VA Rating for Cancer

Home › Conditions › Cancer

Active cancer is rated 100 percent during treatment; afterward the residuals are rated — and the PACT Act and Agent Orange rules make many cancers presumptive. This guide quotes the actual rating criteria from 38 CFR Part 4 for diagnostic code varies / 7528, explains what the C&P examiner measures, covers the presumptive and secondary routes to service connection, and lists the reasons these claims come back denied — and how each gets fixed.

How the VA rates cancer in 2026 — the exact criteria

These are the criteria a VA rater applies, quoted from the rating schedule (§ 4.114 · § 4.115b · § 4.117 and others). Your rating is the highest level whose wording your evidence meets — and evidence that never uses these words tends to be rated at the bottom.

Malignant neoplasms (for example DC 7528 genitourinary; each body system has its own code)

Following the cessation of treatment, the 100 percent rating continues with a mandatory VA examination at the expiration of six months; any reduction is subject to the due-process protections of 38 CFR 3.105(e).

The PACT Act (38 CFR 3.320) made many cancers presumptive for covered exposures — including head, neck, respiratory, gastrointestinal, reproductive, kidney, brain, pancreatic, melanoma and lymphomas — and Agent Orange presumptives (3.309(e)) cover prostate, respiratory, bladder cancers and more.

Honest ceiling: active cancer rates 100% automatically; residuals rate after treatment.

What the C&P examiner measures

The examiner records diagnosis, treatment dates and status (active, in remission, surveillance), and the residuals — voiding dysfunction, renal dysfunction, scarring, fatigue. The 100 percent rating runs through treatment and six months after, then residuals are rated.

The questions that get at the rating criteria — answer them for yourself before the exam:

• Any cancer, ever — even one you beat?
• Where were you deployed when it showed up? Some of these are connected by law.

Service connection: presumptive, direct, or secondary

The PACT Act (38 CFR 3.320) made presumptive for covered toxic-exposure service: head, neck, respiratory, gastrointestinal, reproductive, kidney, brain and pancreatic cancers, melanoma, glioblastoma, and lymphomas of any type. Agent Orange presumptives (3.309(e)) include prostate, bladder, respiratory cancers, soft-tissue sarcomas, Hodgkin's and non-Hodgkin's lymphoma, chronic B-cell leukemias and multiple myeloma.

Every service-connection claim has three legs: a current diagnosis (the C&P exam can supply it), an in-service event, injury, exposure or an already-connected condition, and a link between the two — which the VA's own examiner addresses at the exam for direct and secondary claims, and which the law supplies for presumptive ones. You do not need a private opinion to file; you need one only if the VA denies for lack of nexus, and a supplemental claim within one year keeps your effective date.

Secondary conditions veterans miss

This condition is more often the secondary in a chain than the anchor — see the secondary-claims guides for the recognized pathways.

What the medical literature says

NASEM, Veterans and Agent Orange (updates 1994–2018)
The standing scientific review linking herbicide exposure to specific cancers — the basis of the VA presumptive list. Why it matters: Check his cancer against the AO presumptive list first.

PACT Act (2022) — expanded presumptive cancers for burn-pit/airborne-hazard exposure
Head/neck/respiratory/GI cancers and more are presumptive for covered veterans. Why it matters: Covered theater + listed cancer = presumptive.

Why cancer claims get denied — and the fix

• Reduced after treatment without the mandatory six-month examination and 3.105(e) notice.
• PACT Act or Agent Orange presumption not applied because exposure location was not documented.

A denial is a grade on the evidence packet, not a verdict on you. Filed as a supplemental claim within one year, the fix keeps your original effective date.

Filing it right the first time

1. Intent to File first. It locks your effective date for a year — back pay runs from that day, not from the day the package is ready.
2. File everything at once. Every condition with a real symptom and a plausible route — direct, presumptive, secondary, increase — goes in one claim. The VA's duty to assist schedules the exam and pulls your records; a condition held back "for more evidence" only starts its clock later.
3. Your statement in the criteria's words. A Statement in Support of Claim (VA Form 21-4138) that describes your worst days and your typical days using the language in the table above is the evidence the rater reads first.
4. Your records. VA records through Blue Button, decision letters and code sheet from VA.gov, and private records from each doctor's office or patient portal — or a signed 21-4142 so the VA pulls them.
5. Prepare for the exam. Know what the examiner measures (above) and answer honestly, including the bad days.

Frequently asked questions

Related guides: Vertigo and Meniere's DiseaseTMJVaricose VeinsAll conditionsDenied? The 3 lanesCombined-rating calculator

Rating criteria verified against eCFR (38 CFR Part 4) — last reviewed 2026-09-19. Regulations change; confirm anything decision-critical at ecfr.gov.