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Did you know the VA is constantly updating its presumptive list for VA disability benefits?
Yep, it’s true.
In fact, the VA recently added five new PACT Act presumptive conditions including Hypertension (High Blood Pressure), Monoclonal Gammopathy of Undetermined Significance (MGUS), Male Breast Cancer, Urethral Cancer, and Cancer of the Paraurethral Glands.
As a veteran who served in areas with known toxic exposures, The PACT Act could be the key to unlocking the disability benefits you’ve rightfully earned for serving our country.
The Honoring Our Promise to Address Comprehensive Toxics (PACT) Act of 2022 is one of the most significant expansions of VA health care and disability benefits in history.
This landmark legislation is designed to ensure that veterans exposed to toxic substances during their military service receive the care and compensation they deserve.
In this high-value blog post from VA disability expert Brian Reese, we’ll explore the PACT Act in detail, explain how VA presumptive conditions work, and introduce the list of new VA presumptive conditions for 2024-2025.
Let’s go!
Table of Contents
Summary of Key Points
- The VA frequently updates its list of presumptive conditions for disability benefits, including five new additions to The PACT Act: Hypertension, Monoclonal Gammopathy of Undetermined Significance (MGUS), Male Breast Cancer, Urethral Cancer, and Cancer of the Paraurethral Glands.
- The PACT Act is historic legislation expanding VA healthcare and disability benefits for veterans exposed to toxic substances during service, covering various conditions linked to specific exposures.
- To qualify for a presumptive condition, veterans must demonstrate that they served in a qualifying location and time frame associated with known toxic exposures and subsequently developed one of the approved conditions.
- The PACT Act organizes conditions into 23 categories or “buckets” covering over 330 specific health issues, ranging from respiratory diseases to various cancers, streamlining access to disability benefits for veterans.
What is The PACT Act?
The PACT Act is a law that expands healthcare and disability benefits for veterans who were exposed to toxic substances, like burn pits, during their military service.
It simplifies the process for veterans to receive disability benefits by automatically assuming certain conditions are related to their service, making it easier for them to get the care and compensation they need.
What is a Presumptive VA Disability?
A presumptive disability is one that the VA “presumes” to be service-connected, even if there’s no specific “nexus” (meaning “link” or “connection”) for service-connection.
Presumptive disability works like this:
If you served at X location during the qualifying period and developed Y condition as a result, then X + Y = automatic service connection.
Instead of having to prove a service-connected disability, you only need to show on your DD 214 that you were in an eligible location during a specific period and that you developed a qualifying condition as a result.
We also recommend you write and submit a strong personal VA statement in support of a claim.
Lay evidence can also be helpful in filling in any gaps in service or personnel records.
The PACT Act Basic Eligibility Criteria
To qualify for VA disability benefits under the PACT Act due to exposure to burn pits or other environmental toxins, veterans must have served in specific regions during designated timeframes.
Eligible service locations include:
- From August 2, 1990, onward: Service on the ground or in the airspace above Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, Somalia, United Arab Emirates, the Arabian Sea, the Gulf of Aden, the Gulf of Oman, the neutral zone between Iraq and Saudi Arabia, the Persian Gulf, or the Red Sea.
- From September 11, 2001, onward: Service on the ground or in the airspace above Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Uzbekistan, or Yemen.
If a veteran who served in these areas develops any of the listed presumptive conditions, the VA presumes that the condition is connected to their service, simplifying the process for obtaining compensation.
The 23 Buckets of Conditions in the PACT Act
The PACT Act introduces 23 distinct categories of presumptive conditions, each encompassing a broad range of illnesses related to toxic exposure during military service.
These categories, or “buckets,” group conditions by type or the area of the body they affect, covering everything from respiratory issues to various cancers.
Within these 23 categories, there are more than 330 specific medical conditions that the VA now recognizes as presumptive.
For example, within the “respiratory cancers” category, you’ll find various types of lung cancer, as well as related conditions like bronchial carcinoma and laryngeal cancer.
Although the VA refers to 23 general categories, the actual scope of covered conditions is extensive, ensuring comprehensive coverage for veterans with a wide range of service-related health issues.
List of New VA Presumptive Conditions
The VA regularly updates its list of presumptive conditions based on the latest medical research and study findings.
The following conditions have recently been added to the VA’s presumptive list:
- Hypertension (High Blood Pressure): Recognized as a presumptive condition for veterans exposed to Agent Orange and other toxic substances, making it easier for affected veterans to claim benefits.
- Monoclonal Gammopathy of Undetermined Significance (MGUS): This blood disorder, which can lead to more severe conditions like multiple myeloma, is now presumptive for veterans exposed to toxic chemicals.
- Male Breast Cancer: An increasingly recognized cancer linked to toxic exposures, now included under the presumptive conditions.
- Urethral Cancer: Recently added as a presumptive condition, particularly relevant for veterans exposed to harmful substances.
- Cancer of the Paraurethral Glands: Another specific cancer type added to the presumptive list due to emerging evidence of its connection to military service and toxic exposure.
The Updated List of PACT Act Presumptive Conditions
Here’s the most current list of conditions covered under the PACT Act for presumptive VA disability benefits:
Various Cancers
Brain and Nervous System Cancers
- Glioblastoma (Primary, Secondary)
- Astrocytoma (Anaplastic, Diffuse, Pilocytic)
- Brain stem glioma
- Pineal astrocytic tumors
- Ependymomas (cellular, clear cell, papillary, RELA fusion-positive, tanycytic)
- Malignant pineal gland tumors
- Mixed gliomas (Oligoastrocytoma)
- Oligodendrogliomas
- Pituitary carcinoma
Ear and Eye Cancers
- Ceruminous adenoma
- Rhabdomyosarcoma
- Carcinoid tumors of the orbit and ocular adnexa
- Eye and ocular adnexa cancers (ciliary body, eyelid, iris, optic disc, retina, vitreous, orbit tumors)
- Melanomas of the eye (choroidal, conjunctival, iris)
- Neuroendocrine tumors of the orbit
Mouth, Neck, and Throat Cancers
- Hypopharyngeal cancer (including adenoid cystic carcinoma, lymphoma, mucoepidermoid carcinoma, squamous cell carcinoma)
- Jaw cancer (including ameloblastic carcinoma, clear cell odontogenic carcinoma, ghost cell odontogenic carcinoma, multiple myeloma, odontogenic carcinosarcoma, odontogenic sarcoma, osteosarcoma, primary intraosseous carcinoma, squamous cell carcinoma)
- Laryngeal cancer (including adenocarcinoma, chondrosarcoma, lymphoma, plasmacytoma, sarcoma, squamous cell carcinoma)
- Oral cavity squamous cell carcinoma
- Oropharyngeal cancer (including lymphoepithelioma, lymphoma, minor salivary gland tumors, salivary gland cancer, squamous cell carcinoma, tonsillar cancer)
- Pharyngeal cancer (including basaloid squamous cell carcinoma, keratinizing squamous cell carcinoma, non-keratinizing squamous cell carcinoma)
- Salivary gland cancer (including acinic cell carcinoma, adenoid cystic carcinoma, adenocarcinoma NOS, mucoepidermoid carcinoma, polymorphous adenocarcinoma, secretory carcinoma)
- Thyroid cancer (including anaplastic, follicular, medullary, papillary)
- Tongue cancer (including adenoid cystic carcinoma, mucoepidermoid carcinoma, polymorphous low-grade carcinoma)
Skin Cancers
- Basal cell carcinoma
- Melanoma
- Squamous cell carcinoma
- Merkel cell carcinoma
Nose and Nasal Cancers
- Keratinizing undifferentiated carcinoma
- Non-keratinizing undifferentiated carcinoma
- Squamous cell carcinoma
- Adenocarcinoma
- Adenoid cystic cancer
- Lymphoma
- Neuroendocrine carcinoma
- Olfactory neuroblastoma
- Plasmacytoma
- Fibrosarcoma
- Leiomyosarcoma
- Rhabdomyosarcoma
- Undifferentiated pleomorphic sarcoma
Sarcomas
- Fibromatosis
- Liposarcoma
- Malignant ganglioma, mesenchymoma, schwannoma
- Osteosarcoma
- Dermatofibrosarcoma
- Ectomesenchymoma
- Ewing sarcoma (endocrine)
- Fibrosarcoma
- Leiomyosarcoma
- Low-grade fibromyxoid sarcoma
- Rhabdomyosarcoma
- Angiosarcoma
- Hemangioendothelioma and hemangiopericytoma
- Solitary fibrous tumor
- Vascular sarcoma
Spinal Cord Cancers
- Lymphoma
- Malignant schwannoma
- Multiple myeloma
- Osteosarcoma
- Solitary plasmacytoma
- Chondrosarcoma
- Chordoma
- Ewing’s sarcoma
- Malignant peripheral nerve sheath tumor
Gastrointestinal Cancers
- Anal cancer (including adenocarcinoma, basal cell cancer, carcinoma in situ, melanoma, squamous cell cancer)
- Colorectal cancer (including adenocarcinoma, carcinoid, gastrointestinal stromal tumor, lymphoma)
- Esophageal cancer (including adenocarcinoma, squamous cell carcinoma)
- Liver cancer (including hepatocellular carcinoma, intrahepatic tract cancer)
- Pancreatic cancer (including adenocarcinoma, neuroendocrine cancer)
- Salivary gland cancers (including acinic cell carcinoma, adenoid cystic carcinoma, adenocarcinoma NOS, mucoepidermoid carcinoma, polymorphous adenocarcinoma, secretory carcinoma)
- Small intestine cancers (including adenocarcinoma, carcinoid tumor, gastrointestinal stromal tumor, lymphoma, sarcoma)
- Spleen cancers (including primary tumors of the spleen)
- Stomach cancers (including carcinoid tumors, diffuse adenocarcinoma, gastrointestinal stromal tumor, intestinal carcinoma, lymphoma)
Kidney Cancers
- Renal cell carcinoma (including chromophobe, clear cell, clear cell papillary, collecting duct, medullary, papillary, unclassified types)
- Non-renal cell carcinoma (including renal sarcoma, Wilms tumor)
Lymphomas
- B-cell lymphoma (including diffuse B-cell lymphoma, follicular B-cell lymphoma, other non-Hodgkin mature B-cell lymphoma, small cell B-cell lymphoma)
- Hodgkin’s lymphoma
- Anaplastic large cell lymphoma
- Burkitt lymphoma
- Lymphoblastic lymphoma
- Mantle-cell lymphoma
- Mycosis fungoides
- Non-Hodgkin’s lymphoma
- T-cell lymphoma
Melanomas
- Melanomas of the eye (including choroidal melanoma, conjunctival melanoma, iris melanoma)
- Melanomas of the skin (including acral lentiginous melanoma, lentigo maligna melanoma, nodular melanoma, superficial spreading melanoma)
- Mucosal melanoma
Respiratory Cancers
Bronchial Cancers
- Adenocarcinoma
- Large-cell carcinoma
- Squamous cell carcinoma
Laryngeal Cancers
- Adenocarcinoma
- Chondrosarcoma
- Glottis, laryngeal neuroendocrine, subglottis, or supraglottis neoplasm
- Lymphoma
- Plasmacytoma
- Sarcoma
- Squamous cell carcinoma
Lung Cancers
- Adenocarcinoma
- Carcinoid tumor
- Large cell carcinoma
- Pleomorphic carcinoma
- Salivary gland carcinoma
- Squamous cell carcinoma (epidermoid carcinoma)
- Unclassified carcinoma
- Combined small cell carcinoma
- Small cell carcinoma (oat cell cancer)
- Adenosquamous carcinoma
- Sarcomatoid carcinoma
- Typical and atypical carcinoid
Nasopharyngeal and Paranasal Cancers
Nasopharyngeal Cancers
- Keratinizing undifferentiated carcinoma
- Non-keratinizing undifferentiated carcinoma
- Squamous cell carcinoma
Paranasal Sinus and Nasal Cavity Cancers
- Lymphoma
- Melanoma
- Neuroendocrine carcinoma
- Plasmacytoma
- Squamous cell carcinoma
- Adenocarcinoma
- Adenoid cystic cancer
- Fibrosarcoma
- Undifferentiated pleomorphic sarcoma
- Leiomyosarcoma
- Olfactory neuroblastoma
- Rhabdomyosarcoma
Throat and Trachea Cancers
Throat (Oropharyngeal) Cancers
- Lymphoepithelioma
- Lymphoma
- Minor salivary gland tumors
- Salivary gland cancer
- Squamous cell carcinoma
- Tonsillar cancer
Trachea Cancers
- Adenocarcinoma of the trachea
- Squamous cell carcinoma of the trachea
Non-Cancer Conditions Related to Respiratory Issues
- Asthma (diagnosed after service)
- Chronic bronchitis
- Chronic obstructive pulmonary disease (COPD)
- Chronic rhinitis
- Chronic sinusitis
- Constrictive bronchiolitis or obliterative bronchiolitis
- Emphysema
- Granulomatous disease
- Interstitial lung disease (ILD)
- Pleuritis
- Pulmonary fibrosis
- Sarcoidosis
Contaminated Water Presumptive Conditions
- Adult leukemia
- Aplastic anemia and other myelodysplastic syndromes
- Bladder cancer
- Kidney cancer
- Liver cancer
- Multiple myeloma
- Non-Hodgkin lymphoma
- Parkinson’s disease
Agent Orange Presumptive Conditions Under the PACT Act
Various Cancers
- Chronic B-cell leukemias
- Hodgkin’s disease
- Multiple myeloma
- Non-Hodgkin’s lymphoma
- Prostate cancer
- Respiratory cancers (lung, bronchus, larynx, trachea)
- Soft tissue sarcomas (excluding osteosarcoma, chondrosarcoma, Kaposi’s sarcoma, mesothelioma)
- Chloracne (or similar acneform disease)
Non-Cancer Conditions
- AL amyloidosis
- Chronic peripheral neuropathy
- Hypertension (High Blood Pressure)
- Ischemic heart disease
- Monoclonal Gammopathy of Undetermined Significance (MGUS)
- Parkinson’s disease
- Porphyria cutanea tarda
- Type 2 diabetes (Type II diabetes mellitus)
Respiratory Conditions from Burn Pits and Toxic Exposures
- Asthma (diagnosed after service)
- Chronic bronchitis
- Chronic obstructive pulmonary disease (COPD)
- Chronic rhinitis
- Chronic sinusitis
- Constrictive bronchiolitis or obliterative bronchiolitis
- Emphysema
- Granulomatous disease
- Interstitial lung disease (ILD)
- Pleuritis
- Pulmonary fibrosis
- Sarcoidosis
Additional Conditions Presumed Due to Gulf War, Burn Pits, or Other Toxic Exposures
- Asthma (diagnosed after service)
- Rhinitis
- Sinusitis
- Brain cancer (including glioblastoma)
- Chronic bronchitis
- Chronic obstructive pulmonary disease (COPD)
- Chronic sinusitis
- Constrictive bronchiolitis
- Emphysema
- Granulomatous disease
- Interstitial lung disease (ILD)
- Pleuritis
- Pulmonary fibrosis
- Sarcoidosis
Other Conditions Related to Environmental Exposures
- Hypertension (related to Agent Orange exposure)
- Monoclonal gammopathy of undetermined significance (MGUS)
- Bladder cancer (linked to various exposures, including Agent Orange)
- Hypothyroidism (related to Agent Orange)
- Parkinsonism (related to Agent Orange)
- Birth defects (such as spina bifida in children of certain Vietnam or Korean War veterans, related to Agent Orange exposure)
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About the Author
Brian Reese
Brian Reese is a world-renowned VA disability benefits expert and the #1 bestselling author of VA Claim Secrets and You Deserve It. Motivated by his own frustration with the VA claim process, Brian founded VA Claims Insider to help disabled veterans secure their VA disability compensation faster, regardless of their past struggles with the VA. Since 2013, he has positively impacted the lives of over 10 million military, veterans, and their families.
A former active-duty Air Force officer, Brian has extensive experience leading diverse teams in challenging international environments, including a combat tour in Afghanistan in 2011 supporting Operation ENDURING FREEDOM.
Brian is a Distinguished Graduate of Management from the United States Air Force Academy and earned his MBA from Oklahoma State University’s Spears School of Business, where he was a National Honor Scholar, ranking in the top 1% of his class.
