Jim,
After a C&P hearing in October 2012, I received a letter from the VA alerting me that were going to change my disability rating from 100% to 20%.
The VA is basing this change on a follow-up report dated July 2012, from my doctors at the Univ. of Washington Medical Center where I received brachytherapy in Feb 2011.
In the follow-up report the doctors noted some improvement in my condition. Even after a "bounce" in my PSA levels. However, the VA is using the word remission.
It's only been seventeen months from my brachytherapy to the follow-up report of July 2012.
I am aware that the VA wants to get off their rolls, but does seventeen months seem appropriate?
Where do I find the VA's definition of remission?
Reply:
VA doesn't have a particularly well defined term for remission. However, once you have been treated for prostate cancer, your PSA usually drops to "within normal limits". As a rule, that would be what it was before you were diagnosed with prostate cancer. Although the PSA test is not a very reliable indicator of remission or a cure, it's about all that there is. The other option would be repeated biopsies and that isn't an acceptable way to go.
Most vets are evaluated in 6 to 12 months after treatment. That you were put off until 17 months later is a bit unusual. There was a memo issued a couple of years ago that allows the regional office to delay reexams although prostate cancer exams are often accomplished promptly.
The rules are pretty clear on this one. If you have a cancer that is service connected, you will be paid at the 100% rate. Once your cancer is treated, you'll be paid for and "residuals" of treatment. Many vets have surgery for their prostate cancer and they suffer the consequences of leakage and frequency of urination and they're rated at 60%. Brachytherapy isn't quite as harsh as surgery so the leakage isn't as bad and the rating is 20% or 40%...that depends on how much leakage or frequency there is.
Vets who use the "watchful waiting" approach and don't take any treatment are rated at 100% until they get treatment. It's a temporary 100% rating though and there are none of the usual dependents benefits that are often associated with a 100% rating.
There are a couple of things you should do. If you believe that your PSA is still abnormally high, you may appeal the proposal for a new lower rating. You should provide evidence of an active cancer or that the cancer is potentially active even though it's not as aggressive as it was before. Don't forget to file for erectile dysfunction if you haven't already. I've never met a man with prostate cancer who doesn't have some degree of ED.
Please have a look at my page on prostate cancer here http://www.vawatchdog.org/prostate-cancer.html