VA Disability Benefits for a Hysterectomy
CCK Law: Our Vital Role in Veterans Law
The Department of Veterans Affairs (VA) provides disability benefits to veterans who have suffered service-related injuries or illnesses. While the focus is often on visible physical injuries, it is crucial to recognize that certain medical procedures, like a hysterectomy, can also qualify a veteran for compensation benefits.
In this article, we will explore the eligibility criteria, application process, and potential VA benefits associated with filing a successful claim for a hysterectomy. Additionally, we will look at the disability ratings related to this surgery that female veterans may experience.
What is a Hysterectomy?
According to the American College of Obstetricians and Gynecologists, a hysterectomy is defined as surgery to remove the uterus.
Hysterectomies are a common type of surgery for women in the United States. However, it should be noted that removing the uterus means that the menstrual cycle stops, rendering a woman unable to get pregnant.
Why Are These Surgeries Performed?
Hysterectomies are used to treat many women’s health issues, including:
- Uterine fibroids (the most common reason for a hysterectomy);
- Endometriosis (the lining of the uterus grows outside of the uterus);
- Pelvic support problems (e.g., uterine prolapse);
- Abnormal uterine bleeding;
- Chronic pelvic pain, and other gynecologic symptoms; and
- Gynecologic cancer, such as uterine cancer.
Other factors may contribute to the choice to undergo a hysterectomy.
Women may consider alternative options before considering surgery depending on their specific condition, but there are certain situations in which a hysterectomy is necessary.
Types
There are different types of hysterectomies, including:
- Total hysterectomy: the entire uterus, including the cervix (i.e., tissue connecting the vagina and uterus), is removed;
- Partial hysterectomy: the upper part of the uterus is removed, but the cervix is left in place; can only be performed laparoscopically or abdominally; and
- Radical hysterectomy: a total hysterectomy that also includes removal of structures around the uterus; may be recommended if cancer is diagnosed or suspected.
In some cases, the ovaries and/or fallopian tubes will be removed too; usually, this removal of the ovaries and/or fallopian tubes only occurs if they are abnormal.
Hysterectomy and Health Safety
Many women are concerned about undergoing a hysterectomy due to side effects and complications that may arise. However, it is important to recognize that a hysterectomy is regarded as one of the safest surgical procedures. Most women need to stay in the hospital for only a few days after surgery.
The length of an individual’s hospital stay will depend on the type of hysterectomy and how it was done (e.g., laparoscopically). Doctors will likely tell women to walk around as soon as possible after surgery to prevent blood clots in the legs. Usually, there is medication to manage any residual pain as well.
Women in the Military
Women comprise approximately 14.5 percent of the active-duty military force and almost 18 percent of National Guard and Reserves. As the number of women in the military increases, so does the number of women veterans.
Women make up the fastest-growing population of veterans in the United States, totaling approximately two million as of 2017. As a result, more women veterans are now seeking supportive services from VA.
This growth is highlighted in VA’s 2015 Women Veterans Report:
- In 2015, 840,000 women veterans used at least one VA benefit or service (an increase from 31.2 percent of women veterans in 2005 to 41.1 percent in 2015);
- From 2005 to 2015, the number of women veterans enrolled in VA healthcare increased 83.9 percent, from 397,024 to 729,989;
- From 2005 to 2015, the number of women veterans using VA healthcare increased 46.4 percent, from 237,952 to 455,875;
- 1 percent of all women veterans in 2005 used VA health care compared with 22.4 percent of all women veterans in 2015;
- In 2015, 405,418 women veterans received compensation from VA for a service-connected condition, representing about 20.1 percent of the total population of women veterans; and
- 54 percent of women veterans receiving compensation had a combined disability rating of 50 percent or higher.
VA says it is committed to ensuring that benefits and services for women veterans are made as accessible as possible.
VA Service Connection for a Hysterectomy
If service connection is established, then VA proves disability compensation for a hysterectomy. To establish service connection on a direct basis, veterans must demonstrate the following:
- A completion of a hysterectomy due to a condition related to service;
- An in-service event, injury, or illness; and
- A medical nexus linking the veteran’s in-service event, injury, or illness to the condition resulting in a hysterectomy.
Hysterectomies are among the top five most common service-connected conditions claimed by women veterans. Specifically, about 12,700 women veterans had the complete removal of their ovaries and uterus in 2015 alone.
How VA Rates Hysterectomy
In September 2017, VA initiated updates to its Schedule for Rating Disabilities, which included the addition of a new rating schedule for gynecological conditions and disorders of the breast.
The new rating schedules for gynecological conditions and disorders of the breast did not remove any conditions. However, they did add several new diagnostic codes and made changes to others, such as retitling, restructuring, or updating them.
VA currently rates hysterectomy under the schedule mentioned above (i.e., 38 CFR § 4.116). For women veterans who had both their ovaries and uterus removed, VA assigns diagnostic code 7617 and uses the following rating criteria:
- 100% for three months after removal;
- 50% permanently thereafter.
For women veterans who only have their uterus removed during the hysterectomy, VA uses diagnostic code 7618 and assigns ratings as follows:
- 100% for three months after removal;
- 30% permanently thereafter.
Again, all other gynecological conditions and disorders of the breast are evaluated under this rating schedule.
Establishing Secondary Service Connection
Secondary service connection is another form of service connection available to veterans who may have a condition that was caused or aggravated by an already service-connected condition. Conditions that are secondary service-connected are compensated in the same way as primary service-connected conditions.
An example of a condition secondary to a hysterectomy may be depression. For example, if a veteran intended to become pregnant after their service but had to have a hysterectomy due to their service, then that veteran may consequently become depressed. The veteran then may be able to receive VA disability benefits for depression secondary to a hysterectomy.
Common Secondary Conditions Related to Hysterectomies
Several medical conditions can be caused or aggravated by a hysterectomy. Additionally, a hysterectomy may be secondary service connected to another condition. Below is a non-exhaustive list of some of the most common medical conditions that can constitute secondary service connection.
Depression Secondary to Hysterectomy
As mentioned above, depression can be related to a hysterectomy because of the way it relates to childbearing. If a veteran desires to become pregnant post-service and can no longer as a result of a service-connected hysterectomy, then they may become depressed.
Some studies have found that women who have had a hysterectomy have a higher risk of depressive symptoms than those who have not. Of course, every situation is different and the circumstances for why a person may need a hysterectomy varies.
PTSD Secondary to Hysterectomy
PTSD, like depression, can also be linked to a hysterectomy. For example, if a female veteran suffers a gunshot wound in the abdomen that damages the female reproductive organs, it causes the need for a hysterectomy.
The veteran would be eligible for PTSD secondary to a hysterectomy if the trauma of being shot caused the veteran to develop PTSD, as well as the need for a hysterectomy.
Another potential cause of a hysterectomy in female veterans can relate to military sexual trauma (MST). Research published in Military Medicine has indicated that MST and PTSD exposure were associated with a higher number of hysterectomies in female veterans.
Female veterans who are survivors of military sexual trauma may face increased gynecologic symptoms, such as pelvic pain. This may explain why they are at a higher risk for a hysterectomy.
If a veteran experiences PTSD as a result of MST, which requires a hysterectomy, then the veteran could receive benefits for PTSD secondary to a hysterectomy.
Hysterectomy Secondary to Uterine Fibroids
Fibroids are a form of tumor that can develop in the ovaries (i.e., ovarian cysts or fibroids) or the uterus (uterine fibroids). Sometimes a veteran who has cysts or uterine fibroids may need to undergo a partial or total hysterectomy.
As a result, women veterans may be eligible to receive benefits for a hysterectomy secondary to cysts or uterine fibroids.
Hysterectomy Secondary to Endometriosis
Endometriosis is a disorder that affects the female reproductive system. Specifically, it occurs when the endometrial tissue is present outside of the uterus. If a person has endometriosis, a hysterectomy may be performed to remove the uterus.
If a veteran’s service-connected endometriosis requires a hysterectomy, then they may be awarded benefits for a hysterectomy secondary to endometriosis.
TDIU and Secondary Service Connection for Hysterectomies
Total disability based on individual unemployability, or TDIU, is a monthly benefit available to veterans who are unable to obtain or maintain substantial employment due to their service-connected disability or disabilities.
This benefit compensates veterans at the 100 percent rating, even if their combined rating does not meet 100 percent.
VA outlines TDIU regulations under 38 CFR § 4.16, which includes subsections (a) and (b). To qualify for TDIU under 38 CFR § 4.16(a), or schedular TDIU, a veteran must have:
- One service-connected condition with a 60 percent rating or higher; or
- Two or more service-connected conditions, one of which has a 40 percent rating or higher, with a combined rating of 70 percent or higher.
The ratings given to secondary service-connected conditions also apply to the criteria for schedular TDIU. This means that any rating given to a hysterectomy and a rating given to the secondary service-connected condition can apply to help veterans reach the combined rating of 70 percent or higher.
While the rating percentage immediately following a hysterectomy is 100 percent, the ratings typically get reduced after three months. Any ratings for secondary service-connected conditions can help a veteran reach the criteria for TDIU and receive the 100 percent pay rate after their initial hysterectomy rating has been reduced.
For example, if a veteran is service-connected for PTSD secondary to a hysterectomy, then they may have a 30 percent rating for a hysterectomy and a 50 percent rating for their PTSD. With these ratings, the veteran could then meet the criteria for schedular TDIU.
Veterans who do not meet the schedular requirements under 38 CFR § 4.16(a) may still be considered for extraschedular TDIU under § 4.16(b). VA will determine if their case should be referred to the Director of Compensation Service for extraschedular consideration.
Nonetheless, if you have a service-connected disability and cannot obtain or maintain substantial employment, then you may decide to seek TDIU benefits.
Was Your VA Claim Denied?
Unfortunately, VA denies many disability benefits claims. If your VA disability claim for a hysterectomy has been denied, then the experienced team of attorneys and advocates at Chisholm Chisholm & Kilpatrick LTD may be able to help.
These VA disability benefits can make an impact on your life, and CCK can fight on your behalf to obtain them. Call us today at (800) 544-9144 for a free case evaluation with a member of our team.
