PACT Act & VA presumptive conditions list
A presumptive condition is one the VA automatically links to your service based on where and when you served — so you do not have to separately prove the medical nexus. Below are the presumptive conditions by exposure, with the governing regulation for each (83+ conditions across 6 exposure categories). A presumption still requires qualifying service; the VA makes the final decision.
PACT Act — burn pits & airborne hazards
38 CFR §3.320 / PACT Act of 2022
- Asthma (diagnosed after service)
- Chronic rhinitis
- Chronic sinusitis
- Chronic bronchitis
- Chronic obstructive pulmonary disease (COPD)
- Constrictive bronchiolitis
- Emphysema
- Interstitial lung disease
- Granulomatous disease
- Pleuritis
- Pulmonary fibrosis
- Sarcoidosis
- Brain cancer
- Glioblastoma
- Head cancer of any type
- Neck cancer of any type
- Respiratory (lung) cancer
- Gastrointestinal cancer of any type
- Reproductive cancer of any type
- Lymphoma of any type
- Lymphatic cancer of any type
- Kidney cancer
- Melanoma
- Pancreatic cancer
- Squamous cell carcinoma of the larynx
Agent Orange — herbicide exposure
38 CFR §3.309(e)
- Type 2 diabetes mellitus
- Ischemic heart disease
- Parkinson's disease
- Parkinsonism
- Prostate cancer
- Bladder cancer
- Respiratory cancers (lung, larynx, trachea, bronchus)
- Hodgkin's disease
- Non-Hodgkin's lymphoma
- Multiple myeloma
- AL amyloidosis
- Chronic B-cell leukemias
- Soft-tissue sarcoma
- Hypothyroidism
- Peripheral neuropathy (early-onset — must appear within 1 year of exposure)
- Chloracne
- Porphyria cutanea tarda (PCT)
- Chronic lymphocytic leukemia (CLL)
- Hairy cell leukemia and other chronic B-cell leukemias
- Acute and subacute peripheral neuropathy
Agent Orange — PACT Act additions
PACT Act of 2022 (Agent Orange presumptives)
- High blood pressure (hypertension)
- Monoclonal gammopathy of undetermined significance (MGUS)
Gulf War — undiagnosed & chronic multisymptom illness
38 CFR §3.317
- Chronic fatigue syndrome
- Fibromyalgia
- Functional gastrointestinal disorders (e.g. irritable bowel syndrome)
- Undiagnosed illness with chronic multisymptom presentation
- Chronic headaches
- Chronic joint and muscle pain
- Brucellosis
- Campylobacter jejuni infection
- Coxiella burnetii (Q fever)
- Malaria
- Nontyphoid Salmonella infection
- Shigella infection
- Visceral leishmaniasis
- West Nile virus infection
- Mycobacterium tuberculosis infection
Camp Lejeune — contaminated drinking water
38 CFR §3.309(f) — Camp Lejeune water (Aug 1953–Dec 1987)
Requires 30+ cumulative days of service at Camp Lejeune between Aug 1953 and Dec 1987.
- Adult leukemia
- Aplastic anemia and other myelodysplastic syndromes
- Bladder cancer
- Kidney cancer
- Liver cancer
- Multiple myeloma
- Non-Hodgkin's lymphoma
- Parkinson's disease
Radiation — radiation-exposed veterans
38 CFR §3.309(d) — radiation-exposed veterans
Requires participation in a recognized radiation-risk activity (e.g. atmospheric nuclear testing 1945–1962, or the Hiroshima/Nagasaki occupation Aug 1945–Jul 1946).
- Leukemia (except chronic lymphocytic leukemia)
- Thyroid cancer
- Breast cancer
- Cancer of the pharynx
- Esophageal cancer
- Stomach cancer
- Cancer of the small intestine
- Pancreatic cancer
- Multiple myeloma
- Lymphomas (except Hodgkin's disease)
- Primary liver cancer
- Bone cancer
- Brain cancer
- Colon cancer
- Lung cancer
- Ovarian cancer
- Bronchiolo-alveolar carcinoma
- Cancer of the bile ducts
- Cancer of the gall bladder
- Cancer of the salivary gland
- Cancer of the urinary tract (kidney, renal pelvis, bladder, urethra)
Check if your condition is presumptive for your service
Use the free presumptive checker to see which presumptions may apply based on where and when you served — no signup.
Open the free PACT Act presumptive checker →Informational only and not a guarantee of any rating or outcome. This list is a regulation-cited summary and is not exhaustive; a presumption still requires qualifying service and a current diagnosis, and the VA makes the final decision. This is not medical or legal advice.