PACT Act Presumptive Conditions: List by Exposure and Presumption Checker
VA presumes that certain conditions were caused by service in listed places and dates, and the PACT Act made more than 20 burn pit and other toxic exposure conditions presumptive, added 2 Agent Orange conditions (high blood pressure and MGUS), 5 Agent Orange locations and 3 radiation response efforts. “Presumptive” means VA presumes your service caused the condition; you still need a diagnosis and service that meets the listed place and dates. Pick a location, your service dates and a condition below to see which list it is on, and read the dates and the rule behind every entry.
Maintained by Archie Chang · Sources checked against VA, statute and Federal Register text on October 31, 2026 · Methodology & sources
PACT Act presumption checker
VA lists service in this location on or after August 2, 1990.
The list holds every condition on the three lists below, plus sleep apnea, which is on none of them.
Check the date range
Enter the first and last day of your service in that location as real dates, with the last day on or after the first.
This checks the lists on this page only. It does not estimate an outcome, a rating or a payment amount. A day of service inside the window is enough for this check; VA decides each claim on your records.
What “presumptive” means
“The PACT Act is a law that expands VA health care and benefits for Veterans exposed to burn pits, Agent Orange, and other toxic substances.”
“To get a VA disability rating, your disability must connect to your military service. For many health conditions, you need to prove that your service caused your condition. But for some conditions, we automatically assume (or “presume”) that your service caused your condition. We call these “presumptive conditions.” We consider a condition presumptive when it's established by law or regulation. If you have a presumptive condition, you don’t need to prove that your service caused the condition. You only need to meet the service requirements for the presumption.”
The statute that sets the burn pit presumption says the same thing in legal terms:
“For the purposes of section 1110 of this title, and subject to section 1113 of this title, a disease specified in subsection (b) becoming manifest in a covered veteran shall be considered to have been incurred in or aggravated during active military, naval, air, or space service, notwithstanding that there is no record of evidence of such disease during the period of such service.”
In practice a presumptive condition has two parts to prove: the diagnosis, and the service. VA’s Agent Orange page puts the first part this way:
“We consider a condition presumptive when it’s established by law or regulation. If you’ve been diagnosed with one of these conditions, you don’t need to prove that it started during—or got worse because of—your military service.”
Burn pit and other toxic exposure presumptive conditions
“We’ve added more than 20 burn pit and other toxic exposure presumptive conditions based on the PACT Act. This change expands benefits for Gulf War era and post-9/11 Veterans.”
“Read this page to review the most common types of cancers that we now consider presumptive for eligible Veterans. If you have one of these cancers and had exposure to burn pits or served in a qualifying location, you may be eligible.”
“As of August 10, 2022, the conditions below are presumed to be service-connected due to various in-service toxic exposures.”
The list below is built from 38 U.S.C. 1120(b) (statute), VA’s burn pit page, its cancers page and the two 2025 interim rules covered in the section on rules added after the Act. The fact sheet above lists 25 conditions, including the burn pit conditions the statute phased in on later dates and, for Agent Orange, hypertension and MGUS; the phase-in dates are shown only as background.
| Condition | Added by, and when |
|---|---|
| Asthma that was diagnosed after service Asthma that was diagnosed after service of the covered veteran as specified in subsection (c). | Pub. L. 117-168 § 406(b) (38 U.S.C. 1120(b)) Enacted or effective August 10, 2022; VA’s fact sheet says it has presumed this since August 10, 2022 |
| Chronic bronchitis | Pub. L. 117-168 § 406(b) (38 U.S.C. 1120(b)) Enacted or effective August 10, 2022; VA’s fact sheet says it has presumed this since August 10, 2022; background: the statute’s effective date for most veterans was October 1, 2023 |
| Chronic obstructive pulmonary disease (COPD) | Pub. L. 117-168 § 406(b) (38 U.S.C. 1120(b)) Enacted or effective August 10, 2022; VA’s fact sheet says it has presumed this since August 10, 2022; background: the statute’s effective date for most veterans was October 1, 2023 |
| Constrictive bronchiolitis or obliterative bronchiolitis | Pub. L. 117-168 § 406(b) (38 U.S.C. 1120(b)) Enacted or effective August 10, 2022; VA’s fact sheet says it has presumed this since August 10, 2022 |
| Emphysema | Pub. L. 117-168 § 406(b) (38 U.S.C. 1120(b)) Enacted or effective August 10, 2022; VA’s fact sheet says it has presumed this since August 10, 2022 |
| Granulomatous disease | Pub. L. 117-168 § 406(b) (38 U.S.C. 1120(b)) Enacted or effective August 10, 2022; VA’s fact sheet says it has presumed this since August 10, 2022 |
| Interstitial lung disease (ILD) | Pub. L. 117-168 § 406(b) (38 U.S.C. 1120(b)) Enacted or effective August 10, 2022; VA’s fact sheet says it has presumed this since August 10, 2022 |
| Pleuritis | Pub. L. 117-168 § 406(b) (38 U.S.C. 1120(b)) Enacted or effective August 10, 2022; VA’s fact sheet says it has presumed this since August 10, 2022 |
| Pulmonary fibrosis | Pub. L. 117-168 § 406(b) (38 U.S.C. 1120(b)) Enacted or effective August 10, 2022; VA’s fact sheet says it has presumed this since August 10, 2022 |
| Sarcoidosis | Pub. L. 117-168 § 406(b) (38 U.S.C. 1120(b)) Enacted or effective August 10, 2022; VA’s fact sheet says it has presumed this since August 10, 2022 |
| Chronic sinusitis | Pub. L. 117-168 § 406(b) (38 U.S.C. 1120(b)) Enacted or effective August 10, 2022; VA’s fact sheet says it has presumed this since August 10, 2022 |
| Chronic rhinitis | Pub. L. 117-168 § 406(b) (38 U.S.C. 1120(b)) Enacted or effective August 10, 2022; VA’s fact sheet says it has presumed this since August 10, 2022 |
| Glioblastoma | Pub. L. 117-168 § 406(b) (38 U.S.C. 1120(b)) Enacted or effective August 10, 2022; VA’s fact sheet says it has presumed this since August 10, 2022 |
| Brain cancer | Pub. L. 117-168 § 406(b) (38 U.S.C. 1120(b)) Enacted or effective August 10, 2022; VA’s fact sheet says it has presumed this since August 10, 2022 |
| Head cancer of any type | Pub. L. 117-168 § 406(b) (38 U.S.C. 1120(b)) Enacted or effective August 10, 2022; VA’s fact sheet says it has presumed this since August 10, 2022; background: the statute’s effective date for most veterans was October 1, 2024 |
| Neck cancer of any type | Pub. L. 117-168 § 406(b) (38 U.S.C. 1120(b)) Enacted or effective August 10, 2022; VA’s fact sheet says it has presumed this since August 10, 2022; background: the statute’s effective date for most veterans was October 1, 2024 |
| Respiratory cancer of any type | Pub. L. 117-168 § 406(b) (38 U.S.C. 1120(b)) Enacted or effective August 10, 2022; VA’s fact sheet says it has presumed this since August 10, 2022 |
| Gastrointestinal cancer of any type | Pub. L. 117-168 § 406(b) (38 U.S.C. 1120(b)) Enacted or effective August 10, 2022; VA’s fact sheet says it has presumed this since August 10, 2022; background: the statute’s effective date for most veterans was October 1, 2024 |
| Reproductive cancer of any type | Pub. L. 117-168 § 406(b) (38 U.S.C. 1120(b)) Enacted or effective August 10, 2022; VA’s fact sheet says it has presumed this since August 10, 2022; background: the statute’s effective date for most veterans was October 1, 2024 |
| Lymphoma of any type | Pub. L. 117-168 § 406(b) (38 U.S.C. 1120(b)) Enacted or effective August 10, 2022; VA’s fact sheet says it has presumed this since August 10, 2022; background: the statute’s effective date for most veterans was October 1, 2024 |
| Kidney cancer | Pub. L. 117-168 § 406(b) (38 U.S.C. 1120(b)) Enacted or effective August 10, 2022; VA’s fact sheet says it has presumed this since August 10, 2022; background: the statute’s effective date for most veterans was October 1, 2025 |
| Melanoma | Pub. L. 117-168 § 406(b) (38 U.S.C. 1120(b)) Enacted or effective August 10, 2022; VA’s fact sheet says it has presumed this since August 10, 2022; background: the statute’s effective date for most veterans was October 1, 2025 |
| Pancreatic cancer | Pub. L. 117-168 § 406(b) (38 U.S.C. 1120(b)) Enacted or effective August 10, 2022; VA’s fact sheet says it has presumed this since August 10, 2022; background: the statute’s effective date for most veterans was October 1, 2024 |
| Bladder cancer | VA interim final rule, 38 CFR 3.320a (90 FR 23) Enacted or effective January 2, 2025 |
| Ureter cancer | VA interim final rule, 38 CFR 3.320a (90 FR 23) Enacted or effective January 2, 2025 |
| Acute leukemias | VA interim final rule, 38 CFR 3.320b (90 FR 1894) Enacted or effective January 10, 2025 |
| Chronic leukemias | VA interim final rule, 38 CFR 3.320b (90 FR 1894) Enacted or effective January 10, 2025 |
| Multiple myeloma | VA interim final rule, 38 CFR 3.320b (90 FR 1894) Enacted or effective January 10, 2025 |
| Monoclonal gammopathy of undetermined significance (MGUS) | VA interim final rule, 38 CFR 3.320b (90 FR 1894) Enacted or effective January 10, 2025 |
| Myelodysplastic syndromes (MDS) | VA interim final rule, 38 CFR 3.320b (90 FR 1894) Enacted or effective January 10, 2025 |
| Myelofibrosis | VA interim final rule, 38 CFR 3.320b (90 FR 1894) Enacted or effective January 10, 2025 |
VA’s page also shows the headings “Genitourinary cancer” and “Hematologic and lymphatic cancers.” The rules name bladder and ureter cancers (38 CFR 3.320a) and acute and chronic leukemias, multiple myelomas including MGUS, myelodysplastic syndromes and myelofibrosis (38 CFR 3.320b), so the table and the checker list only the conditions the rules name. Kidney cancer is in the statute.
Locations and start dates
“If you served in any of these locations and time periods, we’ve determined that you had exposure to burn pits or other toxins. We call this having a presumption of exposure.”
| Location | Dates VA lists | Added by, and when |
|---|---|---|
| Bahrain | On or after August 2, 1990 | Pub. L. 117-168 § 302 (38 U.S.C. 1119(c)) Enacted or effective August 10, 2022 |
| Iraq | On or after August 2, 1990 | Pub. L. 117-168 § 302 (38 U.S.C. 1119(c)) Enacted or effective August 10, 2022 |
| Kuwait | On or after August 2, 1990 | Pub. L. 117-168 § 302 (38 U.S.C. 1119(c)) Enacted or effective August 10, 2022 |
| Oman | On or after August 2, 1990 | Pub. L. 117-168 § 302 (38 U.S.C. 1119(c)) Enacted or effective August 10, 2022 |
| Qatar | On or after August 2, 1990 | Pub. L. 117-168 § 302 (38 U.S.C. 1119(c)) Enacted or effective August 10, 2022 |
| Saudi Arabia | On or after August 2, 1990 | Pub. L. 117-168 § 302 (38 U.S.C. 1119(c)) Enacted or effective August 10, 2022 |
| Somalia | On or after August 2, 1990 | Pub. L. 117-168 § 302 (38 U.S.C. 1119(c)) Enacted or effective August 10, 2022 |
| United Arab Emirates (UAE) | On or after August 2, 1990 | Pub. L. 117-168 § 302 (38 U.S.C. 1119(c)) Enacted or effective August 10, 2022 |
| Arabian Sea | On or after August 2, 1990 | Southwest Asia theater of operations, 38 CFR 3.320(a)(6)(i) and 3.320a(c)(1)(i) Already listed; not an addition of the Act |
| Gulf of Aden | On or after August 2, 1990 | Southwest Asia theater of operations, 38 CFR 3.320(a)(6)(i) and 3.320a(c)(1)(i) Already listed; not an addition of the Act |
| Gulf of Oman | On or after August 2, 1990 | Southwest Asia theater of operations, 38 CFR 3.320(a)(6)(i) and 3.320a(c)(1)(i) Already listed; not an addition of the Act |
| Neutral zone between Iraq/Saudi Arabia | On or after August 2, 1990 | Southwest Asia theater of operations, 38 CFR 3.320(a)(6)(i) and 3.320a(c)(1)(i) Already listed; not an addition of the Act |
| Persian Gulf | On or after August 2, 1990 | Southwest Asia theater of operations, 38 CFR 3.320(a)(6)(i) and 3.320a(c)(1)(i) Already listed; not an addition of the Act |
| Red Sea | On or after August 2, 1990 | Southwest Asia theater of operations, 38 CFR 3.320(a)(6)(i) and 3.320a(c)(1)(i) Already listed; not an addition of the Act |
| Afghanistan | On or after September 11, 2001 | Pub. L. 117-168 § 302 (38 U.S.C. 1119(c)) Enacted or effective August 10, 2022 |
| Djibouti | On or after September 11, 2001 | Pub. L. 117-168 § 302 (38 U.S.C. 1119(c)) Enacted or effective August 10, 2022 |
| Egypt | On or after September 11, 2001 | Pub. L. 117-168 § 302 (38 U.S.C. 1119(c)) Enacted or effective August 10, 2022 |
| Jordan | On or after September 11, 2001 | Pub. L. 117-168 § 302 (38 U.S.C. 1119(c)) Enacted or effective August 10, 2022 |
| Lebanon | On or after September 11, 2001 | Pub. L. 117-168 § 302 (38 U.S.C. 1119(c)) Enacted or effective August 10, 2022 |
| Syria | On or after September 11, 2001 | Pub. L. 117-168 § 302 (38 U.S.C. 1119(c)) Enacted or effective August 10, 2022 |
| Uzbekistan | On or after September 11, 2001 | Pub. L. 117-168 § 302 (38 U.S.C. 1119(c)) Enacted or effective August 10, 2022 |
| Yemen | On or after September 11, 2001 | Pub. L. 117-168 § 302 (38 U.S.C. 1119(c)) Enacted or effective August 10, 2022 |
The countries on both lists are in 38 U.S.C. 1119(c) (statute), which also covers the airspace above them and lets VA add other countries; the statute does not name the six bodies of water, but VA’s page lists them with the 1990 group. 38 CFR 3.320(a)(6)(i) names them in its definition of the Southwest Asia theater of operations, and 38 CFR 3.320a(c)(1)(i) refers to 38 CFR 3.317(e)(2) for that definition. One older rule differs on a date: 38 CFR 3.320(a)(5)(ii), the 2023 rule on asthma, rhinitis, sinusitis and nine rare respiratory cancers, counts service in Afghanistan, Syria, Djibouti or Uzbekistan from September 19, 2001. The statute, VA’s page and the 2025 rules use September 11, 2001, and this page and the checker do too.
“You can still apply for disability compensation. If your condition or service location isn’t listed here, you’ll need to submit more evidence to show how your condition connects to your service.”
Agent Orange presumptive conditions and locations
The PACT Act added two conditions to the Agent Orange list and five locations. VA’s page says:
“We’ve also added 5 new Agent Orange presumptive locations.”
| Condition | Added by, and when |
|---|---|
| Bladder cancer | Pub. L. 116-283 § 9109 (38 U.S.C. 1116(a)(2)(I) to (K)) Enacted or effective January 1, 2021 |
| Multiple myeloma | 38 CFR 3.309(e); not added by the PACT Act Already listed; not an addition of the Act |
| Monoclonal gammopathy of undetermined significance (MGUS) | Pub. L. 117-168 § 404(b) (38 U.S.C. 1116(a)(2)(L)) Enacted or effective August 10, 2022; VA’s fact sheet says it has presumed this since August 10, 2022; background: the statute’s effective date for most veterans was October 1, 2022 |
| Respiratory cancers (lung, bronchus, larynx, trachea) | 38 CFR 3.309(e); not added by the PACT Act Already listed; not an addition of the Act |
| Chronic B-cell leukemia | 38 CFR 3.309(e); not added by the PACT Act Already listed; not an addition of the Act |
| Hodgkin’s disease | 38 CFR 3.309(e); not added by the PACT Act Already listed; not an addition of the Act |
| Non-Hodgkin’s lymphoma | 38 CFR 3.309(e); not added by the PACT Act Already listed; not an addition of the Act |
| Prostate cancer | 38 CFR 3.309(e); not added by the PACT Act Already listed; not an addition of the Act |
| Soft tissue sarcomas (some) | 38 CFR 3.309(e); not added by the PACT Act Already listed; not an addition of the Act |
| AL amyloidosis | 38 CFR 3.309(e); not added by the PACT Act Already listed; not an addition of the Act |
| Chloracne (or other acneiform disease like it) Under our rating regulations, this condition must be at least 10% disabling within 1 year of herbicide exposure. | 38 CFR 3.309(e); not added by the PACT Act Already listed; not an addition of the Act |
| Diabetes mellitus type 2 | 38 CFR 3.309(e); not added by the PACT Act Already listed; not an addition of the Act |
| High blood pressure (hypertension) | Pub. L. 117-168 § 404(c) (38 U.S.C. 1116(a)(2)(M)) Enacted or effective August 10, 2022; VA’s fact sheet says it has presumed this since August 10, 2022; background: the statute’s effective date for most veterans was October 1, 2026 |
| Hypothyroidism | Pub. L. 116-283 § 9109 (38 U.S.C. 1116(a)(2)(I) to (K)) Enacted or effective January 1, 2021 |
| Ischemic heart disease | 38 CFR 3.309(e); not added by the PACT Act Already listed; not an addition of the Act |
| Parkinsonism | Pub. L. 116-283 § 9109 (38 U.S.C. 1116(a)(2)(I) to (K)) Enacted or effective January 1, 2021 |
| Parkinson’s disease | 38 CFR 3.309(e); not added by the PACT Act Already listed; not an addition of the Act |
| Peripheral neuropathy, early onset Under our rating regulations, this condition must be at least 10% disabling within 1 year of herbicide exposure. | 38 CFR 3.309(e); not added by the PACT Act Already listed; not an addition of the Act |
| Porphyria cutanea tarda Under our rating regulations, this condition must be at least 10% disabling within 1 year of herbicide exposure. | 38 CFR 3.309(e); not added by the PACT Act Already listed; not an addition of the Act |
38 U.S.C. 1116 (statute) lists hypertension at (a)(2)(M) and MGUS at (a)(2)(L). VA’s fact sheet says that as of August 10, 2022 it presumes both to be service-connected, and VA’s Agent Orange page (last updated September 16, 2025) lists them. The statute’s own note sets October 1, 2026 as the date for hypertension for veterans not in the earlier group (terminally ill, homeless, in extreme financial hardship, over 85 or otherwise covered); that is background, and as of October 31, 2026 the date has passed.
Locations and dates
| Location | Dates VA lists | Added by, and when |
|---|---|---|
| Republic of Vietnam | January 9, 1962 through May 7, 1975 | 38 U.S.C. 1116(d)(1); not one of the five locations the PACT Act added Already listed; not an addition of the Act |
| Any U.S. or Royal Thai military base in Thailand | January 9, 1962 through June 30, 1976 | Pub. L. 117-168 § 403(b) (38 U.S.C. 1116(d)) Enacted or effective August 10, 2022; background: the statute’s effective date for most veterans was October 1, 2022 |
| Laos | December 1, 1965 through September 30, 1969 | Pub. L. 117-168 § 403(b) (38 U.S.C. 1116(d)) Enacted or effective August 10, 2022; background: the statute’s effective date for most veterans was October 1, 2022 |
| Cambodia at Mimot or Krek, Kampong Cham Province | April 16, 1969 through April 30, 1969 | Pub. L. 117-168 § 403(b) (38 U.S.C. 1116(d)) Enacted or effective August 10, 2022; background: the statute’s effective date for most veterans was October 1, 2022 |
| Guam or American Samoa (or the territorial waters off them) | January 9, 1962 through July 31, 1980 | Pub. L. 117-168 § 403(b) (38 U.S.C. 1116(d)) Enacted or effective August 10, 2022; background: the statute’s effective date for most veterans was October 1, 2022 |
| Johnston Atoll or a ship that called at Johnston Atoll | January 1, 1972 through September 30, 1977 | Pub. L. 117-168 § 403(b) (38 U.S.C. 1116(d)) Enacted or effective August 10, 2022; background: the statute’s effective date for most veterans was October 1, 2022 |
VA’s page also lists service in or near the Korean DMZ, on a C-123 aircraft and in the transport, testing or storage of Agent Orange, plus vessels in Vietnam’s inland waterways and offshore; those were not added by the Act and are not in the checker. See the VA page.
“If you have a cancer or illness that’s not on our list of presumptive conditions, but you believe it was caused by Agent Orange exposure, you can still file a claim for VA disability benefits. But you’ll need to submit more evidence.”
Radiation: added response efforts
“If you took part in any of these efforts, we’ll automatically assume (or “presume”) that you had exposure to radiation.”
| Location | Dates VA lists | Added by, and when |
|---|---|---|
| Cleanup of Enewetak Atoll | January 1, 1977 through December 31, 1980 | Pub. L. 117-168 § 401(b) Enacted or effective August 10, 2022 |
| Cleanup of the B-52 bomber off the coast of Palomares, Spain | January 17, 1966 through March 31, 1967 | Pub. L. 117-168 § 402(b) Enacted or effective August 10, 2022 |
| Response to the B-52 fire near Thule Air Force Base, Greenland | January 21, 1968 through September 25, 1968 | Pub. L. 117-168 § 402(b) Enacted or effective August 10, 2022 |
The conditions are the list in 38 CFR 3.309(d)(2) (eCFR); the Act added the three locations, not conditions. VA’s radiation page adds: “Your illness started within a certain period of time (as shown along with the list of illnesses).” The checker lists the 21 conditions below; the other radiation-risk activities, such as atmospheric nuclear tests and the occupation of Hiroshima and Nagasaki, are in 38 CFR 3.309(d)(3).
| Condition | Added by, and when |
|---|---|
| Multiple myeloma | 38 CFR 3.309(d)(2); not added by the PACT Act Already listed; not an addition of the Act |
| Leukemia (other than chronic lymphocytic leukemia) | 38 CFR 3.309(d)(2); not added by the PACT Act Already listed; not an addition of the Act |
| Cancer of the thyroid | 38 CFR 3.309(d)(2); not added by the PACT Act Already listed; not an addition of the Act |
| Cancer of the breast | 38 CFR 3.309(d)(2); not added by the PACT Act Already listed; not an addition of the Act |
| Cancer of the pharynx | 38 CFR 3.309(d)(2); not added by the PACT Act Already listed; not an addition of the Act |
| Cancer of the esophagus | 38 CFR 3.309(d)(2); not added by the PACT Act Already listed; not an addition of the Act |
| Cancer of the stomach | 38 CFR 3.309(d)(2); not added by the PACT Act Already listed; not an addition of the Act |
| Cancer of the small intestine | 38 CFR 3.309(d)(2); not added by the PACT Act Already listed; not an addition of the Act |
| Cancer of the pancreas | 38 CFR 3.309(d)(2); not added by the PACT Act Already listed; not an addition of the Act |
| Lymphomas (except Hodgkin’s disease) | 38 CFR 3.309(d)(2); not added by the PACT Act Already listed; not an addition of the Act |
| Cancer of the bile ducts | 38 CFR 3.309(d)(2); not added by the PACT Act Already listed; not an addition of the Act |
| Cancer of the gall bladder | 38 CFR 3.309(d)(2); not added by the PACT Act Already listed; not an addition of the Act |
| Primary liver cancer (except if cirrhosis or hepatitis B is indicated) | 38 CFR 3.309(d)(2); not added by the PACT Act Already listed; not an addition of the Act |
| Cancer of the salivary gland | 38 CFR 3.309(d)(2); not added by the PACT Act Already listed; not an addition of the Act |
| Cancer of the urinary tract For the purposes of this section, the term “urinary tract” means the kidneys, renal pelves, ureters, urinary bladder, and urethra. | 38 CFR 3.309(d)(2); not added by the PACT Act Already listed; not an addition of the Act |
| Bronchiolo-alveolar carcinoma | 38 CFR 3.309(d)(2); not added by the PACT Act Already listed; not an addition of the Act |
| Cancer of the bone | 38 CFR 3.309(d)(2); not added by the PACT Act Already listed; not an addition of the Act |
| Cancer of the brain | 38 CFR 3.309(d)(2); not added by the PACT Act Already listed; not an addition of the Act |
| Cancer of the colon | 38 CFR 3.309(d)(2); not added by the PACT Act Already listed; not an addition of the Act |
| Cancer of the lung | 38 CFR 3.309(d)(2); not added by the PACT Act Already listed; not an addition of the Act |
| Cancer of the ovary | 38 CFR 3.309(d)(2); not added by the PACT Act Already listed; not an addition of the Act |
Conditions covered through a category, and conditions that depend on the type
The three lists use different names. VA’s cancers page files breast and prostate cancer under reproductive cancers, thyroid and pharyngeal cancer under neck cancers, Hodgkin and non-Hodgkin lymphomas under lymphoma, and esophageal, stomach, colon, small intestine and liver cancer under gastrointestinal cancers. The checker applies those mappings; where a list covers only some types of a condition, it answers “Depends on the type” instead of yes or no. Each row names the list and what it covers for that condition.
| Condition | On the list of | Result |
|---|---|---|
| Glioblastoma | radiation | Depends on the type; the list covers cancer of the brain |
| Brain cancer | radiation | Falls under “Cancer of the brain”: presumptive |
| Head cancer of any type | radiation | Depends on the type; the list covers cancer of the salivary gland |
| Neck cancer of any type | radiation | Depends on the type; the list covers cancer of the thyroid, cancer of the pharynx and cancer of the salivary gland |
| Neck cancer of any type | Agent Orange | Depends on the type; the list covers cancer of the larynx, which VA’s Agent Orange list names under respiratory cancers (lung, bronchus, larynx, or trachea) |
| Respiratory cancer of any type | Agent Orange | Depends on the type; the list covers cancer of the lung, bronchus, larynx, or trachea |
| Respiratory cancer of any type | radiation | Depends on the type; the list covers cancer of the lung and cancer of the pharynx |
| Gastrointestinal cancer of any type | radiation | Depends on the type; the list covers cancer of the esophagus, stomach, small intestine, colon, primary liver and pancreas, and of the bile ducts and gall bladder |
| Reproductive cancer of any type | radiation | Depends on the type; the list covers cancer of the breast and cancer of the ovary |
| Reproductive cancer of any type | Agent Orange | Depends on the type; the list covers prostate cancer |
| Lymphoma of any type | Agent Orange | Depends on the type; the list covers Hodgkin’s disease and Non-Hodgkin’s lymphoma |
| Lymphoma of any type | radiation | Depends on the type; the list covers lymphomas except Hodgkin’s disease |
| Kidney cancer | radiation | Falls under “Cancer of the urinary tract”: presumptive |
| Pancreatic cancer | radiation | Falls under “Cancer of the pancreas”: presumptive |
| Bladder cancer | radiation | Falls under “Cancer of the urinary tract”: presumptive |
| Ureter cancer | radiation | Falls under “Cancer of the urinary tract”: presumptive |
| Acute leukemias | radiation | Falls under “Leukemia (other than chronic lymphocytic leukemia)”: presumptive |
| Chronic leukemias | Agent Orange | Depends on the type; the list covers Chronic B-cell leukemia only; VA’s Agent Orange list does not name other chronic leukemias |
| Chronic leukemias | radiation | Depends on the type; the list covers leukemia other than chronic lymphocytic leukemia |
| Respiratory cancers (lung, bronchus, larynx, trachea) | burn pit and other toxic exposure | Falls under “Respiratory cancer of any type”: presumptive |
| Respiratory cancers (lung, bronchus, larynx, trachea) | radiation | Depends on the type; the list covers cancer of the lung and cancer of the pharynx |
| Chronic B-cell leukemia | burn pit and other toxic exposure | Falls under “Chronic leukemias”: presumptive |
| Chronic B-cell leukemia | radiation | Depends on the type; the list covers leukemia other than chronic lymphocytic leukemia; chronic lymphocytic leukemia is a chronic B-cell leukemia |
| Hodgkin’s disease | burn pit and other toxic exposure | Falls under “Lymphoma of any type”: presumptive |
| Non-Hodgkin’s lymphoma | burn pit and other toxic exposure | Falls under “Lymphoma of any type”: presumptive |
| Non-Hodgkin’s lymphoma | radiation | Falls under “Lymphomas (except Hodgkin’s disease)”: presumptive |
| Prostate cancer | burn pit and other toxic exposure | Falls under “Reproductive cancer of any type”: presumptive |
| Soft tissue sarcomas (some) | burn pit and other toxic exposure | Depends on the type; the list covers sarcomas of the head or neck and sarcomas of the blood vessels |
| Leukemia (other than chronic lymphocytic leukemia) | burn pit and other toxic exposure | Falls under “Acute leukemias and chronic leukemias”: presumptive |
| Leukemia (other than chronic lymphocytic leukemia) | Agent Orange | Depends on the type; the list covers Chronic B-cell leukemia only; VA’s Agent Orange list does not name other chronic leukemias |
| Cancer of the thyroid | burn pit and other toxic exposure | Falls under “Neck cancer of any type”: presumptive |
| Cancer of the breast | burn pit and other toxic exposure | Falls under “Reproductive cancer of any type”: presumptive |
| Cancer of the pharynx | burn pit and other toxic exposure | Falls under “Neck cancer of any type”: presumptive |
| Cancer of the esophagus | burn pit and other toxic exposure | Falls under “Gastrointestinal cancer of any type”: presumptive |
| Cancer of the stomach | burn pit and other toxic exposure | Falls under “Gastrointestinal cancer of any type”: presumptive |
| Cancer of the small intestine | burn pit and other toxic exposure | Falls under “Gastrointestinal cancer of any type”: presumptive |
| Cancer of the pancreas | burn pit and other toxic exposure | Falls under “Pancreatic cancer”: presumptive |
| Lymphomas (except Hodgkin’s disease) | burn pit and other toxic exposure | Falls under “Lymphoma of any type”: presumptive |
| Lymphomas (except Hodgkin’s disease) | Agent Orange | Depends on the type; the list covers Hodgkin’s disease and Non-Hodgkin’s lymphoma |
| Cancer of the bile ducts | burn pit and other toxic exposure | Depends on the type; the list covers gastrointestinal cancer of any type; VA’s page names anal, colorectal, esophageal, liver, pancreatic, small intestine, spleen and stomach cancers but not bile duct cancer |
| Cancer of the gall bladder | burn pit and other toxic exposure | Depends on the type; the list covers gastrointestinal cancer of any type; VA’s page names anal, colorectal, esophageal, liver, pancreatic, small intestine, spleen and stomach cancers but not gall bladder cancer |
| Primary liver cancer (except if cirrhosis or hepatitis B is indicated) | burn pit and other toxic exposure | Falls under “Gastrointestinal cancer of any type”: presumptive |
| Cancer of the salivary gland | burn pit and other toxic exposure | Falls under “Neck cancer of any type”: presumptive |
| Cancer of the urinary tract | burn pit and other toxic exposure | Depends on the type; the list covers kidney, ureter and bladder cancer; urethral cancer is named only under male reproductive cancers |
| Cancer of the urinary tract | Agent Orange | Depends on the type; the list covers bladder cancer |
| Bronchiolo-alveolar carcinoma | burn pit and other toxic exposure | Depends on the type; the list covers respiratory cancer of any type; VA’s page does not name bronchiolo-alveolar carcinoma |
| Bronchiolo-alveolar carcinoma | Agent Orange | Depends on the type; the list covers cancer of the lung, bronchus, larynx, or trachea |
| Cancer of the bone | burn pit and other toxic exposure | Depends on the type; the list covers sarcomas of the head or neck, which VA’s page says include osteosarcoma; VA’s page does not list bone cancer as a category |
| Cancer of the bone | Agent Orange | Depends on the type; the list covers soft-tissue sarcoma other than osteosarcoma, chondrosarcoma, Kaposi’s sarcoma, or mesothelioma |
| Cancer of the brain | burn pit and other toxic exposure | Falls under “Brain cancer”: presumptive |
| Cancer of the colon | burn pit and other toxic exposure | Falls under “Gastrointestinal cancer of any type”: presumptive |
| Cancer of the lung | burn pit and other toxic exposure | Falls under “Respiratory cancer of any type”: presumptive |
| Cancer of the lung | Agent Orange | Falls under “Respiratory cancers (lung, bronchus, larynx, or trachea)”: presumptive |
| Cancer of the ovary | burn pit and other toxic exposure | Falls under “Reproductive cancer of any type”: presumptive |
Presumptive conditions added after the Act
The Act lets VA add presumptions by rule. Two interim final rules took effect in January 2025 for veterans who served in the burn pit locations above, and one notice in November 2025 declined five blood conditions:
“This interim final rule is effective January 2, 2025.”
“This interim final rule is effective January 10, 2025.”
The rules are codified at 38 CFR 3.320a (eCFR) and 3.320b (eCFR), and the Federal Register notices are 90 FR 23 and 90 FR 1894. On November 20, 2025 VA published this decision (90 FR 52494):
“The Department of Veterans Affairs (VA) is issuing notice of the Secretary's determination under title 38 United States Code (U.S.C.) 1174(a)(2) that a presumption of service connection is not warranted for polycythemia vera, essential thrombocythemia, histiocytosis, mastocytosis, and chronic myeloproliferative disease for veterans exposed to fine particulate matter (PM2.5) while serving in the Southwest Asia Theater of Operations or Somalia on or after August 2, 1990, or in Afghanistan, Egypt, Jordan, Lebanon, Syria, Yemen, Djibouti, or Uzbekistan on or after September 11, 2001.”
“This determination that presumptions of service connection are not warranted at this time does not in any way preclude VA from granting service connection based on the evidence in a particular case for any disease, including those specifically discussed in this notice, nor does it change any existing rights or procedures.”
So polycythemia vera, essential thrombocythemia, histiocytosis, mastocytosis and chronic myeloproliferative disease are not presumptive for these locations, and a claim for one of them still depends on the evidence. VA proposed more rules on October 1, 2024 (89 FR 79815), including presumptions for 23 diseases; that notice is a proposal, and this page does not treat it as a rule. As of October 31, 2026, 38 CFR 3.320a and 3.320b remain interim final rules (eCFR shows only the January 2025 versions). Check the Federal Register and VA before relying on this page for a new condition.
Toxic exposure screening
“Every Veteran enrolled in VA health care will receive an initial screening and a follow-up screening at least once every 5 years. Veterans who aren’t enrolled and who meet eligibility requirements can enroll and receive the screening.”
Filing, deadlines and past denials
“Yes. The PACT Act is here to stay, and Veterans and survivors can file for benefits anytime. The sooner you file, the sooner you can start getting your earned benefits.”
“If we denied your disability claim in the past and we now consider your condition presumptive, you can submit a Supplemental Claim. We’ll review your case again.”
This page does not state a rule on effective dates or back pay: VA decides them on your claim. To estimate back pay once VA grants a rating, use the VA back pay calculator. For what each rating level unlocks, see VA benefits at 100 percent and the veterans hub.
Frequently asked questions
What is the PACT Act?
The PACT Act is a law that expands VA health care and benefits for veterans exposed to burn pits, Agent Orange and other toxic substances. Its full name is the Sergeant First Class (SFC) Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act (Public Law 117-168, signed August 10, 2022). VA says it added more than 20 burn pit and other toxic exposure presumptive conditions, added two Agent Orange conditions, added five Agent Orange locations and three radiation response efforts, and requires a toxic exposure screening for every veteran enrolled in VA health care.
What does presumptive mean for a VA claim?
VA presumes that your service caused the condition, so you do not have to prove the link. You still need to meet the service requirements for the presumption, such as serving in a listed location during the listed dates, and a diagnosis of the condition. VA decides each claim on your medical and service records.
Which locations and dates count for the burn pit presumptions?
Service on or after August 2, 1990 in Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, Somalia, United Arab Emirates (UAE), or the airspace above those countries, and service in the Arabian Sea, Gulf of Aden, Gulf of Oman, neutral zone between Iraq and Saudi Arabia, Persian Gulf or Red Sea, which VA lists with them. Service on or after September 11, 2001 in Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Uzbekistan, Yemen, or the airspace above them. Section 1119(c) of title 38 also allows VA to add any other country it finds relevant; VA’s page says none at this time.
Is hypertension a PACT Act presumptive condition?
It depends on the exposure. For Agent Orange, yes: VA’s Agent Orange page lists high blood pressure (hypertension) as a presumptive condition the PACT Act added (38 U.S.C. 1116(a)(2)(M)), for veterans with qualifying service in a listed Agent Orange location during the listed dates, and VA’s fact sheet says that as of August 10, 2022 it presumes hypertension to be service-connected. The statute’s own note gives October 1, 2026 as the date for most veterans; that is background, and it has passed as of October 31, 2026. For burn pits, no: hypertension is not on VA’s burn pit and other toxic exposure list, and it is not on the radiation list in 38 CFR 3.309(d)(2). Separately, 38 CFR 3.309(a) lists “Cardiovascular-renal disease, including hypertension” among the chronic diseases, with timing rules in 38 CFR 3.307 that this page does not cover. You can still file for a condition that is not listed, with more evidence.
Is sleep apnea a PACT Act presumptive condition?
Sleep apnea is not on the lists this page covers. It is not on VA’s burn pit and other toxic exposure list, not on VA’s Agent Orange list and not on the radiation list in 38 CFR 3.309(d)(2). As of October 31, 2026, the VA pages, statutes and rules under Sources do not name it. VA says that when a condition is not listed you can still file, and you will need to submit more evidence to show how it connects to your service.
Is there a deadline to file a PACT Act claim?
VA’s PACT Act page says veterans and survivors can file for benefits anytime, and that the sooner you file, the sooner you can start getting benefits. This page does not state a rule on effective dates or back pay; VA decides those on your claim. VA also says you can submit your intent to file.
Has VA added presumptive conditions since the Act?
Yes, for the burn pit locations. As of October 31, 2026, 38 CFR 3.320a and 3.320b remain interim final rules (eCFR shows only the January 2025 versions). VA published an interim final rule effective January 2, 2025 for urinary bladder and ureter cancers (38 CFR 3.320a), and one effective January 10, 2025 for acute and chronic leukemias, multiple myelomas including MGUS, myelodysplastic syndromes and myelofibrosis (38 CFR 3.320b). A notice published November 20, 2025 says VA decided a presumption is not warranted for polycythemia vera, essential thrombocythemia, histiocytosis, mastocytosis and chronic myeloproliferative disease, and that this does not preclude service connection based on the evidence in a particular case.
What if VA denied my claim before the condition became presumptive?
VA says that if it denied your disability claim in the past and it now considers your condition presumptive, you can submit a Supplemental Claim and VA will review your case again. If VA added the condition after you filed a pending claim, VA says it will still consider the condition presumptive.
Sources
As of October 31, 2026, the VA pages carry these update dates: the PACT Act page June 2, 2026, the burn pit page April 9, 2025, the Agent Orange page September 16, 2025 and the radiation page July 18, 2023.
- VA: The PACT Act and your VA benefits
- VA: Agent Orange exposure and disability compensation
- VA: Exposure to burn pits and other specific environmental hazards
- VA: Ionizing radiation exposure
- VA: Presumptive cancers related to burn pit exposure
- VA fact sheet: Accessing PACT Act benefits and services (PDF)
- 38 U.S.C. 1116 (herbicide agents; covered service) (Cornell LII)
- 38 U.S.C. 1119 (presumptions of toxic exposure) (Cornell LII)
- 38 U.S.C. 1120 (burn pits and other toxins) (Cornell LII)
- 38 CFR 3.309 (eCFR) (Cornell LII)
- 38 CFR 3.320 (eCFR) (Cornell LII)
- 38 CFR 3.320a (eCFR)
- 38 CFR 3.320b (eCFR)
- Federal Register, January 2, 2025 (90 FR 23): bladder, ureter and related genitourinary cancers
- Federal Register, January 10, 2025 (90 FR 1894): leukemias, multiple myelomas, MDS and myelofibrosis
- Federal Register, November 20, 2025 (90 FR 52494): decision on five blood conditions
- Federal Register, October 1, 2024 (89 FR 79815): proposed rule on toxic exposure claims
- Public Law 117-168 (PACT Act), sections 401 to 404