Active cancer is the simplest rating VA has: 100 percent, no symptom checklist. The money is lost after remission, across three dates veterans rarely track: the day treatment ends, the mandatory exam six months later, and the earliest day a reduction can lawfully take effect. The residuals, not the cancer, are where these claims are won or lost.
How VA rates cancer
VA rates almost every active malignancy the same way: 100 percent, with no symptom checklist, for as long as the cancer is active and through the treatment that follows. The complexity starts when treatment ends. The schedule then pivots from the disease to its residuals, and three dates control everything: the day treatment stops, the mandatory follow-up exam six months later, and the day any reduction can legally take effect. Veterans lose money at each of those steps, usually for lack of a page in the file.
The 100 percent rule
Each body system's schedule carries its own malignancy code: DC 7528 for genitourinary cancers (prostate, bladder, kidney), DC 6819 for respiratory cancers, DC 7343 for digestive cancers, DC 5012 for bone cancer, and parallels across the other systems. While the cancer is active, or you are receiving surgery, radiation, chemotherapy, or another therapeutic procedure, the rating is total. Service connection is the real fight in a cancer claim; the percentage during active disease is not.
The six month clock
The notes under these codes share one script, and it is worth knowing as written: the 100 percent rating continues beyond the end of surgical, X-ray, or chemotherapy treatment. Six months after treatment stops, VA schedules a mandatory examination. If there has been no local recurrence and no metastasis, the rating is then based on residuals. Any change coming out of that exam must follow the reduction procedures in 38 CFR 3.105(e).
| Code | Cancers | The 100 percent runs | Then rated on |
|---|---|---|---|
| 7528 | Prostate, bladder, kidney, other genitourinary | 6 months past end of treatment, then mandatory exam | Voiding dysfunction or renal dysfunction, whichever is predominant |
| 6819 | Lung and other respiratory | 6 months past end of treatment, then mandatory exam | Residuals, including breathing capacity |
| 7343 | Digestive tract, exclusive of skin | 6 months past end of treatment, then mandatory exam | Residuals |
| 5012 | Bone, primary or secondary | 1 full year past end of treatment | Residuals |
| 7818 | Skin cancers other than melanoma | 100 percent only when therapy is at the systemic level | Scars, disfigurement, or lost function |
Bone cancer is the outlier worth knowing: its note continues the total rating for a year, not six months. Skin cancer runs the other direction: unless treatment involved a systemic or otherwise extensive therapeutic procedure, such as systemic chemotherapy, radiation beyond the skin surface, or surgery beyond wide local excision, it is rated as scars and disfigurement from the start. Other comparably aggressive treatments may also qualify and should be evaluated on the same basis.
A reduction cannot just happen (38 CFR 3.105(e))
The 100 percent does not fall off automatically at six months. VA must first propose the reduction in writing with its reasons, give you 60 days to submit evidence, and if it finalizes the decision, the lower rating takes effect no earlier than the last day of the month after a further 60 day notice period runs out. In practice the total rating usually pays well past the exam date. Miss the mandatory exam, though, and things go sideways fast: attend it, and walk in with your residuals already documented.
Residuals are where the claim is won or lost
The six month exam does not end the claim; it changes the question. A prostatectomy commonly leaves urinary leakage rated as voiding dysfunction, and erectile dysfunction, which carries special monthly compensation under SMC(k) even when the rating itself is 0 percent. A lobectomy leaves reduced breathing capacity rated on residuals such as pulmonary function test results, exercise intolerance, and the need for supplemental oxygen or other breathing assistance, any of which can support a higher rating. Chemotherapy leaves peripheral neuropathy in hands and feet; radiation leaves proctitis, cystitis, and skin damage. Each residual is separately ratable under its own diagnostic code, and the ratings combine. Get every residual named in the treatment record before the exam, and claim each one explicitly as secondary to the service-connected cancer under 38 CFR 3.310.
Recurrence restores the total rating
If the cancer comes back, locally or as metastasis, the 100 percent applies again. File immediately and send the pathology or imaging with the claim. The same goes for a second primary cancer tied to the same exposure history.
Presumptive cancers
For many veterans, service connection itself is presumed. The PACT Act added a long list of burn pit and airborne hazard cancers for Gulf War and post-9/11 veterans, the Agent Orange list under 38 CFR 3.309(e) covers herbicide exposure, and Camp Lejeune water contamination carries its own pathways. If your cancer is on a presumptive list, VA connects it without a nexus opinion; the guides linked below walk each list.
Common details veterans overlook
- Pin down the exact date treatment ended. The six month clock, the exam, and any reduction all key off it. Ongoing hormone therapy after radiation may or may not count as continuing treatment, and the answer moves the clock: ask your oncologist and get it in a note.
- Do not skip the mandatory exam. A missed exam invites a reduction on a thin record.
- Document residuals before the exam, not after. Pad counts, neuropathy complaints, breathing limits: they belong in the treatment record first.
- Check the dates on any reduction letter. The 3.105(e) notice and effective date rules are strict, and timing errors are appealable.
- Survivors have claims too. When a service-connected cancer contributes to a veteran's death, dependency and indemnity compensation may apply.