VA Disability for Burn Pit Exposure: PACT Act Presumptive Conditions (2026)

Burn Pits and Airborne Hazards

For more than two decades, U.S. military operations in the Middle East and Southwest Asia relied on open-air burn pits to dispose of waste - everything from plastics and rubber to electronics, medical waste, fuels, and human waste. The largest pits ran 24 hours a day and produced thick clouds of acrid smoke that drifted across living quarters, dining facilities, and motor pools. Service members breathed it for months and years on rotation after rotation.

The health consequences were not just respiratory irritation. Over time, peer-reviewed literature documented elevated rates of cancers, chronic respiratory disease, and a constellation of unexplained illnesses among veterans of these deployments. The 2022 PACT Act was Congress's response - a comprehensive expansion of presumptive service connection that finally aligned VA benefits with what the medical evidence had been suggesting.

The PACT Act in Plain English

The Sergeant First Class Heath Robinson Honoring Our Promise to Address Comprehensive Toxics (PACT) Act was signed into law on August 10, 2022. It is the largest expansion of veterans' health care and disability benefits in decades. The Act has three primary effects relevant to burn pit and airborne hazards exposure:

1. Expanded presumptive conditions - more than 20 conditions are now presumed service-connected for veterans who served in qualifying locations
2. Expanded qualifying locations and time periods - dozens of countries are now covered, with broadened service eras
3. Mandatory VA toxic exposure screening - all enrolled veterans receive a toxic exposure screen at least every five years

The PACT Act also expanded Agent Orange presumptive conditions and adjusted certain radiation exposure standards, but the burn pit and airborne hazards expansion is the centerpiece for post-9/11 and Gulf War veterans.

Qualifying Locations and Service Eras

Two service-era windows govern most burn pit and airborne hazards presumptive claims:

Persian Gulf War Era (on or after August 2, 1990)

Service in:

• Bahrain
• Iraq
• Kuwait
• Oman
• Qatar
• Saudi Arabia
• Somalia
• The United Arab Emirates
• The waters of the Persian Gulf, the Arabian Sea, the Red Sea, the Gulf of Aden, the Gulf of Oman
• The airspace above any of the above

Post-9/11 Era (on or after September 11, 2001)

Service in:

• Afghanistan
• Djibouti
• Egypt
• Jordan
• Lebanon
• Syria
• Uzbekistan
• Yemen
• Any of the Persian Gulf War-era locations above

Service can be active duty, active duty for training, or inactive duty training. The presumption applies if the veteran served in any of these locations during the qualifying period - it does not require proof of specific burn pit exposure.

Presumptive Cancers

For each of these cancers, a veteran who served in a qualifying location during a qualifying period and is later diagnosed with the cancer is presumed to have a service-connected condition - no further proof of exposure or causation is needed.

Presumptive Respiratory Conditions

Many of these conditions present subtly - chronic cough, sinus pressure, exercise intolerance - and veterans may live with them for years before realizing they are PACT Act presumptive. Pulmonary function testing, CT imaging, and ENT evaluation can establish the diagnosis. Once diagnosed, the presumption applies if the qualifying service criteria are met.

The Airborne Hazards and Open Burn Pit Registry

The VA maintains the Airborne Hazards and Open Burn Pit Registry - an online questionnaire and optional health evaluation for eligible veterans. Enrolling in the Registry has practical benefits:

• It documents the veteran's self-reported exposure history in a format the VA can later use
• It triggers an offer of a free in-person VA Airborne Hazards and Open Burn Pit Registry health evaluation
• It positions the veteran in VA's surveillance database in case of future presumptive expansions

Registry enrollment is not a substitute for a disability claim - it is a separate, complementary action. Veterans planning to file PACT Act claims should generally enroll in the Registry early and reference the registry questionnaire and evaluation in their claims documentation.

Non-Presumptive Burn Pit Claims

Not every condition that veterans plausibly relate to burn pit exposure is on the presumptive list. Common non-presumptive conditions where direct service connection may still be available include:

• Sleep apnea (in some cases tied to chronic upper-airway inflammation)
• Reactive airway disease that does not meet the asthma criteria
• Gastroesophageal reflux with chronic cough
• Cardiovascular disease with potential exposure-related contribution
• Neurological conditions not on the list

For non-presumptive conditions, veterans must establish direct service connection under 38 CFR 3.303 - current diagnosis, in-service exposure, and a medical link. A nexus letter for these claims should:

• Document the specific qualifying service and exposure history (locations, durations, proximity to burn pits)
• Reference the medical literature on burn pit emissions and the relevant condition
• Address why the condition is at least as likely as not connected to the exposure
• Anchor the opinion in the veteran's specific records and clinical timeline

Filing the Claim

PACT Act claims are filed on VA Form 21-526EZ like any other disability claim. To support the claim:

• Provide documentation of qualifying service (DD-214, deployment orders, evaluations, awards)
• Submit the current diagnosis with treating physician records
• For presumptive claims, no nexus letter is required - simply identify the condition as PACT Act presumptive
• For non-presumptive claims, attach a nexus letter with exposure history and medical rationale
• Reference your Airborne Hazards and Open Burn Pit Registry enrollment if applicable

The VA has actively encouraged veterans to file PACT Act claims, including those who were previously denied a related claim before the law was enacted. Previously denied veterans can refile and have the claim adjudicated under the new framework.

VA Toxic Exposure Screening

The PACT Act requires the VA to provide all enrolled veterans with a toxic exposure screening at least every five years. The screen consists of structured questions about deployments, exposures (burn pits, Agent Orange, radiation, contaminated water, others), and current symptoms. A positive screen triggers follow-up clinical evaluation and connects the veteran to relevant VA care.

For claims purposes, the screening creates a documented exposure history in the VA medical record - useful for both presumptive and non-presumptive claims. Veterans who have not yet been screened should request the screening at their next VA primary care appointment.