The PACT Act (signed August 10, 2022) is the biggest expansion of VA benefits for toxic-exposed veterans in decades. It adds 20+ presumptive conditions, expands Agent Orange and radiation coverage, and — critically — concedes toxic exposure for veterans who served in qualifying locations. No nexus letter needed; service location + diagnosis on the presumptive list is enough. Previously denied claims can be refiled as Supplemental Claims with effective dates back to the original filing under 38 CFR § 3.114.
Before the PACT Act, veterans who developed cancer or other serious conditions after exposure to burn pits, Agent Orange, or radiation often faced years of denied claims because they could not prove a direct connection between their exposure and their illness. The PACT Act fixes that by making many of these conditions presumptive.
A presumptive condition means the VA assumes the condition is service-connected if you served in a qualifying location during a qualifying time period. You do not need a nexus letter — you only need to prove you served there, you have the condition, and the condition is on the presumptive list.
The law also expanded VA health care eligibility to veterans with toxic exposures even if they do not have a disability rating, and requires the VA to conduct a toxic exposure screening as part of every veteran's VA health care visit.
Open-air burn pits were used extensively at military bases in Iraq, Afghanistan, and other locations in the Southwest Asia theater. They incinerated trash, human waste, electronics, batteries, medical waste, and chemicals. Veterans who served near them inhaled fumes now linked to numerous respiratory illnesses and cancers.
Service on or after August 2, 1990 in any of:
Iraq · Afghanistan · Syria · Jordan · Egypt · Lebanon · Yemen · Uzbekistan
The broader Southwest Asia theater of operations, including the airspace above these locations.
The PACT Act expanded the Agent Orange presumptive list and the qualifying locations.
Thailand military bases (expanded beyond perimeter duty)
Guam · American Samoa · Johnston Atoll · Laos
Test and storage locations within the United States
These are in addition to existing Agent Orange presumptives already recognized: type 2 diabetes, ischemic heart disease, Parkinson's disease, and multiple cancers.
The PACT Act also expanded benefits for veterans exposed to radiation — nuclear weapons testing participants, Hiroshima/Nagasaki occupation, cleanup operations (Enewetak Atoll, Palomares Spain). Under 38 CFR § 3.309(d) and the expanded PACT provisions, numerous cancers are presumptive for radiation-exposed veterans, and the “radiation-risk activity” definition now includes additional locations and time periods.
1. Evidence of qualifying service. DD-214 or service records showing service in a qualifying location during the qualifying time period. For burn pits: any service in Southwest Asia after August 2, 1990.
2. Current diagnosis. A medical diagnosis of one of the presumptive conditions. VA records, private treatment records, or a C&P exam.
3. File VA Form 21-526EZ. Submit via VA.gov, by mail, or through an accredited representative. Note the condition is being claimed as presumptive under the PACT Act.
4. Toxic exposure screening. Complete one at your next VA health care appointment if you haven't — creates a record of your exposure history.
If you previously filed a claim for a condition that is now presumptive and were denied, file a Supplemental Claim (VA Form 20-0995) citing the PACT Act as new and relevant evidence under 38 CFR § 3.2501. The VA is required to review under the new law.
Under 38 CFR § 3.114 (liberalizing-law rule), if you file the Supplemental Claim and it is granted, the effective date can go back to the original denied claim date — meaning potentially years of retroactive back pay.
Pre-PACT, veterans often needed to provide specific evidence of individual exposure — a nearly impossible task for many. Under the PACT Act, the VA concedes exposure for veterans who served in qualifying locations. You no longer need to prove you were personally near a burn pit or personally handled Agent Orange. Service in the qualifying location during the qualifying time period is enough.
Post-9/11 combat veterans now have a 10-year enrollment window (expanded from 5 years).
Vietnam-era veterans with Agent Orange exposure can enroll without a disability rating.
Gulf War veterans with toxic exposure can enroll without a disability rating.
The Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 (Pub. L. 117-168, signed August 10, 2022) — the largest expansion of VA health care and disability benefits for toxic-exposed veterans in decades. Codified at 38 USC §§ 1116B, 1117, 1119-1120, with implementing regulations at 38 CFR §§ 3.307, 3.309, 3.317, 3.320.
A condition the VA presumes is service-connected if the veteran served in a qualifying location during a qualifying time period and now has the condition. No nexus letter or medical opinion is required to prove the connection — the VA assumes it.
For veterans who served in qualifying PACT Act locations, the VA now concedes that toxic exposure occurred. No individual proof of exposure is required — service in the qualifying location during the qualifying time period is enough. Major shift from pre-PACT policy where individual-exposure proof was often impossible.
Iraq, Afghanistan, Syria, Jordan, Egypt, Lebanon, Yemen, Uzbekistan, and the broader Southwest Asia theater of operations (including the airspace above) — for service on or after August 2, 1990.
Yes. File a Supplemental Claim citing the PACT Act as new and relevant evidence under 38 CFR § 3.2501. Under § 3.114 (liberalizing-law rule), the effective date can go back to the original denied claim date — meaning significant retroactive back pay.
Yes. Post-9/11 combat veterans now have a 10-year enrollment window (expanded from 5 years). Vietnam-era Agent Orange veterans and Gulf War toxic-exposed veterans can enroll without a disability rating. The VA must also conduct a toxic exposure screening as part of every veteran's VA health care visit.