Jim,

I’m asking a question on behalf of my brother in law George, a fellow Vietnam Vet. He had brain surgery in Feb. 2009 to remove a tumor. The subsequent diagnosis was “primary central nervous system lymphoma”, a non Hodgkins Lymphoma.

Later in 2009 he was granted 100% for NHL due to exposure to Agent Orange.

He received a new rating decision dated February 1, 2011 stating: “Evaluation of non Hodgkins Lymphoma which is currently 100 percent disabling is decreased to 0 percent effective May 1, 2011.” Further more: “A non compensable evaluation is assigned in the absence of active disease or significantly disabling residuals.” Outrages, he has Cancer!

In the atached document you'll see what VA has to say.

He is most certainly not the same mentally or physically as he was before this condition manifested its self. He and his family are concerned that the cancer might become “active” again.

How should his family appeal this decision?

Reply:

The letter from VA is correct. Many veterans don't understand how the system works. Please allow me to explain.

Disability compensation is awarded to veterans based on a decades old process that relates a condition (an injury or illness) to a theoretical loss of the ability to earn an income through gainful employment. The system was put in place (1940's) when the American economy was based on labor...mostly farm labor but a lot of it in manufacturing labor of the era. A veteran who lost an arm while in service was obviously at a disadvantage in the labor market and the VA system compensated for the lost wages.

This has evolved to our system today. In our world today the system makes little sense but it's what we have to work with. The Congress hasn't taken any steps to change it even though there are plenty of studies that tell Congress it should be changed.

Cancer of any sort is devastating. Most cancers that are related to active duty military service (n-Hl, lung cancer, prostate cancer, etc.) are seen as serious enough that upon diagnosis and proper claim the VA will usually rate them as 100% disabling. It's safe to say that during treatments for the disease the veteran won't be working thus the rating.

Once treated, if the cancer is cured, the patient/veteran no longer has the disease. One can't be rated for a disease that he doesn't have. The rating system only sees the current condition, not the past or the possible future.

A good example here might be a badly broken arm. If an arm is shattered in service and disables the veteran after ETS, the veteran is likely to have a rating of 20% to 60% for that condition. If a new surgical technique is learned and the vet has surgery that corrects the deficiency of that arm, he will be reexamined to determine the current rating and the new % of disability will be assigned.

According to the letter, George is capable of all activities of daily living. He drives, he is mentally well and apparently is living a full life. It also says that there are no signs of any disease that can be discovered. If that is true, he will continue to be rated at 0% disabled because he is not functionally disabled in any way.

On the other hand, there are things that may be considered. If he believes that the C & P exam was not correct, I would recommend that he file a disagreement and a further claim for any existing residuals related to treatment of the condition.

It is unfortunate that the treatment of n-Hl is often seen as effective and then in a year or two there is a recurrence. I have a good friend here who has experienced the same issues your brother-in-law has and he has recurred some 7 or 8 times over the last 9 years. He is currently in good remission and today his 100% benefit is seen as P & T.

Finally...your statement, "Outrages, he has Cancer!" isn't accurate. He had cancer. According to the reports I read he no longer has cancer. The best news he could have today is that he won't ever see the 100% benefit again because he will never have n-Hl again.