Today, we’ll explore the definition and purpose of a TERA VA medical opinion.
TERA stands for “Toxic Exposure Risk Activity,” and is commonly associated with PACT Act-related claims for service connection and service-connected death.
Part of VA’s duty to assist veterans in supporting their claims includes obtaining exams and opinions for conditions due to “TERA participation” when the evidence is insufficient to establish service connection for the claimed disability, even if the Veteran did not specifically claim it that way.
Translation: a TERA medical opinion is a request for a specialty C&P exam related to a claimant’s possible participation in a toxic exposure risk activity for PACT Act related claims.
In a non-presumptive claim, if the veteran participated in a TERA event, then an exam and medical opinion will be warranted.
What is a Toxic Exposure Risk Activity (TERA)?
The VA defines a Toxic Exposure Risk Activity (TERA) as exposure to any of the following hazards during military service:
- Herbicide Agent – 2,3,7,8 – Tetrachlorodibenzodioxin (TCDD)
- Radiation – Ionizing
- Mustard Gas – Nitrogen, Sulfur Mustard, or Lewisite
- Camp Lejeune Water Contamination – Perchloroethylene (PCE), Trichloroethylene (TCE), Vinyl Chloride, Benzene
- Burn Pits
Note: The VSR and RVSR will prepare memorandum related to a veteran’s presumption of exposure(s) for one or more of the above hazards during military service.
A specialty C&P exam called a “Request for TERA Medical Opinion” is often ordered to confirm a veteran’s exposure to a TERA event.
What is the TERA VA Flowchart for Presumptive Disability?
The VSR and RVSR follow the flowchart below for determining when TERA is applicable to the claimed issue in disability compensation claims:
What are the Exceptions to a TERA Examination?
38 U.S.C. § 1168(b) provides that TERA examination requirements do not apply if the Secretary determines there is no indication of an association between the disability claimed by the Veteran and participation in the TERA.
Review the job aid below for situations in which TERA examination requirements may or may not apply:
VA TERA Opinion Conclusion
A VA TERA opinion is a request for a specialty C&P exam related to a veteran’s possible participation in a toxic exposure risk activity for PACT Act related claims and benefits.
In a non-presumptive claim, if the veteran participated in a TERA event, then a TERA exam and associated medical opinion will be ordered by the VSR or RVSR.
About the Author
Brian Reese
Brian Reese is one of the top VA disability benefits experts in the world and bestselling author of You Deserve It: The Definitive Guide to Getting the Veteran Benefits You’ve Earned (Second Edition).
Brian’s frustration with the VA claim process led him to create VA Claims Insider, which provides disabled veterans with tips, strategies, and lessons learned to win their VA disability compensation claim, faster, even if they’ve already filed, been denied, gave up, or don’t know where to start.
As the founder of VA Claims Insider and CEO of Military Disability Made Easy, he has helped serve more than 10 million military members and veterans since 2013 through free online educational resources.
He is a former active duty Air Force officer with extensive experience leading hundreds of individuals and multi-functional teams in challenging international environments, including a combat tour to Afghanistan in 2011 supporting Operation ENDURING FREEDOM.
Brian is a Distinguished Graduate of Management from the United States Air Force Academy, Colorado Springs, CO, and he holds an MBA from Oklahoma State University’s Spears School of Business, Stillwater, OK, where he was a National Honor Scholar (Top 1% of Graduate School class).
