The PACT Act Explained: What It Covers, Who Qualifies, and How to File

The Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act - the PACT Act - became law in August 2022. It's the most significant expansion of VA healthcare and benefits for toxic-exposed veterans in over 30 years. The law dramatically expanded the list of presumptive conditions, meaning the VA now assumes certain diagnoses are service-connected if you served in qualifying locations during qualifying time periods.

If you were exposed to toxic substances during service - whether in Vietnam, the Gulf War, Iraq, Afghanistan, or dozens of other locations - this law was written for you. If you filed a claim before and got denied, it may be time to file again.

What the PACT Act Actually Does

The PACT Act creates new presumptive conditions for veterans exposed to burn pits, Agent Orange, and radiation. It expands VA healthcare eligibility to millions of toxic-exposed veterans who previously didn't qualify. Before the PACT Act, a veteran had to individually prove their illness was caused by their specific exposure - an incredibly difficult burden. Presumptive service connection eliminates it.

Burn Pit Exposure: Post-9/11 Veterans

If you served in Iraq, Afghanistan, Syria, Jordan, Egypt, Lebanon, Kuwait, Saudi Arabia, or other qualifying locations after August 2, 1990, the PACT Act likely applies to you. The law added over 20 burn pit and airborne hazard-related conditions to the presumptive list.

Presumptive cancers added for post-9/11 veterans include:

• Bladder cancer
• Head, neck, and respiratory cancers
• Gastrointestinal cancer
• Reproductive cancer
• Lymphatic cancer (including lymphomas)
• Kidney cancer
• Melanoma
• Pancreatic cancer

Beyond cancers, respiratory and other conditions now presumptive for qualifying service include chronic sinusitis, chronic rhinitis, chronic laryngitis, glioblastoma, COPD, and pulmonary fibrosis.

Agent Orange: Vietnam-Era Veterans

The PACT Act expanded the list of presumptive conditions for veterans exposed to Agent Orange and other herbicides, extending coverage to veterans who served in Thailand, Guam, American Samoa, Johnston Atoll, and other locations where tactical herbicides were used or tested.

Conditions added or expanded under the PACT Act for herbicide-exposed veterans include:

• Monoclonal gammopathy of undetermined significance (MGUS)
• High blood pressure (hypertension)
• Bladder cancer
• Parkinsonism

Hypertension alone affects a huge number of Vietnam-era veterans. Before the PACT Act, getting it service-connected for Agent Orange exposure was extremely difficult. Now it's presumptive.

Radiation Exposure

The PACT Act expanded protections for radiation-exposed veterans, including atomic veterans and those exposed to ionizing radiation during service. The law reinforces that veterans who were exposed to radiation during service and later developed covered cancers should receive presumptive service connection.

Expanded VA Healthcare Eligibility

The PACT Act expanded healthcare eligibility to veterans exposed to toxins during service, regardless of whether they have a disability rating. Post-9/11 combat veterans are now eligible for 10 years of VA healthcare after separation (previously 5 years).

Getting into the VA healthcare system now creates a medical paper trail that can strengthen a future disability claim.

How to File a PACT Act Claim

You can file online at VA.gov, call 1-800-827-1000, visit a VA regional office, or work with a Veteran Service Officer (VSO). File a standard claim for disability compensation and specify the condition(s) you're claiming.

Here's what you need:

• Evidence of qualifying service: Your DD-214 or service records showing you served in a qualifying location during a qualifying time period.
• A current diagnosis: Medical records confirming you have one of the covered conditions.
• A claim submission: File using VA Form 21-526EZ. Consider filing an Intent to File first to protect your effective date.

Because these are presumptive conditions, you generally don't need a nexus letter. The VA will likely order a C&P exam to confirm your diagnosis and rate its severity.

File an Intent to File today if you think you qualify. It takes five minutes and locks in your effective date for up to a year while you gather evidence.

Previously Denied? Here's What to Do

If you were previously denied service connection for a condition now presumptive under the PACT Act, you can file a supplemental claim. The PACT Act itself - the change in law that made your condition presumptive - counts as new and relevant evidence.

File using VA Form 20-0995 (Decision Review Request: Supplemental Claim). Reference the PACT Act and the specific presumptive condition. For most supplemental claims, the effective date will be the date you file the new claim, though exceptions exist, particularly for denials after August 10, 2022. A VSO can help ensure your claim is framed correctly.

The Toxic Exposure Screening

The PACT Act requires the VA to screen all enrolled veterans for toxic exposure history during healthcare visits. Be thorough about any exposure - burn pits, contaminated water, herbicides, or radiation - as conditions can develop decades later and documentation strengthens future claims.

Don't Wait to Act

The PACT Act is already law. Every day you delay filing is a day of potential benefits you won't get back - the VA generally doesn't pay retroactively before your claim or Intent to File date. If you served near burn pits, handled Agent Orange, or were exposed to radiation, the law is now on your side.

The PACT Act was designed to right a wrong - decades of veterans being told their illnesses weren't the VA's responsibility. Use it.