The PACT Act (Promise to Address Comprehensive Toxics Act of 2022) is one of the most significant expansions of VA disability benefits in history. It builds on the existing framework of presumptive conditions—disabilities that the VA automatically assumes are service-connected if a veteran served in certain locations, timeframes, or situations.

For veterans exposed to burn pits, Agent Orange, radiation, contaminated water, or other toxic environments, the PACT Act makes it easier than ever to win VA disability claims. At National Security Law Firm (NSLF), we help veterans understand these rules, file correctly, and maximize their benefits.

What Are Presumptive Conditions?

Presumptive conditions are medical conditions the VA automatically links to service based on established risk factors. Normally, a veteran must prove:

  1. A current diagnosis

  2. An in-service event, injury, or exposure

  3. A medical nexus linking the two

With presumptives, the VA waives the nexus requirement. If you qualify under the rules, the VA presumes your condition is service-connected.

How Presumptive Conditions Work

  • The VA publishes specific criteria for eligibility (timeframes, duty stations, exposures).

  • If you meet those criteria and have a recognized condition, the VA must assume it’s service-connected.

  • This makes filing faster and easier—but only if you know which conditions apply.

Categories of Presumptive Conditions

The VA recognizes presumptive conditions across several categories. The PACT Act expanded many of these lists:

Agent Orange and Other Herbicides

For veterans who served in Vietnam, the Korean DMZ, or expanded locations (Laos, Cambodia, Guam, Johnston Atoll).

  • Type 2 diabetes

  • Ischemic heart disease

  • Hodgkin’s and non-Hodgkin’s lymphoma

  • Prostate cancer

  • Parkinson’s disease

  • Respiratory cancers

  • Chronic B-cell leukemias

  • Hypertension (added under PACT Act)

  • MGUS (monoclonal gammopathy of undetermined significance – added under PACT Act)

Radiation Exposure

Applies to veterans involved in nuclear testing, cleanup, or certain occupational exposures.

  • All leukemias (except CLL)

  • Cancers of the thyroid, stomach, colon, lung, brain, ovary, and more

  • Multiple myeloma

  • Lymphomas

Gulf War Service (Undiagnosed & Chronic Multi-Symptom Illnesses)

For veterans of the Persian Gulf War and later operations in Southwest Asia.

  • Chronic fatigue syndrome

  • Fibromyalgia

  • Functional gastrointestinal disorders

Burn Pit & Toxic Exposures (PACT Act Expansion)

For veterans who served in Iraq, Afghanistan, Djibouti, Syria, Uzbekistan, and other post-9/11 locations.

  • Asthma, rhinitis, sinusitis

  • COPD

  • Various respiratory cancers (larynx, lung, trachea, etc.)

  • Brain cancer

  • Kidney cancer

  • Pancreatic cancer

  • Reproductive cancers

  • Gastrointestinal cancers

Prisoner of War (POW) Presumptives

  • Psychosis

  • Any anxiety state

  • Osteoporosis (if PTSD present)

  • Post-traumatic osteoarthritis

  • Stroke/heart disease

Infectious Diseases

  • Malaria

  • Brucellosis

  • Tuberculosis

  • Q fever

  • West Nile virus

Environmental Hazards

  • Camp Lejeune water contamination: bladder, kidney, liver cancer, Parkinson’s, adult leukemia, and more

  • Asbestos exposure: mesothelioma, asbestosis, lung cancer

  • Mustard gas or lewisite: COPD, chronic bronchitis, skin conditions

How to File a Claim for Presumptive Conditions

  1. Gather medical evidence – You still need a current diagnosis even for presumptives.

  2. Confirm eligibility – Verify your service location/timeframe matches VA criteria.

  3. Submit VA Form 21-526EZ – The standard disability application.

  4. Provide service records if requested – To show where and when you served.

  5. VA review – The VA cross-checks your service with presumptive eligibility lists.

Common Mistakes

  • Waiting too long to file → Every month of delay means lost back pay.

  • Forgetting secondary conditions → e.g., cancer causing depression or fatigue, which can also be rated.

  • Thinking VA will maximize for you → The VA rarely considers all your conditions without legal guidance.

Why NSLF

At NSLF, our mission is to maximize your benefits in the shortest possible time.

  • Veteran-Founded: Brett O’Brien, Army veteran and cancer survivor, started NSLF after the VA denied his own claim.

  • Built by Disabled Veterans: Most of our attorneys and paralegals are disabled veterans who have filed their own claims.

  • 4.9-Star Reviews: Veterans across the country trust us (see reviews here).

How Much Does It Cost?

You pay nothing unless we win.

  • Initial appeals (HLR, Supplemental, NOD): Contingency—20% of back pay only.

  • CAVC or advanced appeals: Percentage of past-due benefits awarded.

👉 Importantly: attorneys only receive 20% of past-due back pay. They do not receive any portion of your future monthly benefits. You keep 100% of those payments for life.

See details on our VA Disability Pricing page.

Should You Hire a Lawyer?

The PACT Act and presumptive conditions make filing easier—but “easy” doesn’t mean maximum benefits.

  • The VA may underrate your condition.

  • They may ignore secondary disabilities.

  • They won’t automatically explore unemployability (TDIU) or higher ratings.

Example:

  • Veteran files PACT Act claim for COPD. VA rates them at 30% = $524/month.

  • With legal help, they also file for secondary depression, sleep apnea, and TDIU.

  • Result: 100% = $3,737/month.

That’s over $3,200 more per month, tax-free—for life. In 10 years, that’s nearly $400,000 extra.

And again: your attorney only receives 20% of the back pay—not a cent of your future monthly payments.

Check out our full guide: Do You Need a Lawyer for Your VA Disability Claim?.

Additional Resources

Learn more strategies in our VA Disability Education & Legal Strategy Center—a hub designed to answer every question about VA disability appeals. Whether you go it alone, with a VSO, or with us, it’s the most complete veteran resource available.

Final Thoughts – Don’t Wait

The PACT Act has changed the game for thousands of veterans. If you served in a qualifying location and have a presumptive condition, you may already be entitled to life-changing tax-free benefits. But you only get back pay from the day you file—so waiting costs you money every single month.

At National Security Law Firm, we make the process simple, clear, and successful. We’ve lived this fight ourselves, and we’ll fight for you nationwide.

If you believe your condition qualifies under the PACT Act or other presumptive rules, reach out today.

National Security Law Firm: It’s Our Turn to Fight for You.