Re-evaluation From VA

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grunt
New Member


Date Joined Feb 2007
Total Posts : 10
   Posted 1/18/2009 8:08 PM (GMT -6)   
I am going for  my first re-evaluation at the VA hosp. What can I expect. Does it matter how many pads I use in a day for % of disability?

Bluenose
Regular Member


Date Joined May 2008
Total Posts : 260
   Posted 1/18/2009 8:18 PM (GMT -6)   

 

 I"m assuming you're a boots on the ground Vietnam vet?  To answer your question as to the percentage of sevice connection and pads.......that would be no.


 
  age: 53  Pre-op PSA Feb 08' 5.0, April 08' 4.1
  Biopsy 5.1.08, 5 of 15 cores postive, T2a, Gleason 3+4=7
  DaVinci performed 7.29.08
  Bladder sling installed, umbilical hernia repaired during surgery.
  Path report, "cancer fully contained, margins clear".
  Cath removed 8.8.08, ED therapy begins 8.9.08
  100mg Viagra three times a week, pump for ten minutes daily
  and hold for ten minutes.
  8.16.08 switched to Levitra 20mg, immediate results
  9.15.08 Pad free at night, one thin (light) pad during the day
  9.18.08 1st Post-op PSA Undetectable Zero's....Yes!
  12.22.08 2nd Post-op PSA  Zero's still...
  Pads gone 1.3.09, finally found the courage...Thanks ya'll
          ".....tryin' to reason with hurricane season...."
       


TSFFZ
Regular Member


Date Joined Oct 2008
Total Posts : 25
   Posted 1/18/2009 10:18 PM (GMT -6)   

Yes, it does matter.  Check out the following link:

  http://www.warms.vba.va.gov/regs/38CFR/BOOKC/PART4/S4_115a.DOC

As you know, you are automatically rated at 100% during your treatment.  The re-evaluation will follow the guidelines in the link, which means that the most that you can get is 60% if you use more than 4 pads/ day.  Lesser usage will relate to a lesser disability rating.  Also, there is a 40% disability rating if you have a urination voiding interval of less than one hour or need to get up more than 5 times/night to urinate.  I do not believe that the pad usage and the voiding interval may be cumulative, although that is only a guess on my part. 

I'm a vietnam vet, also.  Good luck, brother.


Bluenose
Regular Member


Date Joined May 2008
Total Posts : 260
   Posted 1/18/2009 11:28 PM (GMT -6)   

 

...mmm, stand corrected, but will check it out on return to work come Tuesday...I've always heard PCa is just that, PCa as far as VA is concerned....but then the squids got screwed on that one..


 
  age: 53  Pre-op PSA Feb 08' 5.0, April 08' 4.1
  Biopsy 5.1.08, 5 of 15 cores postive, T2a, Gleason 3+4=7
  DaVinci performed 7.29.08
  Bladder sling installed, umbilical hernia repaired during surgery.
  Path report, "cancer fully contained, margins clear".
  Cath removed 8.8.08, ED therapy begins 8.9.08
  100mg Viagra three times a week, pump for ten minutes daily
  and hold for ten minutes.
  8.16.08 switched to Levitra 20mg, immediate results
  9.15.08 Pad free at night, one thin (light) pad during the day
  9.18.08 1st Post-op PSA Undetectable Zero's....Yes!
  12.22.08 2nd Post-op PSA  Zero's still...
  Pads gone 1.3.09, finally found the courage...Thanks ya'll
          ".....tryin' to reason with hurricane season...."
       


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25382
   Posted 1/19/2009 8:24 AM (GMT -6)   
As a Viet Nam vet squid myself, is there some special deal or something through the VA that I don't know about? Or are you guys talking about vets that were treated at VA hospitals for their PC?

David in SC
Age 56, 56 at DX
PSA 7/7 5.8, 7/8 12.3, 9/8 14.9, 10/8 16.4
3rd Biopsy 9-2008 Positive 7 of 7 cores positive, ranging from 40 - 90%, G 4+3 & 3+4
Open RP surgery  November 14, 2008 at St. Francis Hospital, Greenville, SC, Dr. Ronald Smith - Surgeon, Non-nerve sparing, 4 days in hospital, staples removed 11/24/8, Catheter out on 12/15/8 on day 32.  Day 33, urine stopped flowing, new catheter put in 12/16/08, Catheter out 12/29/08.  After 7 hours, complete stoppage again, emergency room put in Catheter #3 early evening of day 45, still 12/29/08. 1/5/9 - Cath #3 out, dr. did cycloscope, saw potential blockage, put in Catheter #4, 1/13/9 - Had operation St. Francis - removed blockage, put in Cath #5, suppose to be removed 1/19/9
Post-surgery Pathlogy Report:
Gleason 3+4=7, pT2c pN0 pMx, Prostate 42 grams, tumor 20% cancer
Contained in capsular, neg. margins apex, bladder neck, right lobe, neg. in seminal vessels and lymph nodes.
First PSA Post Surgery  Scheduled now for 2/9/9
 
 


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 1/19/2009 9:05 AM (GMT -6)   
David..agent Orange has been identified to be one of the reasons for PCa. Vets that were exposed to agent Orange are allowed to receive medical treatment at the VA hospitals for this disease without too many questions being asked from my understanding. I am also a squid and was never exposed to the chemical so I don't have any other info than that.
You are beating back cancer, so hold your head up with dignity
 
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal-Gland 38 cc
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral (Perineural Invasion present at base) - Gleason (3+3) 6  Stage T1C
August 23 - Bone Scan - Hips, Spine and ribs marked uptake - X-Ray showed clear -Hooray
Sept 9 2nd DRE - questionable - TRUS...shadow in base - Gland now 41 cc
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (4+3) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
4 tumors in prostate - largest being 6 cm 
PSA 5 week Oct 2008 <.05
       3 month Jan 2009 .06


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25382
   Posted 1/19/2009 9:19 AM (GMT -6)   
Les,

I was never exposed to that as far as I know. I was in VP-17 and flew in missions in the South China sea, we would re-fuel, etc. in Nam but mostly stayed over the water on patrol.

David
Age 56, 56 at DX
PSA 7/7 5.8, 7/8 12.3, 9/8 14.9, 10/8 16.4
3rd Biopsy 9-2008 Positive 7 of 7 cores positive, ranging from 40 - 90%, G 4+3 & 3+4
Open RP surgery  November 14, 2008 at St. Francis Hospital, Greenville, SC, Dr. Ronald Smith - Surgeon, Non-nerve sparing, 4 days in hospital, staples removed 11/24/8, Catheter out on 12/15/8 on day 32.  Day 33, urine stopped flowing, new catheter put in 12/16/08, Catheter out 12/29/08.  After 7 hours, complete stoppage again, emergency room put in Catheter #3 early evening of day 45, still 12/29/08. 1/5/9 - Cath #3 out, dr. did cycloscope, saw potential blockage, put in Catheter #4, 1/13/9 - Had operation St. Francis - removed blockage, put in Cath #5, suppose to be removed 1/19/9
Post-surgery Pathlogy Report:
Gleason 3+4=7, pT2c pN0 pMx, Prostate 42 grams, tumor 20% cancer
Contained in capsular, neg. margins apex, bladder neck, right lobe, neg. in seminal vessels and lymph nodes.
First PSA Post Surgery  Scheduled now for 2/9/9
 
 


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 1/19/2009 9:52 AM (GMT -6)   
David, your risk would appear to be very low if at all. This was primarily for the guys on the ground. I have a couple of Marine buddies, including one that was a tunnel rat and so far they haven't had this disease. So I don't know what qualifies and what doesn't as far as the VA is concerned.
You are beating back cancer, so hold your head up with dignity
 
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal-Gland 38 cc
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral (Perineural Invasion present at base) - Gleason (3+3) 6  Stage T1C
August 23 - Bone Scan - Hips, Spine and ribs marked uptake - X-Ray showed clear -Hooray
Sept 9 2nd DRE - questionable - TRUS...shadow in base - Gland now 41 cc
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (4+3) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
4 tumors in prostate - largest being 6 cm 
PSA 5 week Oct 2008 <.05
       3 month Jan 2009 .06


Bluenose
Regular Member


Date Joined May 2008
Total Posts : 260
   Posted 1/19/2009 11:22 AM (GMT -6)   

 

..hahah great one ziggy!  Dont we all?!?  You're right on the disability payments ziggy, it's an automatic "service connection disability"..."boots on the ground vets" although that still covers the brown water sailors, rivers, canals etc...PBR boats, zippos' and such. At one time the blue water squids had won the right for disability, those stuck out on "Yankee Station"  etc.....that was overturned though just a year ago or so and all those guys lost the benefit.....bottom line though, if any of you guys are Vietnam vets, Vietnam era vets or guys stationed on Air Bases in Thailand where many of the planes carrying the stuff flew out of.....it would be worth checking with your county Veterans Benefits Officer....ya' never know, you might qualify.


 
  age: 53  Pre-op PSA Feb 08' 5.0, April 08' 4.1
  Biopsy 5.1.08, 5 of 15 cores postive, T2a, Gleason 3+4=7
  DaVinci performed 7.29.08
  Bladder sling installed, umbilical hernia repaired during surgery.
  Path report, "cancer fully contained, margins clear".
  Cath removed 8.8.08, ED therapy begins 8.9.08
  100mg Viagra three times a week, pump for ten minutes daily
  and hold for ten minutes.
  8.16.08 switched to Levitra 20mg, immediate results
  9.15.08 Pad free at night, one thin (light) pad during the day
  9.18.08 1st Post-op PSA Undetectable Zero's....Yes!
  12.22.08 2nd Post-op PSA  Zero's still...
  Pads gone 1.3.09, finally found the courage...Thanks ya'll
          ".....tryin' to reason with hurricane season...."
       


TSFFZ
Regular Member


Date Joined Oct 2008
Total Posts : 25
   Posted 1/19/2009 12:31 PM (GMT -6)   

Bluenose,

I believe that we both may be correct in our understanding.  When an in-country viet vet has PCa, he is considered 100% disabled during treatment.  Grunt was asking about the re-evaluation process.  My response assumed that the PCa was "cured/removed" during the treatment process and the re-evaluation just deals with the remaining impacts and side effects of the treatment, which are typically urinary, although there is also some compensation for ED as "loss of a creative organ".  (That terminology always cracks me up)

However, if the vet still has PCa at the time of the re-evaluation and is still undergoing treatment, it is my understanding that the disability will remain at 100%.

I'm not sure how they address the PSA bounce or decling values related to radiation, especially Proton Beam, but I assume that those SE will emphasize urinary frequency, although I have heard that some vets that maintain significant PSA levels following radiation may stay at 100% for a longer time.  But, that's just a guess on my part.

Regardless, it's certainly not worth it to get PCa to obtain the benefits, but they are substantial.  My payments at 100% were about $2,700/month, tax free.  The lesser benefits are significantly reduced, but still a big help.


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4251
   Posted 1/19/2009 1:58 PM (GMT -6)   
TSFFS,
How long did your benefits last? I'm currently getting $1300/mo combination VA and Army retirement for a 40% disability, and thought that they wouldn't go up so never applied for benefits. Now I am rethinking my decision. I go on hormone therapy for about 6 months before I start IMRT. How long do you think I can get benefits?
Diagnosed 10-08 at 63 with PSA of 33
PSA was 4.4 in 1999 and has risen steadily.
Had 13 biopsies and an endorectal MRI, all negative until 10-08. Two cores out of 25 with a gleason 6
2nd opinion with an oncologist said cancer found was insignificant, but suspected larger tumor somewhere.
Doppler ultrasound with target biopsy indicate a large tumor in the transition zone, gleason 7.
Bone and CT scans negative.
PSA3= 43; (high normal is 35)
Scheduled for Combidex MRI in Feb. (Lymph node imaging MRI done in Holland).
Location of tumor makes positive surgical margin unlikely.
Looking at IMRT with hormone therapy as soon as staging is complete with Combidex MRI.
Changed diet, eliminated all meat and dairy. Taking the normal supplements recommended for PC.
 
JohnT
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 


TSFFZ
Regular Member


Date Joined Oct 2008
Total Posts : 25
   Posted 1/19/2009 2:36 PM (GMT -6)   
John T,

I really don't know about the length of benefits or much more than I have already posted but, due to the fact that you are retired Army, your situation may be even better. You should contact your local VFW office at the local/nearest VA and let them know of your situation. As you may already know, the VFW's job is to act a your advocate and to guide you through the system. They certainly have helped me.

Bluenose
Regular Member


Date Joined May 2008
Total Posts : 260
   Posted 1/19/2009 3:52 PM (GMT -6)   

 

 TSF, oh yeah, I understand, wasn't doubting you at all....as far as your disability and service connection goes though, you're still recieving that right? 

  PSA and DRE's are a big thing right now inside the VA, especially for the vietnam vets, big push. Although they don't offer robotic surgery I've known many a vietnam vet get DX'd and then go outside and get his surgery done. Then return to VA for follow up once he's been released. Keeping the service connection, not at 100% per say, but service connection just the same which helps so much in all their health care. (I'm service connected too) I just want all you vets to get what you got comin'.......that's all.


 
  age: 53  Pre-op PSA Feb 08' 5.0, April 08' 4.1
  Biopsy 5.1.08, 5 of 15 cores postive, T2a, Gleason 3+4=7
  DaVinci performed 7.29.08
  Bladder sling installed, umbilical hernia repaired during surgery.
  Path report, "cancer fully contained, margins clear".
  Cath removed 8.8.08, ED therapy begins 8.9.08
  100mg Viagra three times a week, pump for ten minutes daily
  and hold for ten minutes.
  8.16.08 switched to Levitra 20mg, immediate results
  9.15.08 Pad free at night, one thin (light) pad during the day
  9.18.08 1st Post-op PSA Undetectable Zero's....Yes!
  12.22.08 2nd Post-op PSA  Zero's still...
  Pads gone 1.3.09, finally found the courage...Thanks ya'll
          ".....tryin' to reason with hurricane season...."
       


TSFFZ
Regular Member


Date Joined Oct 2008
Total Posts : 25
   Posted 1/19/2009 4:10 PM (GMT -6)   

....as far as your disability and service connection goes though, you're still recieving that right? 

Bluenose....yes, for the present.  However, I recently had my re-evaluation and anticipate a substantial reduction in benefits.  I did not have treatment or diagnosis at a VA clinic so they petitioned my records from the treating facilites.  I don't know how much time that takes but the VA is not the quickest to respond, which means that I get the current disability until they finish the paperwork to reassess me.  However, since it will certainlhy be a reduction to a max of 60% (not counting my current disability rating), I would expect them to be faster in the reassesment than they were in the initial determination since the economy is not good and the feds are trying to save money.  Hopefully, that is not the case as I am a strong supporter of VA benefits.  Many guys gave much more than me in service to their country and are entitled to as much benefit and respect as possible. I'm one of the lucky ones that came back intact, both mentally and physically.

BTW, I didn't think that you were doubting me and there would be no problem with me, even if you were.  We just need to get the information out to the people that need it and discussions like this are always beneficial in doing that.  I don't have any information other than what I have found during my condition; there's a lot of it out there and I'm sure that most of that is subject to interpretation.

Thanks for your help.

 

 

 


justus1292
Regular Member


Date Joined Feb 2009
Total Posts : 63
   Posted 3/25/2009 6:41 PM (GMT -6)   
Click on my user name and send me an email.  I was med ret in 95 and had to cope with the system for 3 to 4 years.

NV RTRD 2007
Regular Member


Date Joined Jan 2009
Total Posts : 75
   Posted 3/25/2009 10:42 PM (GMT -6)   
This is my two cents on this topic. I am not a Vietnam era vet, but I am a retired squid (over 23 years). Retired Sep 2007 and was diagnosed Feb 2008. They rated me 100% effective the day I was diagnosed and not the day I retired. The guy from American Vet who is helping me on this claim told me that I'll be 100% for a year then I will be re evaluated. He also put a claim for ED. I haven't got the results of the ED yet. I agree with TSFFZ that it's not worth to have PCA to get monetary benefits. Yes with me and a wife plus a kid in college I got like $3,000. Money is good , but if can go back in time I rather have zero percent disability than having this PCA and go through all the hassle of incontinence and ED. Zero percent will get my kids free anyway to any University of California or California State.
Age 54; Age DX 53
PSA: May 07- 2.9; Dec 07-4.3; Jan 2008- 6.1; May 2008- 6.4; Sep 2008- 7.3 ; Sep 2008- 9.6
Bone Scan: Mar 2007- Normal without evidence of metastatic disease.
Biopsy Mar 2008: 6/6 core right gland- No evidence of malignancy; 5/6 core left gland- positive Gleason score 3+3=6 average tumor volume 5 mm.Clinical Stage II.
Transrectal ultrasound at UCSF Jun 2008: 7x14x10 mm hypoechoic lesion in left gland. DRE positive, PSA Density- 0.23 and Prostate volume - 27 CC.
RRP: 4 Dec 2008; Discharged - 8 Dec 2008; Cath removed- 18 Dec 08.
Pathology Report: Prostate- 33 grams; L/R pelvic lymph node -No evidence of malignancy; Right Lobe- No definite tumor; Adenocarcinoma, Gleason 3+4.
Post PSA: 7 Jan 2009 - <.05.
              10 Mar 2009 -<.05


Lungman
Regular Member


Date Joined Jan 2008
Total Posts : 276
   Posted 3/27/2009 3:24 PM (GMT -6)   
I am not a vet but I will add some info here. At one of my Man to Man meetings, an attorney was presenting facts on VA Benefits and PCa, I believe his name was Grant Rosensteel, I think from Huntsville, AL. He was very passionate about his cause and seemed to have a very good knowledge base, encouraged phone calls, even if just for info. Just my 2 cents.

Randy
46 you when diagnosed, now 48
Pre-Op PSA 9.9
1 of 12 cores positive, Gleason 3+3
DaVinci on 9/5/2007
Post-Op Gleason 3+6, Negative Nodes and Margins
Less than 1% of prostate involved with CA
3 Month PSA 0.01, 6 Month PSA 0.01, 9 Month PSA 0.01
One Year PSA 0.01, 18 month PSA 0.01
Incontinence resolved 9/15/2007, one day after cath removal
ED showing significant improvement.
Occasional Success with Oral Meds
Success with BiMix


Jersey Boy
New Member


Date Joined Apr 2009
Total Posts : 6
   Posted 4/20/2009 7:48 PM (GMT -6)   

I am a Vietnam vet who is currently rated 100% for Ca of the prostate.  My reevaluation already took place and I expect to have my rating reduced effective May 1 to 20%, plus special monthly compensation for loss of use ($96 extra).  Every "in-country" Vietnam vet who had a radical prostatectomy for cancer, no matter which surgical procedure is used, should be entitled to the extra $96 benefit.  I used to work for VA doing rating decisions, but the prostate issue for Vietnam vets stated after I stopped doing that work.  The number of pads used, etc., as described earlier in this string, applies.  I'm fairly certain that the minimum rating for post-op prostate ca is 20%.

I just saw this forum today for the first time, so sorry for the late contribution.  I'm 14 months post-op, Gleason score of 6 (Dr. Gleason was a VA doc by the way), using trimix with success but hoping to get off injections soon.

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