The PACT Act added 23 presumptive conditions to the VA’s list for veterans exposed to burn pits and other airborne hazards: 12 respiratory illnesses and 11 cancers. If you have one of these diagnoses and served in a qualifying location during the covered time period, the VA presumes your condition was caused by your service. You do not have to prove the link.1Veterans Affairs. The PACT Act and Your VA Benefits
That presumption is the whole point. Burn pit smoke contains hundreds of chemicals, and cancers or lung diseases can surface years or decades after exposure. Trying to tie a 2024 diagnosis to a 2005 deployment through direct medical evidence is often impossible. Presumptive status removes the burden.2VA.gov. Presumptive Service Connection Eligibility
The 12 Respiratory Illnesses
- Asthma (diagnosed 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
Asthma is the one condition with a timing rule. It only qualifies as presumptive if it was diagnosed after you left service. A pre-service or in-service asthma diagnosis does not count under this list.1Veterans Affairs. The PACT Act and Your VA Benefits
The 11 Cancers
- Brain cancer
- Gastrointestinal cancer of any type
- Glioblastoma
- Head cancer of any type
- Kidney cancer
- Lymphoma of any type
- Melanoma
- Neck cancer of any type
- Pancreatic cancer
- Reproductive cancer of any type
- Respiratory (breathing-related) cancer of any type
Several of the categories are written broadly on purpose. Gastrointestinal cancer of any type covers stomach, colon, esophageal, and liver cancers, among others. Reproductive cancer of any type includes ovarian, uterine, cervical, testicular, and prostate cancers. If your specific diagnosis falls inside one of these body systems, it qualifies.1Veterans Affairs. The PACT Act and Your VA Benefits
Where and When You Had to Serve
A qualifying diagnosis is only half of it. Your service has to match one of two location and date groups.1Veterans Affairs. The PACT Act and Your VA Benefits
Service On or After August 2, 1990
- Bahrain
- Iraq
- Kuwait
- Oman
- Qatar
- Saudi Arabia
- Somalia
- The United Arab Emirates (UAE)
- The airspace above any of these locations
Service On or After September 11, 2001
- Afghanistan
- Djibouti
- Egypt
- Jordan
- Lebanon
- Syria
- Uzbekistan
- Yemen
- The airspace above any of these locations
The airspace inclusion matters for aircrew. Flying missions over these countries counts as qualifying service even if you never landed.
How to File a Claim for One of the 23 Conditions
You need two things in your file: medical records showing the diagnosis, and service records showing you served in a qualifying location during the qualifying period. Because the condition is presumptive, you do not need a medical opinion tying the illness to your service.
You can file the disability compensation claim in any of the usual ways:
- Online through VA.gov
- By mail using VA Form 21-526EZ
- In person at a VA regional office
- By fax at 844-531-7818, or 248-524-4260 from outside the U.S.
- With help from an accredited attorney, claims agent, or Veterans Service Organization representative
If you need more time to gather records, submit an Intent to File (VA Form 21-0966) first. That locks in an earlier effective date, and you then have one year to complete the full claim. If you file online, the intent to file is handled automatically.3Veterans Affairs. About VA Form 21-09664Veterans Affairs. How to File a VA Disability Claim
If the VA Denied Your Claim Before
If the VA previously denied a claim for a condition that is now on the presumptive list, you can refile using a Supplemental Claim (VA Form 20-0995). The change in law itself is the basis for reopening. You do not need new medical evidence beyond what documents the diagnosis and its severity.5Veterans Affairs. Supplemental Claims
The PACT Act was signed on August 10, 2022. The one-year window that would have matched your effective date to the law’s effective date has closed, so a claim filed now will generally take an effective date tied to when the VA receives it, potentially reaching back up to one year.6Veterans Affairs. Disability Compensation Effective Dates
If the Veteran Has Died
Surviving spouses, dependent children, and parents may qualify for Dependency and Indemnity Compensation (DIC) if the veteran died from a condition now on the presumptive list. Survivors previously denied DIC because the condition was not then recognized as service-connected can reapply under the new law.7Veterans Affairs. About VA DIC for Spouses, Dependents, and Parents
What the 23 Conditions Do Not Cover
The 23 conditions are the burn pit and airborne hazards list. A few related tracks are easy to confuse with it, and they follow different rules.
Agent Orange has its own presumptive list. The PACT Act added two conditions to it — hypertension and monoclonal gammopathy of undetermined significance (MGUS) — and expanded qualifying locations to include parts of Thailand, Laos, Cambodia, Guam, American Samoa, and Johnston Atoll during specified dates. These are separate from the 23.1Veterans Affairs. The PACT Act and Your VA Benefits
Radiation exposure is also separate. The PACT Act added three qualifying radiation-risk activities: the Enewetak Atoll cleanup (1977–1980), the Palomares, Spain nuclear response (1966–1967), and the Thule Air Force Base, Greenland nuclear response (1968).8Federal Register. Updating Presumptive Radiation Locations Based on the PACT Act
Gulf War veterans with chronic but medically unexplained symptoms fall under a different presumptive framework that covers conditions like chronic fatigue syndrome, fibromyalgia, functional gastrointestinal disorders, and undiagnosed illnesses with symptoms such as joint pain, headaches, skin conditions, and sleep disturbances. The presumptive period for those claims currently runs through December 31, 2026, meaning the qualifying disability must be rated at 10 percent or more by that date. The 23 PACT Act conditions have no comparable expiration.9VA News. VA Extends Presumptive Period for Persian Gulf War Veterans
There is no deadline to file a PACT Act claim for one of the 23 conditions. The law is permanent. But filing sooner means benefits start sooner, and an intent to file protects your effective date while you assemble your records.