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The PACT Act Explained

What is the PACT Act

The PACT Act is a law that expanded health care and benefits for veterans exposed to burn pits and other toxic substances.

The PACT Act provides a list of conditions the VA presumes are caused by exposure to toxic substances which most directly affects Gulf War ear, post 9/11 ear, and Vietnam era veterans. Other exposures are included in the PACT Act and can be found in detail at the VA website.

What is a presumptive condition?

To get a VA disability rating, your disability must connect to your military service. For many health conditions, you need to prove that your service caused your condition. But for some conditions, the VA automatically assumes (or “presume”) that your service caused your condition. These are called “presumptive conditions”.

The VA considers a condition presumptive when it is established by law or regulation. If a veteran has a presumptive condition, they do not have to prove that their service caused their condition. They only need to meet the service requirements for the presumption.

Keep in mind that a veteran’s DD-214 must reflect service in the locations listed.

PACT Act presumptive conditions

Gulf War and post 9/11 era veterans

The following cancers are considered presumptive:

· Brain cancer

· Gastrointestinal cancer of any type

· Glioblastoma

· Head cancer of any type

· Kidney cancer

· Lymphatic cancer of any type

· Lymphoma of any type

· Melanoma

· Neck cancer

· Pancreatic cancer

· Reproductive cancer of any type

· Respiratory cancer of any type

The following illnesses are also presumptive:

· Asthma that was diagnosed during or 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

Locations for Gulf War and Post 9/11 presumptives

If you have any of the above listed conditions AND served on or after September 11, 2001 in any of these locations, the VA will consider the condition presumptive:

· Afghanistan

· Djibouti

· Egypt

· Jordan

· Lebanon

· Syria

· Uzbekistan

· Yemen

· The airspace above any of these locations

If you have any of the above listed conditions AND served on or after August 2, 1990, in any of these locations, the VA will consider the condition presumptive:

· Bahrain

· Iraq

· Kuwait

· Oman

· Qatar

· Saudi Arabia

· Somalia

· The United Arab Emirates

· The airspace above any of these locations

Vietnam Veterans with Agent Orange exposure

The following conditions are considered presumptive by the VA for Vietnam era veterans who have exposure to Agent Orange:

  • Primary amyloidosis

  • Chloracne (manifested to 10% within 1 year of exposure)

  • Type 2 diabetes

  • Hodgkin’s disease

  • Ischemic heart disease

  • Chronic B-cell leukemia

  • Multiple myeloma

  • Non-Hodgkin’s lymphoma

  • Parkinson’s disease

  • Peripheral neuropathy (manifested to 10% within 1 year of exposure)

  • Porphyria cutanea tarda (manifested to 10% within 1 year of exposure)

  • Prostate cancer

  • Lung cancer

  • Bronchial cancer

  • Larynx cancer

  • Trachea cancer

  • Adult fibrosarcoma

  • Dermatofibrosarcoma protuberans

  • Malignant fibrous histiocytoma

  • Liposarcoma

  • Leiomyosarcoma

  • Epithelioid leiomyosarcoma (malignant leiomyoblastoma)

  • Rhabdomyosarcoma

  • Ectomesenchymoma

  • Angiosarcoma (hemangiosarcoma and lymphangiosarcoma)

  • Proliferating (systemic) angioendotheliomatosis

  • Malignant glomus tumor

  • Malignant hemangiopericytoma

  • Synovial sarcoma (malignant synovioma)

  • Malignant giant cell tumor of tendon sheath

  • Malignant schwannoma

  • Malignant mesenchymoma

  • Malignant granular cell tumor

  • Alveolar soft part sarcoma

  • Epitheliod sarcoma

  • Clear cell sarcoma of tendons and aponeuroses

  • Extraskeletal Ewing’s sarcoma

  • Congenital and infantile fibrosarcoma

  • Malignant ganglioneuroma

  • Bladder cancer

  • Hypothyroidism

  • Parkinsonism

  • Hypertension (High blood pressure)

  • Monoclonal gammopathy of undetermined significance

Locations for Agent Orange exposure






Johnston Atoll

Guam or American Samoa

In addition, Veterans who had repeated contact with contaminated C-123s after the war also qualify as having been exposed to Agent Orange. Veterans involved in the testing, storage or disposal of Agent Orange can also qualify.

More information regarding the PACT Act is available at If navigating your VA claims for presumptive conditions seems overwhelming, we can help.

Download or Print a Printer Friendly Version of our PACT Act Document Below.

PACT ACT 1 white_printer
Download PDF • 326KB

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This information is made available for educational purposes only. This information is not a substitute for legal or medical advice. United Veteran Benefits Agency makes no guarantee of the outcome on VA rating decisions.


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