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April 29, 2022

Updated Gulf War Presumptive List for 2022: New VA Rule Grants Presumptive Service Connection for Nine Types of Cancers

Last updated on December 6, 2022

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Updated Gulf War Presumptive List For 2022

As of April 26, 2022, the VA presumes that particulate matter exposures during military service in several regions is likely to have caused certain respiratory cancers. This updated Gulf War presumptive list for 2022 opens doors for many veterans who have been unable to service-connect these respiratory cancers until now. Find out how this new rule might affect YOUR claim and VA rating!

Lung cancer is the deadliest form of cancer affecting veterans. Gulf War veterans have an increased risk of developing lung cancer. Nearly 5,000 veterans die annually from this terrible disease. The VA has just opened a long-overdue door for veterans who suffer from any of nine different respiratory cancers (including five types of lung cancer) to obtain service connection and be eligible for benefits.

In November 2021, President Biden initially ordered the VA to review research into cancer to determine if military service could cause rare respiratory cancers. Thanks to this brand-new rule resulting from that research, it should be much easier to obtain a VA disability rating for these cancers through presumptive service connection if you served in a particular theater during specified periods.

Starting on April 26, 2022, the VA began processing claims for these cancers on a presumptive basis when the veteran is eligible based on location, date of service, and diagnosis of one or more of these respiratory cancers. This new ruling was announced by the VA on April 26, 2022.

BREAKING NEWS! If you served in Southwest Asia or in Afghanistan, Djibouti, Syria, Uzbekistan during specific times and develop respiratory cancer at any point throughout the rest of your life, these cancers will now be presumed to be service-connected. 



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Updated Gulf War Presumptive List for 2022

Effective April 26, 2022, the VA established an interim final rule (87 FR 24421) that identified a link between military service in qualifying areas of certain countries and the following nine rare respiratory cancers:

  • Squamous cell carcinoma of the larynx
  • Squamous cell carcinoma of the trachea
  • Adenocarcinoma of the trachea
  • Salivary gland-type tumors of the trachea
  • Adenosquamous carcinoma of the lung
  • Large cell carcinoma of the lung
  • Salivary gland-type tumors of the lung
  • Sarcomatoid carcinoma of the lung
  • Typical and atypical carcinoid of the lung

In 2021, asthma, rhinitis, and sinusitis were the first disabilities recognized as presumptive conditions for Gulf War veterans. Thanks to the VA’s new presumption, thousands of veterans exposed to particulate matter in overseas military bases—including Iraq and Afghanistan—can more easily secure VA disability compensation for these respiratory cancers.

Who is eligible for the new Gulf War presumptive respiratory cancers?

To be eligible for these new Gulf War presumptives, veterans must be diagnosed with at least one of the respiratory cancers listed above.

Additionally, veterans must have served during one of these periods in these locations:

  • From August 2, 1990, to the present in the Southwest Asia theater of operations, OR
  • From September 19, 2001, to the present in Afghanistan, Uzbekistan, Syria, or Djibouti

Countries in the Southwest Asia Theater of Operations

If you served during the Persian Gulf War, you are likely eligible for this new presumptive ruling. The VA considers the following countries to be within the Southwest Asia theater of operations:

  • Bahrain
  • Iraq
  • Kuwait
  • Oman
  • Persian Gulf
  • Qatar
  • Saudi Arabia
  • The United Arab Emirates
  • Neutral zone between Iraq and Saudi Arabia
  • Gulf of Aden
  • Gulf of Oman
  • Arabian Sea
  • Red Sea

How does presumptive service connection work?

When there is enough evidence that a particular medical condition is more common in veterans who served in a certain environment, the VA presumes that this condition was caused by military service.

The VA created the VA Presumptive List to make it easier for veterans with these conditions to get benefits. If you served in certain places/times and developed a correlating condition on the list, it’s presumed to be caused by that service and is thus eligible for disability (as long as you meet the other criteria for that presumption).

Normally, conditions must be proved service-connected using medical evidence showing a “nexus” (link) between service and the disability—if the link cannot be proven, the claim is denied. Conditions on the Presumptive List are considered service-connected with no individual proof of nexus needed.

 (The claim will still require documentation that the vet does have the condition and was indeed in that location/circumstance at that time in addition to meeting the other criteria for that presumption).

The VA Presumptive List has historically included exposure to Agent Orange for Vietnam and Korean vets, certain conditions for Gulf War veterans, certain conditions for prisoners of war, and more.

Why were these cancers added to the updated Gulf War presumptive list for 2022?

Presumptive service connection to respiratory cancer was granted by the VA to make it easier for veterans who served in these qualifying areas to obtain service connection for their cancer.

These respiratory cancers were added to the updated Gulf War presumptive list because of their high incidence in both Gulf War and Southwest Asia veterans. Mounting evidence links these respiratory cancers to military service in the area since the 1990s.

Additionally, these cancers are incredibly deadly. Even if diagnosed as early as possible, the survival timeframes for these cancers are grim, and the quality of life for affected veterans is universally poor. Getting veterans the help they need now is vital.

The VA has recognized this link and is taking action to ensure that veterans diagnosed with these cancers are cared for. These studies link service in the Southwest Asia theater of operations to exposure to particulate matter and the eventual development of these rare cancers.

What is particulate matter?

Particulate matter is air pollution that consists of tiny particles of solid or liquid matter. These particles are so small that they can’t be seen with the naked eye, but they can still wreak havoc with your health.

There are several potential causes of particulate matter in the Middle East, including dust storms, pollution, vehicle exhaust, fires, and smoke from burn pits.

Burn pits were a common way of disposing of waste during the Gulf War. They were large pits set on fire and used to burn everything from human waste to vehicles, paint, airplane parts, plastics, petroleum, ammunition, and much more. Veterans exposed to the smoke and fumes from these burn pits are at an increased risk of developing respiratory cancers and other respiratory problems.

Is there a time limit for these nine types of cancer and presumptive service connection?

There is no time limit to file a claim for the new presumptive respiratory cancers. Unlike the three original presumptive conditions for Gulf War veterans (asthma, rhinitis, and sinusitis), these cancers can take decades to develop. There is no specific time frame during which you must be diagnosed in order for your cancer to be linked to your service.

If you meet the other qualifications and were ever diagnosed with one of these cancers or are diagnosed in the future, you may be eligible for presumptive service connection. The amount of time you spent in a qualifying area does not matter as long as you meet the date of service requirements listed above.

updated gulf war presumptive list for 2022

How do I get a VA rating for respiratory cancer?

When filing a standard VA claim without service-connection presumption, you typically need three things:

  • A current diagnosis of an illness,
  • An in-service injury or illness, AND
  • A link between your illness and your diagnosis (also known as a medical nexus)

When filing a claim for one of the respiratory cancers listed on the updated Gulf War presumptive list for 2022, you no longer need to prove the nexus linking your service to your respiratory cancer.

Additionally, because cancer can take years to manifest, your in-service event is considered your time in the qualifying area. The VA will now presume that your respiratory cancer is caused by your service in the Southwest Asia theater of operations, Afghanistan, Uzbekistan, Syria or Djibouti.

Just being exposed to harmful burn pits or other environmental hazards in one of the qualifying areas is not enough to qualify for a presumptive service connection. You must have a diagnosis of one of the nine respiratory cancers above when filing.

How will the VA rate my respiratory cancer?

These respiratory cancers will be rated following the same rules that the VA applies to all types of cancer. The VA will automatically rate you at 100% if you’re diagnosed with cancer, but your cancer must be service-connected.

This new presumption of service connection will help thousands of veterans get the 100% VA rating you deserve.

If you’re experiencing one or more of the listed larynx, trachea, or lung cancers, your 100% VA rating will remain in place until six months after you successfully complete your treatment.

You’ll be scheduled for a Compensation and Pension (C&P) exam at the six-month mark. The exam will help the VA determine what residual effects your cancer has left you with and what kind of rating you should receive going forward.

What if I’ve already filed a claim and been denied?

If you have lung cancer or one of the other respiratory cancers on the new presumptive list and have been denied VA benefits in the past, don’t worry. Even if your claim was previously denied, the updated rules mean that your service will now be presumed to be linked to your cancer. Your claim won’t automatically be approved—you’ll still need to meet the other elements of service connection—but you’ll no longer need to prove that your cancer is caused by your service.

The VA will be contacting veterans and their survivors who may be affected by the updated Gulf War presumptive list for 2022. The overwhelming burden of proof requirement placed on veterans has probably kept hundreds or thousands of veterans from applying for VA disability benefits, even though they were suffering from respiratory cancers.

Take Action on Your Respiratory Cancer Now

If you think you or a loved one may qualify for this new Gulf War presumptive , don’t wait for the VA to reach out—start a claim as soon as possible to get the compensation you deserve.

To apply, use VA Form 21-526EZ if applying for the first time, or VA Form 20-0995 if you’re reapplying for these respiratory cancers.

You can also view the VA’s page on Airborne Hazards and Burn Pit Exposure – Public Health ( for more information.

We’re here to help you build a fully-developed claim for your respiratory cancer. If you need help with your claim or have questions, don’t hesitate to reach out to us.

VA Claims Insider and our team of veteran coaches will be keeping abreast of the new rule and its impact on veterans. Stay tuned for more information!


Most veterans are underrated for their disabilities and therefore not getting the compensation they’re due. At VA Claims Insider, we help you understand and take control of the claims process, so you can get the rating and compensation you’re owed by law.

Our process takes the guesswork out of filing a VA disability claim and supports you every step of the way in building a fully-developed claim (FDC)—so you can increase your rating fast!

If you’ve filed your VA disability claim and have been denied or have received a low rating—or you’re unsure how to get started—reach out to us! Take advantage of a FREE VA Claim Discovery Call. Learn what you’ve been missing—so you can FINALLY get the disability rating and compensation you deserve!

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About the Author

Trisha Penrod Bio Photo

Trisha Penrod

Trisha Penrod is a former active-duty Air Force officer. As an Intelligence Officer, she led teams of analysts to apply advanced analytic skills to identify, assess, and report potential threats to U.S. forces.

Trisha attended the U.S. Air Force Academy and holds an MBA from Webster University.  After receiving an honorable discharge in 2018, Trisha worked as a growth marketer and utilizes her analytic skills to help others accomplish their business goals.

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