WingmanOpen the free toolsWingmanOpen the free toolsIf the VA already service-connected your benign prostatic hyperplasia (also called benign prostatic hyperplasia, benign prostatic hypertrophy, bph, enlarged prostate), it can cause or worsen other conditions that are ratable on their own. These "secondary" claims are where many veterans leave money on the table. Below is what a service-connected benign prostatic hyperplasia commonly leads to, why, and what evidence each one takes.
A secondary claim only works if the primary condition (benign prostatic hyperplasia) is already service-connected, and you have a nexus — a doctor's opinion that it is "at least as likely as not" the cause. More on nexus letters →
An enlarged prostate is benign, but the VA does not rate the gland itself. It rates what the obstruction does to your urination. That is where almost all of the evaluation comes from, so the symptoms you report are the claim.
What you'd need: A urology note or a BPH diagnosis, a voiding diary showing your daytime interval and how many times you wake at night, and any uroflowmetry (peak flow rate) results. Post-void residual volumes and catheter use matter too.
The medications used for an enlarged prostate (alpha blockers and 5-alpha-reductase inhibitors like finasteride) and the surgical procedures used to relieve the obstruction are recognized causes of erectile dysfunction. Even at a 0 percent rating, service connection unlocks tax-free SMC-K for loss of use of a creative organ.
What you'd need: An ED diagnosis, your BPH medication list or operative report, and a nexus opinion tying the ED to the BPH or its treatment. No percentage rating is needed for SMC-K.
Urine that never fully drains is urine that sits, and that is how obstruction leads to repeat infections. 38 CFR 4.115a treats recurrent urinary tract infections secondary to obstruction as part of the obstructed voiding picture, so document every one of them.
What you'd need: Urine cultures, the dates of each treated infection, antibiotic courses, and any hospitalization or drainage procedure.
Waking three, four or five times a night to urinate breaks sleep the same way any other cause does, and the resulting daytime fatigue and mood symptoms can be claimed. Report the number of awakenings precisely, because that same number also drives the urinary frequency evaluation.
What you'd need: A voiding diary counting nighttime awakenings, a sleep complaint documented with your provider, and a note connecting the broken sleep to the urinary symptoms rather than to a separate sleep disorder.
Planning your day around where the bathrooms are, and losing sleep to it every night, is a recognized driver of secondary depression and anxiety. This is the same secondary path the VA accepts for other chronic, quality-of-life conditions.
What you'd need: A mental health diagnosis and a provider opinion connecting the mood symptoms to living with the urinary condition.