Bladder cancer

Bladder cancer is a cancer of the genitourinary system (the organs that make and carry urine). When the VA decides a claim, it first looks at whether the cancer is connected to your military service. If it agrees there is a service connection, it then assigns a disability rating using the VA's rating schedule. Bladder cancer is rated under 38 CFR 4.115b, Diagnostic Code 7528, "Malignant neoplasms of the genitourinary system."

Under Diagnostic Code 7528, the rules assign a 100% rating while the cancer is active or while you are getting treatment such as surgery, radiation, or anti-cancer (antineoplastic) chemotherapy. That 100% rating continues for six months after treatment stops. At the end of those six months, a VA examination is required. If there has been no return of the cancer (recurrence) and no spread (metastasis), the rules say the condition is then rated on its leftover effects ("residuals") — either voiding dysfunction (problems with urine leakage, frequency, or obstructed voiding) or renal (kidney) dysfunction, whichever is the main problem. For voiding dysfunction, continual urine leakage that requires wearing absorbent materials changed more than 4 times per day can warrant up to a 60% rating. If the cancer comes back, the rules provide for the 100% rating again.

There is also a presumptive pathway that can ease the burden of proving a connection to service. A presumptive condition means the VA assumes service connection if you meet the exposure and service requirements, so you generally do not need a separate "nexus" opinion linking the cancer to service. Effective January 1, 2021, the National Defense Authorization Act for Fiscal Year 2021 added bladder cancer (along with hypothyroidism and Parkinsonism) to the list of conditions presumptively linked to Agent Orange and other herbicides. The PACT Act further expanded presumptive conditions and added more presumptive-exposure locations for Agent Orange, burn pits, and other toxic exposures. The VA decides eligibility based on the facts of each veteran's case.

If a claim is denied, that is a starting point, not the end — the VA system includes ways to seek further review. This is general educational information about how the VA's rules work, and it is not legal advice or a VA decision.