
TERA / Toxic Exposure / PACT Act
The largest expansion of VA benefits in decades — and the door is open now for burn pit, Agent Orange, Camp Lejeune, and radiation exposure claims
The PACT Act Changed Everything
The PACT Act (Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act), signed into law on August 10, 2022, is the most significant expansion of VA toxic exposure benefits since Agent Orange legislation. It established new presumptive conditions for burn pit exposure, expanded Agent Orange presumptives, created the Toxic Exposure Risk Activity (TERA) framework, and extended eligibility for Gulf War and post-9/11 veterans.
For veterans who were previously denied toxic exposure claims, the PACT Act reopens the door. Conditions that required a difficult-to-obtain nexus letter are now presumptive — meaning the VA presumes they were caused by service if you served in a qualifying location. No nexus letter needed.
If you were denied before the PACT Act for a condition that is now presumptive, file a Supplemental Claim immediately. The new law is the "new and relevant evidence" that reopens your claim.
Burn Pit / Airborne Hazards Presumptives
Post-9/11 veterans who served in Southwest Asia, Afghanistan, or other covered locations after August 2, 1990:
Agent Orange / Herbicide Presumptives
Vietnam-era, Korea DMZ, Thailand, and other covered locations (see FAQ for full location list):
Agent Orange presumptives are among the most powerful in the VA system. A single grant of Type 2 diabetes can unlock an entire secondary condition chain: peripheral neuropathy, retinopathy, kidney disease, erectile dysfunction, and hypertension.
All Exposure Categories
Burn Pit / Airborne Hazards
PACT Act §3.320Iraq, Afghanistan, Southwest Asia (post-9/11, after August 2, 1990)
Conditions: Constrictive bronchiolitis, Constrictive pericarditis, Any cancer diagnosed after August 2, 1990, Sinusitis, rhinitis, laryngitis, rhinosinusitis, Gastric reflux (GERD), Sleep apnea, Reproductive and urinary conditions
Agent Orange / Herbicides
38 CFR §3.309(e)Vietnam, Thailand, Korea DMZ, C-123 aircraft
Conditions: Type 2 Diabetes, Ischemic heart disease, Parkinson’s disease, Non-Hodgkin’s lymphoma, Prostate cancer, Respiratory cancers, Chloracne, AL amyloidosis, Peripheral neuropathy (early-onset), Bladder cancer (added under PACT), Hypothyroidism (added under PACT)
Camp Lejeune Water
Camp Lejeune Justice ActCamp Lejeune, NC (1953-1987)
Conditions: Kidney cancer, liver cancer, leukemia, multiple myeloma, bladder cancer, Parkinson’s
Gulf War Illness
38 CFR §3.317Southwest Asia (1990-present)
Conditions: Chronic fatigue syndrome, fibromyalgia, functional gastrointestinal disorders (IBS), undiagnosed illnesses with objective indications
Radiation Exposure
38 CFR §3.309(d), §3.311Nuclear test sites, Hiroshima/Nagasaki cleanup, uranium processing
Conditions: Multiple cancers, leukemia, thyroid disease
Case Snapshot — Sinusitis (Burn Pit)
Denied → 30% via PACT Act / TERA
The veteran was previously denied for chronic sinusitis due to the lack of a medical nexus connecting the condition to military service. The veteran served in a covered burn pit location in Southwest Asia.
After the PACT Act (Public Law 117-168) made sinusitis a presumptive condition under the toxic exposure framework, we filed under TERA with the verified deployment record. No nexus letter was needed — the law now presumes the connection.
Result: service connection granted at 30%. (Anonymized; individual results depend on the specific file and evidence.)
Accuracy Safeguard
PACT Act presumptives depend on verified deployment locations, dates of service, and specific diagnoses. A veteran who served in a covered location but does not have a covered diagnosis, or vice versa, may not qualify under the presumptive pathway. An accredited records review is the only way to determine which pathway applies to your specific file.
Time-Sensitive: PACT Act Filing Windows
Some PACT Act provisions have filing deadlines that affect your effective date. Veterans who file within one year of a condition being added to the presumptive list may receive an effective date back to the date the provision took effect. Filing after that window means the effective date is the date of the new claim.
Earlier filing = more back pay. If you suspect you qualify, file an Intent to File (VA Form 21-0966) today to lock in your date while you gather documentation.
Related Services
A PACT Act grant can unlock entire secondary chains — Type 2 diabetes alone can yield 5+ additional claims
Previously denied for a now-presumptive condition? File a Supplemental Claim with the PACT Act as new evidence
PACT Act filing windows affect your effective date — earlier filing = more back pay
The Advocate's Take
The PACT Act is the biggest opportunity for toxic-exposed veterans in a generation. Conditions that were routinely denied for decades are now presumptive. But the VA is not going to call you and tell you to file — you have to act.
If you served in a burn pit zone, Vietnam, Thailand, Camp Lejeune, or any other toxic exposure location, and you have a condition on the presumptive list, file now. If you were previously denied, file a Supplemental Claim with the PACT Act as your new evidence. And do not stop at the presumptive condition — look at the secondary condition chains that flow from it. The door is open. Walk through it.
Frequently Asked Questions
What is the PACT Act?
What does "presumptive" mean?
Do I need a nexus letter for a PACT Act claim?
I was previously denied for a condition that is now presumptive. What do I do?
What is the TERA framework?
What are the Agent Orange service locations?
Can PACT Act conditions lead to secondary claims?
Toxic Exposure Map — Find Your Exposure Category
Select your exposure type to see qualifying service locations, conditions, and the governing regulation. If you served in one of these areas, you may have presumptive eligibility.
Toxic Exposure: What the VA Now Presumes
If you served in these places and times, the VA presumes exposure — you don’t have to prove it happened, only that you were there.
Burn Pits & Airborne Hazards
Gulf War & Post-9/11 (on or after Aug 2, 1990 / Sep 11, 2001)
Asthma, rhinitis, sinusitis, many cancers, COPD
Agent Orange (Herbicides)
Vietnam (1962–1975), Thailand, Korean DMZ + Blue Water Navy
Diabetes II, ischemic heart disease, Parkinson’s, prostate cancer
Camp Lejeune Water
Aug 1953 – Dec 1987 (30+ cumulative days)
Kidney/liver cancer, Parkinson’s, bladder cancer, leukemia
Radiation & Gulf War Illness
Atomic veterans; Gulf War undiagnosed illnesses
Certain cancers, chronic fatigue, fibromyalgia, GI issues
Presumption is powerful — but not automatic. You still must file, get a current diagnosis, and be rated. We build the exposure record the VA expects to see.
Real Veterans. Real Claims. Real Outcomes.
Every case on this desk belongs to someone who served. These are the veterans this practice represents — across every era, branch, and condition.
Veteran Representation
Veteran Representation
Veteran RepresentationKnow What the C&P Exam Should Look Like
Even presumptive claims may require a C&P exam to confirm the diagnosis and assign a rating percentage.
Your VA Claim Exam: What to Expect
Tips to Prepare for Your VA Claim Exam
Three Ways to Put an Accredited Agent on TERA / Toxic Exposure / PACT Act
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