PACT Act Presumptive Conditions List: Does Your Condition Qualify?
If you were exposed to toxins during your service, using a presumptive condition is often the easiest way to get your illness connected to your service. With a presumptive condition, the VA automatically links your illness to your service, so you do not have to prove that your service caused it.
The PACT Act presumptive conditions list groups covered conditions by exposure type, shows which service periods qualify, and explains how each group is rated after a claim is approved. Some of these presumptions existed before the PACT Act, which added more conditions and locations. Each section points out what the law changed.
Keep in mind that the VA adds new conditions and locations over time. Knowing exactly how your diagnosis fits into these categories can help turn your exposure into an approved claim.
How to Use This PACT Act Presumptive Conditions List
Before you look at the list, keep in mind that two main factors determine if a presumptive condition will actually result in payment. These are more important than just having a diagnosis. While a presumption means you do not have to prove causation, there are still other requirements. Read this section first to understand the rest of the page.
You still need a current diagnosis: The condition has to be documented in your medical records. A presumption links the condition to service; it does not confirm you have the condition.
You still need qualifying service: Each exposure type has its own locations and dates. If your service does not match, the presumption does not apply, though you can still file a standard claim. Check the details on our PACT Act eligibility guide.
You still need an eligible discharge: Presumptive benefits require a character of discharge other than dishonorable. This gate applies to all exposure types below.
These lists are not always complete: The VA notes that its condition lists, especially for cancer subtypes, do not name every qualifying diagnosis. If yours is not listed, do not assume it qualifies from its general category alone. Check the VA's current condition-specific guidance, or consider a standard service-connection claim.
How these conditions are rated is the other half of the picture, because service connection and payment are two different steps:
Many active cancers are rated 100%: The full rating applies during treatment and for 6 months after treatment ends. The VA then re-examines you and rates any lasting effects based on their severity. One exception is melanoma treated only at the skin level. If a melanoma is managed with wide local excision alone, without systemic chemotherapy, extensive radiation, or more extensive surgery, the 100% rule does not apply, and the VA rates it on scarring, disfigurement, or loss of function instead.
Chronic conditions are rated by severity: Ratings run from 0% (which confirms service connection but pays nothing) up to the maximum for that condition. The diagnosis does not set the tier; the severity does.
Your rating sets the payment tier: Factors like dependents and Special Monthly Compensation can adjust the exact amount. For monthly figures by rating, see our PACT Act compensation breakdown.
Burn Pit and Airborne Hazard Presumptive Conditions
This is the largest group added by the PACT Act. It includes veterans from the Gulf War and post-9/11 eras who were exposed to smoke from open-air burn pits or other airborne hazards. The VA assumes exposure based on your service location and dates, so you do not need to prove you were near a specific burn pit. If your service and diagnosis are both listed below, and you meet the basic discharge requirement, you probably qualify for this presumption.
Qualifying service is either of these:
On or after August 2, 1990: Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, Somalia, the United Arab Emirates, or the airspace above them. This group also includes those who served in the Arabian Sea, Gulf of Aden, Gulf of Oman, Neutral zone between Iraq/Saudi Arabia, Persian Gulf, and Red Sea.
On or after September 11, 2001: Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Uzbekistan, Yemen, or the airspace above them.
The presumptive cancers are grouped by where they occur in the body. Several categories are covered "of any type," meaning your specific diagnosis is swept in, even if it is not named individually:
Brain, head, neck, and nervous system cancers: Including glioblastoma, brain and brain stem cancers, head cancers of any type, neck cancers of any type, and cancers of the cervical spine.
Gastrointestinal cancers: Anal, colorectal, esophageal, hepatic, pancreatic, salivary gland, small intestinal, splenic, and gastric.
Genitourinary cancers: Renal cell carcinoma, urinary bladder, and ureter cancers. (Added January 2025.)
Hematologic and lymphatic cancers: Acute and chronic leukemias, multiple myeloma, myelodysplastic syndromes, and myelofibrosis. (Added January 2025.)
Lymphomas: Hodgkin's, non-Hodgkin's, and B-cell lymphoma of any type.
Melanoma: of the skin, eye, and internal (mucosal) tissues.
Reproductive cancers: Breast, cervical, ovarian, uterine, prostate, testicular, and others.
Respiratory cancers: Any cancer of the lung, bronchus, larynx, pharynx, or trachea.
The burn pit list also includes twelve chronic respiratory illnesses that are not cancer:
Airway and lung conditions: Asthma, chronic bronchitis, COPD, emphysema, constrictive or obliterative bronchiolitis, interstitial lung disease, and pulmonary fibrosis.
Sinus and nasal conditions: Chronic rhinitis and chronic sinusitis.
Inflammatory conditions: Granulomatous disease, pleuritis, and sarcoidosis.
One detail that catches many veterans off guard is that asthma qualifies even if it was first diagnosed after you left service. As for ratings, active respiratory cancers follow the 100% rule above. The chronic conditions are rated based on breathing tests and symptom frequency, with asthma, bronchitis, COPD, and emphysema ranging from 10% to 100%, and chronic sinusitis ranging from 0% to 50%.
Rhinitis ratings depend on the type and severity, typically 10% to 30% for the allergic and vasomotor forms, most often tied to airborne exposure, though rarer granulomatous forms can be rated far higher.
Agent Orange Presumptive Conditions
Agent Orange and other herbicide presumptions apply to veterans who meet specific service or exposure requirements, and Vietnam service is only one of the qualifying paths. This is also where a careful reading of the PACT Act pays off. Most of these conditions were presumptive before 2022. What the PACT Act added were two new conditions, high blood pressure and MGUS, plus five new qualifying locations. The full current list is below, so you are not working from an outdated version.
Qualifying service means meeting at least one of these:
Vietnam service, January 9, 1962, to May 7, 1975: In the Republic of Vietnam, its inland waterways, or within 12 nautical miles of its coast.
Korean DMZ, September 1, 1967, to August 31, 1971: Service in or near the demilitarized zone.
PACT Act locations: Thai military bases (January 9, 1962 to June 30, 1976), Laos (December 1, 1965 to September 30, 1969), Mimot or Krek in Cambodia's Kampong Cham Province (April 16 to April 30, 1969), Guam or American Samoa (January 9, 1962 to July 31, 1980), and Johnston Atoll (January 1, 1972 to September 30, 1977).
C-123 aircraft, 1969 to 1986: You served in an Air Force unit location where a C-123 with traces of Agent Orange was assigned, and had repeated contact with the aircraft through your flight, ground, or medical duties.
Herbicide handling: You were involved in transporting, testing, storing, or otherwise using Agent Orange during your military service.
The presumptive cancers are:
Blood and lymph cancers: Chronic B-cell leukemia, Hodgkin's disease, multiple myeloma, and non-Hodgkin's lymphoma.
Solid tumors: Bladder cancer, prostate cancer, respiratory cancers, including lung cancer, and some soft tissue sarcomas.
Other: AL amyloidosis, MGUS (a precursor to multiple myeloma, not a cancer itself), chloracne, and porphyria cutanea tarda.
Note one exclusion the VA is explicit about: osteosarcoma, chondrosarcoma, Kaposi's sarcoma, and mesothelioma are not on the presumptive sarcoma list. The other presumptive Agent Orange illnesses are:
Metabolic and hormonal: Type 2 diabetes and hypothyroidism.
Cardiovascular: High blood pressure (hypertension) and ischemic heart disease.
Neurological: Parkinson's disease, Parkinsonism, and early-onset peripheral neuropathy.
Other: AL amyloidosis, chloracne, and porphyria cutanea tarda.
Three of these carry a timing rule worth knowing: chloracne, early-onset peripheral neuropathy, and porphyria cutanea tarda must reach at least 10% severity within one year of exposure. On ratings, the common conditions here span wide ranges set by severity, with hypertension rated 10% to 60%, type 2 diabetes and ischemic heart disease rated 10% to 100%, and cancers following the 100% active-disease rule.
Radiation Exposure Presumptive Conditions
Radiation presumptives apply to a group often called atomic veterans, and the structure works differently from the burn pit list. The conditions here are long-standing radiogenic diseases, and the PACT Act's contribution was adding three cleanup and response efforts to the list of presumptive exposure activities. Two features set this track apart. Eligibility is tied to specific radiation-risk activities rather than to broad service regions.
Qualifying service means taking part in a radiation-risk activity, which includes:
Nuclear testing and occupation: On-site participation in atmospheric nuclear tests or the post-war occupation of Hiroshima or Nagasaki between August 6, 1945 and July 1, 1946.
Facilities and sites: Qualifying service at certain gaseous diffusion plants, or at Amchitka Island before 1974.
PACT Act response efforts: The cleanup of Enewetak Atoll (January 1, 1977, to December 31, 1980), the Palomares, Spain cleanup (January 17, 1966 to March 31, 1967), and the response at Thule Air Force Base in Greenland (January 21 to September 25, 1968).
The presumptive radiogenic diseases are almost entirely cancers:
Cancers named on the list: Bile duct, bone, brain, breast, colon, esophagus, gall bladder, primary-site liver, lung, pancreas, pharynx, ovary, salivary gland, small intestine, stomach, thyroid, and urinary tract.
Blood and lymph cancers: Leukemia other than chronic lymphocytic leukemia, lymphomas other than Hodgkin's disease, and multiple myeloma.
The latency rule is the catch to watch. Each disease must appear within a set period after exposure, and for some cancers, that window can be decades long. Because these are cancers, ratings follow the 100% active-disease rule, then move to a residual rating after treatment.
Camp Lejeune Contaminated Water Presumptive Conditions
Camp Lejeune belongs on any toxic-exposure list, with one important clarification that most guides get wrong. The VA presumptive conditions for Camp Lejeune come from earlier law, not the PACT Act itself. The PACT Act's Camp Lejeune provision, the Camp Lejeune Justice Act, is a separate lawsuit pathway, not a VA disability benefit. The presumptive conditions below are those that result in a VA disability rating and monthly compensation.
Qualifying service requires both of these:
Location and time: At least 30 days total at Marine Corps Base Camp Lejeune or MCAS New River between August 1, 1953 and December 31, 1987.
Discharge status: Any discharge other than dishonorable.
The eight presumptive conditions for VA disability compensation are:
Cancers: Bladder cancer, kidney cancer, liver cancer, adult leukemia, multiple myeloma, and non-Hodgkin's lymphoma.
Other conditions: Aplastic anemia, other myelodysplastic syndromes, and Parkinson's disease.
There are two important things to know. First, the VA has a list of fifteen conditions that qualify for copay-free health care. Some of these are not on the compensation list, so being eligible for care does not always mean you will get monthly payments. Second, the Camp Lejeune Justice Act allows veterans, families, and others exposed to the water to file lawsuits.
However, the deadline to submit a new administrative claim with the Department of the Navy was August 10, 2024. Filing under this law does not change your VA disability or health care benefits. The compensation ratings follow the same rules as elsewhere on this page: 100% for active cancer, then a rating based on the severity of the remaining effects.
Keeping Up With a Changing PACT Act Presumptive Conditions List
The key thing to know about the PACT Act presumptive conditions list is that it is still being updated. The law says the VA must regularly review new research on toxic exposure, and either the VA or Congress can add new conditions or locations through official processes. This means a page you looked at last year might not show the latest updates.
The list has kept expanding: The most recent major additions took effect in January 2025 and included genitourinary cancers, acute and chronic leukemias, multiple myeloma, myelodysplastic syndromes, and myelofibrosis. Earlier waves came in 2024 and 2021.
A condition under review is not yet presumptive: Until the VA formally publishes a rule, you cannot treat a proposed condition as covered. You can still file a standard claim with medical evidence.
Filing early protects your date: If your condition is later added, a claim already on file can secure an earlier effective date than one you start afterward.
Where to Go From Here
This pact act presumptive condition list explains which conditions may qualify and where each presumption applies. Next, check whether your service dates and locations meet the requirements, then find out what an approved claim could pay. Each topic has its own guide because both can affect your outcome as much as your diagnosis.
Review your service history on our PACT Act eligibility page, then use our PACT Act compensation breakdown to estimate your potential rating. If your diagnosis is covered and your service qualifies, you generally won’t have to prove that your military service caused the condition. You’ll still need to file a claim, document your diagnosis, and provide evidence showing how severely it affects you.
