The PACT Act (Honoring Our Promise to Address Comprehensive Toxics Act of 2022) is a historic piece of legislation meant to broaden access to health care and other benefits for veterans exposed to hazardous substances during their military service. Enacted into law on August 10, 2022, this Act is one of the most extensive expansions of the Department of Veterans Affairs (VA) benefits in recent history. At the heart of this legislation is the presumptive conditions list, a tool that streamlines the claims process for veterans.
The PACT Act is important because it establishes certain conditions as presumptively connected to service, so that veterans affected by them can receive the care and support they require without having to go through the lengthy process of proving that their condition is connected to their service. In this piece, we’ll dive into what the presumptive conditions list is and how it affects veterans, as well as what this Act means with respect to the larger picture.
What Are Presumptive Conditions?
The presumptive conditions are medical conditions that the VA presumes are connected to a veteran’s military service related to specific environmental exposures, events or locations associated with a veteran’s service. “And with these specific conditions, veterans are not required to do what they normally would which is demonstrate with evidence that their illness was directly linked to their time serving in the military.” Rather, the VA and, apparently, Congress assume a connection given the nature of a veteran’s service.
The presumptive list of conditions under the PACT Act covers such a wide variety of illnesses and diseases associated with:
- Exposure to burn pits during the Global War on Terror and Gulf War eras.
- Exposure to Agent Orange in Vietnam, Thailand and elsewhere.
- Exposure to radiation during nuclear testing or service in specific geographic locations.
Important Additions to the Presumptive Conditions List
The PACT Act vastly broadens the list of presumptive conditions, especially for veterans exposed to burn pits, airborne hazards and toxic chemicals. Here’s a rundown of the biggest new features:
1. Conditions Related to Burn Pit and Other Airborne Hazard Exposures
Veterans who served in certain locations during the Gulf War, the Global War on Terror or other post-9/11 conflicts were often exposed to toxic fumes from burn pits. The pits were used to dump waste, sometimes even hazardous waste, which released toxic chemicals into the atmosphere.
The PACT Act lists several respiratory illnesses as presumptive conditions, including:
- Asthma (diagnosed post-service)
- Chronic bronchitis
- Chronic obstructive pulmonary disease (COPD)
- Chronic rhinitis
- Chronic sinusitis
- Problems obstructing the normal function of the lungs caused by bronchiolitis constriction or obliterative bronchiolitis
- Emphysema
- Granulomatous disease
- Interstitial lung disease (ILD)
- Pleuritis
- Pulmonary fibrosis
- Sarcoidosis
2. Toxic Exposure-Related Cancers
The PACT Act also establishes a presumption of a service connection for several cancers resulting from exposure to burn pits, radiation or toxic chemicals. These include:
- Brain cancer
- Gastrointestinal cancer
- Glioblastoma
- Head cancer (of any type)
- Kidney cancer
- Lymphatic cancer
- Lymphoma (of any type)
- Melanoma
- Neck cancer
- Pancreatic cancer
- An issue with reproductive cancer (of any kind)
- Cancer of the respiratory system (including lung cancer)
3. Health Problems for which the Presumption of Agent Orange Exposure is Applicable
For veterans who served during the Vietnam era, the PACT Act expands the list of conditions associated with Agent Orange, an herbicide widely used during that war. New presumptive conditions are as follows:
- Hypertension
- Monoclonal gammopathy of undetermined significance (MGUS)
The Act also expands Agent Orange presumptive coverage to include veterans who served in previously eligible areas, including Thailand, Laos, Cambodia, Guam, American Samoa and Johnston Atoll.
Places and Times of Potential Exposure
In order to access presumptive conditions under the PACT act, veterans must have served in certain locations during certain timeframes. These include:
1. I was exposed to burn pits and airborne hazards.
Veterans who served in:
- Iraq, Afghanistan or other post-9/11 battlegrounds.
- The Southwest Asia theater of operations (Kuwait, Saudi Arabia, Oman, and Qatar).
2. Agent Orange Exposure
Veterans who served:
- In Vietnam (1962–1975)
- At the Korean DMZ (1967–1971)
- Thailand at certain military bases (1962–1976)
- In Laos, Cambodia, Guam, American Samoa or Johnston Atoll — during certain periods.
3. Radiation Exposure
Veterans involved in:
- Tests of nuclear weapons programs.
- Service in Hiroshima or Nagasaki after World War II.
- Environmental cleanups, like at Enewetak Atoll.
How to File an Oxybenzone Act Claim
The PACT Act adds presumptive conditions, making it easier for veterans to file claims. Here’s how it works:
- Filing a claim: Veterans with a presumptive condition may file a claim using the VA’s online portal, by mail, or in person at a VA regional office.
- Medical Evidence: Veterans do not have to establish that the condition is service connected, but they do need to submit a diagnosis and service records demonstrating they served in a qualifying location.
- Benefit only if approved: upon approval, veterans are entitled to monthly disability compensation and may also qualify for additional healthcare services, vocational training, and caregiver support.
PACT Act Help for Veterans
The PACT Act has many benefits for veterans and their families:
Access to Healthcare: Expanding VA healthcare eligibility for more veterans who were exposed to toxins.
- Disability compensation: Making sure veterans with presumed conditions get paid.
- Survivors Benefits: Providing survivors’ benefits to family members of veterans who died of presumptive conditions.
- Research and Awareness: Expanding support for research on toxic exposures and their effects on veterans’ long-term well-being.
Challenges and Criticisms
The PACT Act is a landmark piece of legislation, but there have been some bumps in the road:
- Claims Backlog: The broadened presumptive conditions have resulted in a spike in claims, and backlogs in processing.
- Awareness gap: Many veterans do not know they are eligible under the new law.
- Implementation: Making sure that VA staff and resources are able to meet increased need for benefits and health care services.
In response to these problems, the VA is continuing to boost staffing, simplify claims processing and initiate outreach campaigns to notify veterans of their entitlements.
How to Get Assistance
Veterans looking for assistance with their claims can:
- Contact a Veterans Service Organization (VSO): Organizations such as the Disabled American Veterans (DAV) and Veterans of Foreign Wars (VFW) provide help for free.
- Go to a VA Regional Office: Similar in function to a post office, these regional offices provide in-person assistance with filing claims and understanding benefits.
- Call the VA hotline: Veterans can call the VA’s toll-free number (1-800-827-1000) for information from representatives who can answer questions.
- Use Online Resources: The VA website has tools, guides, as well as updates related to the PACT Act.
For veterans seeking VA benefits, knowledge about the VA funding fee is important. This one-time fee is usually charged when a veteran uses a VA loan to buy, build or refinance any home. It helps keep the VA loan program going, reducing the burden on taxpayers. But many veterans with disability compensation or who are disabled as a result of service are exempt from a fee payment. The amount of the funding fee can vary greatly depending on factors such as loan type, down payment size and whether this represents a first use of one’s VA loan benefit. It is a key consideration for veterans looking to harness VA resources toward homeownership.
Conclusion
The PACT Act presumptive conditions list is a sea change in how the U.S. government provides care for its veterans. The Act recognizes the long-term impacts of toxic exposures on health, and clarifies the claims process, allowing veterans to receive the care and compensation they need. But there’s more work to do both in addressing implementation challenges and building awareness among eligible veterans.
If you are a veteran or are related to one who served in the military and were potentially exposed to dangerous agents, you’re wise to consider your options under the PACT Act. An updated list of presumptive conditions could mean the difference between receiving critical health care and financial support that honors your service and sacrifice.