Question:

Received a Fed X from LHI stating the VBS requested that we coordinate an exam on your behalf. It’s a telephone exam. “An ACE exam will insure that your claim is being expedited and eliminates any need for travel.” I am on 100% temp disability due to non aggressive, watchful waiting prostate cancer. Checks have always been on time.

My first biopsy was in March 2020 and a second one is is scheduled for March 2022. Why the need for this? I am seeing a private sector doctor. My PSA readings at his office was about 10. Here is one thing I noticed. My VA doctor does routing blood work for Cholesterol and does not order PSA but this time they did the Cholesterol blood and it was an 8 which is still high. Are they playing games with me? Trying to reduce my 100%?

LHI said have your medications to list and otherwise I don’t have to do anything. I will be truthful and as I see it there is no issue. Assume my biopsy comes back with no change we will continue watchful waiting and schedule another biopsy for 18-24 months out. I am 75, a Vietnam vet and in good health. Have you had experience with LCI? Again, I thank you for your service and good work on this most necessary cause. 

Jim's Reply:

What you're experiencing is routine, SOP, the way it's done at your VA. There is a process and VA is as process driven an organization as you'll ever find. To be honest, they aren't very good at it but that doesn't matter. They think they are and they have the keys.
 

There is no reason to complain or to try and change the process. Once you become a member of Congress you can work on that but until then, it's a lot easier to do the little inconvenient senseless things as they come up. 
 

I'm actually pleasantly surprised that they're talking about using the ACE process. The fact that you're being subjected to the exam is pretty pointless but at least you aren't being told to come in for a face to face...as it were.
 

The VA process to manage watchful waiting in a service connected prostate cancer isn't outmoded, it was never put in place. Every cancer, according to 1950s VA philosophy, will be treated aggressively and every cancer will be cured. Until the cancer is treated and cured the veteran is rated at 100% disabled on a temporary award. Once the treatments are completed and the veteran is free of cancer, there are C & P exams (future exams) that are mandated to evaluate any residual disabling conditions from the treatments. VA anticipates treatments will be immediate and you'll be all better soon.
 

With the prostate cancer patient the residuals are usually incontinence and frequency of urination. The veteran may also file for erectile dysfunction, a common residual effect of prostate cancer treatment.
 

The process is so deeply ingrained in the VA DNA that you can't escape it no matter how inane it may be. 
 

Are they trying to reduce your 100% rating? Yes, of course they are. I've worked with veterans who were taking blood pressure drugs and VA decided that was a cancer treatment and reduced the prostate cancer rating. Anticipate that no matter what you do you will get a notice telling you your rating is being reduced. This is annoying but simple to appeal with no interruption to your benefits.
 

Don't buck the system. There is no point in trying to change things for the better, you're wasting your time. In your spare time, write to your representatives, for now stick to the script.
 

When you speak with the LHI examiner be courteous, friendly and precise. Only answer questions posed to you, don't go rogue with all your problems and concerns. Stick to your script that nothing has changed, there have been no treatments and that you still have cancer. You will be asked about symptoms like incontinence and you should answer accurately and truthfully.
 

This is a perfect example of why VA doesn't work. The inefficiency of the C & P process is astounding and of course, there's a profit motive...money is being made on your back. The C & P examiners are contract employees, many are former VA employees.
 

They are paid piecemeal so every nonsensical examination earns them a fee. The more the merrier.
 

No matter who you are or what is happening with your claim, there will be unnecessary and redundant C & P exams built in along the way. It's VA tradition and not likely to change.
 

Good luck sir.