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March 23, 2026 | By Cope | 15 min read

VA Presumptive Conditions in 2026: The Complete List

Presumptive service connection means the VA assumes your condition is related to your service — you do not need a nexus letter. The PACT Act of 2022 was the largest expansion of presumptive conditions in VA history. Here is every category and what qualifies.

DISCLAIMER
Educational information based on publicly available VA regulations. Not legal or medical advice. Not affiliated with the VA.

What Is Presumptive Service Connection?

Under normal service connection (38 C.F.R. 3.303), you need three things: a current diagnosis, an in-service event or exposure, and a medical nexus connecting the two. Presumptive service connection (38 C.F.R. 3.307, 3.309) eliminates the nexus requirement. If you served in a qualifying location during a qualifying period and you have a listed condition, the VA presumes it is connected to your service. You still need a current diagnosis, but you do not need a doctor to write a nexus letter linking it to service.

38 C.F.R. 3.307, 3.309 (Presumptive Service Connection); M21-1, Part IV.ii.1.D

PACT Act (Public Law 117-168)

The PACT Act, signed August 10, 2022, is the most significant expansion of VA health care and benefits in decades. It establishes presumptive service connection for conditions linked to toxic exposures including burn pits, Agent Orange, and radiation. The PACT Act concedes toxic exposure for any veteran who served in a covered location during a covered period.

Public Law 117-168 (PACT Act); M21-1, Part IV.ii.1.D.6

Burn Pit / Airborne Hazards Presumptives

Veterans who served in Southwest Asia, the Gulf War theater, or other designated locations after August 2, 1990, are covered. Conditions include:

PACT Act Burn Pit Conditions
Cancers: bladder, head/neck (pharynx, larynx, trachea), respiratory (bronchus, lung, trachea), reproductive (all types), ureter, kidney (renal pelvis), melanoma, pancreatic, any cancer for which DOD has established a link to burn pit exposure. Respiratory: constrictive bronchiolitis, constrictive pericarditis, COPD, interstitial lung disease, pleuritis, pulmonary fibrosis, sarcoidosis, chronic sinusitis, chronic rhinitis, chronic laryngitis, glioblastoma, lymphatic cancer, lymphomatic cancer, kidney cancer, any illness the VA Secretary determines warrants presumptive.

Agent Orange Presumptives

Veterans who served in Vietnam (1962-1975), Thailand (specific Royal Thai Air Force bases), or locations where Agent Orange was tested or stored are covered. The PACT Act added several new conditions to the list in 2022-2024.

Agent Orange Conditions (38 C.F.R. 3.309(e))
AL amyloidosis, bladder cancer, chronic B-cell leukemias, chloracne, diabetes mellitus type 2, Hodgkin disease, hypertension, ischemic heart disease, monoclonal gammopathy of undetermined significance (MGUS), multiple myeloma, non-Hodgkin lymphoma, Parkinsonism, early-onset peripheral neuropathy, porphyria cutanea tarda, prostate cancer, respiratory cancers, soft tissue sarcomas, parathyroid adenoma (PACT Act addition), high-grade glioma (PACT Act addition).

Gulf War Illness Presumptives

Veterans who served in the Gulf War theater (Southwest Asia) on or after August 2, 1990, may qualify for presumptive coverage for undiagnosed illness or medically unexplained chronic multi-symptom illness (MUCMI) under 38 C.F.R. 3.317.

Gulf War Illness Conditions
Chronic fatigue syndrome, fibromyalgia, functional gastrointestinal disorders (IBS), undiagnosed illness manifesting as: fatigue, headaches, joint pain, muscle pain, neurological symptoms, respiratory symptoms, sleep disturbances, cardiovascular symptoms, abnormal weight loss, menstrual disorders, skin conditions.
38 C.F.R. 3.317 (Gulf War Illness); M21-1, Part IV.ii.1.D

Camp Lejeune Water Contamination

Veterans and family members who lived or worked at Camp Lejeune for at least 30 days between August 1, 1953, and December 31, 1987, are covered for conditions linked to contaminated water.

Camp Lejeune Presumptive Conditions
Bladder cancer, breast cancer, esophageal cancer, female infertility, hepatic steatosis, kidney cancer, leukemia, lung cancer, miscarriage, multiple myeloma, myelodysplastic syndromes, neurobehavioral effects, non-Hodgkin lymphoma, renal toxicity, scleroderma.
38 U.S.C. 1710(e) (Camp Lejeune); Camp Lejeune Justice Act of 2022

Radiation Exposure

Veterans who participated in nuclear weapons testing or were exposed to ionizing radiation during service are covered for specific cancers and other conditions.

Radiation Presumptive Conditions (38 C.F.R. 3.309(d))
Leukemia (except CLL), cancers: thyroid, breast, pharynx, esophagus, stomach, small intestine, pancreas, bile ducts, gallbladder, salivary glands, urinary tract, bone, brain, colon, lung, ovary, multiple myeloma, lymphomas, renal cancers, liver cancer (primary).
CHECK YOUR ELIGIBILITY
Use the PACT Act Scanner to enter your service dates, locations, and MOS to see which presumptive categories apply to you. Use the 347 Condition Guides to find your specific condition and its rating criteria.

How to File a Presumptive Claim

Filing a presumptive claim is the same 21-526EZ form as any other claim. The difference is in what evidence you need. For presumptive conditions: you need proof of service in a qualifying location (DD-214, deployment orders, personnel records) and a current medical diagnosis. You do NOT need a nexus letter from a doctor. The VA presumes the nexus. If the VA denies a presumptive claim by requiring a nexus letter, that is an error you can appeal.

Not affiliated with the U.S. Department of Veterans Affairs. Educational tools only — not legal or medical advice. Consult your VSO, attorney, or accredited claims agent for guidance specific to your claim.