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Bladder Cancer VA Disability Rating
DC 7528 | 38 C.F.R. § 4.115b | M21-1, Part IV.ii.2.E
OVERVIEW
Bladder cancer is rated under DC 7528 (Malignant neoplasms of the genitourinary system) at 38 C.F.R. § 4.115b. 100% during active disease or treatment. Six months after cessation of treatment, mandatory VA examination required. If no recurrence, rate on residuals as voiding dysfunction or renal dysfunction, whichever is predominant. Bladder cancer is a PACT Act presumptive for veterans with qualifying burn pit or toxic exposure and an Agent Orange presumptive for Vietnam-era veterans.
RATING CRITERIA (4 LEVELS)
100% — Active disease or during treatment
100% during active cancer or any treatment phase. Mandatory VA examination 6 months after cessation. If no recurrence, rate residuals as voiding dysfunction or renal dysfunction.
Voiding dysfunction residuals — 60%
Post-treatment residuals: continual urine leakage requiring appliance or absorbent materials changed more than 4 times per day; OR daytime voiding interval less than 1 hour; OR awakening to void 5+ times per night.
Voiding dysfunction residuals — 40%
Absorbent materials changed 2-4 times per day; OR daytime voiding interval 1-2 hours; OR awakening 3-4 times per night.
Voiding dysfunction residuals — 20%
Absorbent materials changed less than 2 times per day; OR daytime voiding interval 2-3 hours; OR awakening 2 times per night.
KEY EVIDENCE TO GATHER
-Pathology report confirming bladder cancer with stage and grade
-Cystoscopy and TURBT records
-Treatment records: BCG therapy, chemotherapy, radiation, cystectomy
-Agent Orange or PACT Act burn pit exposure documentation
-Post-treatment cystoscopy surveillance records
-Records of voiding dysfunction: incontinence, frequency, obstruction
SECONDARY CONDITIONS (3 MAPPED)
DC 7502
Bladder cancer and its treatment cause renal dysfunction — rate as renal dysfunction under § 4.115a if predominant.
DC 7522
Radical cystectomy and radiation cause erectile dysfunction — file separately with SMC-K.
DC 9434
Cancer diagnosis causes significant depression — independently ratable.
C&P EXAM TIPS (5)
1.File immediately upon diagnosis — protect your effective date.
2.PACT Act presumptive: burn pit exposure (Iraq, Afghanistan) establishes service connection without nexus opinion.
3.Agent Orange presumptive: Vietnam-era veterans with bladder cancer file immediately.
4.At the 6-month post-treatment exam, document all voiding symptoms — the rating requires precise measurement of leakage frequency and voiding intervals.
5.Erectile dysfunction after treatment is separately ratable plus SMC-K ($139.87/mo).
RELEVANT CASE LAW
38 C.F.R. § 4.115b, DC 7528 Note
Following cessation of treatment, 100% continues with mandatory VA examination at 6 months. Rate on residuals as voiding dysfunction or renal dysfunction if no recurrence. Reductions subject to § 3.105(e).
PACT Act, Pub. L. 117-168
Bladder cancer is a presumptive condition for veterans with qualifying airborne hazard and open burn pit exposure.
DOLLAR IMPACT
100% during treatment: $3,938.58/mo. Voiding dysfunction residuals after cystectomy: 40-60% ($673-$1,131/mo). Erectile dysfunction adds SMC-K.
EDUCATIONAL TOOL ONLY. NOT LEGAL OR MEDICAL ADVICE.
NOT AFFILIATED WITH THE U.S. DEPARTMENT OF VETERANS AFFAIRS.
CLAIM RECON 2026