VA Is Cutting My 100% Rating After Cancer Treatment
Why the 100% ends
The malignancy diagnostic codes in 38 CFR Part 4 — for example 7528 for malignant genitourinary neoplasms, DC 6819 for malignant respiratory neoplasms, and the digestive and skin analogues — assign a 100% evaluation during active malignancy and for a set period after therapeutic procedures end, commonly six months. That is written into the code itself; it is not a discretionary decision by the rater.
At the end of that period the code directs a mandatory VA examination, and the disability is then rated on residuals. If there are no compensable residuals, the evaluation can drop to 0%. If residuals exist and are documented, they carry their own evaluations, and multiple residuals are often ratable separately.
Where these cases are actually won or lost
The dispute is rarely about whether the 100% could end. It is about whether every residual was identified, examined, and rated. Cancer treatment leaves a long tail: surgical removal of an organ, radiation fibrosis, chemotherapy-induced peripheral neuropathy, hypothyroidism after neck radiation, voiding dysfunction and erectile dysfunction after prostatectomy, lymphedema after node dissection, fatigue, and mental-health effects.
If the examination covered only the primary site and the decision rates only that site, the resulting evaluation is likely to understate the actual disability picture. That is an underrated decision, and it is appealable on the record that already exists.
The procedural protections that apply
- VA must issue a written proposal to reduce before the reduction takes effect (38 CFR § 3.105(e)).
- You have 60 days from the proposal to submit additional evidence.
- You have 30 days from the proposal to request a predetermination hearing — this is the shorter of the two clocks and the one most often missed.
- If the reduction is implemented, the reduced rate generally takes effect the last day of the month following 60 days from the notice of final action.
- A rating in effect for 20 years or more is protected from reduction absent fraud (38 CFR § 3.951(b)).
What to gather before the examination
- The complete oncology record: pathology, operative reports, radiation summaries, and chemotherapy administration records.
- Current treatment notes for each residual — endocrinology for post-radiation thyroid dysfunction, urology for voiding and erectile dysfunction, neurology for neuropathy.
- Objective measures where the rating criteria call for them: pad counts and voiding frequency, pulmonary function testing, , audiometry.
- Documentation of surveillance status, including whether you remain on active surveillance or maintenance therapy, which can bear on whether treatment has actually concluded.
Check this against your VA paperwork
The specific language in the proposal letter and the examination report usually tells you which argument the record supports.
| If your record shows this | What it means |
|---|---|
| The letter is titled 'Proposed Rating Reduction' and gives you 60 days | The reduction has not happened yet. Two clocks are running: 30 days for a predetermination hearing request, 60 days for evidence. The hearing request is the one that expires first. |
| The examination report addresses only the cancer site and says 'in remission' | Residuals were likely not examined. Each residual under its own diagnostic code is the substance of an underrated-decision appeal. |
| You are still on maintenance therapy or hormone therapy | Whether therapeutic procedures have actually ended is a factual question. The six-month clock in the code runs from the cessation of treatment, not from the surgery date alone. |
| The rating dropped to 0% and lists no other conditions | Separate evaluations for neuropathy, hypothyroidism, voiding dysfunction, or scars may never have been considered even though the treatment records document them. |
| The 100% has been in place since a date more than 20 years ago | 38 CFR § 3.951(b) protects a rating continuously in effect for 20 years from reduction except for fraud. Check the effective date on the code sheet, not the date of the last decision. |
| The reduction also ended TDIU or a special monthly compensation award | Collateral awards frequently fall with the underlying evaluation. Those are separate issues and should be identified separately in any appeal. |
Educational only. The regulation and your own record control.
Frequently Asked Questions
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Disclaimer: This page is for educational purposes only and does not constitute legal advice. Oakridge Claims is a private business and is not affiliated with, endorsed by, or operated by the U.S. Department of Veterans Affairs. No guarantees of outcomes are made. Each claim is decided on its individual facts.
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