The PACT Act, also known as Sergeant First Class Heath Robinson Honoring Our Promise to Address Comprehensive Toxic (PACT) Act of 2022, was signed into law on August 10, 2022.
The PACT Act expands VA Healthcare and disability benefits for Veterans exposed to toxic substances during their military service.
Toxic Exposures
Veterans may have experienced any of the following toxic exposures during service:
| Air Pollutants | Burn pits, oil well fires, sulfur fire, sand, dust, and particulates. |
|---|---|
| Chemicals | Agent Orange and other herbicides, burn pits, Camp Lejeune water supplies, pesticides, depleted uranium, chromium, or industrial solvents. |
| Radiation | Nuclear weapons testing, x-rays, or depleted uranium. |
| Warfare Agents | Chemical warfare agents, nerve agents, mustard gas, herbicide tests. |
| Occupational Hazards | Asbestos, lead, fuels, industrial solvents, radiation, vibration, noise, paint on military vehicles, coolants, insulating fluids. |
Expansion of Eligibility for Service-Connected Disabilities
The VA pays Compensation benefits, or service-connected disability benefits, to veterans who have a disability that was incurred in or was aggravated by military service.
The VA and Department of Defense know that during designated periods of time and in certain locations military service members were exposed to toxins that are known to cause medical conditions. The VA presumes that these specific conditions are related to these exposure events.
Presumptive service connection occurs where the VA presumes that the veteran’s condition was caused by their military service. To prove eligibility for a presumptive condition, the veteran must show 1) a current diagnosis; and 2) service during the qualifying time and geographic location.
Veterans must submit an application for the VA to consider eligibility for this benefit. This is true even when the Veteran is already on a toxic exposure registry list. Veterans may submit an their Application for Disability Compensation and Compensation Related Benefits, VA Form 21-526EZ online at va.gov, with the assistance of a VA-accredited Veteran Service Organization (VSO) or attorney, or by mail or fax.
Moreover, the VA is not required to initiate re-adjudication of claims that were previously denied and could have a different result under the PACT Act. It is important to work with a VA-accredited representative on these claims to obtain the most favorable outcome on a case.
Vietnam-Era Veterans
The PACT Act expanded the locations and conditions eligible for toxic exposure due to Agent Orange.
| Dates | Locations |
|---|---|
| January 9, 1962, to and May 7, 1975 |
|
| January 9, 1962, to June 30, 1976 | Any U.S. or Royal Thai military base in Thailand |
| December 1, 1965, to September 30, 1969 | Laos |
| April 16, 1969, to April 30, 1969 | Cambodia at Memot or Krek, Kampong Cham Province |
| January 9, 1962, to July 31, 1980 | Guam or American Samoa or in the territorial waters off Guam or American Samoa |
| January 1, 1972, to September 30, 1977 | Johnston Atoll or on a ship that called at Johnston Atoll |
| September 1, 1967, to August 31, 1971 | Korean Demilitarized Zone |
Other Eligible Criteria:
- Active-duty service in a regular Air Force unit location where a C-123 aircraft with traces of Agent Orange was assigned, and had repeated contact with this aircraft due to flight, ground, or medical duties, or
- Involvement in transporting, testing, storing, or other uses of Agent Orange during military service, or
- Assignment as a Reservist to certain flight, ground, or medical crew duties at one of the following dates and locations:
| Dates | Reserve Locations and Units |
|---|---|
| 1969 to 1986 | Lockbourne/Rickenbacker Air Force Base in Ohio for 906th and 907th Tactical Air Groups or 355th and 356th Tactical Airlift Squadrons |
| 1972 to 1982 | Westover Air Force Base in Massachusetts for 731st Tactical Air Squadron and 74th Aeromedical Evacuation Squadron, or 901st Organizational Maintenance Squadron |
| 1972 to 1982 | Pittsburgh International Airport in Pennsylvania for 758th Airlift Squadron |
Prior to the PACT Act, Vietnam-Era veterans have long been presumptively eligible for the following medical conditions due to exposure to herbicides, including Agent Orange
| Cancers | Diseases |
|---|---|
| Bladder Cancer | AL amyloidosis |
| Chronic B-Cell Leukemia | Chloracne |
| Hodgkin's Disease | Diabetes Mellitus type 2 |
| Multiple Myeloma | Hypothyroidism |
| Non-Hodgkin's Lymphoma | Ischemic heart disease |
| Prostate Cancer | Parkinsonism |
| Respiratory Cancers | Parkinson's Disease |
| Soft Tissue Sarcomas | Peripheral Neuropathy |
| Porphyria Cutanea Tarda |
The PACT Act added the following new diseases for presumptive service-connection:
- Mycobacterium tuberculosis
- Visceral Leishmaniasis
Gulf War Veterans
Gulf War Veterans are those who served in or after the Gulf War on or after August 2, 1990, and after the start of the Global War on Terrorism or after September 11, 2001. They are presumed to have been exposed to toxic substances in the following locations:
Gulf War Locations
- Bahrain
- Iraq
- Kuwait
- Oman
- Qatar
- Saudi Arabia
- Somalia
- The United Arab Emirates (UAE)
Global War on Terrorism Locations
- AfghanistanBahrain
- Djibouti
- Egypt
- Iraq
- Jordan
- Kuwait
- Lebanon
- Oman
- Qatar
- Saudi Arabia
- Somalia
- Syria
- The United Arab Emirates (UAE)
- Uzbekistan
- Yemen
Gulf War veterans are eligible for presumptive service-connection for the following conditions:
Undiagnosed Illnesses
- Chronic Fatigue Syndrome
- Fibromyalgia
- Functional gastrointestinal disorders
- Medically unexplained chronic multi symptomatic illness
- Other undiagnosed illnesses such as cardiovascular signs and symptoms, muscle and joint pain, and headaches
Infectious Diseases Diagnosed Within One Year of Separation
- Brucellosis
- Campylobacter jejuni
- Coxiella burnetii (Q fever)
- Malaria (or sooner in some cases)
- Nontyphoid salmonella
- Shigella
- West Nile virus
Infectious Diseases Diagnosed Any Time After Separation
- Mycobacterium tuberculosis
- Visceral Leishmaniasis
Cancers
- Brain Cancer
- Gastrointestinal Cancer
- Melanoma
- Neck Cancer
- Pancreatic Cancer
- Reproductive Cancer
- Respiratory Cancer
Diseases
- Asthma
- Chronic Bronchitis
- Chronic Obstructive Pulmonary Disease (COPD)
- Rhinitis
- Sinusitis
- Constructive Bronchiolitis or Obliterative Bronchiolitis
- Emphysema
- Granulomatous Disease
- Interstitial Lung Disease
- Pleuritis
- Pulmonary Fibrosis
- Sarcoidosis
Radiation Exposure
The PACT Act expanded service locations for veterans who are eligible for presumptive service connection for diseases which manifested due to radiation exposure. To be eligible, veterans must have had contact with ionizing radiation in one of these ways while serving in the military:
- Part of atmospheric nuclear weapons testing, or
- Service in the postwar occupation of Hiroshima or Nagasaki, or Prisoner of war (POW) in Japan, or
- Performed tasks like those of a Department of Energy (DOE) employee that make them a member of the Special Exposure Cohort (For more details, check 42 U.S.C. 7384L(14))
Veterans may also qualify if they served in at least one of these locations and capacities:
- Underground nuclear weapons testing at Amchitka Island, Alaska, or
- Gaseous diffusion plant at Paducah, Kentucky, or
- Gaseous diffusion plant at Portsmouth, Ohio, or
- Gaseous diffusion plant at Area K-25 at Oak Ridge, Tennessee.
Finally, veterans who participated in response efforts for cleanup of radiation may qualify if they served in the following dates and locations
| Dates | Locations |
|---|---|
| January 17, 1966, to March 31, 1967 | Palomares, Spain (Air Force B-52 Bomber Cleanup) |
| January 21, 1968, to September 25, 1968 | Thule Air Force Base, Greenland (Air Force B-52 Bomber Cleanup) |
| January 1, 1977, to December 31, 1980 | Enewetak Atoll (Cleanup for 43 nuclear tests) |
Veterans who meet the above criteria and have a diagnosis for any of the following radiogenic diseases will be awarded presumptive service-connected disability benefits:
Radiogenic Diseases
- Leukemia
- Multiple Myeloma
- Thyroid Cancer
- Urinary Bladder Cancer
- Breast Cancer
- Prostate Cancer
- Lung Cancer
- Ovarian Cancer
- Bone Cancer
- Cancer of the Rectum
- Liver Cancer
- Salivary Gland Cancer
- Esophageal Cancer
- Tumors of the Brain and Central Nervous System
- Stomach Cancer
- Posterior Subcapsular Cataracts
- Colon Cancer
- Parathyroid Adenoma
- Pancreatic Cancer
- Non-Malignant Thyroid Nodular Disease
- Kidney Cancer
- Lymphomas Other than Hodgkin's Disease
- Skin Cancer
- Any other cancer
Expansion of VA Healthcare Eligibility
The VA has expanded healthcare eligibility for Vietnam, Gulf War, and Post 9/11 veterans in three categories of veterans:
| Category 1 | Veterans who participated in a toxic exposure risk activity while serving on active duty, active duty for training, or inactive duty training. |
|---|---|
| Category 2 | Veterans who served in the following locations and times:
|
| Category 3 | Veterans who deployed in support of Operation Enduring Freedom, Operation Freedom's Sentinel, Operation Iraqi Freedom, Operation New Dawn, Operation Inherent Resolve, or Resolute Support Mission. |
Veterans are subject to the following enrollment eligibility dates for VA Healthcare:
| March 5, 2024 | Veterans in Category 1 |
|---|---|
| Oct. 1, 2024 | Veterans in Categories 1 and 2 who were discharged or released August 2, 1990 - September 11, 2001. |
| Oct. 1, 2026 | Veterans in Categories 1 and 2 who were discharged or released September 12, 2001 - December 31, 2006. |
| Oct. 1, 2028 | Veterans in Categories 1 and 2 who were discharged or released January 1, 2007 - December 31, 2012 |
| Oct. 1, 2030 | Veterans in Categories 1 and 2 who were discharged or released January 1, 2013 - December 31, 2018. |
| Oct. 1, 2032 | Veterans in Category 3. |
Tips
Veterans enrolled in VA Healthcare are eligible for toxic exposure screenings (at least once every 5 years). Here, veterans will be provided with information about benefits, registry exams, and clinical resources. Veterans may also find out if they have a presumptive condition related to toxic exposure based on discussion with a physician and review of medical records.
Veterans should apply for VA Healthcare regardless of their separation date. You may complete an Application for Health Benefits, VA Form 10-10EZ via the Veterans’ Health Administration Enrollment Hotline at 1-877-222-VETS, online at va.gov, or by mail or fax.