PACT Act Benefits for Veterans: Toxic Exposure, Presumptive Conditions, and How to File in 2026

• What Is the PACT Act?
• Burn Pit Exposure: Who Qualifies
• Presumptive Conditions for Burn Pit and Airborne Hazard Exposure
• Agent Orange and Vietnam-Era Veterans
• Radiation Exposure
• Camp Lejeune Water Contamination
• PACT Act Health Care Enrollment
• If You Were Previously Denied
• How to File a PACT Act Claim in 2026
• Conditions Added Since 2022 and What May Come Next
• Frequently Asked Questions

Before the PACT Act, a burn pit or Agent Orange claim often turned on one hard question: could you prove, medically, that a specific exposure caused a specific illness? That burden stopped many valid claims. For covered conditions tied to qualifying service, VA now starts from the presumption that your service caused the illness. This guide explains what is covered, who qualifies, which conditions VA has added since the law passed, and how to file or refile. For the full condition-by-condition breakdown, see our VA presumptive conditions list.

What Is the PACT Act?

The Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act was signed into law on August 10, 2022. According to VA, it expands VA health care and benefits for veterans exposed to burn pits, Agent Orange and other toxic substances, and it adds presumptive conditions, exposure locations and toxic exposure screenings.

In practice the law does three things:

1. Adds presumptive conditions and exposure locations. For listed conditions and qualifying service, VA presumes service connection. You no longer have to find a doctor to link the illness to the exposure.
2. Expands VA health care. Toxic-exposed veterans can enroll without first getting a disability rating. VA moved this up to March 5, 2024, years ahead of the schedule in the law.
3. Adds toxic exposure screening. Enrolled veterans get an initial screening and a follow-up at least once every five years, per VA.

Two points get lost in a lot of PACT Act coverage. First, a presumption removes the need to prove cause, but you still need a current diagnosis of the condition and service that matches the rules for it. Second, the Act did not change Camp Lejeune benefits at VA, which run on a separate track covered below.

Burn Pit Exposure: Who Qualifies

Open-air burn pits were a common way to dispose of waste at U.S. installations in Iraq, Afghanistan and other locations for much of the post-9/11 era. Trash, chemicals, plastics, medical waste and metals burned together, and service members breathed the smoke.

VA presumes exposure to burn pits and other airborne hazards if you served on active duty in one of these places during these periods, per VA’s burn pit and airborne hazard page:

To qualify you also need a diagnosed condition from the list below, active-duty service where the exposure happened, and a discharge that is not dishonorable. You do not have to show you were near a burn pit or document a specific exposure. Where and when you served is the test.

The Airborne Hazards and Open Burn Pit Registry is a separate program that records airborne hazard exposure. VA says taking part is optional and not required to receive compensation, benefits or health care.

Presumptive Conditions for Burn Pit and Airborne Hazard Exposure

A presumptive condition is one VA accepts as service-connected without proof of a direct link, as long as you meet the service requirements. VA lists these cancers and illnesses for burn pit and airborne hazard exposure. VA’s own page notes the list can change, so check VA.gov before you file.

Presumptive Cancers

• Brain cancer and glioblastoma
• Gastrointestinal cancer of any type
• Genitourinary cancer
• Head cancer of any type and neck cancer of any type
• Hematologic and lymphatic cancers
• Lymphoma of any type
• Melanoma
• Pancreatic cancer
• Reproductive cancer of any type
• Respiratory (breathing-related) cancer of any type

Presumptive Illnesses

• Asthma diagnosed after service
• Chronic bronchitis
• Chronic obstructive pulmonary disease (COPD)
• Chronic rhinitis
• Chronic sinusitis
• Constrictive bronchiolitis or obliterative bronchiolitis
• Emphysema
• Granulomatous disease
• Interstitial lung disease (ILD)
• Pleuritis
• Pulmonary fibrosis
• Sarcoidosis

If your condition is not on the list, you can still apply. VA says you will need to submit more evidence linking the condition to your service. See our guides to secondary conditions and the VA disability rating system for how ratings are assigned once a condition is service-connected.

Agent Orange and Vietnam-Era Veterans

The PACT Act added five locations to the Agent Orange presumption and added two conditions to the list. The service locations and dates below come from VA’s Agent Orange page:

Veterans of units that were assigned a C-123 aircraft carrying traces of Agent Orange can also qualify, if they had repeated contact with the aircraft through flight, ground or medical duties. VA does not list dates for this group.

The Agent Orange presumptive list includes:

• Cancers: bladder cancer, chronic B-cell leukemia, Hodgkin’s disease, multiple myeloma, non-Hodgkin’s lymphoma, prostate cancer, respiratory cancers (including lung cancer) and some soft tissue sarcomas
• Other illnesses: AL amyloidosis, chloracne and similar acneiform disease, type 2 diabetes, hypertension, hypothyroidism, ischemic heart disease, MGUS, Parkinsonism, Parkinson’s disease, early-onset peripheral neuropathy and porphyria cutanea tarda

Hypertension (high blood pressure) and monoclonal gammopathy of undetermined significance (MGUS) are the two conditions the PACT Act added to this list, according to VA.

Veterans who were denied an Agent Orange claim before these changes should look at their options in the VA appeals guide and the refiling section below.

Radiation Exposure

Radiation-exposed veterans were already covered for service in activities such as atmospheric nuclear weapons testing, the postwar occupation of Hiroshima or Nagasaki, and being a prisoner of war in Japan. VA’s ionizing radiation page says the PACT Act added three response efforts to the list of presumptive locations:

• Enewetak Atoll: cleanup, January 1, 1977 to December 31, 1980
• Palomares, Spain: cleanup involving a B-52 bomber carrying nuclear weapons, January 17, 1966 to March 31, 1967
• Thule Air Force Base, Greenland: response to a fire on a B-52 bomber carrying nuclear weapons, January 21, 1968 to September 25, 1968

VA also lists other qualifying radiation-risk activities, including underground testing at Amchitka Island, Alaska, and assignment to the gaseous diffusion plants at Paducah, Kentucky; Portsmouth, Ohio; and Oak Ridge, Tennessee. The illnesses covered, and the period in which each must appear, are set out in VA’s regulations, which the VA page links to.

Camp Lejeune Water Contamination

Camp Lejeune is the most commonly misunderstood part of the PACT Act. According to VA, “the PACT Act doesn’t affect VA benefits related to Camp Lejeune.” Those benefits come from earlier laws and still work the way they did before. What the PACT Act added was a separate legal route: Section 804, the Camp Lejeune Justice Act of 2022, lets people seek relief for water-related harm, starting with a Navy administrative claim.

For VA purposes, you qualify if you served at least 30 total days at Marine Corps Base Camp Lejeune or MCAS New River between August 1, 1953 and December 31, 1987, and you do not have a dishonorable discharge. Eight conditions are presumptive:

• Adult leukemia
• Aplastic anemia and other myelodysplastic syndromes
• Bladder cancer
• Kidney cancer
• Liver cancer
• Multiple myeloma
• Non-Hodgkin’s lymphoma
• Parkinson’s disease

VA’s Camp Lejeune Family Member Program is also separate. Family members, such as a spouse or child, may qualify if they lived at the base for at least 30 days in that window, or were in utero while their mother lived there. Applicants submit the Camp Lejeune Family Member Program Application, VA Form 10-10068, by mail or fax. The program reimburses covered medical costs. It is not disability compensation.

PACT Act Health Care Enrollment

The PACT Act expanded VA health care to millions of veterans who may not have a disability rating. VA says that beginning March 5, 2024, years ahead of the schedule in the law, veterans who meet basic service and discharge requirements and who were exposed to toxins or other hazards can enroll. VA’s eligibility page names these groups, among others:

• Gulf War veterans who served in Southwest Asia from August 2, 1990 through November 11, 1998
• Veterans who served at least 30 days at Camp Lejeune between August 1, 1953 and December 31, 1987
• Vietnam-era veterans who served in the Republic of Vietnam, Thailand, Laos, Cambodia (Mimot or Krek), Guam, American Samoa or Johnston Atoll during the dates above
• Post-9/11 veterans who served in any combat zone
• Veterans exposed to toxins or hazards through work such as chemicals, pesticides, lead or asbestos

You can enroll without first filing a disability claim, and enrolling costs nothing to start. A VA medical record also helps if you file a claim later. You can apply on VA.gov. Our guide to VA health care enrollment walks through the application and the priority groups.

Once enrolled, you are offered a toxic exposure screening, and a follow-up at least once every five years. Ask at your next appointment, or ask your local VA facility for the toxic exposure screening navigator.

If You Were Previously Denied

A prior denial does not have to be the end. VA’s guidance says veterans with previously denied claims should submit a Supplemental Claim so VA can review the case again, and you do not have to wait for VA to contact you. VA also says a Supplemental Claim based on a change in law, such as the PACT Act, does not require new evidence. Other Supplemental Claims generally do.

How to refile:

1. File VA Form 20-0995, the Supplemental Claim. Say that you are asking for review under the PACT Act and name the presumptive condition and the qualifying service that now cover you.
2. Make sure your condition is diagnosed. A presumption covers cause, not the diagnosis. Your file should show you have the condition and how it affects you.
3. Mind the effective date. Claims filed under the PACT Act by August 14, 2023 could be backdated to August 10, 2022, and that window has closed. For a claim filed now, the date generally depends on when VA receives it. The 2024 and 2025 additions below have their own dates, so ask an accredited representative how your history applies.
4. If your claim is still pending, you do not need to do anything. VA says it will consider a condition added after you filed and will send a decision notice when its review is complete.

An accredited Veterans Service Organization can help at no cost. The DAV, VFW and American Legion all do. Our guide to VA disability claim assistance explains what accredited help looks like.

How to File a PACT Act Claim in 2026

A PACT Act claim follows the same process as any VA disability claim, with one difference: for a listed presumptive condition, you do not need a nexus letter or an independent medical opinion linking it to your service. Your qualifying service and a diagnosis carry the claim.

1. Check that your service qualifies. Compare your locations and dates with the tables above. Your DD-214 and deployment records document where and when you served. If you need a copy, see our DD-214 guide.
2. Get a current diagnosis. VA health care can provide this, or your private doctor’s records work. The record should show the specific condition and its severity.
3. File VA Form 21-526EZ. You can file online at VA.gov, by mail, in person, or with a trained professional. You can also submit an intent to file first.
4. Call VA with questions at 800-698-2411 (TTY: 711), the number VA lists on its PACT Act page.
5. If you are terminally ill, say so when you file. VA announced in 2022 that it would process PACT Act claims immediately for terminally ill veterans.
6. File even if your condition is not on a list. You will need evidence linking it to your service, but filing sets your claim date. If VA adds the condition while your claim is pending, VA says it will consider it.

The Burn Pit Registry is optional. VA says you do not need to join it to file a claim or to receive benefits or health care.

Decision times vary, and VA does not publish a guaranteed timeline for PACT Act claims. For the wider claims process, see our guide to filing a VA disability claim. Once a condition is service-connected, our VA disability compensation calculator estimates the monthly payment for your rating.

Conditions Added Since 2022 and What May Come Next

VA has kept adding to the list through regulation and policy since the law passed:

Both January 2025 rules were issued as interim final rules, which take effect immediately, and their comment periods have closed. VA has also said it would review a possible link between PFAS exposure and kidney cancer. We did not find a VA announcement of the result, so check the burn pit page on VA.gov before assuming a condition is or is not covered.

We cannot tell you which conditions VA will add next, and we have not found a VA announcement of new additions beyond those above. Do not wait on a possible addition. A claim you file now sets your claim date, and VA will consider a condition that is added while your claim is pending.

Frequently Asked Questions

This article is provided by USMilitary.org, an independent educational resource. We are not affiliated with the Department of Defense, VA, or any government agency. The PACT Act presumptive conditions list is updated regularly. Verify current information at VA.gov.