Travel Pay

​Question:
Since the VA adopted the new mileage application via the internet, I haven't received any travel money. I checked with my travel clerk and he told me that there is a big back log here in Florida. Have others experienced this problem? Thank you Jim.

Jim's Reply:
I'm in Florida so I feel your pain.
We're supposed to be reimbursed a per mile amount for certain travel to and from medical care. In my time with VHA I've seen long lines and over an hour wait to receive a few dollars gas money. Then we went to a fill-out-the-form system. The check-in kiosks were introduced a few years back and those worked well other than you had to remember to sign out and sign in again to submit the travel voucher.
Not all that long ago I checked in to my small clinic and the kiosks were unplugged and parked in a corner. I was told to check in the old school way and only when I asked, I was given an old form to complete for travel pay. I was told the kiosks were gone forever.
I returned to that clinic 2 weeks later and the check in kiosks were back, plugged in and ready to go. There was no option for travel reimbursement, I was told to go to the Internet and figure it out. I haven't seen any deposits either.
I don't have any answer for you other than...welcome to your VA. They care!
​​

Stateside Legal Help For Veterans

Jim Strickland is a Vietnam era Army veteran and nationally recognized expert on VA disability benefits.

Jim writes extensively about VA and Social Security disability benefits. 
Jim's Mailbag is a regular column featured at  Stateside Legal  where veterans, servicemembers,
and family members can  ask Jim their questions  about VA and Social Security disability benefits. 

Welcome Home

The VAWatchdog Dot Org

Department of Veterans Affairs

Agent Orange

Service Connected Prostate Cancer

Watchful Waiting

​Closely watching a patient’s condition but not giving treatment unless symptoms appear or change.

​​Observation or Active Surveillance for Prostate Cancer

Prostate Cancer Foundation-Department of Veterans Affairs Partnership

A Model of Public-Private Collaboration to Advance Treatment and Care of Invasive Cancers

​Prostate cancer is the most frequently diagnosed and treated cancer in the US Department of Veterans Affairs (VA).

As the leading philanthropic source for prostate cancer research, the Prostate Cancer Foundation (PCF) entered

into a unique public-private biomedical research partnership with the VA with the goal of addressing

the urgent health challenges faced by veterans with prostate cancer.

veterans clinical psychologist

Radiation Scatter

Question:
Jim, I have been diagnosed with intermediate prostate cancer and am receiving hormone treatment and will soon start Radiation therapy. I have been awarded SMC-K for ED and temporary 100% for cancer. My question is will the VA consider intestinal issues as a residual of the cancer treatment? There can be damage to the colon from the radiation. Thank you in advance for your response.

Jim's Reply:
Radiation treatments, whether direct beam radiation or implanted 'seeds', can cause damage to nearby delicate tissues as the active components of the radioactive beam or implant may 'scatter' as treatment commences. This is a potential problem and if such a complication should occur, you may file a claim for that residual effect.
​​

Prostate Cancer

​Question:
I had prostate cancer from agent orange. I also developed diabetes II and total erectile dysfunction (ED)  due to the cancer and treatments. I am up many times during the night and I get foot tingling. Regardless of this, they are deceasing my disability to 40%. Don't they take into consideration that my ED has never recovered and that I have other residual issues, or am I just automatically decreased to 40% because I do not wear diapers? What about the ED and my mental stress from all of this?

​Jim's Reply:
The Schedule For Rating Disabilities is the set of regulations that tells raters what they're allowed to do. These rules and regs are derived from law that exists in Title 38. I urge you to take the time to explore each of those as they describe the process you're being subjected to.
While I agree with you, the regulations that the rater must follow doesn't. Once you have been successfully treated for service connected prostate cancer, you no longer have cancer so you can't be rated 100%. You will be rated for the residual effects of having had the cancer and treatments. The residual effects are usually leakage of urine requiring absorbent pads and erectile dysfunction.
Ratings are usually 20%, 40% or 60% depending on the number of pads you use in a day. Erectile dysfunction is rated separately and will earn you 10% if you claimed it along with the residuals you're experiencing. You must make the claim for ED or the VA won't automatically rate it.
Again, I agree with you about the post-procedure effects of having had a cancer and having to suffer treatments. However, as you read through the rating schedule you'll see that VA doesn't consider mental health issues as a part of the process and once again, you must make that claim formally.
I urge veterans to go ahead and do just that...file a claim for the mental health issues you suffer during service connected cancer treatments. You may need an IMO from a provider like http://www.veteranspsychevaluations.com/index.html but it is certainly possible to win such claims.
Good luck sir.

veterans law attorney

Prostate cancer?

​Question:
I was in Vietnam in 1969 and 1970. I have terminal prostate cancer. Will the VA consider this a presumptive disability for Agent Orange? If so, how long after filing does it take to receive compensation? Thanks for your help.

​​Jim's Reply:
Yes, prostate cancer is a service connected condition for the Vietnam veteran. Once you've properly filed the process should take 3 to 6 months on average. Since this is a presumptive disease there isn't as much paper that must be verified. Good luck sir.

Question:
I was diagnosed with prostate cancer and had the Brachy implant surgery performed. My Dr.who was not a Va Dr. that performed the operation said it would be 2 yrs. before I could be determined as cancer free but in your Va watchdog article about prostate cancer it says that my disability will end after the procedure. How can that be?
Reply:
That's how VA works. VA relies on the PSA blood test as the standard to determine whether your cancer is "cured". Once you're treated, your PSA should fall pretty quickly. There isn't any reliable way to declare you as "cancer free" so VA uses the PSA test. It isn't very good but it's all we have. The alternative would be more invasive biopsies but that isn't a good alternative.
Your disability payment won't end, it will be reduced from 100% to 20%, 40% or 60%.
UPDATED

Hey Jim,
I read the question that was posed about
brachytherapy. I am a VA RVSR/QRS and wanted clarify that Veterans who undergo brachytherapy for prostate cancer are considered to be under active treatment for one year after the seeds are implanted. Six months after that, a review examination is conducted so that is a total of 18 months during time the Veteran receives a 100 percent evaluation. Once the examination is conducted and the Veteran's cancer is no longer considered to be active or is in remission,then a proposal to reduce is made. The Veteran has 60 days to submit any additional evidence to show the reduction should not take place (due process period) and then a final rating decision is made that implements the reduction but the actual reduction does not occur until two months after the date of the letter of notification to the Veteran that the reduction is final.
Bottom line, depending on when the Veteran files the claim, he may be entitled to up to 18 months at 100% and then an additional 4-6 months while undergoing re-evaluation and due process. This does not include the time the Veteran receives a 100% evaluation while waiting for a treatment plan to be determined (assuming the Veteran filed his claim as soon as the diagnosis was made).
(Signed)  

VA RVSR/QRS

Prostate Cancer and VA Healthcare

​Question:
I am a Vietnam Vet '69 & '70 and recently developed aggressive prostrate cancer. My Gleason score was 27 and will be undergoing 9 weeks of radiation and then surgery. I have a high deductible medical plan with a $10,000 deductible, and am wondering if I'm eligible for VA health care and when would I be eligible for disability compensation.

​​Jim's Reply:
Your disability compensation benefits will begin the moment that your claim lands at the claims intake center, assuming your claim is awarded. That moment is called the 'effective date' and as your claim goes through the adjudication process all benefits will date back to that date.
You are likely eligible for VA health care right now. Unfortunately the pandemic has every health care (and other) facility in the country running around like their hair was on fire so getting into VA health care could be a challenge. Were I you I'd start right now to open the doors. 
As a service connected disabled veteran all your prostate cancer care at the VA will be at no cost out of your pocket. It won't matter what sort of civilian insurance you have as the cancer will be presumptive to agent orange.
You can easily file this claim yourself from your home. Click https://www.vawatchdog.org/how-to-file-a-claim.html  Remember, the sooner your claim is officially received, the better for the effective date.
The date you'll begin to receive a 100% temporary disability rating will depend on how soon you get in the very long line of claims being processed and how backed up VA is today. Unfortunately it's taking much longer than usual to process benefits claims as VA has some 10,000 employees out because of the pandemic as I write this. Many claims are being managed across the country by raters working from home so the process is slow but it's getting done.
Be patient, be sure your claim is filed accurately and as soon as you can get it done and VA will do the rest. Good luck sir.

Service Connected Prostate Cancer

Life expectancy estimates for patients diagnosed with prostate cancer in the Veterans Health Administration

​Materials and methods: Using national Veterans Health Administration electronic health records, we identified Veterans

diagnosed with prostate cancer between 2000 and 2015. We abstracted demographics, comorbidities, oncologic staging,

and treatment information. We fit Cox Proportional Hazards models to determine the impact of age, comorbidity,

cancer risk, and race on survival. We stratified life expectancy estimates by age, comorbidity and cancer stage.

Secondary Conditions

Question:
I developed prostate cancer and had my prostate removed prior to the Blue Water Navy laws going into effect. Upon passage of the law, I immediately applied for compensation, and was awarded 100% as is standard, then dropped down to 50% (including my dependent's 10%). I recently applied for anxiety and depression benefits secondary to prostate cancer, and was boosted up to a total of 80%.
My question: Since I have suffered the loss of a productive organ, erectile dysfunction, deformity, incontinence, and have basically become unemployable (teaching was my career), should I apply for 100%? I would not have these psychiatric problems had it not been for the exposure to known carcinogens. As a man, the loss of a productive organ is about the most significant loss one can experience. The argument may be that I should have applied for these secondary disabilities when I applied initially, but I was not informed that was even a possibility. My argument is that I would not have developed depression and anxiety had I not had prostate cancer caused by my service, so, even if I wasn't informed about secondary disabilities, the cause was apparent. Anxiety and depression do not suddenly descend on a person. Any advice? Thanks for what you do!

​​Jim's Reply:
It's entirely reasonable to file a claim for any secondary conditions that you believe were caused, contributed to or aggravated by the primary condition or the treatment of the primary condition. In the rating schedule VA ignores the mental health trauma of most cancer treatments and if you don't claim it, VA won't hand it to you.
Often enough you're going to need an Independent Medical Opinion (IMO) that agrees with you. Click https://www.vawatchdog.org/imo-ime-medical-opinions-exams.html 
Were I you, I'd file the claims soon. Good luck sir.

Citation Nr: 21044997   DOCKET NO. 19-22 460
Service connection for prostate cancer, to include claimed as due to herbicide exposure, is denied.

Service connection for hypertension, to include claimed as due to herbicide exposure, is denied.

Service connection for diabetes mellitus, to include claimed as due to herbicide exposure, is denied.​​

Prostate Cancer

​Question:
I am currently received V.A. disability for prostate cancer from agent orange. I have completed my radiation treatments and will see my Oncologist again in 6 months. How does the V.A. monitor the status of my cancer? Am I to report changes to them or will they contact me for updates. Thanks

​​Jim's Reply:
You will be scheduled for a "future exam" by VA about 6 months or so after your treatment has ended. VA has your folder on an estimated future schedule so you do not need to notify them of anything. If they have any questions, they'll ask you.
Once your treatments have ended and an appropriate time passes, the VA will want to look at your PSA and maybe a bit of other info. If the PSA has become normal, your 100% rating will convert to something less since you no longer have a cancer. 
You'll be rated on the residual effects of having the disease treated. Those are usually incontinence and ED. The ratings are usually 20%, 40% or 60% and directly correspond to how many absorbent pads you use each day for the leakage. Don't forget to file for erectile dysfunction as that will be rated separately.
Don't miss the exam. It may just be a phone call to confirm medical record findings so not an inconvenience at all. Good luck!

nexus letters

The Vietnam veteran who served with "boots on the ground" in the Republic of Vietnam is generally eligible for Service Connected Prostate Cancer & Disabled Veterans Benefits once the medical diagnosis of prostate cancer is made.

Nexus Independent Medical Opinion Veterans Doctor