PACT Act

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) Act. If you’re a veteran or surviving spouse, you can file claims now to apply for PACT Act-related benefits.

The PACT Act will bring these changes:

Expand and extend eligibility for VA health care for veterans with toxic exposures and veterans of the Vietnam War, Gulf War, and Post-9/11 eras,
Add more than 20 new presumptive conditions for burn pits and other toxic exposures,
Add more presumptive exposure locations for Agent Orange and radiation,
Require VA to provide a toxic exposure screening to every veteran enrolled in VA health care,
Help the VA improve research, staff education, and treatment related to toxic exposures.

To get a VA disability rating, your disability must be connected to your military service. For some conditions, the VA will automatically presume your service caused your condition. The VA calls those “presumptive conditions” and they are listed below for different areas of the world and different periods of service. If you have a condition not on the presumptive list, it is up to you to prove your condition is service-connected. Vietnam Veterans

Vietnam Veterans

Based on the PACT Act, two new Agent Orange presumptive conditions have been added and five new locations have been added. Below are the new presumptive conditions and locations.

New Presumptive Conditions:

High blood pressure (also called hypertension),
Monoclonal Gammopathy of Undetermined Significance

New Presumptive Locations and Periods of Service:

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.

Gulf War Era and Post-9/11 Veterans

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,
Lymphatic cancer of any type,
Lymphoma of any type,
Melanoma,
Neck cancer of any type,
Pancreatic cancer,
Reproductive cancer of any type,
Respiratory (breathing-related) cancer of any type.

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.

If you served in any of these locations and time periods, the VA has determined you had exposure to burn pits or other toxins, which is called 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.

Radiation Exposure:

The VA has added three new response efforts to the list of presumptive locations. If you took part in any of these efforts, the VA will automatically presume you had exposure to radiation.

Those locations and periods of service are:

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.

VA Health Care

The following veterans, who may not have been eligible for VA health care in the past are, or will be, eligible for it now.

Category 1:

Veterans who participated in a toxic exposure risk activity while serving on active duty, active duty for training, or inactive duty training.

Category 2:

Covered veterans, which means any veteran who on or after August 2, 1990, performed active military, naval, air, or space service while assigned to a duty station in, including airspace above:

Bahrain,
Iraq,
Kuwait,
Oman,
Qatar,
Saudi Arabia,
Somalia,
United Arab Emirates; or

On or after September 11, 2001, performed active military, naval, air, or space service while assigned to a duty station in, including airspace above:

Afghanistan,
Djibouti,
Egypt,
Jordan,
Lebanon,
Syria,
Yemen,
Uzbekistan,
Any other country determined relevant by the Secretary.

Category 1 and 2 veterans, who served from August 2, 1990-September 11, 2001, will be eligible for hospital care, including mental health services and counseling, medical services, and nursing home care for any illness effective October 1, 2024.
Category 1 and 2 veterans, who served from September 12, 2001-December 31, 2006, will be eligible for hospital care, including mental health services and counseling, medical services, and nursing home care for any illness effective October 1, 2026.
Category 1 and 2 veterans, who served from January 1, 2007-December 31, 2012, will be eligible for hospital care, including mental health services and counseling, medical services, and nursing home care for any illness effective October 1, 2028.
Category 1 and 2 veterans, who served from January 1, 2013-December 31, 2018, will be eligible for hospital care, including mental health services and counseling, medical services, and nursing home care for any illness effective October 1, 2030.

Category 3:

Veterans who deployed in support of a contingency operation. Contingency operations include: Operation Enduring Freedom, Operation Freedom’s Sentinel, Operation Iraqi Freedom, Operation New Dawn, Operation Inherent Resolve, and Resolute Support Mission.
Category 3 veterans will be eligible for hospital care, including mental health services and counseling, medical services, and nursing home care for any illness effective October 1, 2032.

Surviving Spouse and Other Family Members

If you’re a surviving spouse or child, who was deemed incapacitated before the age of 18, you may be eligible for these benefits:

A monthly Dependency and Indemnity Compensation (DIC) payment. You may qualify if you’re the surviving spouse or child of a veteran who died from a service-connected disability,
A one-time accrued benefits payment. You may qualify if you’re the surviving spouse or child of a veteran who the VA owed unpaid benefits at the time of their death,
A Survivor’s Pension. You may qualify if you’re the surviving spouse or child of a veteran with wartime service.

UPDATES

Since this was written, here are a few more things we’ve learned:

All claims filed within a year the bill was signed (August 10, 2022) will be backdated to the date it was signed. All claims after that will be effective the date the VA receives them.
There’s a special enrollment period for VA health care from October 1, 2022-October 1, 2023 for Post 9/11 combat veterans who were separated between September 11, 2001-October 1, 2013. If these veterans didn’t apply before, they are eligible to now.
For PACT Act questions, people can call 800-MYVA411.
The VA will begin processing claims in January 2023.
The VA will prioritize claims for veterans with active cancer.

Veterans Services