See which presumptive rules may fit your service and condition.

Source date

eCFR extract date: 2026-07-01. Source: 38 CFR Part 3.

PACT Act non-cancer conditions

Source: 38 CFR 3.320(a)(2)

• Asthma
• Rhinitis
• Sinusitis, to include rhinosinusitis

PACT Act cancers

Source: 38 CFR 3.320(a)(3)

• Squamous cell carcinoma of the larynx
• Squamous cell carcinoma of the trachea
• Adenocarcinoma of the trachea
• Salivary gland-type tumors of the trachea
• Adenosquamous carcinoma of the lung
• Large cell carcinoma of the lung
• Salivary gland-type tumors of the lung
• Sarcomatoid carcinoma of the lung
• Typical and atypical carcinoid of the lung

Agent Orange presumptive conditions

Source: 38 CFR 3.309(e)

• AL amyloidosis
• Chloracne or other acneform disease consistent with chloracne
• Type 2 diabetes (also known as Type II diabetes mellitus or adult-onset diabetes)
• Hodgkin's disease
• Ischemic heart disease (including, but not limited to, acute, subacute, and old myocardial infarction; atherosclerotic cardiovascular disease including coronary artery disease (including coronary spasm) and coronary bypass surgery; and stable, unstable and Prinzmetal's angina)
• All chronic B-cell leukemias (including, but not limited to, hairy-cell leukemia and chronic lymphocytic leukemia)
• Multiple myeloma
• Non-Hodgkin's lymphoma
• Parkinson's disease
• Early-onset peripheral neuropathy
• Porphyria cutanea tarda
• Prostate cancer
• Respiratory cancers (cancer of the lung, bronchus, larynx, or trachea)
• Soft-tissue sarcoma (other than osteosarcoma, chondrosarcoma, Kaposi's sarcoma, or mesothelioma)

Gulf War presumptive conditions

Source: 38 CFR 3.317 and the military-exposure module

• Chronic Fatigue Syndrome
• Fibromyalgia
• Functional Gastrointestinal Disorders (including IBS)
• Undiagnosed Illnesses manifesting with signs/symptoms
• Medically Unexplained Chronic Multisymptom Illness (MUCMI)

Radiation presumptive conditions

Source: 38 CFR 3.309(d)

• Leukemia (other than chronic lymphocytic leukemia)
• Cancer of the thyroid
• Cancer of the breast
• Cancer of the pharynx
• Cancer of the esophagus
• Cancer of the stomach
• Cancer of the small intestine
• Cancer of the pancreas
• Multiple myeloma
• Lymphomas (except Hodgkin's disease)
• Cancer of the bile ducts
• Cancer of the gall bladder
• Primary liver cancer (except if cirrhosis or hepatitis B is indicated)
• Cancer of the salivary gland
• Cancer of the urinary tract
• Bronchiolo-alveolar carcinoma
• Cancer of the bone
• Cancer of the brain
• Cancer of the colon
• Cancer of the lung
• Cancer of the ovary

Camp Lejeune presumptive conditions

Source: 38 CFR 3.309(f)

• Kidney cancer
• Liver cancer
• Non-Hodgkin's lymphoma
• Adult leukemia
• Multiple myeloma
• Parkinson's disease
• Aplastic anemia and other myelodysplastic syndromes
• Bladder cancer

PACT Act exposures, service periods, and locations

PACT Act and Agent Orange presumptive conditions list (2026)

A presumptive condition is one VA connects to your service by law, so you do not have to prove what caused it. VA's PACT Act page puts the rule simply: if you have a presumptive condition, you only need to meet the service requirements for the presumption. You still need three things on paper: a diagnosis of a listed condition, service that matches the rule's places and dates, and evidence of how severe the condition is now.

VA's PACT Act page says the 2022 law added more than 20 presumptive conditions for burn pits, Agent Orange and other toxic exposures, and added presumptive exposure locations for Agent Orange and radiation. The lists below come from the statutes and regulations, checked October 6, 2026. Each program's full list sits in its own section.

Claim Raven's presumptive checker puts these programs side by side, free with an account. Search a condition or open a program, and it shows the service dates and places beside the condition, what a presumption still needs, and the rule to read. If your account has your service history, it marks the programs that may fit. A match is a rule to check against your records, not a VA decision.

Agent Orange presumptive conditions list

VA presumes these conditions were caused by herbicide exposure in a veteran with qualifying service (the places and dates are in the next section). Under 38 CFR 3.307(a)(6)(ii), most of them can appear at any time after service. Three cannot: chloracne (or a similar acneform disease), porphyria cutanea tarda and early-onset peripheral neuropathy must have reached at least 10 percent disabling within one year after your last exposure.

Three details decide a lot of claims:

• Soft-tissue sarcoma has exclusions. The presumption does not cover osteosarcoma, chondrosarcoma, Kaposi's sarcoma or mesothelioma.
• High blood pressure is its own presumption. The regulation says ischemic heart disease does not include hypertension, peripheral vascular disease or stroke. Hypertension became presumptive on its own on August 10, 2022.
• Five conditions are in the statute, not yet in the regulation. As of the October 1, 2026 eCFR, 38 CFR 3.309(e) lists 14 diseases. Bladder cancer, hypothyroidism, parkinsonism, MGUS and hypertension were added by Congress to 38 U.S.C. 1116(a)(2), and VA's claims manual cites the statute for those five (M21-1 VIII.i.1.A). If your decision cites section 1116 instead of 3.309(e), that is why.

Claim Raven's condition guides cover several listed conditions in depth: type 2 diabetes, hypertension, hypothyroidism, Parkinson's disease, early-onset peripheral neuropathy, ischemic heart disease, prostate cancer, bladder cancer, respiratory cancers, chronic B-cell leukemias and non-Hodgkin's lymphoma.

Agent Orange eligibility by place and date

You have a presumption of exposure if your service fits one row below. Any period of service in the place and dates is enough (38 CFR 3.307(a)(1)).

VA's Agent Orange page also lists veterans who were involved in transporting, testing, storing or other uses of Agent Orange during service. For a C-123 claim, VA asks for one or more of USAF Form 2096, Form 5 or Form 781.

Two dates in older guides are out of date:

• Korea starts September 1, 1967. The regulation at 38 CFR 3.307(a)(6)(iv) still prints April 1, 1968, but the 2019 Blue Water Navy law set September 1, 1967, in 38 U.S.C. 1116B, and VA's Agent Orange page and claims manual use that date. VA's manual looks at whether your unit operated in or near the DMZ.
• Thailand runs to June 30, 1976, at any base. Since the PACT Act, service at any U.S. or Royal Thai base counts, without regard to where on the base you were or what your job was. You do not need to show perimeter duty, and the rule is not limited to a short list of bases.

If you served somewhere else, or outside these dates, you can still claim herbicide exposure, but VA's manual says the burden is on you to establish the exposure as a fact (M21-1 VIII.i.1.A).

Blue Water Navy and the 12-nautical-mile line

The offshore rule is not measured from the beach. 38 U.S.C. 1116A(d) lists coordinates for a line that starts at the southwestern demarcation line between the waters of Vietnam and Cambodia, and a position not more than 12 nautical miles seaward of that line counts. Records of where your ship actually was decide it. VA's manual sends claims that turn only on service at sea to centralized processing teams, because regional offices are not authorized to decide nautical herbicide exposure (M21-1 VIII.i.1.B).

If VA denied you before, the Blue Water Navy law has its own back-pay rule. Under 38 U.S.C. 1116A(c), if you filed a claim between September 25, 1985, and December 31, 2019, VA denied it because service connection was not shown, and you file again on or after January 1, 2020, for the same condition and VA grants it, VA treats the new claim as filed on the date of the earlier one. VA's Agent Orange page says to use a Supplemental Claim for this.

When the newest Agent Orange conditions became presumptive

The start date matters because it limits back pay (see effective dates under How to file a presumptive VA claim). VA's claims manual gives these dates for the five most recent additions (M21-1 VIII.i.1.C):

VA's Agent Orange page says that if it denied bladder cancer, hypothyroidism or parkinsonism in the past, it will review the case again automatically and send you a letter. For other conditions VA denied before they became presumptive, file a Supplemental Claim.

Conditions VA says are not linked to Agent Orange

Some common conditions are not on the list, and VA has gone further for some of them. Based on National Academy of Sciences reports, the Secretary has found no positive association between herbicide exposure and a list that includes skin cancers (melanoma, basal cell and squamous cell), colorectal and other digestive cancers, thyroid cancer, breast cancer, leukemias other than chronic B-cell leukemias, asthma, COPD, hearing loss and immune system disorders, including autoimmunity (M21-1 VIII.i.1.B).

That finding means no Agent Orange presumption, and VA treats these conditions as an exception to the TERA exam rule when herbicide is your only exposure (see the TERA section below). It does not bar service connection. 38 CFR 3.303(d) lets VA grant a disease first diagnosed after service when all the evidence shows it began in service. And several of these, including melanoma, colon cancer and thyroid cancer, are on the PACT Act burn pit list if you also have qualifying Gulf War era or post-9/11 service. See the condition guides for skin cancer, colon cancer and thyroid cancer.

PACT Act burn pit presumptive conditions

The burn pit presumptions cover a "covered veteran": someone who served while assigned to a duty station in, or in the airspace above, one of these countries on or after the date shown (38 U.S.C. 1119(c)).

The statute lets VA add other countries. VA's PACT Act page says it has added none at this time.

The statute names countries, not the waters around them. VA's 2024 processing guidance (VBA Letter 20-24-06) told claims staff to also count the neutral zone between Iraq and Saudi Arabia, the Gulf of Aden, the Gulf of Oman, the Persian Gulf, the Arabian Sea and the Red Sea while a regulation catches up. VA's January 2025 regulations for bladder, ureter and blood cancers (38 CFR 3.320a and 3.320b) already cover the whole Southwest Asia theater, waters included.

What the list means in practice:

• "Any type" is broad. VA's page on burn pit cancers lists thyroid cancer among the mouth, neck and throat cancers it counts, cancers of the pharynx and larynx as neck cancers, breast, prostate and testicular cancer as reproductive cancers, colon, esophageal, stomach and liver cancer as gastrointestinal cancers, and basal cell and squamous cell carcinoma of the skin of the mouth and neck as presumptive. VA says its examples are not a complete list.
• Asthma counts when it was diagnosed after the service that qualifies you (38 U.S.C. 1120(b)(1)).
• There is no deadline. The statute covers a listed disease that becomes manifest in a covered veteran, with no time limit, and 38 CFR 3.320 covers its conditions if they appear to any degree at any time after separation.
• The presumption can be rebutted with affirmative evidence, for example that the disease was caused by something that happened between your service and its onset (38 CFR 3.320(b), 3.320a(d) and 3.320b(c)).

Condition guides for burn pit presumptives include asthma, COPD, chronic bronchitis, constrictive bronchiolitis, sarcoidosis, pulmonary fibrosis, chronic sinusitis, rhinitis, lung cancer, kidney cancer, lymphoma, bladder cancer, leukemia, testicular cancer and skin cancer.

Four PACT Act rules with different service dates

The burn pit presumptions live in one statute and three regulations, and their service rules are not identical.

Afghanistan shows why the dates matter. Afghanistan service in 1995 does not meet any of the burn pit rules, which start in 2001. It can still meet the Gulf War illness rule in 38 U.S.C. 1117, which covers Afghanistan during the whole Persian Gulf War period from August 2, 1990.

The PACT Act toxic exposure screening

The PACT Act requires VA to give every veteran enrolled in VA health care a toxic exposure screening, with a follow-up at least once every five years. It asks about burn pits and other airborne hazards, Gulf War exposures, Agent Orange, radiation, Camp Lejeune water and other exposures, then points you to benefits, registry exams and care. Ask about it at your next VA health care appointment, or contact your local VA facility to get screened sooner.

The screening is a health care step, not a claim. VA's claims guidance says the screening report goes into your treatment records and does not count as a claim, though claims staff may use it as evidence. To get compensation, you still file a claim.

TERA: toxic exposure risk activity under 38 U.S.C. 1168

A presumption covers listed conditions in listed places. TERA covers what the lists miss. The PACT Act added 38 U.S.C. 1168, which changes when VA must get a medical exam and opinion for a toxic exposure claim. As of October 6, 2026, VA has proposed TERA regulations (Federal Register, October 1, 2024) but has not issued a final rule, so the rules below come from the statute and VA's claims guidance.

What is a TERA?

A toxic exposure risk activity is any activity that requires an entry in an exposure tracking record system, such as the Individual Longitudinal Exposure Record (ILER), or that VA determines qualifies when it considers what is reasonably prudent to protect veterans' health (38 U.S.C. 1710(e)(4)(C), which section 1168 adopts). VA's manual treats exposure to environmental and military occupational hazards as a type of TERA (M21-1 VIII.iii.9.A).

VA's guidance tells claims staff to read the evidence liberally, apply reasonable doubt, and concede TERA participation when it is consistent with the places, types and circumstances of your service, including your job (VBA Letter 20-24-06). Your own statement, or statements from people who served with you, can establish the exposure when they fit the facts of your service (M21-1 VIII.iii.9.B). VA's manual gives an example: a veteran says his duties exposed him to fuel, his personnel records show fuel systems maintenance, and VA concedes the fuel exposure as TERA participation.

Two limits apply. A military job title alone is not TERA participation, and name-only entries in an exposure record, or entries from contractor or civilian service periods, do not count.

When VA must order a TERA exam and medical opinion

Under 38 U.S.C. 1168(a), when your claim includes evidence of a disability and evidence that you took part in a TERA, and that evidence is not enough to grant service connection, VA must give you a medical exam and ask whether it is at least as likely as not that the disability is linked to the TERA.

That bar is lower than VA's general duty to examine. VA's guidance explains the difference: the general rule calls for an exam when VA cannot decide the claim, and section 1168 calls for one whenever VA cannot grant it. Unless an exception applies, VA must get the exam and opinion before it denies a TERA-related condition.

The examiner must consider your total potential exposure across all your deployments and the combined effect of all your toxic exposure risk activities (38 U.S.C. 1168(a)(2)).

TERA exceptions: when VA can skip the exam

Section 1168(b) lets VA skip the exam when it determines there is no indication of an association between your disability and the TERA. VA's June 12, 2024 guidance (VBA Letter 20-24-06), which VA's claims manual still cites, lists six situations:

1. Conditions from physical trauma that are not presumptive: blunt force, repetitive use or penetrating injuries. Penetrating injuries that left toxic embedded fragments do not fall under this exception, and hearing loss is not treated as physical trauma.
2. Mental disorders, meaning any condition in the mental disorders section of the rating schedule (38 CFR 4.130). VA says these should be considered on a direct or secondary basis.
3. Conditions the Secretary has found have no positive association with herbicide exposure, when herbicide is the only TERA. VA still has to look for any other TERA in your record.
4. Conditions that began in service, where no nexus opinion is needed, or whose cause is clearly unrelated to toxic exposure. VA tells staff to err on the side of caution and order the exam when in doubt.
5. The only TERA evidence is an exposure-record entry that does not show an activity with potential exposure, such as a routine health visit.
6. The only TERA evidence is a self-reported exposure-record entry that cannot be substantiated.

VA's manual adds that a circumstance-based exception should not be applied just because an ILER entry notes potential exposure to toxic substances (M21-1 VIII.iii.9.B). If your decision says VA skipped the exam, look for which exception it named and whether it fits your facts.

The TERA memorandum and a conceded TERA

When VA verifies an exposure, claims staff document that exposure and every other TERA on a TERA Memorandum (M21-1 VIII.iii.9.B). A conceded TERA means VA accepts that you took part in the activity. It is not a finding that the exposure caused your condition; the exam and opinion answer that question. If your decision mentions toxic exposure, the memorandum and the exam request are worth reading in your claims file.

What to check in a TERA medical opinion

• the diagnosis the examiner addressed matches the one you claimed
• the exposure history matches what VA conceded, across all your deployments
• the examiner considered the combined effect of all your exposures
• the opinion explains its reasoning instead of only checking a box
• the examiner did not reject the claim only because the condition is not presumptive, since presumptive rules are not meant to limit direct service connection (38 CFR 3.303(d))

The C&P exam guide covers how to read an exam report, and the nexus letter guide covers what a private medical opinion needs.

Gulf War illness presumptions (38 U.S.C. 1117 and 38 CFR 3.317)

A Persian Gulf veteran is anyone who served on active duty in the Southwest Asia theater of operations, Afghanistan, Israel, Egypt, Turkey, Syria or Jordan during the Persian Gulf War (38 U.S.C. 1117(f)). That period began August 2, 1990, and no end date has been set (38 CFR 3.2(i)). The Southwest Asia theater means Iraq, Kuwait, Saudi Arabia, the neutral zone between Iraq and Saudi Arabia, Bahrain, Qatar, the United Arab Emirates, Oman, the Gulf of Aden, the Gulf of Oman, the Persian Gulf, the Arabian Sea, the Red Sea and the airspace above those locations (38 CFR 3.317(e)(2)).

VA pays compensation for a "qualifying chronic disability": an undiagnosed illness, a medically unexplained chronic multisymptom illness such as chronic fatigue syndrome, fibromyalgia or a functional gastrointestinal disorder like irritable bowel syndrome, or a combination. The claim needs:

• objective indications, meaning signs a doctor can observe or other non-medical indicators that can be independently verified
• chronicity: the disability has lasted six months or more, or has come and gone over a six-month period
• for an undiagnosed illness, symptoms that cannot be attributed to any known clinical diagnosis

That last point makes this the one presumption that does not need a diagnosis. A Gulf War undiagnosed-illness claim rests on objective signs of a chronic disability that no known clinical diagnosis explains.

The regulation still prints a deadline: the disability had to reach 10 percent or more by December 31, 2026. The PACT Act removed it: under 38 U.S.C. 1117(a)(1), a qualifying chronic disability may become manifest to any degree at any time. VA's claims manual says that until 3.317 is updated, the statute governs (M21-1 VIII.ii.1.A).

See the condition guides for Gulf War illness, chronic fatigue syndrome, fibromyalgia and irritable bowel syndrome.

Gulf War infectious diseases

A separate presumption in 38 CFR 3.317(c) covers nine infectious diseases. It requires service in the Southwest Asia theater during the Persian Gulf War or in Afghanistan on or after September 19, 2001; the wider list of countries in section 1117 does not apply here. Most of the diseases must reach 10 percent disabling within one year after you leave qualifying service. Malaria can also qualify when medical treatises place the start of its incubation period during service, and visceral leishmaniasis and tuberculosis have no time limit. If VA connects one of these infections, 3.317(d) lists long-term health effects VA must consider with it.

Radiation presumptive conditions

VA presumes service connection for 21 cancers listed in 38 CFR 3.309(d) in a "radiation-exposed veteran," meaning someone who took part in a radiation-risk activity. Those activities include onsite participation in an atmospheric nuclear test, the occupation of Hiroshima or Nagasaki between August 6, 1945, and July 1, 1946, at least 250 days at certain gaseous diffusion plants before February 1, 1992, certain duty on Amchitka Island, Alaska, before January 1, 1974, and three response efforts the PACT Act added:

• cleanup of Enewetak Atoll, January 1, 1977, to December 31, 1980
• the response near Palomares, Spain, January 17, 1966, to March 31, 1967
• the response near Thule Air Force Base, Greenland, January 21, 1968, to September 25, 1968

Other radiation claims go through 38 CFR 3.311, which is not a presumption. VA gets a dose estimate and a review by its Under Secretary for Benefits. That path covers "radiogenic" diseases such as posterior subcapsular cataracts, non-malignant thyroid nodular disease and any other cancer, with timing rules: most must appear five years or more after exposure. Keep your orders and any dosimetry records.

Camp Lejeune presumptive conditions

You have a presumption of exposure if you served at least 30 days, consecutive or not, at Marine Corps Base Camp Lejeune or Marine Corps Air Station New River, North Carolina, between August 1, 1953, and December 31, 1987. Former reservists and National Guard members count. The listed diseases count if they reach 10 percent disabling at any time after service, and the service must be shown by military orders or other official service records (38 CFR 3.307(a)(7)).

Condition guides that apply here include kidney cancer, bladder cancer, leukemia, lymphoma and Parkinson's disease.

What a presumptive claim still needs

A presumption answers one question: the link to service. Your claim still needs evidence for the rest.

You do not need a nexus letter for a condition that meets a presumption. A private medical opinion matters when your condition, your service or your dates fall outside the list.

VA can still rebut a presumption with affirmative evidence, such as evidence that the disease was not incurred in service or came from something after service (38 CFR 3.307(d)). VA's manual also says a listed cancer that spread from a primary cancer not on the Agent Orange list does not qualify (M21-1 VIII.i.1.C).

Two Claim Raven tools fit here. Raven Scan reads your medical records and reports documented conditions, symptoms and treatment history with references to the original pages, which helps you find the exact diagnosis wording and dates a presumption turns on. It is included with the Plus plan. The free Claim Readiness Review reviews one document, such as a VA decision letter or a medical record, up to 5 MB, and explains what it says and what needs a closer look.

If your condition is not on a presumptive list

Missing from a list is not the same as a denial. You have three routes:

1. Direct service connection. 38 CFR 3.303(d) lets VA grant a disease first diagnosed after service when all the evidence shows it began in service. For Agent Orange, VA's page says you need evidence that the problem started during or got worse because of service, or scientific or medical evidence, such as a journal article or published study, that Agent Orange causes the condition.
2. A TERA exam. If the record shows you took part in a toxic exposure risk activity and the evidence is not enough to grant, VA must get an exam and opinion unless an exception applies (see the TERA section above).
3. Secondary service connection. A disability caused by a condition VA already service connected is service connected too (38 CFR 3.310).

Build the exposure facts VA can check: dates, places, unit, duties, what you were exposed to, how often and for how long, and statements from people who served with you. The buddy letter guide and the Personal Statement Builder help with the statements, and Raven Research finds VA rules, medical studies and Board decisions to put in front of a doctor.

How to file a presumptive VA claim

1. Protect your date with an intent to file. It sets a potential start date for your benefits, and you then have one year to file the claim. Submit it online, by calling 800-827-1000 (TTY 711), Monday through Friday, 8:00 a.m. to 9:00 p.m. Eastern Time, or on VA Form 21-0966. Starting the online disability claim or Supplemental Claim while signed in with a verified account also notifies VA of your intent to file. The Intent to File tracker keeps the one-year date in view.
2. File a new claim on VA Form 21-526EZ if you have never claimed the condition. You can file online, by mail, in person, or with an accredited representative. Find a VSO if you want help.
3. File a Supplemental Claim if VA denied the condition before it became presumptive. Use VA Form 20-0995, online for disability claims. A Supplemental Claim based on a change in law, such as the PACT Act, does not need new and relevant evidence, but you need to submit or identify medical evidence of the diagnosis and its severity. VA says it will try to contact veterans it thinks may now be eligible, but you do not need to wait.
4. Do nothing extra if your claim is pending. VA says that if it added your condition after you filed, it will still consider it presumptive.

Effective dates for a newly presumptive condition

VA treats every PACT Act presumption as applying from August 10, 2022, the day the law was signed, so that is the earliest effective date for a PACT Act presumption in a veteran's claim (VBA Letter 20-24-06). After that, the change-of-law rule in 38 CFR 3.114(a) applies:

• If VA received your claim within one year of the date the law took effect, benefits can start on that date.
• If VA received it more than one year later, benefits can go back one year before the date VA received your claim.
• Either way, you must have met every requirement on the law's effective date and continuously after.

Two Agent Orange rules can reach further back: the Nehmer court orders for Vietnam veterans (38 CFR 3.816) and the Blue Water Navy rule in 38 U.S.C. 1116A(c). VA's manual says 3.114(a) applies unless one of those gives an earlier date (M21-1 VIII.i.1.C).

Fictional example: a veteran served on Johnston Atoll in 1974, was diagnosed with MGUS in 2021, and files a claim for it on January 8, 2026. MGUS became presumptive on August 10, 2022, and the claim arrived more than a year later, so the earliest effective date under 3.114(a)(3) is January 8, 2025, one year before the claim. Nehmer does not apply, because the service was not in Vietnam. A claim filed within one year of August 10, 2022, could have started on August 10, 2022.

Questions about Agent Orange, PACT Act and TERA claims

What are the PACT Act presumptive conditions?

For Gulf War era and post-9/11 veterans, the PACT Act list covers cancers of the head, neck, respiratory system, gastrointestinal system and reproductive organs of any type, lymphoma of any type, kidney, brain and pancreatic cancer, melanoma and glioblastoma, plus asthma diagnosed after service and eleven other respiratory illnesses: chronic bronchitis, COPD, constrictive or obliterative bronchiolitis, emphysema, granulomatous disease, interstitial lung disease, pleuritis, pulmonary fibrosis, sarcoidosis, chronic sinusitis and chronic rhinitis. VA regulations add rare respiratory cancers, bladder and ureter cancers, leukemias, multiple myelomas, myelodysplastic syndromes and myelofibrosis. For Vietnam era veterans, the PACT Act added hypertension and MGUS to the Agent Orange list.

What are the Agent Orange presumptive conditions?

VA lists 19 conditions: eight cancer groups (including prostate, bladder and respiratory cancers) and eleven other illnesses (including type 2 diabetes, ischemic heart disease, hypertension, hypothyroidism and Parkinson's disease). The full list is in the Agent Orange section above.

Do you need a nexus letter for a presumptive condition?

No. If the condition is on the list and your service meets the rule, you do not have to prove what caused it. You still need the diagnosis, proof of the service and evidence of severity.

Is high blood pressure presumptive for Agent Orange?

Yes. The PACT Act made hypertension an Agent Orange presumptive condition on August 10, 2022. It is separate from ischemic heart disease, which by regulation does not include hypertension.

Is skin cancer or colon cancer presumptive for Agent Orange?

No. VA has found no positive association between herbicide exposure and skin cancers, including melanoma, basal cell and squamous cell carcinoma, or colorectal cancer. You can still claim them on a direct basis with medical evidence, and they can be presumptive under the PACT Act burn pit rules if you have qualifying Gulf War era or post-9/11 service.

What Thailand service qualifies for Agent Orange exposure under the PACT Act?

Service at any U.S. or Royal Thai military base in Thailand from January 9, 1962, through June 30, 1976, no matter where on the base you were or what your job was.

Is a TERA the same as a presumptive condition?

No. A presumption connects a listed condition without a medical opinion. A TERA is an exposure VA accepts, and it can require VA to get an exam and a medical opinion on whether your condition is linked to it. There is no separate TERA list of presumptive conditions.

What if VA denied my condition before it became presumptive?

File a Supplemental Claim (VA Form 20-0995) based on the change in law. You do not need new and relevant evidence, but you need medical evidence of the diagnosis and severity. VA reviews old bladder cancer, hypothyroidism and parkinsonism denials automatically.

Does a toxic exposure screening count as a claim?

No. The screening is part of VA health care. VA's guidance says the report goes into your treatment records and does not count as a claim, so you still need to file one.

Sources

Checked October 6, 2026.

• VA, The PACT Act and your VA benefits (opens in a new tab) (last updated June 2, 2026): burn pit conditions and locations, Agent Orange and radiation additions, toxic exposure screening, pending and denied claims
• VA, Agent Orange exposure and disability compensation (opens in a new tab) (last updated September 16, 2025): conditions, service requirements, evidence, automatic review, Blue Water Navy
• VA, Presumptive cancers related to burn pit exposure (opens in a new tab) (last updated April 8, 2025): examples of cancers VA counts
• VA, Supplemental Claims (opens in a new tab) (last updated October 5, 2026): claims based on a change in law, VA Form 20-0995
• VA, Your intent to file a VA claim (opens in a new tab) (last updated September 22, 2026)
• VBA Letter 20-24-06, Updated Guidance on Processing Claims Involving the PACT Act (opens in a new tab), June 12, 2024 (copy hosted by the Tennessee Department of Veterans Services): TERA exam threshold and exceptions, covered waters, effective dates, screening
• M21-1, VIII.i.1.A, VIII.i.1.B and VIII.i.1.C (herbicide exposure), VIII.ii.1.A (Gulf War), VIII.iii.9.A and VIII.iii.9.B (environmental and occupational hazards and TERA)
• 38 U.S.C. 1116, 1116A, 1116B, 1117, 1119, 1120, 1168 and 1710(e)(4) (Legal Information Institute)
• 38 CFR 3.2, 3.114, 3.303, 3.307, 3.309, 3.310, 3.311, 3.317, 3.320, 3.320a, 3.320b, 3.816 and 4.130 (eCFR, October 1, 2026)
• Federal Register, VA Adjudication Regulations for Disability or Death Benefit Claims Based on Toxic Exposure, proposed rule, October 1, 2024 (document 2024-21852)

Claim Raven is not a law firm, a VSO or an accredited representative, and this guide is not legal advice. For help with your claim, talk to an accredited representative.

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