Veterans exposed to tactical herbicide agents, most commonly Agent Orange, during qualifying service are eligible for presumptive service connection for a specific list of conditions. This means the VA automatically accepts that the condition is related to military service without requiring a separate nexus opinion. The list of presumptive conditions has expanded significantly over the years, most recently through the PACT Act in 2022 and additional VA rulemaking in 2025.
The complete current list of herbicide agent presumptive conditions includes AL amyloidosis, bladder cancer (added by the PACT Act), chronic B-cell leukemias including hairy-cell leukemia and chronic lymphocytic leukemia, chloracne or similar acneform disease consistent with chloracne, type 2 diabetes mellitus, Hodgkin disease, hypertension (added January 2025), hypothyroidism (added by the PACT Act), ischemic heart disease, monoclonal gammopathy of undetermined significance also known as MGUS (added January 2025), multiple myeloma, non-Hodgkin lymphoma, Parkinson disease, parkinsonism (added by the PACT Act as a distinct condition from Parkinson disease), early-onset peripheral neuropathy, prostate cancer, respiratory cancers including cancers of the lung, bronchus, larynx, and trachea, and some soft tissue sarcomas.
The distinction between Parkinson disease and parkinsonism is important. Parkinson disease is a specific diagnosis. Parkinsonism is a broader category that includes conditions with Parkinson-like symptoms such as tremors, stiffness, and slowness of movement but that may have a different underlying cause. The PACT Act added parkinsonism as a separate presumptive condition, so veterans diagnosed with parkinsonism who do not meet the criteria for Parkinson disease itself are now covered.
Qualifying service locations for herbicide agent presumptive conditions include Vietnam including in-country, offshore, and brown water Navy service between January 9, 1962 and May 7, 1975. Veterans who served on Thai military bases during the Vietnam era may also qualify. The specific Royal Thai Air Force Bases recognized by the VA include U-Tapao, Korat, Ubon, Nakhon Phanom, Udorn, Takhli, and Don Muang. Veterans who served on or near the perimeters of these bases are presumed to have been exposed.
Additional qualifying locations include Guam, American Samoa, Johnston Atoll, and Wake Island, where herbicide agents were tested or stored. The PACT Act and subsequent VA rulemaking in January 2025 added five new exposure locations. Veterans who served in these locations during the applicable periods do not need to prove they were personally sprayed with herbicide agents. Service in the qualifying location during the qualifying timeframe is sufficient.
For herbicide presumptive claims, no nexus letter is required. You need to establish that you served in a qualifying location during a qualifying period and that you have a current diagnosis of one of the listed conditions. The VA will then presume the connection to service. If you have a condition on this list and qualifying service, filing a claim is straightforward.
Some conditions on the list have specific onset requirements. Chloracne must manifest within one year of the last date of exposure. Early-onset peripheral neuropathy must manifest within one year as well. For all other conditions on the list, there is no time limit on when the condition must appear after service.
Veterans who were previously denied a claim for a condition that has since been added to the presumptive list, such as hypertension, bladder cancer, hypothyroidism, MGUS, or parkinsonism, should file a supplemental claim citing the regulatory change as new and relevant evidence.
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).