Last Checked: October 18, 2026Next Check: April 18, 2027
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The PACT Act of 2022 expands VA disability pay and health care for veterans exposed to burn pits, Agent Orange, radiation, and other military toxins. The law adds more than 20 burn pit conditions and expands Agent Orange locations across Asia and the Pacific. Since March 5, 2024, veterans who took part in a toxic risk activity can also enroll right into VA health care without applying for disability pay first.
Presumptive coverage does not make every veteran’s claim automatic: presumptive rules only waive proof that military service caused a listed disease, so a veteran still needs a current diagnosis and qualifying service dates. Veterans with an unlisted illness must show a direct link between their condition and an in-service toxic exposure.
Surviving spouses, dependent children, and parents can also claim monthly survivor pay, unpaid benefits, and burial aid if a veteran died from a covered illness. A separate provision in the 2022 toxic-exposure statute created a federal right to sue for veterans, family members, and workers harmed by tainted water at Camp Lejeune between 1953 and 1987.
Who Qualifies and What Is Covered
In the law’s first year, VA completed 458,659 toxic-exposure claims and paid more than $1.85 billion in earned benefits to veterans and their survivors. The statute adds new service zones and disease lists across Gulf War, post-9/11, and Vietnam eras:
- Gulf War and post-9/11 duty: Federal law presumes toxic exposure for duty since August 2, 1990, in Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, Somalia, or the United Arab Emirates. The rule also covers duty since September 11, 2001, in Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Yemen, or Uzbekistan.
- Burn pit lung illnesses: For those covered veterans, federal law presumes service connection for asthma diagnosed after service, chronic bronchitis, chronic obstructive pulmonary disease, constrictive or obliterative bronchiolitis, and emphysema. It also covers granulomatous disease, interstitial lung disease, pleuritis, pulmonary fibrosis, sarcoidosis, chronic sinusitis, and chronic rhinitis.
- Burn pit cancers: The same statutory list covers glioblastoma, melanoma, lymphoma, and head, neck, respiratory, gastrointestinal, reproductive, kidney, brain, and pancreatic cancers.
- Vietnam and Agent Orange sites: The law adds hypertension and monoclonal gammopathy of undetermined significance to the herbicide list. Beyond service in Vietnam from January 9, 1962, to May 7, 1975, herbicide rules now cover set dates in Thailand, Laos, Cambodia at Mimot or Krek, Guam, American Samoa, and Johnston Atoll.
Since March 5, 2024, veterans who took part in a toxic exposure risk activity (TERA) during active duty or training can join Priority Group 6. That priority tier gives cost-free care for conditions possibly tied to service without needing a disability rating or low income. Covered hazards include air pollutants, burn pits, pesticides, depleted uranium, asbestos, solvents, lead, firefighting foams, radiation, and warfare agents, while people exposed only as civilians or contractors do not qualify for VA care.
Surviving family members qualify for up to three VA benefits when a veteran died from a covered service-connected illness. Depending on relationship and dependency, a surviving spouse, dependent child, or dependent parent can receive monthly Dependency and Indemnity Compensation (DIC), a one-time accrued benefits payment for unpaid benefits due at death, and a burial allowance.
For tainted water at Camp Lejeune in North Carolina, federal hospital care rules cover veterans who served on active duty there for at least 30 days between August 1, 1953, and December 31, 1987. Those veterans qualify for hospital care for 15 listed illnesses, including bladder, kidney, lung, breast, and esophageal cancers, leukemia, and nerve effects.
Under the Camp Lejeune Justice Act of 2022, anyone exposed to the base’s water for at least 30 days from August 1, 1953, to December 31, 1987, could file a claim and sue in the Eastern District of North Carolina. That right covers veterans, family members, civilian workers, and children exposed in utero, with any court award offset by VA, Medicare, or Medicaid benefits for the same harm.
How Ratings and Monthly Pay Work
When a veteran has more than one service-connected condition, VA uses the whole person theory so that combined ratings never top 100%, because a person cannot be more than 100% able-bodied. Each rating percentage represents how much a disability decreases overall health and ability to function, so two 10% disabilities combine to 19% rather than 20%. Ratings from 30% to 100% pay higher monthly rates for veterans with a spouse, child, or dependent parent.
Suppose a veteran has two disabilities rated at 50% and 30%. On VA’s combined chart, pairing the highest rating of 50 in the left column with 30 in the top row gives 65, which rounds to the nearest 10% for a 70% rating. Under the 2026 VA compensation rate table, adding that 30% disability raises a single veteran’s monthly payment from $1,132.90 at 50% to $1,808.45 at 70%.
Suppose a veteran with a 70% rating has three children under age 18 and a spouse who gets Aid and Attendance benefits. The 2026 calculation starts with the $2,074.45 basic monthly rate for a veteran with a spouse and one child. VA adds $76.00 for each of the two extra children under 18 and $141.00 for spousal Aid and Attendance, bringing the total monthly payment to $2,367.45.
How Toxic Exposure Rules Compare
| Exposure Category | Qualifying Service or Location | Covered Presumptive Conditions | Benefit or Claim Pathway |
|---|---|---|---|
| Burn pits and airborne hazards | Duty in Bahrain, Iraq, Somalia, or Afghanistan, among others | Listed lung illnesses, cancers, and leukemias and myelomas | Presumptive pay and Priority Group 6 care |
| Agent Orange herbicides | Vietnam, Thailand, Laos, Cambodia, Guam, and other sites | Listed conditions including hypertension, monoclonal gammopathy, and diabetes | Presumptive disability pay and hospital care |
| Other toxic risk activities (TERA) | Duty contact with hazards including radiation, asbestos, or foam | Toxic exposure risk activity health care eligibility | Priority Group 6 care and claim review |
| Camp Lejeune water contamination | 30 days at Camp Lejeune (1953 to 1987) | Hospital care for 15 listed conditions | VA care and federal court lawsuits |
How VA Adds Conditions and Funds Care
On January 2, 2025, VA issued an interim final rule adding bladder, ureter, and related urinary tract cancers as presumptive conditions tied to fine particulate matter. Eight days later, on January 10, 2025, a second rule added acute leukemias, chronic leukemias, multiple myelomas, myelodysplastic syndromes, and myelofibrosis. Because those blood cancers are mostly diagnosed in older adults and 551,000 post-1990 veterans are now aged 65 or older, the rule lets aging Gulf War veterans qualify without proving which exposure caused their cancer.
In December 2025, VA published its formal response to 42 public comments on its review of PFAS chemicals and kidney cancer. Veterans and service groups voiced concern that studying only kidney cancer was too narrow given firefighting foam use, and several commenters asked for immediate presumptive status, PFAS blood tests, and an exposure registry.
In reply, VA explained that federal law requires an expert panel to review peer-reviewed studies and claims data before a 120-day formal check. VA also declined to offer PFAS blood tests or a self-reported registry, noting that blood tests cannot show when exposure happened or guide medical care. Using that same review process, VA announced a new technical group in 2026 to review studies and claims data on military exposures and brain diseases.
Alongside the scientific reviews, VA proposed a rule in October 2024 to drop time limits for Gulf War undiagnosed illnesses and set exam rules for TERA claims. To keep growing toxic-exposure care, claims, and research costs above 2021 levels from competing with other programs under annual agency budget caps, Section 805 of the PACT Act created the Cost of War Toxic Exposures Fund and counts that money as direct mandatory spending.
How to Apply or Reopen a Denied Claim
Veterans and survivors who want to apply for PACT Act care or benefits can take four steps:
- Lock in your start date: Starting a claim online gives a claimant 365 days to finish the form while saving the start date for back pay.
- File a new or supplemental claim: Veterans can submit a disability claim online, where VA took an average of 68.2 days to finish claims in September 2026. If VA denied a veteran’s or survivor’s condition in the past that is now presumptive, claimants can file a Supplemental Claim for review.
- Enroll in VA health care: Eligible veterans can apply on VA Form 10-10EZ, Application for Health Benefits, or update their file on VA Form 10-10EZR, Health Benefits Update Form, and enrolled veterans get a toxic exposure screening at least once every 5 years.
- Call the VA help lines: Claimants can call the VA benefits line at 1-800-827-1000 Monday through Friday from 8:00 a.m. to 9:00 p.m. ET, or call the MyVA411 main line at 1-800-698-2411.
