Camp Lejeune Renal Cancer Rating

[pawmbi]

Hello trying to get an understanding for filing a claim for my dad for renal cancer.  He was at Camp Lejeune from 1968-1969.  He is 90% and in the past six months a mass was found on his kidney, it was determined at the time the kidney was only performing at about 28% so they removed it.  After testing it was was found to be Malignant neoplasm of left kidney, except renal pelvis (I am typing this directly from his medical records.  Anyway,  I'd like to file a FDC since this is considered one of the presumptive conditions.  However, since the cancerous kidney was removed what percentage would he qualify for?  I was reading through the rating for renal cancer and obviously if he didn't have surgery he would be 80% or 100% I think ( or we could at least argue that) but since they had to remove it does he fall to 0 or 10% if it is SC?  Also his doctor, a retired Navy Urologist put in "more likely than not caused by exposure to agent orange and/or contamination in Camp Lejeune water" language in the bottom of his notes.  Any advice suggestions would be very helpful.  

[Phury & Rhage]

1 hour ago, pawmbi said:

does he fall to 0 or 10% if it is SC

Hi,

I don't have time to give a complete answer at this moment, but,  at a minimum, removal of a kidney gets a 30% rating (if service connected obviously).  However, active cancer gets a temp 100% when service connected.  I'm still at work  but I'll write more later...

Phury

Edited July 5, 2022 by Phury & Rhage
grammar

[pawmbi]

21 minutes ago, Phury & Rhage said:

Hi,

I don't have time to give a complete answer at this moment, but,  at a minimum, removal of a kidney gets a 30% rating (if service connected obviously).  However, active cancer gets a temp 100% when service connected.  I'm still at work  but I'll write more later...

Phury

Oh this is perfect...I didn't see this.  Thanks I'll do some more research.  I like to put in the statements what the rater should consider so that is why I am jumping through this hoop!

[Phury & Rhage]

Hi again,

Is your dad service connected for any other Camp Lejeune condition?  I only ask because then we know that exposure is conceded.  That will speed things up.  If he hasn't been service connected for anything related to Camp Lejeune, it'll take slightly longer.  If you have a copy of his DD 214, check to see if it shows his Camp Lejeune service:  particularly in the box about last duty station or place released from.  It's often in the remarks box as well.  Regardless, they have a copy of his personnel records if he's been service connected for anything related to Agent Orange and those records should easily confirm that he was stationed at Camp Lejeune for at least 30 days (an important number).  

What you should submit is a VA Form 21-526EZ and you can do that online if he has an account set up or through his VSO if he has appointed one.  You should make sure there is a VA Form 21-4138 from your dad saying that he had service at Camp Lejeune (the dates too if he has them) and that he has renal cancer which is a presumptive condition under 38 CFR 3.309(f).  He should state (if it is true) that he has active cancer and he has had one kidney surgically removed.  If he has active cancer, his statement and the 526 should request a temporary 100% and include a request for SMC S.  Make sure you get a statement from his doctor that says his cancer is active (if it is) and also get any biopsy results that show the cancer diagnosis.  Include all of those items with the 526 when it is submitted.  If his DD 214 shows Camp Lejeune service, make sure you highlight that and include it - even though they have it.

By the way, Fully Developed Claims don't actually receive special processing anymore (long, boring topic).  However, it doesn't hurt anything to select that box.  The primary thing to remember is that it will massively speed up the process if you include all the documentation when you file the application.  Another thing to know, if the doctor provides a statement about a current diagnosis of active renal cancer - there is NO EXAM.  The only evaluation available for active cancer is a temporary 100%.  I've posted about this in another thread recently if you want to do a search.

If you get stuck or have any questions, please reach out.

Good luck,

Phury

Edited July 5, 2022 by Phury & Rhage
grammar/spelling

[pawmbi]

Thank you! This information is great.  Your response hits on exactly what I am trying to figure out, which is to some degree a medical question or interpretation??  His exact medical records says -

"Assessment: GU: Malignant, neoplasm of the left kidney, except renal pelvis -C64.2"

A little further down it says...

" Notes 6/30/22 Doing well postoperatively. New diagnosis of renal cancer.  In my opinion this cancer is as likely as not, caused by exposure to agent orange or contamination in Camp Lejeune water at the time.  I am a retired Navy Urologist and served as program director for many years. 

Proceed with MRI FUSION BIOPY OF THE PROSTATE FOR THE 3 PIRADS 4 LESIONS".

I am not asking you to determine if this is "active" but is sure sounds like it to me. and based on what you said in the statement forms you pointed to I will make that assertation.  Because no were does it say "remission" which is what I think, medically, you would say if the cancer was not active?  Anyway I'm not a doctor but it won't hurt to try this argument.  Yes he has all his medical records I don't want to re-send his records but I will just to speed this process up and hopefully get him to temporary 100

Anyway, you gave me some really really good information to start this process and I sincerely appreciate it!  

 

[Phury & Rhage]

I agree that it sounds like his cancer would be considered active, but the simplest thing to do is take the Kidney DBQ to the doctor (attached below) and have him fill it out. 

Presumptive conditions don't require medical opinions.  If the Veteran meets the requirements for presumption (Camp Lejeune service between August 1, 1953 and December 31, 1987 for at least 30 days and diagnosis of a listed presumptive condition under 3.309(f)), service connection is warranted and will be granted.  Technically, the DBQ isn't necessary either - just current medical documentation of the cancer status and acceptable diagnostic proof, but the DBQ has a bunch of the questions/answers that will allow the decisionmaker to grant the claim quickly.

This is from 38 CFR 3.307(a)(7)

I'm attaching the current DBQ from VA's public website.

I hope this gets handled quickly!

All the best,

Phury

kidney.pdf