When the PACT Act (Promise to Address Comprehensive Toxics Act) became law, it marked one of the biggest expansions of VA benefits in U.S. history. For decades, veterans exposed to burn pits and airborne toxins during service struggled to prove that their health conditions were linked to their military duties.
Now, thanks to the PACT Act, the VA presumes that 23 specific conditions are caused by toxic exposure, meaning veterans no longer need to prove a medical nexus between their illness and their service. This change has already allowed hundreds of thousands of veterans to qualify for VA disability compensation and healthcare that was once out of reach.
Overview of Burn Pit Presumptive Conditions Under the PACT Act
| Category | Number of Conditions | Examples |
|---|---|---|
| Respiratory Conditions | 9 | Chronic rhinitis, asthma, sinusitis, chronic bronchitis |
| Cancers (Respiratory & Digestive) | 8 | Lung, brain, head, neck, and gastrointestinal cancers |
| Cancers (Genitourinary & Reproductive) | 3 | Kidney, reproductive organ, and urinary tract cancers |
| Other Systemic Cancers | 3 | Melanoma, pancreatic, and lymphatic cancers |
| Total Presumptive Conditions | 23 | Recognized automatically for eligible veterans |
Full List of the 23 Burn Pit Presumptive Conditions (as of 2026)
Respiratory Diseases (Non-Cancerous)
- Asthma (diagnosed after service)
- Chronic bronchitis
- Chronic obstructive pulmonary disease (COPD)
- Chronic rhinitis
- Chronic sinusitis
- Constrictive bronchiolitis
- Emphysema
- Granulomatous disease
- Interstitial lung disease
“These respiratory conditions are the most common effects of prolonged toxic exposure from burn pits,” explains Dr. James Keller, a VA pulmonary specialist. “Veterans often present with chronic inflammation and airway scarring years after deployment.”
Respiratory Cancers
- Lung cancer
- Head cancer (nasal cavity, sinuses, pharynx)
- Neck cancer (larynx and trachea)
- Laryngeal cancer
Gastrointestinal Cancers
- Esophageal cancer
- Stomach (gastric) cancer
- Pancreatic cancer
- Colon (colorectal) cancer
Genitourinary & Reproductive Cancers
- Kidney cancer
- Urinary bladder cancer
- Reproductive organ cancers (including testicular and ovarian)
Other Systemic Cancers
- Brain cancer
- Lymphoma (including Hodgkin’s and Non-Hodgkin’s)
- Melanoma (skin cancer)
“Before the PACT Act, many veterans with rare cancers had claims denied simply because the VA required proof of exposure,” says Allison Brooks, Veterans Legal Advocate with the American Legion. “Now, presumptive status eliminates that barrier.”
PACT Act Eligibility: Who Qualifies?
To qualify for these presumptive conditions, veterans must meet both service location and time criteria under the PACT Act.
1. Eligible Service Locations
Veterans who served in the following regions are automatically covered for burn pit exposure:
- Southwest Asia theater of operations (Aug 2, 1990 – present)
- Iraq
- Kuwait
- Saudi Arabia
- Bahrain
- Qatar
- Oman
- United Arab Emirates (UAE)
- Afghanistan, Syria, Djibouti, or Uzbekistan (Sept 19, 2001 – present)
2. Service Requirements
- Active duty, reserve, or National Guard service qualifies.
- The exposure is presumed if your service falls within the above timeframes and regions.
“You no longer need to prove you stood near a burn pit, your presence in these regions is enough,” emphasizes Mark Reynolds, accredited Veterans Service Officer (VSO).
How Presumptive Service Connection Works?
Under the presumptive rule, the VA automatically assumes your illness was caused by service if:
- You served in a qualifying area and timeframe, and
- You have one of the 23 recognized conditions.
You do not need to provide additional medical nexus evidence linking the illness to exposure, saving months or even years in the claim process.
Example
- A veteran who served in Iraq in 2006 develops chronic bronchitis in 2022.
- Because chronic bronchitis is presumptive, the VA automatically grants service connection.
- The veteran becomes eligible for monthly disability payments, healthcare, and potential survivor benefits.
Recent Updates to the PACT Act (2026)
Since its passage in August 2022, the VA has:
- Processed over 1.3 million PACT Act-related claims.
- Added additional training for VA examiners to identify toxic exposure symptoms.
- Extended outreach to National Guard and Reserve members previously excluded.
As of January 2026, these 23 conditions remain on the presumptive list, but VA officials have signaled plans to review additional diseases such as thyroid disorders and autoimmune illnesses.
“Science continues to evolve, and so does policy,” says Dr. Maria Gonzalez, VA Environmental Health Director. “The goal is to ensure that no exposed veteran is left behind.”
How to File a PACT Act Claim?
| Step | Action | Where to File |
|---|---|---|
| 1 | Gather your diagnosis and service records | Military medical records, DD-214 |
| 2 | File a new claim or supplemental claim | VA.gov |
| 3 | Attend your C&P Exam (if scheduled) | VA Medical Center |
| 4 | Track claim progress | VA.gov account or contact your VSO |
| 5 | Receive decision letter and retroactive pay if approved | Direct deposit |
Tip: If you’ve previously been denied for a burn pit-related condition, file a supplemental claim. The PACT Act allows retroactive approval if your illness is now presumptive.
Expert Tips for Stronger Claims
- Obtain an updated diagnosis from a VA or private doctor to verify that the condition is on the PACT Act list.
- List all related symptoms- chronic coughing, fatigue, weight loss, or breathing difficulty.
- Submit a personal statement (VA Form 21-4138) describing your deployment environment.
- Work with a VSO for free claim preparation and review.
“Even though these are presumptive, veterans should still provide clear medical documentation, it speeds up approval,” recommends John Miller, Senior Veterans Claims Specialist at DAV.
Final Thoughts
The 23 burn pit presumptive conditions recognized by the VA under the PACT Act have changed the landscape of veterans’ healthcare and compensation. Veterans who once faced years of denials can now access the benefits they’ve earned, without the burden of proving exposure.
If you served in Iraq, Afghanistan, or nearby regions, and have a respiratory illness or cancer, you may already qualify. File a claim or reopen your old one today.
“The PACT Act restored fairness for an entire generation of veterans,” says Allison Brooks, American Legion Legal Advocate. “No veteran should suffer silently when the law now recognizes their sacrifice.”
Frequently Asked Questions
Do I need proof that I was near a burn pit?
No. If you served in qualifying areas during the specified periods, exposure is automatically presumed.
Can survivors apply if the veteran has passed away?
Yes. Eligible dependents can file for Dependency and Indemnity Compensation (DIC) benefits.
What if my condition isn’t on the list yet?
You can still file, the VA may approve based on direct service connection or future PACT Act expansions.
Are National Guard and Reserve members included?
Yes, if they were deployed to qualifying regions during eligible timeframes.
Can I appeal a denied PACT Act claim?
Yes. You can file a Higher-Level Review, Supplemental Claim, or appeal directly to the Board of Veterans’ Appeals.
