The PACT Act, signed into law in August 2022, is the most significant expansion of VA benefits for toxic-exposed veterans in decades. It establishes presumptive service connection for dozens of conditions linked to burn pit and airborne hazard exposure, meaning qualifying veterans no longer need to prove a direct link between their service and their illness. If you served in a covered location during a covered period and develop one of the listed conditions, the VA presumes your condition is connected to service.
Before the PACT Act, burn pit claims had an approval rate of roughly 25 percent because veterans had to independently prove a connection between their exposure and their illness. Since the PACT Act took effect, approval rates for these claims have jumped to approximately 75 to 78 percent. The law fundamentally changed the burden of proof in favor of the veteran.
The PACT Act covers two broad categories of presumptive conditions: respiratory illnesses and cancers. The respiratory conditions include asthma diagnosed after discharge, chronic bronchitis, chronic obstructive pulmonary disease, constrictive or obliterative bronchiolitis, emphysema, granulomatous disease, interstitial lung diseases, pleuritis, pulmonary fibrosis, sarcoidosis, chronic sinusitis, and chronic rhinitis.
The presumptive cancers originally covered by the PACT Act include glioblastoma, head cancer of any type, neck cancer of any type, respiratory cancers including lung, bronchus, larynx, and trachea, gastrointestinal cancer of any type, reproductive cancer of any type, lymphoma of any type, lymphomatic cancer of any type, kidney cancer, brain cancer of any type, melanoma, and pancreatic cancer.
In June 2024, the VA added male breast cancer, urethral cancer, and cancer of the paraurethral glands to the presumptive list. In January 2025, the VA further expanded the list to include leukemias, multiple myeloma, myelodysplastic syndrome, myelofibrosis, and urinary bladder cancer. Veterans diagnosed with any of these conditions should file a claim immediately, as the effective date for benefits is typically the date the claim is received.
To qualify for PACT Act presumptive coverage, you must have served in one of the covered locations during the specified periods. For service on or after August 2, 1990, covered locations include Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, Somalia, the United Arab Emirates, and the waters of the Arabian Sea, Gulf of Aden, Gulf of Oman, the neutral zone between Iraq and Saudi Arabia, the Persian Gulf, and the Red Sea. For service on or after September 11, 2001, covered locations also include Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Uzbekistan, and Yemen.
A critical benefit of the PACT Act is that a nexus letter from a private physician is not required for presumptive claims. The VA concedes toxic exposure based on your service location and dates. You still need a current diagnosis and evidence that you served in a qualifying location during a qualifying period, but you do not need a medical opinion linking the two. This dramatically simplifies the claims process.
Every veteran enrolled in VA healthcare is now required to receive a toxic exposure screening at their medical appointments. This screening takes approximately five to ten minutes and is repeated every five years. The screening asks about your service locations, potential exposures, and current symptoms. Completing this screening creates a documented record of your exposure history that supports future claims.
If you were previously denied a burn pit or toxic exposure claim before the PACT Act took effect, you should file a supplemental claim citing the PACT Act as the new and relevant evidence. Many veterans who were denied under the old standards now qualify automatically under the presumptive framework. The effective date for a supplemental claim is generally the date the new claim is received, though in some cases it may relate back to the original filing.
Average processing time for PACT Act claims is approximately 81 days as of late 2025, though complex cases may take longer. Filing a Fully Developed Claim with all evidence included upfront can speed up processing significantly.
Note: This article references sections of the VA's M21-1 Adjudication Procedures Manual. The VA periodically reorganizes the M21-1 and section numbers may have changed since this article was written. For the most current section references, visit the VA's public M21-1 Web Automated Reference Material System (WARMS).