The PACT Act added 300+ presumptive conditions for toxic exposure veterans. See the full list of new conditions, eligibility requirements, and step-by-step filing instructions for 2026.
The PACT Act — formally the Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act — is the largest expansion of VA healthcare and benefits in decades. Signed into law in August 2022, it has been rolling out in phases, and as of 2026, all major provisions are fully in effect. If you served after 1990 and haven't revisited your VA benefits recently, the PACT Act may have changed what you're eligible for.
The most significant change is the expansion of presumptive conditions for toxic exposure. Before the PACT Act, veterans who were exposed to burn pits, Agent Orange, radiation, and other toxins often had to prove a direct connection between their service and their illness — a burden of proof that was nearly impossible for many conditions. The PACT Act flipped that equation. It established a list of presumptive conditions where the VA now assumes your illness is connected to your service if you meet certain criteria.
For burn pit and airborne hazard exposure, the PACT Act covers veterans who served in Southwest Asia, the Gulf War theater, or other specified locations. Presumptive conditions now include several types of cancer (including respiratory cancers, reproductive cancers, melanoma, pancreatic cancer, and kidney cancer), constrictive bronchiolitis, and other respiratory illnesses. The full list continues to expand as the VA reviews emerging research.
Vietnam-era veterans also gained expanded coverage. Agent Orange presumptive conditions now include monoclonal gammopathy of undetermined significance (MGUS), high blood pressure, and additional cancers. Veterans who served in Thailand, Guam, American Samoa, and other previously excluded locations during the Vietnam era are now covered for Agent Orange exposure.
One of the most important and underused provisions is the free toxic exposure screening. Any veteran enrolled in VA healthcare can request a screening, and any combat-era veteran can enroll in VA healthcare for the screening even if they haven't enrolled before. This screening creates a documented record of your potential exposures, which can support future claims. If you served in any capacity where you may have been exposed to burn pits, contaminated water, radiation, or other hazards, get this screening done — even if you feel fine today.
Filing a PACT Act claim follows the same process as any VA disability claim, but with a critical advantage: for presumptive conditions, you don't need to provide a nexus letter proving the connection between your service and your condition. You need your service records showing you served in a qualifying location during a qualifying period, and a current diagnosis of a presumptive condition. Veterans Service Organizations like the DAV, VFW, and American Legion can help you file for free.
If you were previously denied a claim for a condition that's now presumptive under the PACT Act, you can file a supplemental claim citing the new legislation as "new and relevant evidence." Many veterans who were denied years ago are now being approved. Use our free briefing tool to see which PACT Act benefits may apply to your specific service history.
The PACT Act (Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act) is the largest expansion of VA healthcare and benefits in decades. Signed in August 2022, it expands presumptive conditions for toxic exposure including burn pits, Agent Orange, and radiation, making it easier for veterans to get disability compensation without proving a direct service connection.
Veterans who served after 1990 and were exposed to burn pits, Agent Orange, radiation, or other toxic substances may be eligible. This includes veterans who served in Southwest Asia, the Gulf War theater, Vietnam, Thailand, Guam, and other specified locations during qualifying periods.
Presumptive conditions include several types of cancer (respiratory, reproductive, melanoma, pancreatic, kidney), constrictive bronchiolitis, and other respiratory illnesses for burn pit exposure. For Agent Orange exposure, additions include MGUS, high blood pressure, and additional cancers.
Yes. If you were previously denied for a condition that is now presumptive under the PACT Act, you can file a supplemental claim citing the new legislation as new and relevant evidence. Many previously denied veterans are now being approved.
Any veteran enrolled in VA healthcare can request a free toxic exposure screening. Combat-era veterans can enroll in VA healthcare specifically for this screening even if they haven't enrolled before. The screening creates a documented record of potential exposures that can support future claims.
No. For presumptive conditions under the PACT Act, you do not need a nexus letter. You need service records showing you served in a qualifying location during a qualifying period and a current diagnosis of a presumptive condition.