The PACT Act presumptive conditions list represents the most significant expansion of veteran healthcare and disability benefits in more than 30 years. Signed into law on August 10, 2022, the Sergeant First Class Heath Robinson Honoring Our Promise to Address Comprehensive Toxics (PACT) Act reshaped how the Department of Veterans Affairs (VA) reviews claims related to toxic exposures during military service.
For millions of veterans who served near burn pits, around Agent Orange, in contaminated water areas, or at radiation cleanup sites, this new framework eliminates the need to prove a direct link between service and illness. If a condition appears on the list and you served in a qualifying location and timeframe, the VA now presumes service connection. Here is what you need to know about the presumptive conditions list and how it could impact you.
What “Presumptive” Means
The VA assumes service connection if you meet both: qualifying service in a listed location and timeframe, plus a diagnosis of a listed presumptive condition. Recently, the VA has added more than 20 burn-pit and airborne-hazard conditions as presumptive, and it has also expanded Agent Orange, radiation, and other exposure rules.
Burn Pit and Airborne Hazards: Who is Covered
You may qualify if you served in any of the following:
- Post-9/11 era: Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Uzbekistan, Yemen, and the airspace above these locations, on or after September 11, 2001
- Gulf War era: Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, Somalia, United Arab Emirates, plus surrounding waters and airspace including the Arabian Sea, Gulf of Aden, Gulf of Oman, Persian Gulf, Red Sea, and the neutral zone between Iraq and Saudi Arabia, on or after August 2, 1990
Presumptive Cancers Tied to Burn Pits and Airborne Hazards
The VA groups many cancers as presumptive for these exposures, including:
- Brain and related nervous-system cancers
- Head and neck cancers
- Gastrointestinal cancers of any type
- Kidney cancer
- Lymphatic and lymphoma cancers of any type
- Melanoma
- Neck cancers
- Pancreatic cancer
- Reproductive cancers, including cancers of the paraurethral glands and urethra
- Respiratory cancers
- Sarcomas
Presumptive Non-Cancer Respiratory Diseases
If you have a diagnosis of any of the following after qualifying service, the VA considers them presumptive:
- Asthma diagnosed after service
- Chronic bronchitis
- COPD
- Chronic rhinitis
- Chronic sinusitis
- Constrictive or obliterative bronchiolitis
- Emphysema
- Granulomatous disease
- Interstitial lung disease
- Pleuritis
- Pulmonary fibrosis
- Sarcoidosis
Agent Orange: Conditions and Locations Expanded by the PACT Act
New Presumptive Conditions Under the PACT Act
- Hypertension
- Monoclonal gammopathy of undetermined significance (MGUS)
Previously established Agent Orange presumptives include bladder cancer, chronic B-cell leukemias, Hodgkin’s disease, multiple myeloma, non-Hodgkin’s lymphoma, prostate cancer, respiratory cancers, soft-tissue sarcomas, AL amyloidosis, type 2 diabetes, ischemic heart disease, Parkinson’s disease, and hypothyroidism.
Expanded locations for Agent Orange exposure now include, in addition to Vietnam and the Korean DMZ, several sites such as Thai bases, Laos, Cambodia, Guam, American Samoa, and Johnston Atoll with specific date windows.
Radiation-Exposed Veterans: New Presumptive Cleanup Locations
The PACT Act added three cleanup operations as presumptive radiation locations:
- Enewetak Atoll cleanup, 1977 to 1980
- Palomares, Spain B-52 accident cleanup, January 17, 1966 to March 31, 1967
- Thule Air Base, Greenland accident response, January 21, 1968 to September 25, 1968
Radiation presumptives include leukemias (except CLL), certain solid cancers, lymphomas, and multiple myeloma.
Camp Lejeune Water Contamination
If you served 30 days or more at Marine Corps Base Camp Lejeune or MCAS New River between August 1, 1953 and December 31, 1987 and have one of eight listed diseases, the VA presumes service connection. The eight conditions are adult leukemia, aplastic anemia and other myelodysplastic syndromes, bladder cancer, kidney cancer, liver cancer, multiple myeloma, non-Hodgkin lymphoma, and Parkinson’s disease.
Gulf War Illnesses and Undiagnosed Conditions
Gulf War veterans who served in the Southwest Asia theater may qualify for presumptive service connection for certain chronic multi-symptom illnesses and functional GI disorders, as well as specific infectious diseases. Examples include chronic fatigue syndrome, fibromyalgia, functional GI disorders, and medically unexplained chronic multisymptom illness, plus a list of recognized infections.
What Changed in 2025
The VA announced additional presumptives effective in January 2025, including acute and chronic leukemias and several genitourinary cancers. For some conditions the effective date was January 2, 2025, and for others January 10, 2025. Check the VA’s current resources for specifics and ongoing updates.
How to Use the PACT Act Presumptive Conditions List to File a Claim
- Confirm you meet a qualifying service location and timeframe. Use the official VA pages for burn pits, Agent Orange, radiation, Camp Lejeune, or Gulf War. That is the fastest way to check eligibility against the current PACT Act presumptive conditions list.
- Get a clear diagnosis. You need medical records that show a current diagnosis matching a VA presumptive. If you have symptoms but not a diagnosis yet, enroll in VA health care and ask for evaluation.
- Gather your service records. Your DD-214 and any deployment orders that place you in the qualifying locations and dates are key.
- File your claim. You can file online, by mail, or in person. If a condition was added after you were previously denied, file a Supplemental Claim. If you never filed, submit a new claim.
- Complete VA toxic exposure screening. VA offers a short screening to record possible exposures and guide follow-up care. It is available to all enrolled veterans.
- Attend your C&P exam if scheduled. Go to the appointment and bring a list of your symptoms and medications.
Tips That Speed Things Up
Here are a few quick tips that can help speed up the process.
- Match your diagnosis wording to the VA list when possible.
- Upload the key pages, not a giant file. Label files clearly.
- If you are unsure, meet with a Veterans Service Organization for free filing help.
For Survivors
If a veteran died from a presumptive condition linked to qualifying service, survivors may be eligible for:
- Dependency and Indemnity Compensation
- Accrued benefits
- Survivors pension
- Education benefits
- CHAMPVA health care
- Burial benefits
If you were denied in the past, recheck eligibility now that rules have expanded.
Common Pitfalls and How to Avoid Them
Mistakes are common when filing for VA benefits. You’ll want to avoid these pitfalls when you are going through the process.
- Over-claiming every symptom: Focus on diagnosed presumptives first. Add secondary conditions later if needed.
- Relying on unofficial lists: The VA updates pages regularly. If a blog contradicts the VA, trust the VA.
- Missing evidence of location and dates: Your DD-214 alone may not show you were in a specific country. Add deployment orders or award citations if they prove location.
- Not filing a Supplemental Claim after past denial: If your condition is now presumptive, the Supplemental Claim path exists for exactly this scenario.
Where to Get Help
There are several good places to get help. Here are two places to look.
- VSOs: American Legion, VFW, DAV, state and county veterans services. They file for free and know the paperwork.
- VA benefits site: Use the PACT Act hub and the specific exposure pages listed in this article to verify eligibility, conditions, and locations.
Recent Changes to Watch
The VA’s January 2025 notice added presumptions for certain leukemias and genitourinary cancers, with effective dates in early January. The VA also continues to publish clarifying pages, such as the reproductive-cancers resource. Check back before you file, since the PACT Act presumptive conditions list is still being refined.
Where To Get Help
If your service matches the listed locations and timeframes and you have a diagnosis on the PACT Act presumptive conditions list, the VA will presume service connection. That simplifies the process, but it still requires accurate records and a complete claim. Use the VA’s current pages, get a clean medical diagnosis, and file with help if needed.
At Allveteran.com, we seek to help veterans connect with resources that may make all the difference. To find out your disability rating, take our free medical evidence screening today!
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