How to file a VA burn pit respiratory claim — PACT Act presumptive locations and conditions, 38 CFR 3.320, and how asthma, COPD, sinusitis and rhinitis are rated
The PACT Act made more than 20 conditions presumptively service-connected for veterans with a presumption of burn pit or other toxic exposure. Exposure is presumed for service on or after August 2, 1990 in Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, Somalia or the United Arab Emirates, and on or after September 11, 2001 in Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Uzbekistan or Yemen, including the airspace above these locations. Presumptive illnesses: asthma diagnosed after service, chronic bronchitis, chronic obstructive pulmonary disease, chronic rhinitis, chronic sinusitis, constrictive or obliterative bronchiolitis, emphysema, granulomatous disease, interstitial lung disease, pleuritis, pulmonary fibrosis and sarcoidosis. Presumptive cancers: brain, gastrointestinal of any type, glioblastoma, head of any type, kidney, lymphoma of any type, melanoma, neck of any type, pancreatic, reproductive of any type and respiratory of any type. A presumptive claim needs the diagnosis and proof of qualifying service — no nexus opinion. Each condition is then rated under 38 CFR 4.97, mostly by pulmonary function tests and treatment.
What you'll need
- VA Form 21-526EZ (or VA Form 20-0995 if VA denied the condition before the PACT Act)
- DD-214, deployment orders or other records showing service in a covered location and period
- Diagnosis and treatment records, including pulmonary function tests (FEV-1, FEV-1/FVC, DLCO), imaging, and medication history; pathology for a cancer
- A free accredited representative (CVSO or VSO)
Step-by-step
Step 1: Confirm a covered location and period
On or after August 2, 1990: Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, Somalia, the United Arab Emirates, or the airspace above them. On or after September 11, 2001: Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Uzbekistan, Yemen, or the airspace above them. Service in these places for any length of time creates the presumption of exposure; VA does not require proof that you were near a burn pit. Any VA-enrolled veteran can also ask for the toxic exposure screening the PACT Act requires VA to offer.
Reference: https://www.va.gov/resources/the-pact-act-and-your-va-benefits/
Step 2: Match your diagnosis to the presumptive list
Illnesses: asthma diagnosed after service, chronic bronchitis, COPD, chronic rhinitis, chronic sinusitis, constrictive or obliterative bronchiolitis, emphysema, granulomatous disease, interstitial lung disease, pleuritis, pulmonary fibrosis, sarcoidosis. 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 cancer of any type. VA's regulation at 38 CFR 3.320 separately lists asthma, rhinitis, sinusitis and nine rare respiratory cancers for Southwest Asia and Afghanistan, Syria, Djibouti and Uzbekistan service. A condition not on either list can still be service-connected directly with medical evidence linking it to the exposure.
Step 3: File the claim
On VA Form 21-526EZ list each condition by its diagnosis and note the covered service (country and dates). Attach the diagnosis and treatment records; VA obtains your service records to confirm the location. File online, by mail to the Claims Intake Center (PO Box 4444, Janesville, WI 53547-4444), in person or through a free accredited representative. If VA denied the same condition before it became presumptive, file a Supplemental Claim (VA Form 20-0995) and VA reviews it under the new rules. Survivors of a veteran who died from a presumptive condition can file for DIC the same way.
Reference: https://www.va.gov/disability/file-disability-claim-form-21-526ez/
Step 4: The exam and the rating criteria
The exam records spirometry and, for some codes, DLCO and exercise capacity. Asthma (DC 6602): 10% for FEV-1 of 71–80% predicted, FEV-1/FVC of 71–80%, or intermittent bronchodilator therapy; 30% for FEV-1 of 56–70%, FEV-1/FVC of 56–70%, daily bronchodilator therapy, or inhalational anti-inflammatory medication; 60% for FEV-1 of 40–55%, FEV-1/FVC of 40–55%, at least monthly physician visits for exacerbations, or at least three courses a year of systemic corticosteroids; 100% for FEV-1 under 40%, FEV-1/FVC under 40%, more than one attack a week with respiratory failure, or daily high-dose systemic corticosteroids or immunosuppressants. Chronic bronchitis (6600), emphysema (6603) and COPD (6604) use the same FEV-1/FEV-1/FVC bands plus DLCO, exercise capacity, cor pulmonale, pulmonary hypertension, respiratory failure and outpatient oxygen for 100%. Sinusitis (6510–6514): 10% for one or two incapacitating episodes a year needing four to six weeks of antibiotics or three to six non-incapacitating episodes; 30% for three or more incapacitating or more than six non-incapacitating episodes; 50% after radical surgery with chronic osteomyelitis or near-constant sinusitis after repeated surgeries. Allergic or vasomotor rhinitis (6522): 10% with greater than 50% obstruction of both nasal passages or complete obstruction of one; 30% with polyps. Active cancer is rated 100% during treatment and for six months after, then on residuals.
Step 5: The registry and other exposures
The Airborne Hazards and Open Burn Pit Registry is a research tool; since August 1, 2024 VA adds eligible veterans automatically from Defense Department records, participation is optional, and it does not affect care or benefits. Veterans with Gulf War service may also have claims for undiagnosed illnesses and medically unexplained chronic multisymptom illnesses under 38 CFR 3.317, and veterans with Agent Orange or radiation exposure have separate presumptive lists — see the PACT Act guide. Questions: VA's PACT Act line, 800-698-2411.
Reference: https://www.publichealth.va.gov/exposures/burnpits/registry.asp
Critical tips
- Asthma is presumptive when diagnosed after service; a diagnosis from any licensed clinician with spirometry supports it.
- Hypertension is a PACT Act presumptive for Agent Orange exposure, not for burn pits — see the hypertension guide for the Vietnam-era rule.
- Secondary conditions still need a nexus opinion: for example sleep disturbance or anxiety linked to a service-connected lung disease is claimed under 38 CFR 3.310.
- Bring your inhaler and medication list to the exam; the DC 6602 levels turn partly on daily versus intermittent therapy and on courses of oral steroids.
- A county veterans service officer can file the claim or the Supplemental Claim for free: warriorsfund.org/find-cvso.
- In crisis: dial 988 then press 1, or text 838255.