The short answer
- Presumptive means you don't have to prove what caused the condition. You only need the right service (place and dates) and a current diagnosis.
- Gulf War-era and post-9/11 veterans who served in listed countries have a presumption of exposure to burn pits and other toxins.
- Vietnam-era veterans gained two Agent Orange conditions (hypertension and MGUS) and five new locations.
- The PACT Act has no expiration date, but filing (or an Intent to File) sets how far back VA pays.
The PACT Act became law on August 10, 2022. VA calls it perhaps the largest health care and benefit expansion in its history. Here's where things stand as of October 2026, based on VA.gov and the Federal Register. Living in Arkansas? Pair this with our PACT Act checklist for Arkansas veterans, which covers local VA facilities and PFAS at Arkansas bases.
Burn pit and airborne hazard presumptions
If you served in one of these places during the listed period, VA presumes you were exposed to burn pits or other toxins:
| Service on or after | Locations (including the airspace above them) |
|---|---|
| August 2, 1990 | Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, Somalia, the United Arab Emirates. VA's hazard page also lists the Arabian Sea, Gulf of Aden, Gulf of Oman, Persian Gulf, Red Sea, and the neutral zone between Iraq and Saudi Arabia. |
| September 11, 2001 | Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Uzbekistan, Yemen |
Presumptive cancers on VA's current list include brain cancer and glioblastoma, gastrointestinal cancer of any type, genitourinary cancer, head and neck cancer of any type, hematologic and lymphatic cancers, lymphoma of any type, melanoma, pancreatic cancer, reproductive cancer of any type, and respiratory cancer of any type.
Presumptive illnesses include asthma diagnosed after service, chronic bronchitis, COPD, chronic rhinitis, chronic sinusitis, constrictive or obliterative bronchiolitis, emphysema, granulomatous disease, interstitial lung disease, pleuritis, pulmonary fibrosis, and sarcoidosis. See our burn pit conditions guide, and always check VA's current list, which VA updates.
Agent Orange: new conditions and locations
The PACT Act added high blood pressure (hypertension) and monoclonal gammopathy of undetermined significance (MGUS) to the Agent Orange list, on top of long-standing conditions like type 2 diabetes, ischemic heart disease, and several cancers. It also added these presumptive locations:
- Any U.S. or Royal Thai military base in Thailand, January 9, 1962 – June 30, 1976
- Laos, December 1, 1965 – September 30, 1969
- Mimot or Krek, Kampong Cham Province, Cambodia, April 16 – April 30, 1969
- Guam or American Samoa, or their territorial waters, January 9, 1962 – July 31, 1980
- Johnston Atoll, or a ship that called there, January 1, 1972 – September 30, 1977
These are in addition to the Republic of Vietnam and other long-recognized locations. See our guides to hypertension and diabetes and Agent Orange.
Radiation response efforts
The law added three radiation-risk activities: cleanup of Enewetak Atoll (January 1, 1977 – December 31, 1980), cleanup after the B-52 incident off Palomares, Spain (January 17, 1966 – March 31, 1967), and the response to the B-52 fire near Thule Air Force Base, Greenland (January 21 – September 25, 1968).
Gulf War illness and the "December 31, 2026" confusion
38 CFR § 3.317 still says an undiagnosed or chronic multisymptom illness must show up to a 10% degree "not later than December 31, 2026." That date has caused a lot of worry. The PACT Act rewrote the underlying law, 38 U.S.C. § 1117, so it covers a qualifying chronic disability that became manifest "to any degree at any time." VA proposed updating the regulation to match on October 1, 2024, but as of October 21, 2026 the Federal Register shows no final rule. The Board of Veterans' Appeals has applied the statute in recent decisions. December 31, 2026 is not a filing deadline. If a decision on your claim relies on the old date, that may be worth challenging.
We'll check your DD-214 and deployment history against VA's PACT Act lists. The review is free.
Health care and the toxic exposure screening
Since March 5, 2024, veterans who served in the Vietnam War, the Gulf War, Iraq, Afghanistan, or any other combat zone after 9/11, who deployed in support of the Global War on Terror, or who were exposed to toxins during service can enroll in VA health care without first applying for disability benefits. Basic service and discharge requirements still apply.
Every veteran enrolled in VA health care should get a toxic exposure screening, with a follow-up at least once every five years. It asks about burn pits, Gulf War exposures, Agent Orange, radiation, Camp Lejeune water, and other exposures. Ask at your next appointment, contact your facility's toxic exposure screening navigator, or schedule a telehealth screening. The screening doesn't file a claim. It documents your exposure history and points you to benefits and registries.
Deadlines and effective dates
- No deadline to file. VA says the PACT Act is "here to stay."
- The special backdating window is closed. Veterans who filed by August 14, 2023 could be paid back to August 10, 2022.
- Liberalizing-law rule. When a law or regulation creates a new presumption, a claim filed more than a year after the change can generally be paid for up to one year before VA received it, if you met all eligibility requirements the whole time (38 CFR § 3.114). Otherwise the usual effective-date rules apply. See how back pay works.
- Intent to File. If you need time to gather records, an Intent to File can protect your date for up to a year.
Denied before? It may be time to file again
If VA denied a condition that's now presumptive, file a Supplemental Claim. VA says it will try to contact some veterans it previously denied, but you don't need to wait. Survivors of a veteran who died from a condition that's now presumptive may qualify for Dependency and Indemnity Compensation (DIC).
How to file a PACT Act claim
- Confirm your locations and dates with your DD-214, deployment orders, and service records.
- Get or confirm a current diagnosis. Presumptions only work for diagnosed, listed conditions.
- File an Intent to File if you need time.
- File VA Form 21-526EZ and complete its toxic exposure section, listing where and when you were exposed. See how to file step by step.
- For conditions that aren't on a presumptive list, add evidence of exposure and a medical opinion. A nexus letter can link a non-listed condition to a documented exposure.
What's still pending
- A PACT Act adjudication rule. VA proposed rules on October 1, 2024 to update how toxic exposure claims are decided. Its regulatory agenda says the final version would add service locations for certain presumptions. As of October 21, 2026, no final rule appears in the Federal Register.
- Neurodegenerative diseases. On February 10, 2026, VA announced it will assess a National Academies review of possible links between military exposures and conditions like Parkinson's disease, Alzheimer's disease, and peripheral neuropathy. That's research, not a presumption.
- Stateside PFAS. VA has not established a PFAS presumption. These claims still need direct evidence.
We don't predict what VA will add. We'll update this page when VA publishes changes.
Sources
VA: The PACT Act and your benefits · VA: Burn pits and specific environmental hazards · 38 U.S.C. 1117 · 38 CFR 3.114 · Federal Register: Proposed toxic exposure adjudication rule (Oct 1, 2024) · Federal Register: Neurodegenerative disease assessment notice (Feb 10, 2026)
This article is general information, not legal advice. VA and SSA rules change; verify current rules with VA.gov or SSA.gov or talk to an accredited representative.