Developing Claims Based On Exposure to Burn Pits and Other Toxins, Including Fine Particulate Matter (BPOT)

Overview

In This Section

This section contains the following topics:

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1. Developing Claims for Qualifying Disabilities Due to BPOT Exposure

Introduction

This topic contains general information about developing for qualifying disabilities, including

• identifying a claim for qualifying disabilities due to BPOT exposure
• establishing covered Veteran status
• developing for evidence of qualifying disabilities
• considering the 1119 corporate flash
• handling discrepancies with the 1119 corporate flash, and
• documenting BPOT exposure.

Change Date

November 25, 2025

VIII.ii.2.B.1.a. Identifying a Claim for Qualifying Disabilities Due to BPOT Exposure

Claims processors should sympathetically read claims from Veterans whose symptoms and service suggest potential entitlement to presumptive service connection (SC) based on exposure to burn pits and other toxins, including fine particulate matter (BPOT). Veterans with service in a qualifying BPOT location who claim a disability or symptom related to a disability recognized under 38 U.S.C. 1120, 38 CFR 3.320a, or 38 CFR 3.320b do not need to specifically claim BPOT exposure.

Example: The Veteran may

• identify symptoms of a general medical condition, such as shortness of breath or respiratory issues rather than explicitly listing a diagnosis, or
• describe respiratory cancer in other terms, such as cancer of the throat or neck.

Notes:

• If a claim is unclear, claims processors should review the medical evidence to determine if a qualifying diagnosis exists, or follow the procedures in M21-1, Part III, Subpart i, 2.D.1.c to clarify the claim.
• If the Veteran claims a disability that is not recognized as a BPOT presumptive, process the claim under direct SC guidelines in accordance with the toxic exposure risk activity procedures outlined in the Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act of 2022 Implementation Standard Operating Procedure (SOP).
• The claimant must identify the disability(ies) that resulted from BPOT exposure. If the claimant only alleges exposure without identifying a symptom or disability, follow the procedures for handling an incomplete application in M21-1, Part II, Subpart iii, 1.C.2.b and c.

VIII.ii.2.B.1.b. Establishing Covered Veteran Status

When processing a claim for a BPOT presumptive condition, verify the Veteran’s service qualifies for covered Veteran status. Verify service in a qualifying location by reviewing

• the Veteran’s corporate record for the Toxic Exposure – Sec.1119 Covered Veteran flash
• available service records, and
• Individual Longitudinal Exposure Record (ILER).

Important: If qualifying service cannot be verified using the available evidence noted above, obtain all pertinent service records, if not already of record, prior to referring the claim for a decision.

References: For more information on

• covered Veteran service locations, see
• 38 U.S.C. 1119, and
• M21-1, Part VIII, Subpart ii, 2.A.1.e
• considering the 1119 corporate flash, see M21-1, Part VIII, Subpart ii, 2.B.1.d
• ILER, see the ILER Guidance, and
• requesting service treatment records and the entire official military personnel file, see M21-1, Part III, Subpart ii, 2.B and C.

VIII.ii.2.B.1.c. Developing for Evidence of Qualifying Disabilities

Follow standard claims development procedures to obtain all relevant medical treatment records in order to substantiate the Veteran’s claimed disability(ies).

Reference: For more information on claims development, see M21-1, Part III, Subpart i, 2.

VIII.ii.2.B.1.d. Considering the 1119 Corporate Flash

When the Department of Veterans Affairs (VA)/Department of Defense Identity Repository (VADIR) data can establish service in a qualifying location, Veterans Benefits Administration systems will

• automatically establish a corporate flash, Toxic Exposure – Sec.1119 Covered Veteran, and
• update the PACT ACT DEPLOYMENTS tab (on the MILITARY SERVICE screen) in the Veterans Benefits Management System (VBMS) Core to reflect details provided by VADIR that were used to verify the Veteran’s 38 U.S.C. 1119 -qualifying service.

Important:

• The information shown under the PACT ACT DEPLOYMENTS tab is provided solely to establish the Veteran has at least one qualifying deployment that satisfies the criteria for presumptive toxic exposure per 38 U.S.C. 1119, and may not necessarily reflect a complete listing of the Veteran’s 38 U.S.C. 1119 -qualifying service history.
• The absence of the 1119 corporate flash should never be construed to mean that no qualifying service exists. When the Toxic Exposure – Sec.1119 Covered Veteran flash was not applied by automation, claims processors must review all available evidence, such as ILER, personnel records and/or the DD Form 214, Certificate of Release or Discharge from Active Duty, to determine whether the Veteran served in any location covered by 38 U.S.C. 1119.

Reference: For more information on corporate flashes, see

• M21-1, Part III, Subpart i, 2.F.1.b, and
• M21-4, Appendix E, 1.b.

VIII.ii.2.B.1.e. Handling Discrepancies With the 1119 Corporate Flash

Use the table below to determine how to handle discrepancies between the Veteran’s service locations and the Toxic Exposure – Sec.1119 Covered Veteran corporate flash.

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VIII.ii.2.B.1.f. Documenting BPOT Exposure

Document exposure in a qualifying BPOT location by either

• uploading the Individual Deployment History from ILER, or
• annotating other service records that establish service in a qualifying location.

References: For more information on

• ILER, see the ILER Guidance, and
• annotating a record in the claims folder, see the VBMS Core User Guide.

2. Examinations for Qualifying Disabilities Due to BPOT Exposure

Introduction

This topic contains information about examinations for qualifying disabilities, including

• when to request an examination or medical opinion
• medical opinions to determine aggravation of a pre-existing disability, and
• examination guidelines for BPOT presumptive disabilities.

Change Date

June 6, 2025

VIII.ii.2.B.2.a. When to Request an Examination or Medical Opinion

For presumptive SC BPOT claims, follow the general presumptive SC examination guidelines noted in M21-1, Part IV, Subpart i, 1.B.1.g.

VIII.ii.2.B.2.b. Medical Opinions to Determine Aggravation of a Pre-Existing Disability

When evidence shows the disability existed prior to enlistment, follow the procedures in M21-1, Part IV, Subpart i, 1.B.1.f to obtain a medical opinion regarding aggravation of a pre-service disability.

Exception: A medical opinion for aggravation of a pre-existing disability is not needed if the disability manifests between periods of active duty, but after a qualifying period of service. In this instance, review the claim to determine if presumptive SC is otherwise warranted, and if needed, obtain an examination to determine the current severity of the disability.

References: For more information on

• aggravation of a pre-existing disability, see M21-1, Part V, Subpart ii, 2.C, and
• qualifying service, see M21-1, Part VIII, Subpart ii, 2.A.1.e.

VIII.ii.2.B.2.c. Examination Guidelines for BPOT Presumptive Disabilities

When requesting an examination for one of the BPOT presumptive disabilities, follow the below guidelines.

• Any condition that requires an invasive diagnostic procedure, such as a biopsy, is considered outside of the scope of VA examination practice. In these cases, follow guidance in M21-1, Part IV, Subpart i, 2.A.1.d regarding scope of practice relative to examinations.
• Bronchiolitis is extremely difficult to diagnose and generally requires a lung biopsy.
• If there is question as to whether the Veteran is diagnosed with a presumptive condition that generally requires a biopsy, but there is no biopsy report, request a medical opinion.
• Do not request a biopsy or for the Veteran to be sedated and/or undergo an invasive procedure.
• Identify any evidence for the examiner supporting why the biopsy was not conducted.
• If the evidence of record is unclear as to whether the Veteran is diagnosed with one of the presumptive cancers, or whether the cancer is considered the primary site of the cancer, request a medical opinion to help determine the originating site of the cancer.

References: For more information on

• history of BPOT exposure policies, see M21-1, Part VIII, Subpart ii, 2.A.1.a, and
• considering presumptive SC for metastatic cancer, see M21-1, Part V, Subpart ii, 2.B.1.b.