The Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act of 2022 was signed into law on August 10, 2022. Two years in, many eligible veterans still haven’t filed — either because they don’t know about it, were previously denied, or don’t understand how the presumptive system works. Here’s the full picture for 2026.
Who Is Covered
The PACT Act covers veterans who served in: Southwest Asia (Iraq, Afghanistan, Syria, Djibouti, and other locations) after August 2, 1990; Vietnam and surrounding areas with Agent Orange exposure; areas with radiation exposure from nuclear testing or Hiroshima/Nagasaki occupation; and Camp Lejeune during the contaminated water period (1953–1987).
New Presumptive Conditions Added
The PACT Act added a significant list of cancers as presumptive for veterans with burn pit or toxic exposure: head cancer, neck cancer, respiratory cancer (including laryngeal and bronchial), reproductive cancers, melanoma, squamous cell carcinoma, any malignant tumor of the reproductive system, and several others. The VA continues adding conditions as research develops — the list is not static.
Non-cancer conditions added include: constrictive bronchiolitis obliterans, constrictive pericarditis, and several respiratory conditions associated with airborne hazards. Chronic rhinitis, sinusitis, and laryngitis are also recognized for post-9/11 veterans with documented burn pit exposure.
Healthcare Expansion
Separate from disability compensation, the PACT Act extended VA healthcare eligibility to all post-9/11 combat veterans — regardless of disability rating — for a 10-year window after separation. Veterans who served in combat after September 11, 2001 who haven’t enrolled in VA healthcare should enroll immediately, as this is a time-limited benefit.
How to File Under the PACT Act
File VA Form 21-526EZ online at va.gov or through a VSO. In the remarks section, note your toxic exposure location and dates. The VA will conduct a military exposure review as part of the claims process. If you were previously denied for a condition that is now presumptive under the PACT Act, file a Supplemental Claim — the new presumptive status constitutes new and relevant evidence.
If You Were Previously Denied
This is critical: the PACT Act created new presumptives retroactively. If you were denied before August 2022 for a condition that is now presumptive, you can file a Supplemental Claim. Your effective date — and therefore your back pay — goes back to your original filing date if the Supplemental Claim is approved. For veterans who filed years ago and were denied, this could mean substantial retroactive compensation.
Do I need a nexus letter for PACT Act presumptive conditions?
No. That’s the entire point of a presumptive — the VA accepts the service connection without requiring you to prove causation. You need a current diagnosis of the condition and documentation of qualifying service in an exposure area.
Is there a deadline to file a PACT Act claim?
There is no deadline for VA disability or healthcare claims. However, your effective date is based on when you file — earlier filing means more potential back pay if approved. Don’t wait.
How do I prove burn pit exposure?
Service records showing deployment to covered locations are generally sufficient. The VA maintains a burn pit registry and also uses deployment records, unit records, and military occupational specialty documentation to establish exposure. You can self-certify exposure in many cases.