VA Disability Rating for Cancer in Remission: Exams and Reductions

A VA disability rating for cancer in remission usually does not stay at 100 percent for long. Active malignancy carries a 100 percent rating, and that rating continues for six months after treatment ends. After that, the VA schedules an examination, and if the cancer has not returned, your rating drops to whatever level reflects the lasting effects of the cancer or its treatment. Those residual ratings can range from zero percent to 60 percent or higher, depending on your symptoms.

The Six Months After Treatment Ends

Every diagnostic code for cancer works the same way on this point. Genitourinary cancers fall under Diagnostic Code (DC) 7528, digestive system cancers under DC 7343, respiratory cancers under DC 6819, and skin cancers under DC 7818 or DC 7833 for melanoma.¹ Each assigns 100 percent while the cancer is active and for six months after surgery, radiation, chemotherapy, or other therapeutic treatment ends.²

That window is built into the regulation. It gives your body time to recover and gives the VA a reasonable period to see whether the cancer will come back. Compensation stays at the 100 percent rate throughout those six months.

The Mandatory C&P Exam and How the Rating Changes

Once six months have passed since treatment ended, the VA is required to schedule a compensation and pension (C&P) examination. The exam checks for local recurrence or metastasis and, if neither is found, evaluates whatever symptoms you still have.³ The exam is not optional for the VA — it is a regulatory requirement inside the diagnostic codes themselves.

If the exam finds no recurrence, the VA proposes reducing the 100 percent rating. Legally, this is treated as a “staged rating” rather than a traditional reduction, because the diagnostic codes contain a built-in temporal element: the 100 percent rating exists only while the cancer is active or within the six-month post-treatment period.² Once the criteria for 100 percent no longer apply, the rating changes by operation of the regulation.

Does Active Surveillance Keep the 100 Percent Rating?

This comes up often with prostate cancer. Many veterans finish initial treatment and move to active surveillance or watchful waiting — periodic PSA tests or imaging without further surgery, radiation, or chemotherapy. Surveillance does not count as a therapeutic procedure under DC 7528. The Board of Veterans’ Appeals has held that whether an oncologist has declared a veteran “cured” is “irrelevant to the narrower discussion of the status of his cancer at a certain point in time.” What matters for rating purposes is whether active treatment is ongoing.⁴

Outcomes can vary on individual facts. In a 2025 case, the Board granted a permanent and total rating to a veteran on active surveillance for prostate cancer where the record showed an active malignancy, a worsening condition, and a medical opinion that improvement was remote.⁵ That decision was non-precedential and applied only to that veteran.

How Residuals Are Rated by Cancer Type

The residuals rating depends on the type of cancer and which body system was affected.

Genitourinary Cancers (Prostate, Bladder, Kidney)

Under DC 7528, residuals are rated on voiding dysfunction or renal dysfunction, whichever is more disabling. The voiding dysfunction levels under 38 C.F.R. § 4.115a break down this way:⁶

Urine leakage: 20 percent if absorbent materials need to be changed less than twice a day; 40 percent if changed two to four times daily; 60 percent if an appliance is needed or materials are changed more than four times daily.
Urinary frequency: 10 percent for daytime intervals of two to three hours or waking twice per night; 20 percent for intervals of one to two hours or waking three to four times; 40 percent for intervals under one hour or waking five or more times.
Obstructed voiding: noncompensable for mild obstruction, up to 30 percent for urinary retention requiring catheterization.⁷

Respiratory Cancers

Lung and other respiratory cancers under DC 6819 follow the same structure: 100 percent during active disease, a mandatory examination six months after treatment ends, then a residuals-based rating if there is no recurrence or metastasis.⁸ Residuals are rated under whatever respiratory impairment remains, such as reduced lung capacity or chronic breathing difficulty.

Digestive System Cancers

DC 7343 uses the same framework — 100 percent during active disease and for six months post-treatment, then a mandatory VA examination and a residuals-based evaluation.⁹

Skin Cancers

Skin cancers under DC 7818 (non-melanoma) and DC 7833 (melanoma) are handled differently. A 100 percent rating applies only if the cancer requires systemic treatment — chemotherapy, extensive radiation, or surgery beyond a simple wide local excision. If treatment is confined to the skin, the 100 percent rating does not apply at all, and the condition is rated on disfigurement, scarring, or functional impairment.¹⁰ When systemic treatment is involved, the standard six-month post-treatment examination and residuals framework applies.

Secondary Conditions From Cancer Treatment

Cancer treatment often leaves veterans with problems beyond the original cancer site. These secondary conditions can be separately service-connected and rated, and they add to the overall combined rating when the 100 percent rating for the cancer itself ends.

Peripheral neuropathy is one of the most commonly claimed. Chemotherapy and radiation frequently damage nerves, causing pain, numbness, and mobility problems. The Board has granted service connection for bilateral upper and lower extremity peripheral neuropathy as secondary to chemotherapy and radiation for service-connected cancers, based on medical evidence tying the neuropathy to treatment.¹¹

Erectile dysfunction is another common residual, especially after prostate cancer. ED itself is typically rated at zero percent, but veterans can receive Special Monthly Compensation at the “k” level for loss of use of a creative organ, which is paid on top of standard disability compensation.¹¹

Mental health conditions can be claimed as secondary to service-connected cancer. You need a current diagnosis and medical evidence, typically a nexus opinion from a mental health professional, establishing that depression, anxiety, or PTSD was caused or worsened by the cancer or its treatment.¹² Mental health ratings run 0, 10, 30, 50, 70, and 100 percent based on the degree of occupational and social impairment.¹³

Due Process Before a Reduction Is Finalized

The VA cannot cut your rating without following specific steps under 38 C.F.R. § 3.105(e). You receive a written proposal explaining the intended reduction and the evidence behind it. From the date of that notice, you have 30 days to request a predetermination hearing and 60 days to submit new evidence showing the reduction is not warranted.² If you request a hearing, the VA cannot finalize the reduction until it takes place.

The VA bears the burden of showing that your condition has actually improved. A single examination is not enough on its own. The VA must consider your full disability history, including medical records, treatment history, and personal statements. Temporary or fluctuating improvements are not valid grounds for a permanent reduction.⁹

Longer-held ratings get more protection. Ratings held for five or more years require evidence of sustained improvement before they can be reduced. Ratings in place for 20 or more years generally cannot be reduced below the lowest level reached during that period, absent evidence of fraud.⁹

Appealing a Reduction

If the VA finalizes the reduction, you have one year from the date of the decision letter to start an appeal. Under the Appeals Modernization Act, there are three review lanes:¹⁴

Supplemental Claim (VA Form 20-0995) if you have new and relevant evidence not previously considered.
Higher-Level Review (VA Form 20-0996), a paper-based review by a senior reviewer, used when you believe the original decision contained a factual or legal error. No new evidence is allowed.
Board of Veterans’ Appeals (VA Form 10182), where a Veterans Law Judge reviews the case. You choose between direct review, evidence submission, or a hearing.¹⁵

If the Cancer Comes Back

The 100 percent rating can be reinstated if the cancer recurs. The right form is not a Supplemental Claim. The VA instructs veterans whose service-connected condition has worsened to file a claim for increased disability compensation using VA Form 21-526EZ.¹⁶ Send medical evidence of the recurrence with the claim — pathology reports, imaging, or an oncologist’s statement. Once active malignancy is confirmed, the 100 percent rating resumes, and if the cancer goes back into remission the six-month post-treatment cycle starts over.

When Residuals Are Severe: TDIU and Higher SMC

Some veterans come out of remission with residuals bad enough that steady work is not realistic even though the schedular rating dropped below 100 percent. Total Disability based on Individual Unemployability (TDIU) pays at the 100 percent rate in that situation. Eligibility generally requires one service-connected disability rated at 60 percent or more, or two or more service-connected disabilities with at least one at 40 percent and a combined rating of 70 percent or more.¹⁷ The analysis looks only at whether the service-connected conditions currently prevent substantially gainful employment; age and non-service-connected conditions are excluded.

Higher levels of Special Monthly Compensation may also apply if residuals are severe. SMC-S (housebound) covers veterans substantially confined to their homes due to service-connected disabilities. SMC-L (aid and attendance) covers veterans who need daily help with basic activities like eating, dressing, and bathing.¹⁸ Qualifying for these levels requires VA Form 21-2680, completed by a medical professional documenting the functional limitations.¹⁹

1
eCFR. Title 38, Chapter I, Part 4
2
U.S. Department of Veterans Affairs. Board of Veterans Appeals Decision
3
U.S. Department of Veterans Affairs. Board of Veterans Appeals Decision
4
U.S. Department of Veterans Affairs. Board of Veterans Appeals Decision
5
U.S. Department of Veterans Affairs. Board of Veterans Appeals Decision
6
U.S. Department of Veterans Affairs. Board of Veterans Appeals Decision
7
U.S. Department of Veterans Affairs. Board of Veterans Appeals Decision
8
Cornell Law Institute. 38 CFR § 4.97 Schedule of Ratings, Respiratory System
9
U.S. Department of Veterans Affairs. Board of Veterans Appeals Decision
10
eCFR. 38 CFR § 4.118 Schedule of Ratings, Skin
11
U.S. Department of Veterans Affairs. Board of Veterans Appeals Decision
12
U.S. Department of Veterans Affairs. Board of Veterans Appeals Decision
13
VA Disability Group. VA Disability Ratings for Anxiety Disorders
14
U.S. Department of Veterans Affairs. VA Decision Reviews and Appeals
15
U.S. Department of Veterans Affairs. VA Form 10182, Decision Review Request: Board Appeal
16
U.S. Department of Veterans Affairs. VA Supplemental Claims
17
U.S. Department of Veterans Affairs. VA Individual Unemployability
18
U.S. Department of Veterans Affairs. Special Monthly Compensation Rates
19
U.S. Department of Veterans Affairs. VA Form 21-2680, Examination for Housebound Status or Permanent Need for Regular Aid and Attendance