PACT Act & Toxic Exposure

Burn pit and Gulf War presumptive conditions

If you served in a covered location (below) and have one of these diagnosed conditions, VA presumes it is connected to your service.

Cancers:

• Brain cancer and glioblastoma
• Gastrointestinal cancer of any type
• Head and neck cancers, including cancers of the mouth, throat and sinuses
• Kidney and pancreatic cancer
• Lymphoma and lymphomatic cancer of any type
• Melanoma
• Reproductive cancer of any type
• Respiratory cancer of any type
• Added by VA in January 2025: acute and chronic leukemias, multiple myeloma, myelodysplastic syndromes, myelofibrosis, and urinary bladder, ureter and related genitourinary cancers

Breathing-related illnesses:

• Asthma diagnosed after service
• Chronic bronchitis, chronic rhinitis and chronic sinusitis
• Chronic obstructive pulmonary disease (COPD) and emphysema
• Constrictive or obliterative bronchiolitis
• Granulomatous disease and sarcoidosis
• Interstitial lung disease, pleuritis, pulmonary fibrosis and idiopathic pulmonary fibrosis

Covered locations and dates

On or after August 2, 1990: Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, Somalia and the United Arab Emirates, including the airspace above these locations.

On or after September 11, 2001: Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Uzbekistan and Yemen, including the airspace above these locations.

Gulf War Veterans also have separate presumptives for chronic multisymptom illnesses, including functional gastrointestinal disorders such as irritable bowel syndrome (IBS), chronic fatigue syndrome and fibromyalgia. Those come from VA’s Gulf War illness rules, not the burn pit list, but the claim process is similar.

Agent Orange: what the PACT Act changed

The law added high blood pressure (hypertension) and monoclonal gammopathy of undetermined significance (MGUS) to the Agent Orange presumptive list, and added new locations:

• Any U.S. or Royal Thai military base in Thailand, January 9, 1962 to June 30, 1976
• Laos, December 1, 1965 to September 30, 1969
• Certain provinces of Cambodia (Mimot or Krek, Kampong Cham), April 16 to April 30, 1969
• Guam or American Samoa, or their territorial waters, January 9, 1962 to July 31, 1980
• Johnston Atoll, or a ship that called there, January 1, 1972 to September 30, 1977

The PACT Act also added radiation-exposure locations, including the Enewetak Atoll cleanup (1977 to 1980), the Palomares, Spain cleanup (1966 to 1967) and the Thule, Greenland cleanup (1968).

How to file a PACT Act claim

1. Get a current diagnosis. VA needs a diagnosed condition, not just symptoms.
2. Gather proof of where you served. DD-214, deployment orders, or service personnel records showing a covered location and date.
3. File a claim or Intent to File. An Intent to File (VA Form 21-0966) can protect your effective date for up to one year while you gather evidence.
4. Ask for a toxic exposure screening. VA offers screenings to enrolled Veterans and records the exposure in your health record.
5. If you were denied before, a condition that is now presumptive can be filed again as a supplemental claim.

VA health care for toxic-exposed Veterans

Since March 5, 2024, Veterans who served in the covered Gulf War and post-9/11 locations, and Veterans exposed to toxins during training or active duty, can enroll in VA health care without first applying for disability compensation. See VA health care for enrollment.

Related guides

• Service-connected conditions
• Secondary conditions
• DIC for surviving spouses, which can apply when a Veteran dies of a presumptive condition
• Denied VA claims