The PACT Act of 2022 and Its Impact on Military Veterans with Presumptive Conditions

Introduction

The PACT Act is perhaps the largest health care and benefit expansion in VA history. The full name of the law is The Sergeant First Class (SFC) Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT). The PACT Act of 2022 is a significant piece of legislation that has far-reaching implications for military veterans. This act aims to address the challenges faced by veterans who develop certain medical conditions as a result of their service. By recognizing these conditions as presumptive, the act streamlines the process for veterans to receive the necessary healthcare and benefits.

Understanding Presumptive Conditions

Presumptive conditions are medical conditions that are presumed to be service-connected. This means that veterans who develop these conditions are not required to prove a direct link between their military service and the development of the condition. Instead, the burden of proof is shifted to the government to show that the condition is not related to the veteran's service.

Presumptive conditions are typically associated with exposure to certain hazards or experiences during military service. These conditions may not manifest immediately but can develop over time. Examples of presumptive conditions include certain types of cancer, respiratory illnesses, and mental health disorders.

The Importance of the PACT Act

Prior to the PACT Act, veterans with presumptive conditions often faced significant challenges in accessing healthcare and benefits. They had to navigate a complex and time-consuming process to establish a direct link between their service and their medical condition. This often meant providing extensive medical evidence and documentation, which could be burdensome and delay the necessary care and support.

The PACT Act addresses these challenges by recognizing certain conditions as presumptive. This means that veterans diagnosed with these conditions can receive the necessary healthcare and benefits without having to prove a direct link to their military service. The act acknowledges the sacrifices made by veterans and ensures that they receive the care and support they deserve.

Gulf War era and post-9/11 Veteran eligibility

What burn pit and other toxic exposure conditions are now presumptive?

The VA has added more than 20 burn pit and other toxic exposure presumptive conditions based on the PACT Act. This change expands benefits for Gulf War era and post-9/11 Veterans.

These cancers are now presumptive:

• Brain cancer

• Gastrointestinal cancer of any type

• Glioblastoma

• Head cancer of any type

• Kidney cancer

• Lymphoma of any type

• Melanoma

• Neck cancer of any type

• Pancreatic cancer

• Reproductive cancer of any type

• Respiratory (breathing-related) cancer of any type

Learn more about presumptive cancers related to burn pits

These illnesses are now presumptive:

• Asthma that was 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

Learn about other hazardous materials presumptive conditions that may make you eligible for care or benefits

How do I know if I have a presumptive exposure to burn pits?

If you served in any of these locations and time periods, the VA assumes that you had exposure to burn pits or other toxins, thus the presumption of exposure.

On or after September 11, 2001, in any of these locations:

• Afghanistan

• Djibouti

• Egypt

• Jordan

• Lebanon

• Syria

• Uzbekistan

• Yemen

• The airspace above any of these locations

On or after August 2, 1990, in any of these locations:

• Bahrain

• Iraq

• Kuwait

• Oman

• Qatar

• Saudi Arabia

• Somalia

• The United Arab Emirates (UAE)

• The airspace above any of these locations

Are there more exposure-related presumptive conditions?

Yes. The PACT Act adds new presumptive conditions. But there are also many other health conditions that we presume are caused by exposure to toxic (or hazardous) materials. If you have any of these other conditions, you may be eligible for health care or benefits.

Learn about other presumptive conditions based on exposure to hazardous materials

Am I eligible for free VA health care as a post-9/11 combat Veteran?

The VA is extending and expanding VA health care eligibility based on the PACT Act. You are encourage you to apply, no matter your separation date. Your eligibility depends on your service history and other factors.

If you meet the requirements listed here, you can get free VA health care for any condition related to your service for up to 10 years from the date of your most recent discharge or separation. You can also enroll at any time during this period and get any care you need, but you may owe a copay for some care.

At least one of these must be true of your active-duty service:

• You served in a theater of combat operations during a period of war after the Persian Gulf War, or

• You served in combat against a hostile force during a period of hostilities after November 11, 1998

And this must be true for you:

• You were discharged or released within 10 years

you are encouraged to enroll now so the VA can provide any care you may need now or in the future. Enrollment is free.

Vietnam era Veteran eligibility

What new Agent Orange presumptive conditions will VA add?

Based on the PACT Act, the VA added 2 new Agent Orange presumptive conditions:

• High blood pressure (also called hypertension)

• Monoclonal gammopathy of undetermined significance (MGUS)

You may also be eligible for disability compensation based on other Agent Orange presumptive conditions. These conditions include certain cancers, type 2 diabetes, and other illnesses.

Get a list of other Agent Orange presumptive conditions

If you think you’re eligible for VA health care and benefits, you are encourage to apply now.

Are there more exposure-related presumptive conditions?

Yes. The PACT Act adds new presumptive conditions. But there are also many other health conditions that we presume are caused by exposure to toxic (or hazardous) materials. If you have any of these other conditions, you may be eligible for health care or benefits.

Learn about other presumptive conditions based on exposure to hazardous materials

What new Agent Orange presumptive locations will VA add?

The VA added these 5 new locations to the list of presumptive locations:

• Any U.S. or Royal Thai military base in Thailand from January 9, 1962, through June 30, 1976

• Laos from December 1, 1965, through September 30, 1969

• Cambodia at Mimot or Krek, Kampong Cham Province from April 16, 1969, through April 30, 1969

• Guam or American Samoa or in the territorial waters off of Guam or American Samoa from January 9, 1962, through July 31, 1980

• Johnston Atoll or on a ship that called at Johnston Atoll from January 1, 1972, through September 30, 1977

If you served on active duty in any of these locations, its automatically assume (or “presume”) that you had exposure to Agent Orange.

Note: This isn’t the full list of presumptive locations for Agent Orange exposure. Review eligibility requirements for more presumptive locations.

Review eligibility requirements for Agent Orange presumptive exposure

What new radiation presumptive locations will VA add?

The VA added these 3 new response efforts to the list of presumptive locations:

• Cleanup of Enewetak Atoll, from January 1, 1977, through December 31, 1980

• Cleanup of the Air Force B-52 bomber carrying nuclear weapons off the coast of Palomares, Spain, from January 17, 1966, through March 31, 1967

• Response to the fire onboard an Air Force B-52 bomber carrying nuclear weapons near Thule Air Force Base in Greenland from January 21, 1968, to September 25, 1968

If you took part in any of these efforts, its automatically assume (or “presume”) that you had exposure to radiation.

Get a list of other radiation presumptive locations

Am I eligible for VA health care as a Vietnam Veteran?

If you served on active duty in any of these locations during these time periods, you’re now eligible to apply for VA health care:

• The Republic of Vietnam between January 9, 1962, and May 7, 1975

• Thailand at any U.S. or Royal Thai base between January 9, 1962, and June 30, 1976

• Laos between December 1, 1965, and September 30, 1969

• Certain provinces in Cambodia between April 16, 1969, and April 30, 1969

• Guam or American Samoa (or their territorial waters) between January 9, 1962, and July 31, 1980

• Johnston Atoll (or on a ship that called at Johnston Atoll) between January 1, 1972, and September 30, 1977

Impact on Military Veterans

Can I get a toxic exposure screening at VA?

Toxic exposure screenings are available at VA health facilities across the country.

Every Veteran enrolled in VA health care will receive an initial screening and a follow-up screening at least once every 5 years. Veterans who are not enrolled and who meet eligibility requirements will have an opportunity to enroll and receive the screening.

The screening will ask you if you think you were exposed to any of these hazards while serving:

• Open burn pits and other airborne hazards

• Gulf War-related exposures

• Agent Orange

• Radiation

• Camp Lejeune contaminated water exposure

• Other exposures

The VA will then give you information about any benefits, registry exams, and clinical resources you may need.

Ask about the screening at your next VA health care appointment. If you don’t have an upcoming appointment, or if you want to get the screening sooner, contact your local VA health facility. Ask to get screened by the toxic exposure screening navigator.

The PACT Act has a significant impact on military veterans, particularly those with presumptive conditions. Here are some key ways in which this legislation benefits veterans:

Streamlined Access to Healthcare

One of the primary benefits of the PACT Act is that it streamlines the process for veterans to access healthcare. Veterans with presumptive conditions no longer have to go through the arduous process of proving a direct link between their service and their medical condition. This ensures that they receive timely and appropriate medical care, which is crucial for managing their conditions and improving their quality of life.

Enhanced Benefits

In addition to healthcare, the PACT Act also enhances the benefits available to veterans with presumptive conditions. These benefits may include disability compensation, vocational rehabilitation, and assistance with housing and transportation. By recognizing the impact of presumptive conditions, the act ensures that veterans receive the support they need to live fulfilling lives after their military service.

Reduced Financial Burden

Presumptive conditions can often lead to significant financial burdens for veterans and their families. The costs associated with medical treatment, medications, and ongoing care can quickly add up. The PACT Act helps alleviate this burden by ensuring that veterans with presumptive conditions have access to the necessary resources and support without incurring excessive financial strain.

Improved Mental Health Support

Mental health conditions, such as post-traumatic stress disorder (PTSD), are among the presumptive conditions recognized by the PACT Act. This is a crucial development, as mental health issues are prevalent among veterans and can have a profound impact on their well-being. The act ensures that veterans with mental health conditions receive the necessary support and resources to address their unique needs.

Information for survivors

Can Veterans’ survivors get compensation payments under the PACT Act?

Yes. If you’re a surviving family member of a Veteran, you may be eligible for these benefits:

• A monthly VA Dependency and Indemnity Compensation (VA DIC) payment. You may qualify if you’re the surviving spouse, dependent child, or parent of a Veteran who died from a service-connected disability.
  Learn how to apply for VA DIC

• A one-time accrued benefits payment. You may qualify if you’re the surviving spouse, dependent child, or dependent parent of a Veteran who we owed unpaid benefits at the time of their death.
  Learn about evidence needed for accrued benefits

• A Survivors Pension. You may qualify if you’re the surviving spouse or child of a Veteran with wartime service.
  Learn how to apply for a Survivors Pension

What if VA denied my DIC claim and I think I’m now eligible?

You can submit a new application for VA dependency and indemnity compensation (VA DIC).

Learn about VA DIC and how to apply

Note: If we denied your claim in the past and we think you may be eligible now, we’ll try to contact you. We may be able to reevaluate your claim. But you don’t need to wait for us to contact you before you reapply.

What other VA benefits are survivors eligible for?

You may be eligible for these VA benefits as the surviving family member of a Veteran:

• Burial benefits and memorial items such as a gravesite in a VA national cemetery or a free headstone, marker, or medallion.

• A burial allowance to help with the Veteran’s burial and funeral costs. You may qualify if you’re the Veteran’s surviving spouse, partner, child, or parent.

• Education and training. You may qualify if you’re the survivor of a Veteran who died in the line of duty or as a result of service-connected disabilities.

• Health care through the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA). You may qualify if you’re the survivor or dependent of a Veteran with a service-connected disability.

• A VA-backed home loan. You may qualify if you’re the surviving spouse of a Veteran.

Learn more about family member benefits

Conclusion

The PACT Act of 2022 is a significant step forward in recognizing the challenges faced by military veterans with presumptive conditions. By streamlining access to healthcare and enhancing benefits, this legislation ensures that veterans receive the care and support they deserve. The act recognizes the sacrifices made by veterans and aims to provide them with the necessary resources to lead fulfilling lives after their service. It is a testament to the commitment of society to honor and support those who have served their country.