule for Rating Disabilities. On May 13, 2018 the new rating schedule for gynecological conditions and disorders of the breast became effective. No conditions were removed from the new rating schedule for gynecological conditions and disorders of the breast; however, several new diagnostic codes were added and others were re-titled, restructured, or updated. The new rating schedule guarantees both men and women veterans are evaluated equally in this regard.
How VA Rates Gynecological Conditions
Before receiving VA disability benefits for your gynecological condition, you must first establish service connection. Service connection for gynecological conditions involves the following three elements:
- A current diagnosis of a gynecological condition
- An in-service event, injury, or illness
- A medical nexus linking the current, diagnosed gynecological condition to the in-service event
In many cases, veterans will attend a Compensation & Pension (C&P) examination in order for VA to assess the cause and/or severity of their gynecological conditions. During the examination, a VA gynecologist or healthcare professional will ask the veteran questions about their condition and what they are experiencing. In certain cases, the examiner will perform tests in order to rule out other potential conditions. Once a diagnosis is established, the VA examiner will provide an opinion as to whether the veteran’s condition is “at least as likely as not” due to their time in service.
If the examiner provides a positive nexus opinion as described above, VA will likely grant service connection and assign a disability rating. VA rates gynecological conditions under 38 CFR § 4.116, Schedule of Ratings – Gynecological Conditions and Disorders of the Breast.
VA Infertility Services
VA infertility services are available to help eligible veterans. Through VA health care, enrolled veterans have access to many different types of fertility treatments, procedures and services including infertility counseling, laboratory blood testing, genetic counseling, sperm testing, ultrasounds, surgery, reversal of a vasectomy or tubal ligation, medication, and other treatments. Importantly, veterans with certain service-connected conditions that result in infertility, and their spouses, may be eligible for in vitro fertilization (IVF) or another form of assisted reproductive technology services. According to VA, coverage is determined case by case, based on an infertility evaluation at a VA medical center. However, qualified veterans or their spouses may be eligible for up to three IVF treatment cycles. To qualify for this benefit:
- The veteran must be legally married
- The veteran must have a service-connected condition causing infertility
- The veteran or spouse must have an intact uterus and at least one functioning ovary or own cryopreserved eggs
- The veteran or spouse must be able to produce sperm or own cryopreserved sperm
Gynecological conditions causing infertility may include a number of the conditions in the first section (“What Are Gynecological Conditions?”). However, the Veterans Health Administration (VHA) deliberately chose not to produce a list of service-connected conditions that cause infertility because they thought that would be limiting. For example, if a veteran had a service-connected condition that produced infertility, but was not included on VHA’s list, they might believe they are not entitled to infertility services.
VHA Breast Imaging Services
VA has expanded access to onsite mammograms by 62 percent since 2010, which is an outcome of the focus on improving access to breast screening and coordination of care. As of 2019, VHA has 67 mammography programs. Some facilities offer mammograms to walk-in patients and same-day ultrasounds. All eligible women veterans have access to mammograms either on-site or through care in the community.
VA’s performance measurements show that women veterans are much more likely to receive age-appropriate breast cancer screenings than women in private-sector health care. In 2015, VA screened 86 percent of its women veteran patients aged 50-74, compared with the private sector at 73 percent.
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