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Posted 8/1/2018 4:36 PM (GMT 0)
Hello All , I just had an C&P (compensation & pension ) re-evaluation exam from a outsourced VA medical contractor at a nearby private office . The outfit QTC will ask me questions that the VA gives them to ask me . Basically about side effects , voiding , etc . The DR. about 65 yrs old , a family doctor she is . Not a Uro or RO . She asked me did I know what percent of men get prostate cancer . I said 1 in 6 and more for Agent Orange . She said 98 % of men get it . Kind downplaying the presumed Agent Orange connection . I said I would like to see that study . At 90 yrs old they say your chances of having PC is 90% and so on down the line .

Then she asked to examine me , a digital to feel for nodules and to check my manhood . I wondered if she would know what to feel for knowing she is just a GP ? She just held each nut and asked if there was any pain . But she gave the prostate check and said its fine . Which i new from day 1 , and get checked by my RO every 6 months

Bottom line is VA wants to reduce my 100 % to a much lower number . And this company QTC will add their comments to what they think and usually its not good for us . Any vets out there gone to this contractor QTC , as they have a huge multi-billion dollar contract with VA across the USA . SemperFi , John
Posted 8/1/2018 5:34 PM (GMT 0)
0311
I'm an Agent Orange vet and have had a couple of C&P exams by VA doctors and one by a contractor - can't remember if it was QTC or not. But regardless, the contract doctors are supposed to follow the same guidelines and standards for disability ratings. Google 38 CFR if you want to read their guidelines. I wouldn't be concerned about your particular doctors comments about percentage of men who get PCa. Increased incidence of the disease with Agent Orange exposure has been documented and boots on the ground service in Vietnam is presumptive of AO exposure under VA rules. The doc is entitled to her personal opinion but her opinion doesn't invalidate your eligibility for AO benefits.

Eligibility is one thing. The disability rating is something else. You are entitled to 100 percent disability pay while you are under treatment for active prostate cancer. Treatment can be radiation, surgery, ADT, active surveillance, or any combination. about 6 months after treatment ends you are subject to a C&P exam to review whether your cancer is still active and under treatment. If not your disability rating will be reduced to cover only the residual effects of treatment - extent if any of voiding disfunction, impotence, any damage or pain from surgical scarring, etc. A typical disability rating for residuals might be 20 or 30 percent - in some cases more. If your cancer becomes active again you can file for return to 100 percent while under further treatment.


Since your primary treatment was radiation there may be a gray area as to when your treatment is considered "ended" and when or if your cancer is no longer "active." If you disagree with a revised disability rating you have a period of time (not sure how long) to file a notice of disagreement with the VA. You might ask your RO if he considers your cancer still active. If so you can ask him for a letter to the VA saying that your cancer is still active and you are under treatment (watchful waiting). You can file your disagreement yourself via eBenefits or if you have a good veterans agent in your town or county or a veterans service officer (VSO) from one of the veterans organizations he or she can file for you.

FWIW I spent most of the past years with a 10% rating for minor incontinence plus special pay for impotence. After return of active cancer in late 2016 I was re-rated at 100 percent.


Jim (USN Coastal Surveillance '67 - '68)
Posted 8/1/2018 7:17 PM (GMT 0)
I saw a VA employee years ago. The VA reduced me from 100% to 20% based on residual symptoms plus about $100 a month for ED.
I thought that was fair and did not appeal.
Posted 8/1/2018 9:36 PM (GMT 0)

RobertC said...
I saw a VA employee years ago. The VA reduced me from 100% to 20% based on residual symptoms plus about $100 a month for ED.
I thought that was fair and did not appeal.

This was almost exactly my situation. I went from 100% to 20%+ED allowance after
a C&P exam last May.
Posted 8/2/2018 12:38 AM (GMT 0)
I've gone through 4 reevaluations. You are right the contract doctors know nothing about PC. The first three continued my 100% disability even though my psa had been >.02 for years. The last evaluation said I was cured and my disability was reduced back to my original 40% before the PC. Getting my retired pay and my VA disability pay straighten out took 6 months and finally a call to my senator. The Federal Bureaucracy is so bad it takes a congressional review to get the simplest things accomplished. On the other hand they were so incompetent I got 8 extra years of pay I didn't deserve.
Posted 8/2/2018 12:14 PM (GMT 0)
The Dr. was a Indian . Almost impossible to understand . I had to constantly say , WHAT ! She didnt even ask me about ED. I will appeal when they reduce my rating .
Posted 8/2/2018 1:25 PM (GMT 0)
Jim really nailed the situation with the VA. My first C&P exam was by an idiot contractor MD, English was not his first language. We spent most of the time talking about everything except my situation. Finally he asked a few questions about my PCa. about a month later I received another C&P notification.

Being really puzzled about the new C&P exam I called the benefits people and they said the idiot MD didn't answer the primary question - what was the diagnosis (or something along those lines.)

For the second C&P exam I saw a contract nurse practitioner who was *very* sympathetic to my situation. She spent about ten or fifteen minutes entering her narrative. about a month later I had a notification that my 100% disability was permanent, to say I was surprised was an understatement. My VSO said "it happens sometimes." I think I went permanent because I have lymphodema in my legs due to 42 lymph nodes being excised and one of them was positive.

I would gladly give the VA my disability money back in exchange for a healthy prostate.
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