Prostate Cancer Compensation

Discussion in 'Chit Chat' started by ricmanz, Jan 16, 2007.

  1. ricmanz

    ricmanz New Member

    Likes Received:
    0
    Trophy Points:
    0
    I'm new to this forum and seaching for some info concerning my PC claim.
    I am a Vietnam vet that was stationed Quan Tri. I'm awaiting my rating for prostate cancer surgery I had almost 3 years ago. I applied back in March of 2006 and had my C&P exam 8 weeks ago. I should be hearing something back soon but am courious of my rating. I understand ratings are based on residuals. In my case, I change protective pads 5 times per day due to leakage and have erectile dysfunction and of course the loss of the prostate. Anyone else that may be in the same situation and what the rating may be?
  2. gator

    gator New Member

    Likes Received:
    0
    Trophy Points:
    0
    I had prostate surgery in 2005 and although they hoped to get all of the cancer, the pathology report showed that it had spread beyond the prostate. I have some leakage and also have erectile disfunction. I was rated at 100% disabled along with special compensation for the erectile disfunction. I am now on chemo (hormone) therapy. Good luck to you.
  3. TinCanMan

    TinCanMan Active Member

    Likes Received:
    0
    Trophy Points:
    36
    ...but your situation is based on having active cancer which gets you 100% until it is considered in remission. ricmanz no longer has cancer, at least he hasn't said otherwise, therefor he will be compensated exclusively on the basis of residuals. In his case, voiding disfunction and ED.
  4. grunt1

    grunt1 Member

    Likes Received:
    1
    Trophy Points:
    16
    hello ricmanz.hope all is well with you today and hope your claim is settled soon. i only have one question for you.how is your prostate cancer a service connected disability?
  5. TinCanMan

    TinCanMan Active Member

    Likes Received:
    0
    Trophy Points:
    36
    ricmanz says he is a Vietnam veteran. Prostate Cancer is fairly common among Vietnam vets as one of the conditions presumptive of Agent Orange exposure.
  6. ricmanz

    ricmanz New Member

    Likes Received:
    0
    Trophy Points:
    0
    Thanks for your info guys. I appreciate it. God Bless.
  7. grunt1

    grunt1 Member

    Likes Received:
    1
    Trophy Points:
    16
    tincanman--thanks for the info.i assumed it was agent orange,but with this government you never know.
  8. westerville

    westerville New Member

    Likes Received:
    0
    Trophy Points:
    0
    Hello Gator,
    I was rated 100% for my locally advanced prostate cancer in dec, 2007. I am currently on hormonal treatment which has brought my psa down for the first time since surgery and radiation. Now after my C&P exam the VA says after six months since my radiation they want to schedule an at once exam to evaluate the current status of my prostate cancer. Since I am suppose to be on this hormone treatment for two years isn't that still considered treatment for my cancer? This decision I received yesterday mentions the C&P doctors name throughout and his clinical notes. This doctor just asked questions to see if the cancer had gone to the bones he did not have any of my medical records. I wonder if this next exam will be the same. They seem to be stating in this reasons for decision that since it has been six months since radiation they only give 100% during actice malignancy or antineoplastic therapy. I googled antineoplastic therapy and it seems to be for when one becomes hormone refactory. That being when the cancer finds away around the needs for testosterone to feed on. So I guess what I am asking is while I am on hormonal treatment the VA considers that to be in remission which I guess I am right now.
    Thanks, Westerville
  9. TinCanMan

    TinCanMan Active Member

    Likes Received:
    0
    Trophy Points:
    36
    Westerville:

    I don't know the answer to your question, I'll see if I can get some help with this. It might take several days to a week. I'll get back to you on it.

    I'm a bit confused at the schedule of events, though. Can you help me out?

    From your post it appears the VA has scheduled you for an exam to determine the condition of your cancer. Has that exam taken place? You also mention a decision. Did the VA propose a reduction in rating below 100%? Please lay out the events in order.
  10. westerville

    westerville New Member

    Likes Received:
    0
    Trophy Points:
    0
    cancer decision

    Thanks tincanman,

    The order of things went like this,
    first in December of 07 I got my rating of 100% for prostate cancer but it said it was not permanent.

    second I get a call from this lady saying I have an appointment for a medical exam the next day at 8:30 am. This turned out to be a C&P exam. This happened around the middle of January 08.

    third I get a letter dated feb 08, 2008 saying we have made a decision on your service - connected compensation just like the one I got in december. we determined that the following service connected conditions haven't changed:
    100% for prostate cancer with residual disease post surgery and radiation associated with herbicide exposure.
    but a few pages later there is the reasons for decision.
    the part I do not understand is : "An evaluation of 100% is assigned during active malignancy or antineoplastic therapy. Six months following completion of treatment residual disability is determined by findings from a VA examination conducted at that time."
    "As these records indicate that you completed your treatment in August of 2007 and we have no treatment records since that time, an at once VA review examination has been scheduled to evaluate the current status of your prostate cancer. You will be notified of where and when to report for this examination in separate correspondence."
    I started hormone shots in October of 07 and I sent those medical records to my DAV service officer along with a release form to obtain the records directly from my doctor in case they don't like the ones I sent them. I have the paper from the DAV where the VA received them on Jan 30th 08.
    So I believe what has happened is the VA thinks I have not had any further treament since august of 07 when I finished my radiation because they probably don't have my recent medical records posted yet. I can understand this.
    I just don't want to go to this at once cancer exam until they acknowledge they have received my up to date medical records.
    I hope this is not too confusing I apologize but I am confused myself.
    thanks,
    Westerville
  11. TinCanMan

    TinCanMan Active Member

    Likes Received:
    0
    Trophy Points:
    36
    When did your Chemo/Rad treatments stop? I need to get some info on how the VA evaluated hormone therapy. That can go on for 3 years. From what I read, it's more of an enhancement rather than treatment for an active cancer. I don't know at the moment. I will try to find out. In the mean time you must go to the C&P exam. You can try to get it rescheduled but you must go or service connection will be severed. It is routine for VA to schedule a followup C&P 6 mos post treatment. What does your doctor have to say. Can he say your cancer is not in remission?
  12. westerville

    westerville New Member

    Likes Received:
    0
    Trophy Points:
    0
    remission

    My surgery was March 15, 2007 after which my surgeon said my cancer was outside the gland and very aggressive. He said no matter what I did would help with my survival , mentioned quality of life as opposed to further treatments. He reluctantly sent me to a medical oncologist who said the same thing but said if it were him he would go for radiation. I went to the radiation doctor in July of 2007 he said I still had active cancer since my psa was continually rising and said it was very serious. He said he could try to radiate and it might help but couldn't promise anything since the cancer was so wide spread. I ended the treatments in August of 07 took a psa test it rose again. I got an opinion from a medical oncologist specialist at the Cleveland Clinic he suggested I should have been on Hormonal treatments sooner but if I started now he said it should work. No cure just cutting my testosterone which feeds my cancer, they call it chemical castration. So I start my Eligard ( lupron ) shot in October of 07 and take a psa test in January of 08 and cool my psa is down for the first time. The VA calls me for a C&P exam and take a blood test , two weeks later they say due to the clinical records of the C&P doctor and it has been 6 months since my radiation they need to evaluate the current status of my prostate cancer.
    I told the C&P doctor about my hormonal treatment but my guess he did not write it down. I have requested a copy of my C&P exam and maybe that will explain somethings.
    Thanks again,
    Westerville
  13. TinCanMan

    TinCanMan Active Member

    Likes Received:
    0
    Trophy Points:
    36
    OK, thanks. I'm trying to get more info on how the VA evaluates hormone therapy. Also, there's another issue going on here. You no longer have prostate cancer because you no longer have a prostate gland if I understand correctly. However, your prostate cancer has metastasized elsewhere. So it would seem to me, you still have an active cancer. It's just no longer prostate cancer. Now the question is; how does the VA evaluate this new cancer? Is it considered part of PC or something new entirely. Again, I don't know the answer to that and have asked for help. It seems to me a reasonable person would consider it part of the original disability and automatically be SC. We still need to know how the VA will treat this, not what I think should happen.

    In the interim, you should insure the VA is appraised of your hormone therapy .AND. the fact that your cancer has metastasized.
  14. westerville

    westerville New Member

    Likes Received:
    0
    Trophy Points:
    0
    hormonal therapy and remission

    Hello tincanman,
    I found this testimony on the House Committee of Veterans Affairs during my search for information. This seems to answer that I am not in remission, maybe I will include a copy of this when I go for my exam.
    Thanks, Westerville

    My name is Ted H. Wolf. I’m a Vietnam veteran. I served in Vietnam from September 1966 through August 1967. I was in a transportation unit stationed at the Newport facility on the Saigon River. One of the operations of the facility was the handling of Agent Orange drums. As is well known and well documented, Agent Orange is the code name for a herbicide developed for the military. The purpose of the product was to defoliate trees and shrubbery where the enemy could hide. My exposure to broken drums containing Agent Orange caused me to become inflicted with prostate cancer.

    My prostate cancer did not become “active” until August 2002. However, even before then my family and I experienced other effects of the Agent Orange. In the 1970s, my wife suffered seven miscarriages. Furthermore, my only living daughter was born with a hemangioma. We now believe that both of these events were related to my exposure to Agent Orange.

    My prostate cancer was diagnosed by a urologist in August 2002. I immediately went to Memorial Sloan-Kettering Cancer Center for further information, and eventually treatment. One way in which doctors rate the aggressiveness of prostate cancer is through a Gleason score. A patient is graded on a scale of 1-10. I was diagnosed with a 9. At Sloan-Kettering, I was treated with localized radiation as well as hormone therapy.

    Sometime during the course of my treatment, I investigated and found out that Agent Orange was a cause of prostate cancer. I submitted an application to the Veterans Administration for disability compensation on account of my diagnosis of prostate cancer. In April 2003, after enduring a physical and sending my medical records from Memorial Sloan-Kettering, I was granted a disability rating of 100%.

    In February 2004, my disability rating was lowered to 40%. I was informed that this reduction in benefits was on account of the fact that I was not utilizing the required number of pads for leakage each day and also because my PSA score (a number used to determine the presence of prostate cancer) had declined. On account of these two factors, the Veterans Administration deemed that I was in remission.

    I did not feel that this was fair, but I did not have the strength to commence an action. In preparing for this hearing, however, I spoke with my oncologist at Memorial Sloan-Kettering, Dr. Michael Morris. Dr. Morris explained to me that the Veterans Administrations’ reasons for reducing my benefits were absurd. Firstly, he said there is absolutely no correlation between number of pads used for leakage and the severity of prostate cancer. Secondly, he explained that although my PSA number had decreased, I was not actually in remission. Rather, he explained that there is a residual effect from hormone therapy, which keeps the PSA down for approximately 2 - 3 years. What is disturbing is that the Veterans Administration handled my case without having any knowledge of my illness and it made decisions without any basis in fact. In May 2006, my PSA tripled indicating that the disease was still active. Bone scans taken in August 2006 indicated progression to eight different spots on my skeleton. At this point, I contacted the Veterans Administration. They asked me to send proof which I did, and they then responded by saying that it would be a minimum of 3-4 months before any action was taken on my case.

    The county in which I live, Rockland County, New York, maintains an office of Veterans Affairs. I contacted them for assistance, and they recommended that I contact my Congressperson. The office of the Congressperson attempted to assist me, however, she was defeated in the November 2006 election and therefore no real action took place.

    In January, I contacted the newly elected Congressperson, Representative John Hall, and his office rendered immediate assistance. The person in his office who assisted me was Lisa DeMartino. She worked miracles and within three weeks, the Veterans Administration increased my compensation and gave me back compensation from June 2006.

    My concern is that without the assistance of wonderful people at the congressional level, the average veteran is forced to wait a long period of time to get any assistance. I pay for my own healthcare. Our family rate is $14,000 a year, and I am able to select where I want to be treated for my illness. Under no circumstances would I want to be treated by the Veterans Administration. I do not believe that their level of competency for treating my disease would have reached an acceptable level. I have no confidence in them, especially in light of the fact that they lowered my initial benefits, thereby showing that they had no idea of how prostate cancer functions.

    My concern is for the young veterans returning from Iraq and Afghanistan. The backlog that they face in receiving care is unconscionable. Competent healthcare should be available to all veterans. We currently have in place the Medicare system which allows one to select his/her own doctor. This would allow a veteran to find medical care close to home without having to travel to a VA facility. The closest VA facility may be many miles away, perhaps requiring an overnight stay.

    The Veterans Administration has for too long been allowed to defend its bricks and mortar policy of large facilities, which until the war were inadequately used. I feel that the American serviceman could best be served by being able to avail themselves of the best private care available.

    I want to thank this committee for investigating the Veterans Administration and the healthcare being provided to our returning veterans. A service person who has volunteered to serve his country should receive the best possible care available regardless of cost. Their benefits, if unable to continue to work, should be such that they are being paid a living wage to take care of their families. Those that have given so much should not be forced to continue to pay for their willingness to serve their country. Our troops who served with pride and distinction should not have to beg for adequate health care. It is our continued responsibility to provide the best health care possible whether within the VA heath care system or the private sector.
  15. TinCanMan

    TinCanMan Active Member

    Likes Received:
    0
    Trophy Points:
    36
    That's pretty much what I'm seeing. I talked with 2 veterans that are getting their 100% temporary rating continued. One of them for 10 years now. I also found a BVA citation where the BVA ordered the 100% restored on the basis of hormone therapy. Understand, BVA citations don't set precedent but the fact that the vet even needed to appeal to the BVA implies it isn't a well settled issue or the decision maker just made a mistake. Nothing I've found so far is authoritative. The same applies to the testimony you posted. Speaking of testimony...

    I would classify Dr. Morris as an idiot when it comes to understanding the VASRD. He might be a good doctor, he ought to stick to that because no one at VA thinks leakage and pads have anything to do with the cancer. They are a residual effect and residuals are how most veterans are rated after the active phase is over.

    ...and all the good doctor has to do is tell the VA that.

    In the end, I would suggest your doctor either provide you with a letter for the VA stating your PC is not in remission and you are still in the active phase. .OR. make clinical notes to that effect and then you tell the VARO where new evidence is located.

    The VA is just doing what it is supposed to do in cancer cases and that is to re-evaluate. Go to the exam and tell the examiner that your cancer has spread and you are receiving hormone therapy to keep it controlled. Let the VARO know this as well.

    Hopefully, I should have more authoritative info next week. I'll keep you posted.
  16. westerville

    westerville New Member

    Likes Received:
    0
    Trophy Points:
    0
    remission

    Hi TinCanMan,

    I agree with you on the pads issue, I thought that was a strange statement when I read it. I have e-mailed my doctor requesting the statement of remission. I have sent him the fax number to the triage of the VA so maybe it will get their sooner.
    I agree the VA is just doing their job in determining my cancer. As I said before all they have at hand is the psa test from the C&P doctor showing my low psa. But I told him about my surgery, radiation, and hormone therapy when he asked what treatments I have had.
    But like you said it's not clear how they preceive the hormonal treatment.

    Later,
    Westerville
  17. westerville

    westerville New Member

    Likes Received:
    0
    Trophy Points:
    0
    hormone therapy

    Here is another quote from a prostate cancer patient about hormone therapy. Dr. Mark Scholz is one of the few expert oncologist specialist on prostate cancer in the U.S.

    [ "On Dr. Scholz advice I am on androgen deprivation therapy (ADT):(also
    called hormone therapy) or testosterone inactivating pharmaceuticals
    (TIP)) (Lupron+Casodex+Avodart)

    Dr. Scholz said ADT is also diagnostic in that my PSA/Testosterone
    reduction profile(how low/fast) in about 6 months would tell us if my
    cancer is aggressive or not" ]

    So I guess by seeing how low or how fast the psa and testosterone levels goes probably they can see how the cancer is progressing. I guess that is why my doctor has me go for blood work every month to monitor my cancer aggressiveness. This doesn't sound like remission to me.

    I got a letter from the VA yesterday, thought it was about my C&P but no it was from the service-disabled vet insurance. I got this same letter in Dec. when I got my first temp 100% rating. I signed up for the $10,000.00 in life insurance back then since I am not able to get civilian insurance at a decent price or at all since I have prostate cancer. So I am covered and they take the premiums out of my disability check which is real nice.

    Westerville
  18. TinCanMan

    TinCanMan Active Member

    Likes Received:
    0
    Trophy Points:
    36
    A couple of points; No studies or information regarding treatment of others is of interest to VA decision makers. They are not allowed to make medical decisions. All you need is for your doctor to say your cancer is not in remission and provide a sound rationale for his opinion. Likewise BVA decisions are also useless. It is only your condition and your treatment that is relevant to a decision maker.

    Good thing you mentioned the insurance. Contact them and ask the premiums be waived. In many cases they will do just that.
  19. TinCanMan

    TinCanMan Active Member

    Likes Received:
    0
    Trophy Points:
    36
    westerville:

    I just got word from someone in a position to know and provide an authoritative answer to your situation and I'm told the DVA does consider hormone therapy to be for an active cancer and will compensate at 100% no matter how long it takes. Additionally, if your cancer has spread, you should claim that as well.

    On the odd chance your claim for 100% is denied, you need to appeal it.
  20. westerville

    westerville New Member

    Likes Received:
    0
    Trophy Points:
    0
    Hormonal Treatment

    Thank you TinCanMan for finding that out for me.

    Westerville

Share This Page