If the VA already service-connected your bladder cancer (also called cancer of the bladder, bladder tumor, bladder carcinoma, urothelial carcinoma), 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 bladder cancer commonly leads to, why, and what evidence each one takes.
Bladder cancer is rated under diagnostic code 7528, malignant neoplasms of the genitourinary system (38 CFR 4.115b):
Bladder cancer is listed in the herbicide statute, 38 U.S.C. 1116(a)(2)(J). If you have qualifying herbicide exposure, VA presumes the service link. (The regulation list at 38 CFR 3.309(e) does not show it yet; the presumption comes from the statute.)
Bladder cancer is one of the eight Camp Lejeune water diseases in 38 CFR 3.309(f), for exposure that meets 38 CFR 3.307(a)(7).
Without a presumption, you need the usual three pieces: a diagnosis, an in-service event or exposure, and a medical link. See the nexus letter sample and template.
For most veterans the long-term rating comes from urine leakage or frequency. Keep a voiding diary and count pad changes per day before the six-month exam. More on how leakage is measured: urinary incontinence VA rating.
| Voiding dysfunction: urine leakage (38 CFR 4.115a) | Rating |
|---|---|
| Requiring an appliance, or absorbent materials changed more than 4 times per day | 60% |
| Absorbent materials changed 2 to 4 times per day | 40% |
| Absorbent materials changed less than 2 times per day | 20% |
| Voiding dysfunction: urinary frequency | Rating |
|---|---|
| Daytime voiding interval less than one hour, or waking to void 5+ times per night | 40% |
| Daytime interval between one and two hours, or waking 3 to 4 times per night | 20% |
| Daytime interval between two and three hours, or waking 2 times per night | 10% |
| Renal dysfunction (38 CFR 4.115a) | Rating |
|---|---|
| CKD with GFR under 15, or regular routine dialysis, or eligible kidney transplant recipient | 100% |
| CKD with GFR 15 to 29 | 80% |
| CKD with GFR 30 to 44 | 60% |
| CKD with GFR 45 to 59 | 30% |
| GFR 60 to 89 plus casts, structural kidney abnormality, or albumin/creatinine ratio of 30 mg/g or more | 0% |
Each GFR level must be present for at least 3 consecutive months during the past 12 months. GFR is in mL/min/1.73 m².
Erectile dysfunction after pelvic surgery or radiation is rated 0% under DC 7522 but is reviewed for special monthly compensation (SMC-K) under 38 CFR 3.350(a). See also prostate cancer and ED secondaries.
A secondary claim only works if the primary condition (bladder cancer) is already service-connected, and you have a nexus — a doctor's opinion that it is "at least as likely as not" the cause. Nexus letter sample and template →
The VA pays 100 percent while the cancer is being actively treated, then re-examines you six months after treatment stops. If there is no recurrence, the rating moves to your residuals, and for bladder cancer that is usually voiding dysfunction: frequency, urgency, leaking, or needing absorbent pads. Those residuals are the claim after treatment. Also worth knowing: bladder cancer was added to the Agent Orange presumptive list in January 2021 by 38 U.S.C. 1116(a)(2).
What you'd need: A voiding diary, urology notes, pad usage, and the results of the mandatory six-month post-treatment VA examination.
Surgery and radiation in the pelvis can damage the nerves and blood supply involved in erections. This is a recognized residual of bladder cancer treatment and it carries extra monthly pay.
What you'd need: A urology note documenting the dysfunction and its timing relative to your treatment, plus a nexus opinion tying it to the cancer treatment.
A cancer diagnosis, the treatment, and living with recurrence surveillance are recognized drivers of secondary depression and anxiety.
What you'd need: A mental health diagnosis and a provider opinion connecting it to the cancer diagnosis and treatment.