PACT Act Claims Continue to Drive VA Filing Volume

The Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act — signed into law on August 10, 2022 — remains one of the largest single drivers of new VA disability claims activity nearly four years after its passage. On the law’s second anniversary in August 2024, VA reported that more than 1 million veterans and survivors had received disability compensation or DIC benefits under the PACT Act, with more than $6.8 billion in PACT Act benefits delivered. Roughly 740,000 veterans had also enrolled in VA health care since the law’s enactment.

Why the PACT Act mattered so much

Before the PACT Act, veterans exposed to burn pits in Iraq and Afghanistan, Agent Orange residue in Thailand, radiation in cleanup operations, and a long list of other toxic environments faced an uphill battle at VA. They were typically required to medically prove that their cancer, lung disease, or other condition was caused by service — often decades after the exposure, with limited records and no straightforward way to establish causation.

The PACT Act addressed that by creating presumptive service connection for a wide range of conditions linked to specific exposures. When a presumption applies, the veteran no longer has to prove the medical link. They only have to show:

1. A current diagnosis of a covered condition.
2. Qualifying service in a covered location during a covered time window.

That structural change is what allowed VA to process so many claims so quickly. The presumption framework is codified in 38 CFR Part 3, with the toxic-exposure presumptions added or expanded by the PACT Act listed alongside the older Agent Orange and Gulf War presumptions.

Who the law covers

The PACT Act expanded eligibility for several distinct cohorts of veterans. The most significant groups include:

• Post-9/11 veterans who served in covered Southwest Asia and Central Command locations where burn pits were widely used. The PACT Act presumption locations include Afghanistan, Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, Somalia, Syria, the United Arab Emirates, Yemen, and the airspace above those locations, plus Djibouti, Egypt, Jordan, Lebanon, and Uzbekistan during specified time windows. The exact eligible dates and locations are listed on VA’s PACT Act resource page.
• Gulf War veterans who served in the Persian Gulf during Desert Shield, Desert Storm, and the broader 1990–1991 deployment window.
• Vietnam-era veterans exposed to Agent Orange, including newly added locations and time periods (notably Thailand, Laos, Cambodia, Guam, American Samoa, and Johnston Atoll).
• Veterans exposed during atmospheric nuclear testing and cleanup operations, including expanded recognition for Enewetak Atoll and Palomares cleanup participants.

For exact dates and locations, VA’s PACT Act resource page maintains the authoritative list. Some categories were expanded again in subsequent VA rulemaking after the original 2022 enactment.

What conditions are now presumptive

The PACT Act added or expanded presumptions for more than 20 conditions, with several rare cancers and respiratory illnesses included. Categories include:

• Respiratory conditions — chronic bronchitis, chronic obstructive pulmonary disease (COPD), constrictive bronchiolitis, emphysema, granulomatous disease, interstitial lung disease, pleuritis, pulmonary fibrosis, and chronic sinusitis or rhinitis.
• Cancers — brain cancer, gastrointestinal cancers of any type, glioblastoma, head and neck cancers of any type, kidney cancer, lymphatic cancers of any type, melanoma, pancreatic cancer, reproductive cancers of any type, and respiratory cancers of any type.
• Hypertension — added as a presumptive Agent Orange condition under the law.
• Monoclonal gammopathy of undetermined significance (MGUS) — also added as Agent Orange–presumptive.

For each, the legal basis is the relevant section of 38 CFR Part 3 implementing the statute. Our PACT Act guide walks through how to map your service history and diagnosis onto the right presumption.

Why PACT Act volume is still climbing

Several factors keep PACT Act claim activity high years after passage:

• Ongoing outreach. VA has continued public-awareness campaigns at military bases, veteran organizations, and through direct mail to veterans whose service records suggest possible exposure.
• Late-presenting conditions. Many toxic-exposure illnesses — especially cancers and interstitial lung disease — appear years or decades after the exposure ended. Veterans who were healthy in 2022 may now be receiving qualifying diagnoses.
• Expanded interpretations. Subsequent VA guidance and rulemaking has added or clarified covered locations and time periods, bringing additional veterans into eligibility.
• Survivor claims. Family members of veterans who died from covered conditions can file for DIC benefits, and many of those claims came in after the initial wave of living-veteran filings.

What this means for veterans today

If you have a current diagnosis of a covered condition and a service history in a covered location, the PACT Act dramatically simplifies your claim. The presumption removes the hardest evidentiary obstacle. You still need to:

1. Get a current diagnosis documented by a qualified provider — VA or private.
2. File your claim through VA.gov, by mail, in person, or with the help of a VSO or accredited representative. Filing an Intent to File preserves your effective date if you need time to gather evidence.
3. Be ready for a C&P exam. Even with a presumption, VA may still schedule a Compensation and Pension exam to confirm the diagnosis and rate the severity. Our C&P exam guide covers what to expect.

If you previously filed a claim for one of these conditions and were denied before the PACT Act took effect, you may be able to file a supplemental claim under 38 CFR § 3.2501 using the new presumption as new and relevant evidence. Our supplemental claim guide walks through that process.

Read more

• PACT Act guide — full eligibility, conditions, and filing walkthrough
• How to file a VA disability claim — step-by-step process
• Supplemental claim guide — for veterans previously denied
• Burn pit lung disease — rating criteria and evidence requirements