How to file a PACT Act presumptive-condition claim — burn pits, Agent Orange and other toxic exposures

Step 1: Check whether you have a presumption of exposure

Burn pits and other toxins: service on or after September 11, 2001 in Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Uzbekistan or Yemen, or on or after August 2, 1990 in Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, Somalia or the United Arab Emirates — including the airspace above them. Agent Orange: the law added any U.S. or Royal Thai base in Thailand (January 9, 1962 – June 30, 1976), Laos (December 1, 1965 – September 30, 1969), Cambodia at Mimot or Krek (April 16–30, 1969), Guam, American Samoa and their territorial waters (January 9, 1962 – July 31, 1980) and Johnston Atoll or a ship that called there (January 1, 1972 – September 30, 1977). Radiation: the Enewetak Atoll cleanup (1977–1980), the Palomares, Spain cleanup (January 17, 1966 – March 31, 1967) and the Thule, Greenland response (January 21 – September 25, 1968).

Reference: https://www.va.gov/resources/the-pact-act-and-your-va-benefits/

Step 2: Check whether your condition is presumptive

Burn pit and toxic exposure cancers: brain, gastrointestinal (any type), glioblastoma, head (any type), kidney, lymphoma (any type), melanoma, neck (any type), pancreatic, reproductive (any type) and respiratory (any type). Burn pit 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 and sarcoidosis. Agent Orange: high blood pressure (hypertension) and monoclonal gammopathy of undetermined significance (MGUS) were added to the existing list of certain cancers, type 2 diabetes and other illnesses. A condition that is not on a presumptive list can still be service-connected with medical evidence linking it to your service.

Reference: https://www.va.gov/disability/eligibility/hazardous-materials-exposure/

Step 3: Get the diagnosis on paper

A presumption removes the need to prove the cause, not the need to show you have the condition. Bring a current diagnosis from any licensed provider and your recent treatment records; VA may also schedule a claim exam. If you are enrolled in VA health care, ask for the toxic exposure screening — VA offers it to every enrolled veteran and repeats it at least every five years — and ask your provider to document any condition it turns up.

Step 4: File VA Form 21-526EZ — or a Supplemental Claim if VA denied you before

File online at VA.gov, by mail, in person at a regional office, or through a free accredited representative, and list every condition you want rated. If VA denied the same condition in the past and it is now presumptive, file a Supplemental Claim (VA Form 20-0995) instead; VA reviews the claim again under the new presumption and does not require you to wait for its outreach letter. If you have a pending claim for a condition that became presumptive after you filed, you do not need to do anything — VA applies the presumption when it decides.

Reference: https://www.va.gov/disability/file-disability-claim-form-21-526ez/

Step 5: Apply for VA health care too, and know what happens next

Under the PACT Act you can enroll in VA health care without a disability rating if you served in the Vietnam War, the Gulf War, Iraq, Afghanistan or any other combat zone after 9/11, deployed in support of the Global War on Terror, or were exposed to toxins or other hazards during service — apply on VA Form 10-10EZ. Claim processing time depends on the type of claim, how many conditions you claimed and how long evidence takes to gather; VA publishes its current average on VA.gov rather than a fixed timeline. Survivors of a veteran who died from a presumptive condition can apply for Dependency and Indemnity Compensation on VA Form 21P-534EZ.

Reference: https://www.va.gov/health-care/apply-for-health-care-form-10-10ez/