Testicular Cancer

Active testicular cancer is evaluated under Diagnostic Code 7528 for malignant neoplasms of the genitourinary system. The current schedule assigns 100 percent while the malignancy is active and during surgical, radiation, chemotherapy, or other antineoplastic treatment. The 100-percent evaluation continues after treatment ends until VA conducts the mandatory examination required six months later.

If there has been no local recurrence or metastasis, VA then rates the remaining disability as voiding dysfunction or renal dysfunction, whichever predominates. Removal or atrophy of a testis may also fall under DC 7524 or 7523, and the schedule directs VA to review possible special monthly compensation.

TL;DR

• Active testicular cancer and antineoplastic treatment rate at 100 percent under DC 7528.
• The 100-percent evaluation continues after treatment ends, with a mandatory VA examination at six months.
• If there is no recurrence or metastasis, DC 7528 directs VA to rate the predominant voiding or renal residual.
• Removal of one testis is 0 percent under DC 7524; removal of both is 30 percent, subject to the code's special note.
• Anatomical loss of a testis should trigger review for SMC-K, but the applicable facts and service connection still must be established.
• Testicular cancer may be presumptive as a reproductive cancer for qualifying toxic-exposure service under the PACT Act.
• Malignant tumors are also listed chronic diseases, so manifestation to a compensable degree within one year after qualifying service may support a presumption.
• Fertility, endocrine, neurologic, scar, and other treatment effects should be documented even when they are not the residual route named in DC 7528.

The Current DC 7528 Rating

38 CFR § 4.115b assigns 100 percent for a malignant neoplasm of the genitourinary system. The note to DC 7528 keeps that evaluation in place after surgical, radiation, chemotherapy, or other treatment ends. VA then schedules an examination six months after cessation of treatment.

The examination is a decision point, not an automatic reduction date. If the cancer has recurred locally or metastasized, the 100-percent evaluation continues. If it has not, the code directs rating based on voiding dysfunction or renal dysfunction, whichever is predominant. Any reduction must also follow the notice protections in § 3.105(e) when they apply.

Treatment records should identify the date active treatment actually ended. Surveillance, laboratory monitoring, and follow-up imaging do not necessarily equal antineoplastic treatment. The oncologist's characterization of the treatment course matters.

Orchiectomy, Atrophy, and SMC Review

When a testis has been removed, DC 7524 provides:

• 0 percent for removal of one testis; and
• 30 percent for removal of both testes.

The code has a special note for a service-connected removal of one testis when the other testis is absent or nonfunctioning for reasons unrelated to service. The exact facts must be compared with that note rather than assuming the ordinary one-testis percentage resolves the claim.

DC 7523 rates complete atrophy of one testis at 0 percent and both at 20 percent. Both codes direct adjudicators to review entitlement under 38 CFR § 3.350. Anatomical loss of a creative organ may support SMC-K even when the schedular orchiectomy percentage is 0. The current payment amount should be checked on VA's compensation-rate page rather than hard-coded into a condition guide.

PACT Act and Other Presumptive Routes

VA's PACT Act benefits guide includes reproductive cancer of any type among covered presumptive cancers for veterans with qualifying service and exposure. Testicular cancer falls within that reproductive-cancer category, but the veteran must still meet the applicable service-location and timing requirements.

The PACT route is not the only possible presumption. 38 CFR § 3.309(a) lists malignant tumors as chronic diseases. Under § 3.307, manifestation to at least a 10-percent degree within one year after qualifying separation may support presumptive service connection even if the formal diagnosis came later. A retrospective oncology opinion can be important when symptoms or a mass were present during that window but the workup finished afterward.

Direct Service Connection

Direct service connection under § 3.303 may apply when the cancer began in service or a clinician connects it to an in-service event or exposure. Useful evidence can include:

1. service records documenting a mass, swelling, pain, imaging, tumor markers, or referral;
2. pathology identifying the malignancy and histologic type;
3. operative, oncology, chemotherapy, and radiation records;
4. a timeline from first symptoms to diagnosis; and
5. a medical opinion addressing onset or a documented exposure when no presumption applies.

A diagnosis after service does not by itself prove or disprove onset during service. The medical opinion should discuss the tumor's course and the actual record rather than rely only on the date pathology was signed.

Treatment Residuals to Document

The National Cancer Institute explains that treatment may include inguinal orchiectomy, chemotherapy, radiation, retroperitoneal lymph-node surgery, or surveillance, depending on tumor type and stage. The resulting record may raise issues beyond the active-cancer evaluation, including:

• voiding or renal dysfunction;
• anatomical loss or complete atrophy of a testis;
• surgical scars or painful scars;
• infertility or impaired fertility;
• endocrine effects such as clinically established hypogonadism;
• peripheral neuropathy or other chemotherapy effects; and
• complications from lymph-node surgery or radiation.

Not every side effect receives a separate rating. A distinct diagnosis, service-connected causal link, and nonoverlapping functional impairment are needed. Section 4.14 prevents paying twice for the same manifestation.

What the C&P Record Should Establish

The record should answer:

• Is the malignancy active, recurrent, metastatic, in remission, or under surveillance?
• What treatment was antineoplastic, and when did it end?
• Has the mandatory six-month post-treatment examination occurred?
• If the cancer is inactive, which voiding or renal residual predominates under DC 7528?
• Was one or both testes removed or completely atrophied?
• Does the record raise SMC for anatomical loss or loss of use of a creative organ?
• What other diagnosed treatment residuals remain, and are they functionally distinct?
• Does the veteran meet a PACT Act or chronic-disease presumptive route?

Common Failure Modes

• Treating the six-month date as an automatic reduction rather than the point for a mandatory examination.
• Continuing 100 percent solely because follow-up surveillance continues after antineoplastic treatment has ended.
• Missing recurrence or metastasis evidence that keeps DC 7528 at 100 percent.
• Rating only the orchiectomy and overlooking the active-cancer period.
• Assuming a 0-percent rating for removal of one testis means SMC cannot apply.
• Calling every treatment effect separately compensable without a diagnosis and distinct impairment.
• Ignoring PACT Act eligibility or the one-year malignant-tumor presumption.

Bottom Line

A testicular-cancer claim has two different stages. During active malignancy and qualifying treatment, DC 7528 assigns 100 percent. After treatment and the required examination, VA must determine whether the cancer remains active and, if not, evaluate the proper residuals. The strongest record preserves the oncology timeline, pathology, treatment dates, recurrence status, orchiectomy facts, and every medically identified residual.

Legal and medical sources: 38 CFR § 4.115b, § 3.307, § 3.309, § 3.350, VA PACT Act benefits, and National Cancer Institute testicular-cancer treatment, checked August 14, 2026.