Resources

PACT Act Presumptive Checker

Public Law 117-168

Check if your condition qualifies for presumptive service connection under the 2022 PACT Act.

Eligibility check

Select your service era, location, and a diagnosed condition to check presumptive eligibility.

Source: Public Law 117-168, 38 CFR Part 3.320, va.gov/resources/the-pact-act-and-your-va-benefits/. This is an eligibility orientation tool — not a VA decision. Final adjudication is by VA after filing.

Your service & diagnosis

Full PACT Act Presumptive List

Burn-pit Presumptive Cancers

  • • Brain cancer
  • • Gastrointestinal cancer (any type)
  • • Glioblastoma
  • • Head cancer (any type)
  • • Kidney cancer
  • • Lymphoma (any type)
  • • Melanoma
  • • Neck cancer (any type)
  • • Pancreatic cancer
  • • Reproductive cancer (any type)
  • • Respiratory cancer (any type)

Burn-pit Presumptive Respiratory / Lung Illnesses

  • • Asthma (diagnosed after service)
  • • Chronic bronchitis
  • • COPD (Chronic Obstructive Pulmonary Disease)
  • • Chronic rhinitis
  • • Chronic sinusitis
  • • Constrictive bronchiolitis / Obliterative bronchiolitis
  • • Emphysema
  • • Granulomatous disease
  • • Interstitial lung disease
  • • Pleuritis
  • • Pulmonary fibrosis
  • • Sarcoidosis

Agent Orange PACT Act Expansion

  • • High blood pressure (hypertension)
  • • Monoclonal gammopathy of undetermined significance (MGUS)

Qualifying Service Locations

Post-9/11 (≥ Sept 11, 2001)

Afghanistan · Djibouti · Egypt · Jordan · Lebanon · Syria · Uzbekistan · Yemen

Includes the airspace above any of these locations.

Gulf War (≥ Aug 2, 1990)

Bahrain · Iraq · Kuwait · Oman · Qatar · Saudi Arabia · Somalia · United Arab Emirates

Includes the airspace above any of these locations.

Vietnam-Era Agent Orange

  • • Republic of Vietnam — Jan 9, 1962 – May 7, 1975
  • • Thailand bases — Jan 9, 1962 – Jun 30, 1976
  • • Laos — Dec 1, 1965 – Sep 30, 1969
  • • Cambodia (Mimot or Krek, Kampong Cham Province) — Apr 16, 1969 – Apr 30, 1969
  • • Guam / American Samoa — Jan 9, 1962 – Jul 31, 1980
  • • Johnston Atoll — Jan 1, 1972 – Sep 30, 1977

Covered service is defined at 38 U.S.C. § 1116(d), as added by PACT Act § 403. Cambodia (§ 1116(d)(4)) qualifies only for service at Mimot or Krek in Kampong Cham Province.

What the PACT Act actually changed

The Honoring our PACT Act of 2022 (Public Law 117-168), signed August 10, 2022, is the largest expansion of VA presumptive service connection in decades. It does three things:

  1. Adds 23 new presumptive conditions (11 cancers + 12 respiratory illnesses) for veterans exposed to burn pits and other toxic substances during Gulf War and post-9/11 service.
  2. Adds 2 conditions (hypertension and MGUS) to the Vietnam-era Agent Orange presumptive list, and expands location coverage to include Thailand, Laos, Cambodia (Mimot/Krek only), Guam, American Samoa, and Johnston Atoll.
  3. Establishes a presumption of toxic exposure (38 U.S.C. § 1119, added by PACT Act § 302) for covered veterans who served in qualifying locations during qualifying periods — VA concedes exposure unless affirmative evidence shows you were not exposed, so you do not have to prove specific exposure events, only that you served in the listed time and place.

Why presumptive service connection matters

VA Disability Compensation requires a service connection — meaning the condition must be linked to military service. For most claims, the veteran (or representative) must produce medical and lay evidence connecting current disability to a service event. That can take years of nexus letters, medical opinions, and appeals.

A presumptive service connection inverts the burden: if you have a listed condition AND served in a listed location during a listed period, VA presumes the connection. You only need to document:

  • Diagnosis of the condition (medical records)
  • Proof of qualifying service (DD-214 / NGB-22 / service personnel record showing the time and location)

Because you do not have to establish a medical nexus, a presumptive claim needs far less evidence development than a direct service-connection claim for the same condition. VA does not publish a guaranteed approval rate or timeline — every claim is still adjudicated on its own record.

How to file a PACT Act claim

  1. Get a recent diagnosis from a treating physician (VA or civilian) — medical records documenting the diagnosis are the medical evidence a presumptive claim needs.
  2. Pull your DD-214 / NGB-22 and any military personnel records showing the dates and locations of your qualifying service.
  3. File VA Form 21-526EZ online at va.gov, by mail, or through a VA-accredited Veteran Service Organization (VSO) — American Legion, VFW, DAV, MOAA. VSO representation is free.
  4. Attend any C&P (Compensation and Pension) examination VA schedules — VA uses the exam findings to assign the rating percentage.
  5. Receive a rating decision. VA does not publish a guaranteed PACT Act timeline — check current average claim-processing times at va.gov. Terminally ill, financially distressed, and homeless veterans receive priority processing.

Once approved, retroactive pay flows back to the claim filing date. If you filed shortly after PACT Act passage (Aug 2022), retroactive pay could cover multiple years.

Other presumptive lists (not PACT Act)

The existing presumptive lists remain in effect and may apply to your situation:

  • Existing Agent Orange presumptives (38 CFR § 3.309(e)): diabetes mellitus type 2, ischemic heart disease, Parkinson's disease, prostate cancer, soft-tissue sarcomas, multiple myeloma, non-Hodgkin's lymphoma, hairy cell leukemia, chloracne, peripheral neuropathy, AL amyloidosis, and others.
  • Camp Lejeune contaminated water (38 CFR § 3.309(f)): bladder cancer, kidney cancer, liver cancer, non-Hodgkin lymphoma, adult leukemia, multiple myeloma, Parkinson's disease, aplastic anemia and other myelodysplastic syndromes.
  • Atomic veterans / ionizing radiation (38 CFR § 3.309(d)): various cancers and conditions linked to specific qualifying nuclear-test or occupation participation.
  • Gulf War Syndrome / undiagnosed chronic multi-symptom illness (38 CFR § 3.317): chronic fatigue, fibromyalgia, IBS, and undiagnosed chronic illnesses for Gulf War service.
  • Tropical diseases (38 CFR §§ 3.307(a)(4), 3.309(b)) and POW-specific presumptives (38 CFR § 3.309(c)) for specific service profiles.

If your condition is not PACT Act presumptive, check these other lists with a VSO before assuming direct service connection is your only path.

FAQ

PACT Act — frequently asked questions

What is the PACT Act?
The Honoring our PACT Act of 2022 (Public Law 117-168) is the largest expansion of VA presumptive service connection in decades. It adds 23 new presumptive conditions (11 cancers + 12 respiratory illnesses) for burn-pit exposure during Gulf War and post-9/11 service, plus 2 conditions (hypertension and MGUS) and expanded location coverage for Vietnam-era Agent Orange.
What does "presumptive service connection" mean?
For most VA disability claims, you must prove the condition is linked to military service via medical and lay evidence. A presumptive claim inverts the burden: if you have a listed condition AND served in a listed location during a listed period, VA presumes the connection. You only need to document the diagnosis and the qualifying service.
Which conditions does PACT Act cover for burn-pit veterans?
11 cancers (brain, GI, glioblastoma, head, kidney, lymphoma, melanoma, neck, pancreatic, reproductive, respiratory) and 12 respiratory/lung illnesses (asthma diagnosed post-service, chronic bronchitis, COPD, chronic rhinitis, chronic sinusitis, constrictive/obliterative bronchiolitis, emphysema, granulomatous disease, interstitial lung disease, pleuritis, pulmonary fibrosis, sarcoidosis).
What did PACT Act change for Vietnam-era Agent Orange?
Two new conditions: high blood pressure (hypertension) and MGUS (monoclonal gammopathy of undetermined significance). Plus expanded service-location coverage to include Thailand bases, Laos, Mimot or Krek in Kampong Cham Province, Cambodia, Guam/American Samoa, and Johnston Atoll on specific dates. The existing Agent Orange presumptive list under 38 CFR § 3.309(e) remains in effect.
How long do PACT Act claims take?
VA does not publish a guaranteed PACT Act timeline — check current average claim-processing times at va.gov. Terminally ill, financially distressed, and homeless veterans receive priority processing. File VA Form 21-526EZ online at va.gov, by mail, or through a VSO (American Legion, VFW, DAV, MOAA) — VSO representation is free. Once approved, retroactive pay flows back to the claim filing date.

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Public Law 117-168 · 38 CFR Part 3.320 + § 3.309 · va.gov/resources/the-pact-act-and-your-va-benefits

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