AO - Prostate Cancer - ITF?

[VN-Vet]

I have read what threads, that would come up here, on prostate cancer and agent orange, and what is on the VA site. 

I realize that having served in Vietnam, my recently diagnosed prostate cancer should be a presumptive of agent orange by the VA, and I should get 100% disability for as long as I show active cancer, *** and I believe while I am being treated – or perhaps I must be in an approved treatment process, and then for 6 months after treatment ends. 

I had also thought I had read here that the VA does NOT recognize Watchful Waiting / Active Surveillance, as therapies that they will continue to payout on – but hopefully I am wrong, but I can’t seem to find that thread now, or it may be one of the threads I can’t get to come up now. 

My first question has to do with what ‘date’ will the VA use as the start date of compensation? I had filed an ITF, several months back, as I am also developing other claims for other conditions I have, and have had for some time. 

I believe that if I file for my ‘Agent Orange - Prostate Cancer’ before I file my other claims, that will use the placeholder my ITF provides, but what I don’t know is, if the VA will use the ITF date to start my PC compensation, or try and use the date of my biopsies or pathology reports, and I’ll just lose out on the months between those dates?

It was in the process of seeing the many doctors for the other conditions when  my prostate cancer was found, not a pleasant surprise. I don’t really have a large prostate, comparatively, and my PSA is under 10, but it is the small size and higher PSA for its size that places me at a higher risk, as well as the inclusion of ‘Perineural Invasion’ (PNI), that my private urologist wants to take more immediate action.

I am preparing myself for what is ahead, it has been a week today that I found out. I have read tons of stuff, but mostly created 5 or more years ago – and much has changed. I really like my urologist and trust him, but I also believe I need a second opinion as far as treatments are concerned, as I would hate second guessing myself for a hasty decision. (btw – my urologist is retired Army – interned at Walter Reed)

My second question is – how do I file? I tried calling the newer local VA clinic, The Regional VA hospital, and the VA 800 number. I have left my number for a return call on some, and was told by a recording that due to unavoidable circumstances my call cannot be answered, other times.

I have my dd214 showing my tours in Vietnam, I have my urologist’s diagnosis and copy of the pathology report, I have our marriage license, what else would I need if I just showed up at the clinic to file a claim? 

Third question – not as important – is there anyway I can file my other claims, not developed, before I file the PC claim, if I find out I would otherwise lose the ITF date when filing the PC claim?
 

Edited October 19, 2018 by VN-Vet

[Berta]

The VA  will use the date of your claim or claims for any retroactive benefits.

Does your county have a Veterans Service agency or any VSO at your VAMC where you could file the claim?

I was concerned about what you stated- yes, some of the info here is outdated when you use the search feature.

https://www.publichealth.va.gov/exposures/agentorange/conditions/index.asp#veterans

These above are all of the AO presumptives. I am posting the link again in the AO forum- I couldnt find it-under a search and also I could not find the Watchful Waiting / Active Surveillance thread.

I hope you dont have any other presumptive but if so, now is the time to file for them.

You might want to apply on line here-

https://www.ebenefits.va.gov/ebenefits/homepage

Ypu have to enroll into ebenefits first- but I am not sure that means any type of claim- such as ITF- others will answer that question.

The VA web site has somewhere a list of accredited  veterans reps.

If we know what state you are in we could probably find a few.

 

 

[VN-Vet]

Thanks Berta – and sorry – I did not mean the title of the thread I cannot find was Watchful Waiting / Active Surveillance, only that someone mentioned those, or one of them, as not being acceptable PC therapy that the VA would continue to pay disability on. I even may have read this somewhere else, months ago when I thought that PC might be 1 of my conditions. Actually – that is prescribed to some older men, that have a slow growing prostate and PSA, but not really a viable option for me.

I am trying to just accept the AO/PC diagnosis and the rock and hard place I seem to be in. 

I might be able to cope with everything a bit better if I was just assured that my current AO/PC would be paid back to at least back to the diagnosis date, of last week, no matter when I file for it. As of now – the latest date for that date would be 3/29/19, as my active ITF expires then.

Conditions I have been actively working on to file are:
1.    Back Problems: I have back problems I have some current work up on, but found so far that the Army Doctor did not put in my injury or his diagnosis that I had DDD, back in 1973, when he explained to me that I would probably have a rod in my spine before I was 35 because of it. But feel I need more on this. 1 thing would be the x-rays taken, several times at Womack Army Hospital back in 1973 – if that would even be possible, then my current doc could compare, also see the DDD then, and make a stronger nexus. My back problems do have several secondary conditions associated with it as well.
2.    Seborrhea Dermatitis: I do have a current diagnosis of Seborrhea Dermatitis, several diagnoses of this over the years, and a diagnosis from when I was stateside and back from Vietnam, that refers back to when I was treated for this in Vietnam – which is not in the file. Those of us that have it, know once you do, you can never be cured, just better days then other days.
3.    Right Elbow: I have a right elbow that the Army pieced together with bone grafts from my hip, that aches and has neuropathy – that I am working on.
4.    Tinnitus and Hearing Loss: I do have tinnitus and hearing loss – and I had my ears worked on while in Vietnam – but cannot find the report in my file. Drives me crazy at times, and I say ‘what’, far too often.
These I would like to file before I file for my prostate cancer disability, just because they should be provable and I really hate to give up the ITF date. Probably whichever 1 looks the best.

My question on this is, can I file these claims and then work on them? 
Also – how is RAMP going to affect me trying to get this together?
https://www.blogs.va.gov/VAntage/32368/successfully-file-va-compensation-claim/

Then there is my MST/PTSD, probably as important, or more in many ways, then even my AO/PC. This I confess I haven’t started in earnest – as just thinking about it makes me even ore useless. Not even planned it yet.

I live in NC, in a county with more than 10,000 vets. When I called the county VA VSO and asked for an appointment, all I heard was laughter (what an a-s). I still have not heard back from anyone from the VA – I made more calls today, to no avail.

I have appointments for second opinions to make for my PC, treatments to consider that will be life altering/changing, then recovery after the operation, etc. Then just praying the cancer is gone. I am going to be hard pressed to get this done at all, let alone in less than 6 months. I’ll probably – reluctantly – require help – and I know I need all the prayers anyone can offer.

Thanks everyone so far from what you have shared with me, and have shared in these threads. Today I was impressed with Buck shared, several years ago, along these lines. I just did not see how it turned out for him.

Bless all those that help others here.

I am lucky – I believe I can get my PC treated as needed without the VA’s help, but I really do not want to do something I could get them to do for me. Would the VA pay for my private doctor, meds, etc, if I file before I am treated? Trust me, there is no doubt about the PC ☹ 

 

 

[VN-Vet]

Just a follow-up – partially for me, but mainly an object lesson for anyone else who travels down this path.
If you served in Vietnam, please get on the Agent Orange Registry and take the exam. 

For more: https://www.va.gov/disability/eligibility/hazardous-materials-exposure/agent-orange/registry-health-exam/

Next, if you get one of the covered conditions listed, file as soon as possible and let the VA pay, or help pay for your treatments. This will be a personal choice made by considering your personal facts and what conditions you have.

For me, it has cost me my copay for last year and since my Prostatectomy is Monday, in a new year, that will me this year’s entire deductible and copay. In my case, and as had been advised here, I should have filed in October of 2018.

I did file recently, but too late to have the VA help pay for my surgery.

I will have at least several months, if not years, of recuperation, and with the Grace of God, my cancer will be gone. If not - I’ll deal with it as it comes.

I filed in mid-January an FDC on eBenefits, numbered the files in order, starting with a Forwards and Table of Contents, then a Certified pdf of my DD 214, showing service in Vietnam. Then in order of how things progressed, copy of my original pathology report showing Prostate Cancer, then my Urologist’s letter with his diagnosis of Prostate Cancer, then the original treatment for surgery to have taken place 2 weeks ago, then a DBQ he filled out. Then another note about my decision to get second opinions on both the pathology, but also on the surgery. Then I copied the second opinion of the pathology that confirmed the cancer and upgraded 2 of the cores, and the new Oncologist/Urologist opinion of the cancer, and his scheduling of the Prostatectomy I am about to have. My new doctor is a retired Army Colonel, used to head up the Army’s Prostate Center, and now does, or used to, head up one of the top ten Prostate Cancer Centers of Excellence at a Major University, where I’ll be heading.  He has authored and coauthored many scientific studies that have advanced the treatment of Prostate Cancer. Then finally, I supplied a contact sheet with phone and fax numbers, and addresses of everyone involved. 

Almost immediately, the VA acted on my claim, really expediting it and now I see:

“ Your claim moved to Evidence gathering, review, and decision”

Estimated date: July 14, 2019 

I have a feeling I’ll be rated much sooner than that date, and honestly everyone at the VA has treated me nicely. However, I did receive conflicting advice about when to file, and for me, as it turned out, I should have filed back in October and requested to be examined by VA Health. What may soften the blow for me, is I had an ‘Intent To File’, already in I intended to use for another issue.

How to proceed for here – I am all Eyeballs and Ears.

BTW - would you suggest the new doctor complete another DBQ and write a letter saying it is as likely as not that Agent Orange caused or at least worsened the Prostate Cancer? I am half afraid of submitting more at this point, so I might just hold on to it if I need it.
 

[Berta]

It won't hurt! The more medical evidence the better.

"If you served in Vietnam, please get on the Agent Orange Registry and take the exam. "

You are right! And as of Tuesday this past wekk,this goes for ALL BLUE WATER NAVY Veterans too!

They won in court! The decision affects about 90,000 BWN vets, and unfortunately many have already died but it will affect their survivors ---I hope--- as it might  generate another Nehmer decision that includes Footnote One provisions.

It sounds like you are getting exempliary medical care. Let us know how the surgery goes.
 

Edited February 2, 2019 by Berta

[VN-Vet]

Thanks Berta - and yes my care has been great - so to speak.

I filed my FDC Claim [cancer - prostate (related to: Agent Orange - Vietnam) ] in late/mid January, then had my prostatectomy the first week of February. I have had a few issues like; loss of blood, anemia due to loss of blood, UTI, Incision infection, and now what appears to be a urethral stricture (scar tissue)?  

My pathology report did not turn out as well as we had hoped - it came in as pT3a N0 MX R1. I had been reassured the cancer was confined in the prostate capsule - but apparently not.

I still have a good long term prognosis - I just may have more to go through then I had hoped, but not nearly as bad as many others.

Questions: - what should I do? 

In the past few days I recieved a call from QTC, saying I had an appointment with a PA for a C&P exam - for my 'contention' of prostate cancer, this Thursday. I had less then a week to prepare for it. I am also supposed to have a urinalysis, as well as a blood CBC and PSA test. This is right at 3 weeks since my foley catheter was removed, I am in diapers/pads, and take several meds. I am scheduled to have my first followup at Duke to get my PSA tested for the first on many followups the first week of May.  Very suspicious, as I am still being treated by my doctor, and I don;t understand what the VA intends to find out by those tests at this time. At this time my PSA should be around '0', which would indicate no active cancer, however I am under treatment and most like will be receiving radiotherapy either in May or somewhat later, as my cancer was not confined, and metastasis is unknown at this point.

What to do?

At the same time, I recieved a letter from the VA - 'Private Medical Records Retrieval Center' advising me that they are contacting my original urologist and my urologist at Duke, for my medical records. Also reminding me that it is my responsibility to supply evidence to support my claim , they just have a duty to assist. Not crazy about this either.

Since I filed my claim when I still had a prostate, much has changed. I had my prostate out at Duke Hospital (great care btw) - however since I was being seen at the Duke Cancer Center / Prostate Cancer Center, i did not include Duke Hospital in the forms. The letter states not to send any medical records from anyone else other then those listed already listed.

I have more 'evidence' I can upload into my claim - should I at this point?

I have the pathology report - and I may be able to get another DBQ filled out as after the surgery?

What to do? 

Am I worrying too much????

 

Thanks all

[Berta]

I suggest that you make sure VA has ALL of your private medical records.

Any additional evidence should be uploaded.

I think we all worry too much! And you are dealing with a lot.

But Evidence is everything.

"I might be able to cope with everything a bit better if I was just assured that my current AO/PC would be paid back to at least back to the diagnosis date, of last week, no matter when I file for it. As of now – the latest date for that date would be 3/29/19, as my active ITF expires then."

The VA, with some exceptions, uses the date of the claim for the retro amount.

"Since I filed my claim when I still had a prostate, much has changed"

"In the past few days I recieved a call from QTC, saying I had an appointment with a PA for a C&P exam - for my 'contention' of prostate cancer, this Thursday. "

It would not hurt to bring any medical evidence you can, as to this disability.

" I had my prostate out at Duke Hospital (great care btw) - however since I was being seen at the Duke Cancer Center / Prostate Cancer Center, i did not include Duke Hospital in the forms. The letter states not to send any medical records from anyone else other then those listed already listed."

I think the Duke Hospital records are critical to the claim. Do you have any of those records? If not, I assume you do have their discharge certificate, after the surgery.

"The letter states not to send any medical records from anyone else other then those listed already listed."

Regardless of what the letter says- These records are critical.

VA cannot properly determine a rating without all evidence of  the surgery and what the rating should be-

Is it possible that the Duke Cancer Center had them and that VA does have them as well, from the Cancer Center

I hope all goes well at the C & P exam for you. It should.

The reason I make this point about evidence is that we recently had a claimant here who supplied ,as new and material evidence, a document she had for 8 years.

VA was aware of  the document existed and asked her for it.When she sent it to them ,as she re opened her claim, her EED was the date they received the document.

She thought they owed her the additional 8 years as well.

The VA cannot make a proper EED finding ( Earliest Effective Date) on something, that was critical evidence, that they asked for, but never received from this claimant - for 8 years.

I feel you will certainly do OK at the C & P exam. Please let us know how it turns out.