PACT Act: Presumptive Conditions

Tw0 veterans in front of a table where women take information from them
Veterans check in to a PACT Act informational event put on by the VA Long Beach Healthcare System. (VA Long Beach Healthcare System via Facebook)

The Department of Veterans Affairs estimates that "potentially millions" more veterans or their survivors could be eligible to receive health care or financial compensation for toxic exposure-related medical conditions newly considered presumptive under the PACT Act, said Steve Miska, PACT Act transitional executive director.

The law's presumptive aspect "gives us the opportunity to automatically assume, that by virtue of a veteran having this condition, it must be due to their service," Miska told "That is a game changer in terms of how veterans historically have had to file a claim" for PACT Act conditions: "Not only did they have to prove that those conditions were manifesting, but they also had to prove the service connection."

The law added what Miska described as 23 new "buckets of conditions," amounting to more than 330 medical conditions altogether. Some of the buckets contain, for example, a number of types of cancers.

Whereas in the past, the VA approved about 25% of claims related to burn pit exposures, the rate was about 78.6% for PACT Act claims in the first year, Miska said.

The PACT Act presumes a service connection -- provided the veteran served in a certain place at a certain time -- for the following conditions related to toxic exposures from burn pits, contaminated water at Marine Corps bases in North Carolina, and the Vietnam-era chemical defoliant, Agent Orange.

Burn Pit Presumptive Conditions

To be eligible for PACT Act compensation for exposure to burn pits or other toxins, veterans must have served at some point since Aug. 2, 1990, on the ground or in the airspace above Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, Somalia, United Arab Emirates, the Arabian Sea, the Gulf of Aden, the Gulf of Oman, the neutral zone between Iraq and Saudi Arabia, the Persian Gulf or the Red Sea; or since Sept. 11, 2001, on the ground or in the airspace above Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Uzbekistan or Yemen.

If the veteran has, or has had, one of these conditions, the PACT Act assumes it is connected to burn pits:

  • Brain cancer
  • Gastrointestinal cancer of any type
  • Glioblastoma
  • Head cancer of any type
  • Kidney cancer
  • Lymphoma of any type
  • Melanoma
  • Neck cancer of any type
  • Pancreatic cancer
  • Reproductive cancer of any type
  • Respiratory (breathing-related) cancer of any type
  • Asthma that was 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

Contaminated Water Presumptive Conditions

To be eligible for PACT Act benefits for exposure to contaminated water in North Carolina, veterans must have served at either Marine Corps Base Camp Lejeune or Marine Corps Air Station New River between Aug. 1, 1953, and Dec. 31, 1987.

If the veteran has, or has had, one of these conditions, the PACT Act assumes it is connected to contaminated water:

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

Agent Orange Presumptive Conditions

The PACT Act added five new locations where it presumes conditions are related to exposure to the defoliant Agent Orange: military bases in Thailand, Jan. 9, 1962-June 30, 1976; Laos, Dec. 1, 1965-Sept. 30, 1969; locations in Cambodia, April 16-30, 1969; Guam or American Samoa or territorial waters off either location, Jan. 6, 1962-July 31, 1980; and Johnston Atoll or on a ship that called there, Jan. 1, 1972, through Sept. 30, 1977.

If the veteran has, or has had, one of these conditions, the PACT Act assumes it is connected to Agent Orange:

  • High blood pressure (also called hypertension)
  • Monoclonal gammopathy of undetermined significance (MGUS)

The VA already presumed a service connection to Agent Orange for a number of other conditions at additional locations.

More Exposure-Related Presumptive Conditions

The PACT Act only added new presumptive service connections. The VA already covered conditions presumed to be from exposure to asbestos, mustard gas, chemical testing and more circumstances of military service.

Just because the PACT Act hasn't declared a condition presumptive yet doesn't mean it never will, Miska said. The law requires the VA to examine evidence of service connection to "future potential conditions" to recommend for inclusion.

-- Amanda Miller can be reached at

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