Malignant tumor of the bile ducts (cholangiocarcinoma)
VA doesn't add ratings together. It combines them using the table in 38 CFR § 4.25, so two ratings usually total less than their sum.
During active treatment, medical records confirming a diagnosis of bile duct cancer and documentation of ongoing surgical, X-ray, chemotherapy, or other therapeutic procedures are the core evidence supporting the 100% rating. After treatment ends, the mandatory VA examination six months later becomes a critical record. At that exam, findings about whether the cancer has recurred or spread — such as imaging results, biopsy reports, lab values, or oncologist notes — will determine whether the 100% rating continues or whether rating on residuals is appropriate. If rating on residuals, records showing the nature and severity of remaining symptoms matter. These might include gastroenterology or surgical notes, imaging studies, nutrition and weight records, and statements from you or those who know you describing how ongoing symptoms affect your daily functioning and ability to work. Any specialist treatment records from the period after discontinuation of therapy are also relevant to that determination.
VA exam form (DBQ) for this condition:
If your service meets the rules below, VA presumes this condition is connected to it.
Conditions that are often caused or made worse by this one. If you have any of these, they may be claimable as secondary service connection.
