Benefits Reference
VA Presumptive Conditions for Toxic Exposure
A presumptive condition is one the VA automatically assumes is connected to your service, so you do not have to prove the link. Search the list below.
| Condition | Category | Presumptive for | Notes |
|---|---|---|---|
| Brain cancer | Cancer | Burn pits / airborne hazards | Added by the PACT Act 2022; requires qualifying service on or after August 2, 1990 (Gulf War locations) or September 11, 2001 (post-9/11 locations). |
| Glioblastoma | Cancer | Burn pits / airborne hazards | Added by the PACT Act 2022; listed separately from other brain and nervous system cancers. |
| Head cancer of any type | Cancer | Burn pits / airborne hazards | Added by the PACT Act 2022. |
| Neck cancer of any type | Cancer | Burn pits / airborne hazards | Added by the PACT Act 2022. |
| Gastrointestinal cancer of any type | Cancer | Burn pits / airborne hazards | Added by the PACT Act 2022; VA examples include esophageal, stomach, colorectal, liver, and small intestine cancers. |
| Genitourinary cancer (including kidney, bladder, and ureter) | Cancer | Burn pits / airborne hazards | Kidney cancer added by the PACT Act 2022; bladder, ureter, and related genitourinary cancers added by VA rule effective January 2025. |
| Hematologic and lymphatic cancers | Cancer | Burn pits / airborne hazards | Added by VA rule effective January 2025; covers acute and chronic leukemias, multiple myelomas, myelodysplastic syndromes, and myelofibrosis. |
| Lymphoma of any type | Cancer | Burn pits / airborne hazards | Added by the PACT Act 2022; includes Hodgkin's and non-Hodgkin's lymphomas. |
| Melanoma | Cancer | Burn pits / airborne hazards | Added by the PACT Act 2022. |
| Pancreatic cancer | Cancer | Burn pits / airborne hazards | Added by the PACT Act 2022. |
| Reproductive cancer of any type | Cancer | Burn pits / airborne hazards | Added by the PACT Act 2022; VA examples include breast, cervical, ovarian, uterine, prostate, and testicular cancers. |
| Respiratory (breathing-related) cancer of any type | Cancer | Burn pits / airborne hazards | Added by the PACT Act 2022; includes lung, laryngeal, bronchial, and tracheal cancers. |
| Asthma (diagnosed after service) | Respiratory | Burn pits / airborne hazards | Presumptive under a 2021 VA rule and the PACT Act 2022; must be diagnosed after separation. |
| Chronic bronchitis | Respiratory | Burn pits / airborne hazards | Added by the PACT Act 2022. |
| Chronic obstructive pulmonary disease (COPD) | Respiratory | Burn pits / airborne hazards | Added by the PACT Act 2022. |
| Chronic rhinitis | Respiratory | Burn pits / airborne hazards | Presumptive under a 2021 VA rule and the PACT Act 2022. |
| Chronic sinusitis | Respiratory | Burn pits / airborne hazards | Presumptive under a 2021 VA rule and the PACT Act 2022. |
| Constrictive bronchiolitis or obliterative bronchiolitis | Respiratory | Burn pits / airborne hazards | Added by the PACT Act 2022. |
| Emphysema | Respiratory | Burn pits / airborne hazards | Added by the PACT Act 2022. |
| Granulomatous disease | Respiratory | Burn pits / airborne hazards | Added by the PACT Act 2022. |
| Interstitial lung disease (ILD) | Respiratory | Burn pits / airborne hazards | Added by the PACT Act 2022. |
| Pleuritis | Respiratory | Burn pits / airborne hazards | Added by the PACT Act 2022. |
| Pulmonary fibrosis | Respiratory | Burn pits / airborne hazards | Added by the PACT Act 2022. |
| Sarcoidosis | Respiratory | Burn pits / airborne hazards | Added by the PACT Act 2022. |
| Bladder cancer | Cancer | Agent Orange | Vietnam era herbicide exposure; PACT Act added qualifying locations including Thailand, Laos, Cambodia, Guam, American Samoa, and Johnston Atoll. |
| Chronic B-cell leukemias | Cancer | Agent Orange | Vietnam era herbicide exposure; covers B-cell leukemias such as chronic lymphocytic leukemia and hairy cell leukemia. |
| Hodgkin's disease | Cancer | Agent Orange | Vietnam era herbicide exposure. |
| Multiple myeloma | Cancer | Agent Orange | Vietnam era herbicide exposure. |
| Non-Hodgkin's lymphoma | Cancer | Agent Orange | Vietnam era herbicide exposure. |
| Prostate cancer | Cancer | Agent Orange | Vietnam era herbicide exposure. |
| Respiratory cancers (including lung cancer) | Cancer | Agent Orange | Vietnam era herbicide exposure; includes cancers of the lung, larynx, trachea, and bronchus. |
| Soft tissue sarcomas | Cancer | Agent Orange | Vietnam era herbicide exposure; excludes osteosarcoma, chondrosarcoma, Kaposi's sarcoma, and mesothelioma. |
| AL amyloidosis | Other | Agent Orange | Vietnam era herbicide exposure. |
| Chloracne (or similar acneiform disease) | Other | Agent Orange | Must be at least 10 percent disabling within 1 year of herbicide exposure. |
| Diabetes mellitus type 2 | Other | Agent Orange | Vietnam era herbicide exposure. |
| High blood pressure (hypertension) | Other | Agent Orange | Added by the PACT Act 2022. |
| Hypothyroidism | Other | Agent Orange | Vietnam era herbicide exposure; added by VA in 2021 under the National Defense Authorization Act. |
| Ischemic heart disease | Other | Agent Orange | Vietnam era herbicide exposure. |
| Monoclonal gammopathy of undetermined significance (MGUS) | Other | Agent Orange | Added by the PACT Act 2022; a blood condition that can precede multiple myeloma. |
| Parkinsonism | Other | Agent Orange | Vietnam era herbicide exposure; added by VA in 2021 under the National Defense Authorization Act. |
| Parkinson's disease | Other | Agent Orange | Vietnam era herbicide exposure. |
| Peripheral neuropathy, early onset | Other | Agent Orange | Must be at least 10 percent disabling within 1 year of herbicide exposure. |
| Porphyria cutanea tarda | Other | Agent Orange | Must be at least 10 percent disabling within 1 year of herbicide exposure. |
| Adult leukemia | Cancer | Camp Lejeune water | Requires at least 30 days total at Camp Lejeune or MCAS New River, North Carolina between August 1, 1953 and December 31, 1987. |
| Aplastic anemia and other myelodysplastic syndromes | Other | Camp Lejeune water | Requires at least 30 days total at Camp Lejeune or MCAS New River between August 1, 1953 and December 31, 1987. |
| Bladder cancer | Cancer | Camp Lejeune water | Requires at least 30 days total at Camp Lejeune or MCAS New River between August 1, 1953 and December 31, 1987. |
| Kidney cancer | Cancer | Camp Lejeune water | Requires at least 30 days total at Camp Lejeune or MCAS New River between August 1, 1953 and December 31, 1987. |
| Liver cancer | Cancer | Camp Lejeune water | Requires at least 30 days total at Camp Lejeune or MCAS New River between August 1, 1953 and December 31, 1987. |
| Multiple myeloma | Cancer | Camp Lejeune water | Requires at least 30 days total at Camp Lejeune or MCAS New River between August 1, 1953 and December 31, 1987. |
| Non-Hodgkin's lymphoma | Cancer | Camp Lejeune water | Requires at least 30 days total at Camp Lejeune or MCAS New River between August 1, 1953 and December 31, 1987. |
| Parkinson's disease | Other | Camp Lejeune water | Requires at least 30 days total at Camp Lejeune or MCAS New River between August 1, 1953 and December 31, 1987. |
| Chronic fatigue syndrome | Other | Gulf War | Requires Southwest Asia service on or after August 2, 1990; illness must have lasted at least 6 months. |
| Fibromyalgia | Other | Gulf War | Requires Southwest Asia service on or after August 2, 1990; illness must have lasted at least 6 months. |
| Functional gastrointestinal disorders | Other | Gulf War | Requires Southwest Asia service on or after August 2, 1990; includes conditions such as irritable bowel syndrome; must have lasted at least 6 months. |
| Undiagnosed illnesses and medically unexplained chronic multisymptom illness | Other | Gulf War | Covers unexplained chronic symptoms such as fatigue, muscle and joint pain, and headaches lasting at least 6 months; PACT Act removed the prior end date for this presumption. |
| Brucellosis | Other | Gulf War | Infectious disease presumptive; must appear within 1 year of separation after qualifying Southwest Asia or Afghanistan service. |
| Campylobacter jejuni | Other | Gulf War | Infectious disease presumptive; must appear within 1 year of separation. |
| Coxiella burnetii (Q fever) | Other | Gulf War | Infectious disease presumptive; must appear within 1 year of separation. |
| Malaria | Other | Gulf War | Infectious disease presumptive; must appear within 1 year of separation. |
| Nontyphoid salmonella | Other | Gulf War | Infectious disease presumptive; must appear within 1 year of separation. |
| Shigella | Other | Gulf War | Infectious disease presumptive; must appear within 1 year of separation. |
| West Nile virus | Other | Gulf War | Infectious disease presumptive; must appear within 1 year of separation. |
| Mycobacterium tuberculosis | Respiratory | Gulf War | Infectious disease presumptive; may be diagnosed at any time after separation from qualifying service. |
| Visceral leishmaniasis | Other | Gulf War | Infectious disease presumptive; may be diagnosed at any time after separation from qualifying service. |
| Leukemia (except chronic lymphocytic leukemia) | Cancer | Radiation | Requires a qualifying radiation-risk activity (atmospheric nuclear testing, Hiroshima or Nagasaki occupation, certain POWs in Japan, and others); PACT Act added Enewetak Atoll, Palomares, and Thule cleanup crews. |
| Multiple myeloma | Cancer | Radiation | Requires a qualifying radiation-risk activity; PACT Act added Enewetak Atoll (1977 to 1980), Palomares Spain (1966 to 1967), and Thule Greenland (1968) response crews. |
| Lymphomas (except Hodgkin's disease) | Cancer | Radiation | Requires a qualifying radiation-risk activity. |
| Thyroid cancer | Cancer | Radiation | Requires a qualifying radiation-risk activity. |
| Breast cancer | Cancer | Radiation | Requires a qualifying radiation-risk activity. |
| Cancer of the pharynx | Cancer | Radiation | Requires a qualifying radiation-risk activity. |
| Cancer of the esophagus | Cancer | Radiation | Requires a qualifying radiation-risk activity. |
| Cancer of the stomach | Cancer | Radiation | Requires a qualifying radiation-risk activity. |
| Cancer of the small intestine | Cancer | Radiation | Requires a qualifying radiation-risk activity. |
| Cancer of the colon | Cancer | Radiation | Requires a qualifying radiation-risk activity. |
| Cancer of the pancreas | Cancer | Radiation | Requires a qualifying radiation-risk activity. |
| Cancer of the bile ducts | Cancer | Radiation | Requires a qualifying radiation-risk activity. |
| Cancer of the gall bladder | Cancer | Radiation | Requires a qualifying radiation-risk activity. |
| Primary liver cancer | Cancer | Radiation | Requires a qualifying radiation-risk activity; not presumptive if cirrhosis or hepatitis B is indicated. |
| Cancer of the salivary gland | Cancer | Radiation | Requires a qualifying radiation-risk activity. |
| Cancer of the urinary tract (kidney, renal pelvis, bladder, urethra) | Cancer | Radiation | Requires a qualifying radiation-risk activity. |
| Bone cancer | Cancer | Radiation | Requires a qualifying radiation-risk activity. |
| Brain cancer | Cancer | Radiation | Requires a qualifying radiation-risk activity. |
| Lung cancer (including bronchiolo-alveolar carcinoma) | Cancer | Radiation | Requires a qualifying radiation-risk activity. |
| Ovarian cancer | Cancer | Radiation | Requires a qualifying radiation-risk activity. |
Common questions
- What does a presumptive condition actually mean?
- For a presumptive condition, VA automatically assumes (presumes) your service caused the condition, so you do not have to prove the connection yourself. You generally still need a current diagnosis and proof that you meet the service requirements for that exposure, such as serving in a specific place during a specific time period. The details vary by condition, so VA.gov is the best place to check the rules that apply to you.
- How do I know if I qualify?
- It usually comes down to where and when you served. Each exposure has its own locations and dates, for example service in Iraq or Afghanistan on or after August 2, 1990 or September 11, 2001 for burn pits, Vietnam era service for Agent Orange, or at least 30 days at Camp Lejeune between 1953 and 1987. VA also offers free toxic exposure screenings at VA health facilities. If you are unsure, VA.gov, your VA regional office, or an accredited Veterans Service Officer can help you check, at no cost.
- Is there a deadline to file a PACT Act claim?
- No. According to VA, there is no deadline, and veterans and survivors can file for PACT Act related benefits at any time. That said, your effective date (which can affect back pay) is generally tied to when you file, so VA suggests submitting an intent to file if you need more time to gather paperwork.
- What if my claim was denied before my condition became presumptive?
- VA encourages veterans in this situation to file a Supplemental Claim. If your condition is now on a presumptive list (for example, one added by the PACT Act in 2022 or the 2025 cancer expansions), VA will review the decision again under the new rules. A previous denial does not prevent you from being approved now.
- How do I file a claim?
- You can file a disability claim online at VA.gov, by mail, by fax, in person at a VA regional office, or with free help from an accredited Veterans Service Officer, agent, or attorney. The standard form is VA Form 21-526EZ. Survivors of veterans may also be eligible to file for benefits such as DIC. This is general information, not legal advice, and VA.gov has the current step by step instructions.
This page is for informational purposes only and is not medical or legal advice. Consult a qualified professional about your health or benefits.