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 Under the PACT Act
• Agent Orange and Vietnam-Era Veterans
• Camp Lejeune Water Contamination
• Radiation Exposure
• PACT Act Health Care Enrollment
• If You Were Previously Denied
• How to File a PACT Act Claim in 2026
• The 2026 Mandatory Review: What May Come Next
• Frequently Asked Questions

Before the PACT Act, a burn pit or Agent Orange claim often turned on a single, nearly impossible question: can you prove, medically, that a specific exposure caused a specific illness? That burden stopped hundreds of thousands of valid claims. Veterans waited years. More than 300,000 died waiting for benefits they had earned. The PACT Act changed the math. For covered conditions tied to qualifying service, the VA now starts from the presumption that your service caused it — the burden of proof has shifted. This guide explains what’s covered, who qualifies, what’s been added in 2026, and how to file.

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. It is the most significant expansion of VA health care and disability benefits since the Agent Orange Act of 1991.

The law does three core things:

1. Expands presumptive service connection for conditions linked to burn pits, Agent Orange, radiation exposure, Camp Lejeune water contamination, and other toxic exposures — removing the requirement for veterans to individually prove a medical nexus between their exposure and their illness
2. Expands VA health care eligibility to veterans who served after August 2, 1990, in qualifying locations, regardless of whether they have a service-connected disability rating
3. Creates a framework for ongoing expansion — requiring the VA to review scientific evidence on a two-year cycle and add new presumptive conditions as research develops

As of mid-2026, the VA recognizes over 330 specific presumptive conditions across more than 23 exposure categories. Rather than phasing in new presumptions over several years as the law permitted, the VA made all new toxic exposure conditions effective immediately after enactment — and expanded health care eligibility ahead of the scheduled timeline in March 2024.

Burn Pit Exposure: Who Qualifies

Open-air burn pits were the primary method of waste disposal at U.S. military installations in Iraq, Afghanistan, and other Southwest Asia locations for much of the post-9/11 era. Everything went into these pits — human waste, unexploded ordnance, chemicals, medical waste, metals, and plastics — and the smoke that resulted was inhaled by service members 24 hours a day, seven days a week in many locations.

The PACT Act recognizes burn pit and airborne hazard exposure for veterans who served in qualifying locations. Qualifying service locations and periods include:

• Southwest Asia theater of operations on or after August 2, 1990 — covers Iraq, Kuwait, Saudi Arabia, Bahrain, Qatar, UAE, Oman, Gulf of Aden, Gulf of Oman, Arabian Sea, Red Sea, and airspace above these areas
• Afghanistan, Uzbekistan, Syria, or Djibouti on or after September 19, 2001
• Somalia or Airspace above Somalia on or after September 19, 2001
• Egypt, Jordan, Lebanon, Yemen and other qualifying areas on or after August 2, 1990

If you served in any of these locations during the qualifying periods, the VA presumes you were exposed to burn pits and airborne hazards. You do not need to prove you were near a burn pit or document the specific exposure. Location and dates of service are the primary eligibility criteria.

Presumptive Conditions Under the PACT Act

A presumptive condition is one the VA accepts as service-connected without requiring you to prove a direct link between your illness and your service — as long as you meet the service location and period requirements. The PACT Act dramatically expanded this list.

Presumptive Cancers (Burn Pit and Toxic Exposure)

All of the following cancers are now presumptive for veterans with qualifying toxic exposure service:

• Any cancer of the head, neck, respiratory tract, reproductive organs, bladder, thyroid, or urinary tract
• Melanoma and other skin cancers
• Squamous cell carcinoma of the larynx and trachea
• Adenocarcinoma and salivary gland-type tumors of the trachea and lung
• Adenosquamous carcinoma, large cell carcinoma, and sarcomatoid carcinoma of the lung
• Typical and atypical carcinoid tumors of the lung
• Gastrointestinal cancers (colon, rectal, stomach, esophageal, liver, gallbladder, bile duct, pancreatic)
• Reproductive cancers (ovarian, testicular)
• Lymphatic and hematological cancers (lymphoma, leukemia, multiple myeloma)
• Any other cancer the VA determines warrants presumptive status based on new research

Non-Cancer Presumptive Conditions

The PACT Act also covers non-cancer conditions linked to toxic exposure. Constrictive or obliterative bronchiolitis, constrictive pericarditis, and other respiratory and cardiovascular conditions connected to burn pit exposure are now presumptive. The 2025 review cycle added several significant conditions including:

• Hypertension (high blood pressure) — now presumptive for veterans with Agent Orange and certain other toxic exposures
• Monoclonal Gammopathy of Undetermined Significance (MGUS) — a blood disorder that can progress to multiple myeloma, now presumptive for veterans exposed to toxic chemicals
• Male breast cancer — added due to emerging evidence of links to toxic exposures
• Urethral cancer and cancer of the paraurethral glands

For the complete, current list of all presumptive conditions, visit the official VA PACT Act resources page. The list is updated as new conditions are added through the mandatory review process.

Agent Orange and Vietnam-Era Veterans

The PACT Act significantly expanded Agent Orange presumptive coverage beyond what the Agent Orange Act of 1991 originally covered. Vietnam-era veterans now have a stronger claim framework, including veterans who served in Thailand, Laos, Cambodia, Guam, American Samoa, and Johnston Atoll during qualifying periods — locations where Agent Orange exposure had previously been harder to establish.

Key expansions for Vietnam-era veterans under the PACT Act:

• Blue Water Navy veterans who served in the territorial waters off the coast of Vietnam between January 9, 1962, and May 7, 1975, now have presumptive Agent Orange exposure status
• C-123 aircraft crews and ground support personnel who served in units that flew contaminated aircraft after the Vietnam War are now covered
• Veterans who served in Korea near the DMZ between September 1, 1967, and August 31, 1971, retain presumptive exposure status
• Hypertension, MGUS, and several other conditions have been added to the Agent Orange presumptive list for Vietnam-era veterans specifically

Veterans who were previously denied Agent Orange-related claims before the PACT Act — particularly Blue Water Navy veterans who fought for decades for recognition — should review their eligibility under the updated framework and consider refiling. See the VA Presumptive Conditions List for a full breakdown by exposure category.

Camp Lejeune Water Contamination

Veterans and their family members who lived or worked at Marine Corps Base Camp Lejeune or Marine Corps Air Station (MCAS) New River in North Carolina for at least 30 cumulative days between August 1, 1953, and December 31, 1987, may be eligible for disability compensation and health care under the PACT Act’s Camp Lejeune provisions.

The contaminated water at Camp Lejeune contained volatile organic compounds including trichloroethylene (TCE), perchloroethylene (PCE), benzene, and vinyl chloride. Eight conditions are now presumptive for qualifying Camp Lejeune veterans:

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

Family members (spouses and children who resided at Camp Lejeune during the qualifying period) may also be eligible for reimbursement of out-of-pocket medical expenses for covered conditions — not disability compensation, but healthcare cost reimbursement through a separate program. Apply using VA Form 10-10068.

Radiation Exposure

The PACT Act expanded radiation presumptive coverage for veterans who participated in nuclear weapons testing and veterans who served in Hiroshima or Nagasaki, Japan after World War II. The law also updated coverage for veterans involved in nuclear cleanup operations.

Presumptive radiation-related conditions include virtually all cancers for veterans with documented radiation exposure during qualifying service. Veterans who participated in above-ground nuclear weapons tests at designated sites between 1945 and 1962 — known as “atomic veterans” — have the strongest presumptive framework. Contact VA’s Radiation Exposure page for full location and period details.

PACT Act Health Care Enrollment

One of the most significant — and underutilized — provisions of the PACT Act is the expansion of VA health care eligibility to veterans who may not have a service-connected disability rating at all.

Beginning March 5, 2024 — years ahead of the statutory timeline — the VA opened health care enrollment to:

• Veterans who served on or after August 2, 1990, and who were deployed to Southwest Asia, Afghanistan, Syria, Djibouti, Somalia, or other qualifying locations
• Veterans who can demonstrate exposure to burn pits or other airborne hazards during qualifying service
• Veterans who served in combat — defined broadly under the PACT Act’s expanded health care provisions

This health care enrollment is separate from disability compensation. Even if you don’t have a listed presumptive condition or don’t yet want to file a disability claim, enrolling in VA health care under PACT Act eligibility costs you nothing and establishes a VA medical record that can support a future claim. Enroll at VA.gov or call 1-800-827-1000.

VA health care coverage through the PACT Act includes screening for toxic exposure-related conditions through the Airborne Hazards and Open Burn Pit Registry. Enrolling in the registry creates a documented record of your deployment and potential exposure that strengthens future claims. Register at VA’s Burn Pit Registry.

If You Were Previously Denied

A prior denial does not have to be the end. If the VA denied your toxic exposure claim before the PACT Act — or before specific conditions were added to the presumptive list — you may now qualify under the updated framework. The PACT Act explicitly allows refiling under the new presumptive standards.

How to refile a previously denied claim:

1. File a Supplemental Claim using VA Form 20-0995. A supplemental claim allows you to add new evidence or request reconsideration based on a change in law — including the addition of new presumptive conditions — without restarting the entire claim from scratch or losing your effective date.
2. Reference the specific PACT Act provision. Identify the presumptive condition that now covers your illness and the qualifying service location that establishes your exposure. Your claim should cite the relevant PACT Act section and the updated VA regulation.
3. Include a current diagnosis. The PACT Act eliminates the nexus letter requirement but does not eliminate the need for a confirmed diagnosis. Your claim still needs medical evidence documenting your condition’s current status and severity.
4. Note your effective date carefully. For most PACT Act claims in 2026, compensation begins from the date the VA receives the claim — not from when the condition first developed. For veterans refiling after a prior denial, an accredited claims agent or VSO can advise on whether an earlier effective date may be preserved.

Veterans with conditions that were denied because they couldn’t prove a nexus under the old system — but whose condition is now on the presumptive list — have the strongest case for a supplemental claim. Working with an accredited Veterans Service Organization (VSO) like the DAV, VFW, or American Legion at no cost gives you the strongest starting position.

How to File a PACT Act Claim in 2026

Filing a PACT Act disability claim follows the same process as any VA disability claim — with one important difference: for listed presumptive conditions, you do not need a nexus letter or independent medical opinion linking your condition to your service. Your service location and dates, combined with a confirmed diagnosis, are the foundation of the claim.

1. Confirm your service meets qualifying criteria. Review the exposure locations and service periods above. Your DD-214 and deployment records document your service location.
2. Get a confirmed diagnosis. A current medical diagnosis is required. VA health care can provide this, or your private physician’s records are acceptable. The diagnosis must document the specific condition, current severity, and functional limitations.
3. Enroll in the Burn Pit Registry if you haven’t. This establishes a VA record of your exposure and deployment that supports your claim independent of your medical records.
4. File VA Form 21-526EZ online at VA.gov. Apply at VA.gov or through an accredited VSO. The online system allows you to upload supporting documents at the time of filing.
5. Request expedited processing if eligible. The VA has established expedited processing procedures for life-threatening or terminal conditions related to toxic exposure. If your condition qualifies, flag this when filing — decisions can be significantly accelerated.
6. If your condition isn’t yet presumptive, file anyway. A condition currently under the VA’s 2026 review cycle can still be claimed through a traditional service-connection framework with supporting medical evidence. Filing now establishes your claim date, which determines your effective date for compensation if the condition is later added to the presumptive list.

Processing times for PACT Act claims improved significantly after the VA stood up dedicated PACT Act claims teams at regional offices. Veterans filing PACT Act claims in 2026 are receiving decisions roughly 65% faster than traditional disability claims, according to recent VA data. However, hundreds of thousands of claims remain pending, and timelines are still measured in months for most cases.

For more on the disability claims process generally, see our guide to filing a VA disability claim and our VA disability ratings guide. Use our VA disability compensation calculator to estimate your monthly benefit based on your rating and dependent status.

The 2026 Mandatory Review: What May Come Next

Section 902 of the PACT Act requires the VA to review scientific evidence on a two-year cycle and formally consider adding new presumptive conditions. August 2026 marks four years since the law passed — triggering the second mandatory review cycle.

The VA Advisory Committee on Toxic Exposures has reportedly examined approximately 47 potential new presumptive conditions in this cycle. Areas under active consideration include:

• Additional Camp Lejeune illnesses beyond the original eight covered conditions
• New respiratory diseases linked to burn pit research published since 2022
• Additional neurological conditions associated with toxic exposure
• Conditions specific to Gulf War illness that weren’t addressed in the original PACT Act framework

Until the VA formally publishes a final rule, these conditions are not yet presumptive. Veterans with conditions currently under review should not wait — filing a traditional claim with supporting medical evidence now establishes your claim date and positions your file for potential automatic conversion to presumptive status if your condition is added during this review cycle.

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.