If the VA already service-connected your prostate cancer (also called cancer of the prostate, prostate ca, prostate carcinoma, prostate malignancy), 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 prostate cancer commonly leads to, why, and what evidence each one takes.
Prostate cancer is rated under diagnostic code 7528, malignant neoplasms of the genitourinary system (38 CFR 4.115b):
Prostate cancer is also on the Agent Orange presumptive list (38 CFR 3.309(e)), so a qualifying herbicide exposure removes the need to prove the service link.
After treatment, 60% is the top of the urine-leakage scale. It is reached when leakage requires an appliance or absorbent pads changed more than 4 times a day. If kidney function is the bigger problem, 60% on the renal scale takes chronic kidney disease with a GFR of 30 to 44 for at least 3 consecutive months in the past year. VA uses whichever scale gives the predominant picture, so your records should document pad changes per day or your lab values clearly.
| 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.
ED after prostatectomy, radiation, or hormone therapy is one of the most common secondaries. ED itself is rated under DC 7522 at 0%, but the schedule flags it for special monthly compensation review: 38 CFR 3.350(a) pays SMC-K for loss of use of a creative organ, on top of your regular compensation. A treating urologist's note tying the ED to your cancer treatment is usually the key evidence.
A secondary claim only works if the primary condition (prostate 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 →
Prostate cancer surgery, radiation, and hormone therapy very commonly cause ED. Even at a 0% rating, service connection unlocks tax-free SMC-K for loss of use of a creative organ.
What you'd need: An ED diagnosis, your treatment records (surgery/radiation), and a nexus opinion. No percentage rating is needed for SMC-K.
Leakage and frequent urination are common residuals after prostate cancer treatment and are rated on their own (often higher than the residual cancer rating once treatment ends).
What you'd need: Urology records and a description of pad use/frequency (voiding dysfunction is rated by how often you change absorbent material).
A cancer diagnosis and its aftermath commonly lead to secondary depression or anxiety that VA can service-connect.
What you'd need: A mental-health diagnosis and a nexus opinion linking it to the cancer experience.