The Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 is the statute that expanded Department of Veterans Affairs health care and disability compensation for specified toxic exposures. Congress enacted it as Public Law 117-168 on August 10, 2022. The short titles in the Act are:
“This Act may be cited as the ‘Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022' or the ‘Honoring our PACT Act of 2022'.”
Pub. L. 117-168, § 1(a), 136 Stat. 1759 (Aug. 10, 2022).
This page states what the Act and the implementing Code and regulations actually provide. It is not a promise of a grant, a rating, or a particular effective date. Eligibility depends on the veteran's service, diagnosis, and the record. Presumptions are rebuttable. 38 U.S.C. § 1113(a).
The Jacks Law Group represents veterans in VA claims and appeals and related VA benefits.
What a PACT Act presumption does
For a “covered veteran,” 38 U.S.C. § 1120(a) provides:
“For the purposes of section 1110 of this title, and subject to section 1113 of this title, a disease specified in subsection (b) becoming manifest in a covered veteran shall be considered to have been incurred in or aggravated during active military, naval, air, or space service, notwithstanding that there is no record of evidence of such disease during the period of such service.”
38 U.S.C. § 1120(a) (text in effect on August 15, 2026).
“Covered veteran” for § 1120 is the same term defined in 38 U.S.C. § 1119(c). 38 U.S.C. § 1120(c).
Section 1119 also creates a presumption of exposure for those covered veterans:
“The Secretary shall, for purposes of section 1110 and chapter 17 of this title, presume that any covered veteran was exposed to the substances, chemicals, and airborne hazards identified in the list under paragraph (2) during the service of the covered veteran specified in subsection (c)(1), unless there is affirmative evidence to establish that the covered veteran was not exposed to any such substances, chemicals, or hazards in connection with such service.”
38 U.S.C. § 1119(b)(1) (text in effect on August 15, 2026).
If the veteran has a listed disease and is a covered veteran, the veteran does not have to prove that the listed disease was incurred in service. The veteran still must have the diagnosis and the qualifying service. The Secretary may still deny the presumption if the statutory rebuttal rule in 38 U.S.C. § 1113(a) is met:
“Where there is affirmative evidence to the contrary, or evidence to establish that an intercurrent injury or disease which is a recognized cause of any of the diseases or disabilities within the purview of section 1112, 1116, 1117, 1118, or 1120 of this title, has been suffered between the date of separation from service and the onset of any such diseases or disabilities, or the disability is due to the veteran's own willful misconduct, service-connection pursuant to section 1112, 1116, 1118, or 1120 of this title, or payments of compensation pursuant to section 1117 of this title, will not be in order.”
38 U.S.C. § 1113(a) (text in effect on August 15, 2026).
A disease that is not on a presumptive list can still be service-connected if it is otherwise shown to have been incurred in or aggravated by service. 38 U.S.C. § 1113(b).
Who is a “covered veteran” for burn-pit and airborne-hazard presumptions
38 U.S.C. § 1119(c)(1) defines “covered veteran” as any veteran who:
“(A) on or after August 2, 1990, performed active military, naval, air, or space service while assigned to a duty station in, including airspace above—
(i) Bahrain;
(ii) Iraq;
(iii) Kuwait;
(iv) Oman;
(v) Qatar;
(vi) Saudi Arabia;
(vii) Somalia; or
(viii) United Arab Emirates; or
(B) on or after September 11, 2001, performed active military, naval, air, or space service while assigned to a duty station in, including airspace above—
(i) Afghanistan;
(ii) Djibouti;
(iii) Egypt;
(iv) Jordan;
(v) Lebanon;
(vi) Syria;
(vii) Yemen;
(viii) Uzbekistan; or
(ix) any other country determined relevant by the Secretary.”
38 U.S.C. § 1119(c)(1) (text in effect on August 15, 2026).
The Secretary's public materials current as of June 2, 2026, state that no additional country has been determined relevant under § 1119(c)(1)(B)(ix) at this time. Department of Veterans Affairs, *The PACT Act and your VA benefits*, https://www.va.gov/resources/the-pact-act-and-your-va-benefits/ (last updated June 2, 2026).
Diseases the statute itself lists (38 U.S.C. § 1120(b))
These are the diseases specified in 38 U.S.C. § 1120(b), quoted in full:
“(1) Asthma that was diagnosed after service of the covered veteran as specified in subsection (c).
(2) The following types of cancer:
(A) Head cancer of any type.
(B) Neck cancer of any type.
(C) Respiratory cancer of any type.
(D) Gastrointestinal cancer of any type.
(E) Reproductive cancer of any type.
(F) Lymphoma cancer of any type.
(G) Kidney cancer.
(H) Brain cancer.
(I) Melanoma.
(J) Pancreatic cancer.
(3) Chronic bronchitis.
(4) Chronic obstructive pulmonary disease.
(5) Constrictive bronchiolitis or obliterative bronchiolitis.
(6) Emphysema.
(7) Granulomatous disease.
(8) Interstitial lung disease.
(9) Pleuritis.
(10) Pulmonary fibrosis.
(11) Sarcoidosis.
(12) Chronic sinusitis.
(13) Chronic rhinitis.
(14) Glioblastoma.
(15) Any other disease for which the Secretary determines, pursuant to regulations prescribed under subchapter VII that a presumption of service connection is warranted based on a positive association with a substance, chemical, or airborne hazard identified in the list under section 1119(b)(2) of this title.”
38 U.S.C. § 1120(b) (text in effect on August 15, 2026).
Pub. L. 117-263, § 5124(a) (Dec. 23, 2022), 136 Stat. 3211, struck the former statutory entry “Lymphomatic cancer of any type” and redesignated the remaining cancer subparagraphs. That amendment “shall take effect as if included in the enactment of the Honoring our PACT Act of 2022 (Public Law 117-168).” Pub. L. 117-263, § 5124(d).
Congress staggered the first application of some § 1120(b) diseases. Pub. L. 117-168, § 406(d), 136 Stat. 1784. The last of those dates was October 1, 2025 (kidney cancer and melanoma for claimants not in the statute's immediate-application categories). As of August 16, 2026, every disease listed in § 1120(b)(1)–(14) is past its statutory application date.
Diseases VA later added by regulation (not in the original § 1120 list)
Section 1120(b)(15) authorizes the Secretary to add diseases by regulation. Two later rules do that for “covered veterans” as defined in 38 C.F.R. § 3.320a(c).
38 C.F.R. § 3.320a (published Jan. 2, 2025, 90 Fed. Reg. 29) provides that the following diseases “becoming manifest in a covered veteran … shall be considered to have been incurred in or aggravated during active military, naval, air, or space service, notwithstanding that there is no record of evidence of such disease during the period of such service”:
“(1) Urinary bladder cancer, including over-lapping sites of the bladder.
(2) Ureter cancer, including the ureteric orifice, and urachus.”
38 C.F.R. § 3.320a(b).
38 C.F.R. § 3.320b (published Jan. 10, 2025, 90 Fed. Reg. 1901) provides the same presumption for:
“(1) Acute leukemias.
(2) Chronic leukemias.
(3) Multiple myelomas, including monoclonal gammopathy of undetermined significance (MGUS).
(4) Myelodysplastic Syndromes (MDS).
(5) Myelofibrosis.”
38 C.F.R. § 3.320b(b).
Both rules use a “covered veteran” definition that tracks § 1119(c), with the August 2, 1990 locations stated as “the Southwest Asia theater of operations as defined in § 3.317(e)(2)” plus Somalia, and the September 11, 2001 locations listed as Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Yemen, and Uzbekistan. 38 C.F.R. § 3.320a(c). Both rules are subject to the regulation's own exceptions (affirmative evidence the disease was not incurred or aggravated in service; a supervening cause after service; or willful misconduct). 38 C.F.R. §§ 3.320a(d), 3.320b(c).
These regulatory diseases are not in the original statutory list in 38 U.S.C. § 1120(b)(1)–(14). They rest on § 1120(b)(15) and the Secretary's subchapter VII process.
The earlier fine-particulate-matter rule (38 C.F.R. § 3.320) is a different rule
38 C.F.R. § 3.320, “Claims based on exposure to fine particulate matter,” remains in force. It is not the PACT Act statutory list. As amended at 88 Fed. Reg. 60341 (Sept. 1, 2023), it presumes service connection, after a “qualifying period of service,” for:
- asthma; rhinitis; sinusitis, to include rhinosinusitis, 38 C.F.R. § 3.320(a)(2); and
- nine specified rare cancers of the larynx, trachea, and lung, 38 C.F.R. § 3.320(a)(3).
“Qualifying period of service” under § 3.320(a)(5) is active service in the Southwest Asia theater of operations during the Persian Gulf War, or in Afghanistan, Syria, Djibouti, or Uzbekistan on or after September 19, 2001, during the Persian Gulf War. That location list is narrower than 38 U.S.C. § 1119(c). Do not treat § 3.320 as the complete PACT Act disease or location list.
The current C.F.R. has not been rewritten to match every PACT Act amendment. 38 C.F.R. §§ 3.307 and 3.309 still describe pre-PACT herbicide locations and do not list hypertension or MGUS. 38 C.F.R. § 3.317 still uses a December 31, 2026 manifestation cutoff and the older Southwest Asia definition, even though 38 U.S.C. § 1117 now says a qualifying chronic disability that “became manifest to any degree at any time” and names additional countries. Where the regulation and the statute conflict, the statute controls. The March 5, 2024 health-care enrollment expansion is published at 89 FR 15753; current 38 C.F.R. § 17.36 has not yet been rewritten to name the three new cohorts.
Agent Orange: locations and two diseases the PACT Act added
The PACT Act amended 38 U.S.C. § 1116. It did not repeal the pre-existing Agent Orange disease list. It added two diseases and redefined “covered service.”
Diseases added by Pub. L. 117-168, § 404:
“(L) Monoclonal gammopathy of undetermined significance.
(M) Hypertension.”
38 U.S.C. § 1116(a)(2)(L), (M) (text in effect on August 15, 2026).
The other diseases already in § 1116(a)(2) remain: non-Hodgkin's lymphoma; specified soft-tissue sarcomas; chloracne (with a one-year manifestation rule); Hodgkin's disease; porphyria cutanea tarda (with a one-year manifestation rule); respiratory cancers (lung, bronchus, larynx, or trachea); multiple myeloma; type 2 diabetes mellitus; parkinsonism; bladder cancer; and hypothyroidism. Several of those entries require manifestation “to a degree of disability of 10 percent or more.” 38 U.S.C. § 1116(a)(2)(A)–(K).
“Covered service” after the PACT Act is active military, naval, air, or space service:
“(1) performed in the Republic of Vietnam during the period beginning on January 9, 1962, and ending on May 7, 1975;
(2) performed in Thailand at any United States or Royal Thai base during the period beginning on January 9, 1962, and ending on June 30, 1976, without regard to where on the base the veteran was located or what military job specialty the veteran performed;
(3) performed in Laos during the period beginning on December 1, 1965, and ending on September 30, 1969;
(4) performed in Cambodia at Mimot or Krek, Kampong Cham Province during the period beginning on April 16, 1969, and ending on April 30, 1969; or
(5) performed on Guam or American Samoa, or in the territorial waters thereof, during the period beginning on January 9, 1962, and ending on July 31, 1980, or served on Johnston Atoll or on a ship that called at Johnston Atoll during the period beginning on January 1, 1972, and ending on September 30, 1977.”
38 U.S.C. § 1116(d) (text in effect on August 15, 2026).
A veteran who performed covered service “shall be presumed to have been exposed during such service to an herbicide agent containing dioxin or 2,4-dichlorophenoxyacetic acid, and may be presumed to have been exposed during such service to any other chemical compound in an herbicide agent, unless there is affirmative evidence to establish that the veteran was not exposed to any such agent during that service.” 38 U.S.C. § 1116(c).
Application dates for the two added diseases (do not collapse these):
MGUS, Pub. L. 117-168, § 404(d)(1): the amendment applies on August 10, 2022, for chapter 13 dependency-and-indemnity-compensation claimants and for veterans the Secretary determines are terminally ill, homeless, under extreme financial hardship, more than 85 years old, or capable of demonstrating other sufficient cause; and on October 1, 2022, for everyone else. Retroactive MGUS awards under that paragraph are limited to the described DIC claimants. Pub. L. 117-168, § 404(d)(1)(B), 136 Stat. 1782.
Hypertension. Today is August 16, 2026. Ordinary application under Pub. L. 117-168, § 404(d)(2)(A)(ii) is October 1, 2026. That date has not arrived.
Pub. L. 117-168, § 404(d)(2), 136 Stat. 1782 (note under 38 U.S.C. § 1116; https://www.govinfo.gov/content/pkg/PLAW-117publ168/pdf/PLAW-117publ168.pdf; Cornell LII note under https://www.law.cornell.edu/uscode/text/38/1116):
“(2) Hypertension.—
(A) In general.—The amendment made by subsection (c) shall take effect on the date of the enactment of this Act [Aug. 10, 2022] and shall apply as follows:
(i) On the date of the enactment of this Act for claimants for dependency and indemnity compensation under chapter 13 of title 38, United States Code, and for veterans whom the Secretary of Veterans Affairs determines are—
(I) terminally ill;
(II) homeless;
(III) under extreme financial hardship;
(IV) more than 85 years old; or
(V) capable of demonstrating other sufficient cause.
(ii) On October 1, 2026, for everyone not described in subparagraph (A).”
Immediate application on enactment is only for DIC under chapter 13 and for veterans the Secretary determines are terminally ill, homeless, under extreme financial hardship, more than 85 years old, or capable of demonstrating other sufficient cause. § 404(d)(2)(A)(i). Retroactive hypertension awards under that paragraph are limited to the described DIC claimants. Pub. L. 117-168, § 404(d)(2)(B).
VA's page last updated June 2, 2026, already lists “High blood pressure (also called hypertension)” as a new Agent Orange presumptive condition. Department of Veterans Affairs, *The PACT Act and your VA benefits*, https://www.va.gov/resources/the-pact-act-and-your-va-benefits/ (last updated June 2, 2026). The statute controls the application date. Do not treat VA's public list as moving ordinary hypertension to now.
The location amendments in § 403 apply on August 10, 2022, for DIC claimants and the same special-cause categories, and on October 1, 2022, for everyone else. Pub. L. 117-168, § 403(e), 136 Stat. 1781.
Radiation-risk activities the PACT Act added
The PACT Act added three radiation-risk activities to 38 U.S.C. § 1112(c)(3)(B):
“(v) Cleanup of Enewetak Atoll during the period beginning on January 1, 1977, and ending on December 31, 1980.
(vi) Onsite participation in the response effort following the collision of a United States Air Force B–52 bomber and refueling plane that caused the release of four thermonuclear weapons in the vicinity of Palomares, Spain, during the period beginning January 17, 1966, and ending March 31, 1967.
(vii) Onsite participation in the response effort following the on-board fire and crash of a United States Air Force B–52 bomber that caused the release of four thermonuclear weapons in the vicinity of Thule Air Force Base, Greenland, during the period beginning January 21, 1968, and ending September 25, 1968.”
38 U.S.C. § 1112(c)(3)(B)(v)–(vii) (added by Pub. L. 117-168, §§ 401(b), 402(b); text in effect on August 15, 2026).
If a radiation-exposed veteran has a disease listed in 38 U.S.C. § 1112(c)(2), that disease “shall be considered to have been incurred in or aggravated during active military, naval, air, or space service, notwithstanding that there is no record of evidence of such disease during a period of such service.” 38 U.S.C. § 1112(c)(1). The § 1112(c)(2) list is leukemia (other than chronic lymphocytic leukemia); cancers of the thyroid, breast, pharynx, esophagus, stomach, small intestine, pancreas, bile ducts, gall bladder, salivary gland, urinary tract, bone, brain, colon, lung, and ovary; multiple myeloma; lymphomas (except Hodgkin's disease); primary liver cancer (except if cirrhosis or hepatitis B is indicated); and bronchiolo-alveolar carcinoma. 38 U.S.C. § 1112(c)(2).
Toxic-exposure health care eligibility (separate from disability ratings)
Disability compensation under chapter 11 and hospital care under chapter 17 are different benefits. The PACT Act amended 38 U.S.C. § 1710 so that the Secretary “shall furnish hospital care and medical services, and may furnish nursing home care,” which the Secretary determines to be needed, to any veteran “who is a toxic-exposed veteran, in accordance with subsection (e).” 38 U.S.C. § 1710(a)(2)(F).
The PACT Act added three health-care categories in § 1710(e)(1):
“(G) Beginning not later than the applicable date specified in paragraph (6), and subject to paragraph (2), a veteran who participated in a toxic exposure risk activity while serving on active duty, active duty for training, or inactive duty training is eligible for hospital care (including mental health services and counseling), medical services, and nursing home care under subsection (a)(2)(F) for any illness.
(H) Beginning not later than the applicable date specified in paragraph (6), and subject to paragraph (2), a covered veteran (as defined in section 1119(c) of this title) is eligible for hospital care (including mental health services and counseling), medical services, and nursing home care under subsection (a)(2)(F) for any illness.
(I)(i) Beginning not later than the applicable date specified in paragraph (6), and subject to paragraph (2), a veteran who deployed in support of a contingency operation specified in clause (ii) is eligible for hospital care (including mental health services and counseling), medical services, and nursing home care under subsection (a)(2)(F) for any illness.
(ii) A contingency operation specified in this clause is any of the following:
(I) Operation Enduring Freedom.
(II) Operation Freedom's Sentinel.
(III) Operation Iraqi Freedom.
(IV) Operation New Dawn.
(V) Operation Inherent Resolve.
(VI) Resolute Support Mission.”
38 U.S.C. § 1710(e)(1)(G)–(I) (text in effect on August 15, 2026).
“Toxic exposure risk activity” means any activity “(i) that requires a corresponding entry in an exposure tracking record system (as defined in section 1119(c) of this title) for the veteran who carried out the activity; or (ii) that the Secretary determines qualifies for purposes of this subsection when taking into account what is reasonably prudent to protect the health of veterans.” 38 U.S.C. § 1710(e)(4)(C).
38 U.S.C. § 1710(e)(6)(A) (text in effect on August 15, 2026) sets the statutory phase-in dates as October 1, 2024; October 1, 2026; October 1, 2028; October 1, 2030; and October 1, 2032:
“(6)(A) The Secretary shall determine the dates in subparagraphs (G), (H), and (I) of paragraph (1) as follows:
(i) October 1, 2024, with respect to a veteran described in such subparagraph (G) or (H) who was discharged or released from the active military, naval, air, or space service during the period beginning on August 2, 1990, and ending on September 11, 2001.
(ii) October 1, 2026, with respect to a veteran described in such subparagraph (G) or (H) who was discharged or released from the active military, naval, air, or space service during the period beginning on September 12, 2001, and ending on December 31, 2006.
(iii) October 1, 2028, with respect to a veteran described in such subparagraph (G) or (H) who was discharged or released from the active military, naval, air, or space service during the period beginning on January 1, 2007, and ending on December 31, 2012.
(iv) October 1, 2030, with respect to a veteran described in such subparagraph (G) or (H) who was discharged or released from the active military, naval, air, or space service during the period beginning on January 1, 2013, and ending on December 31, 2018.
(v) October 1, 2032, with respect to a veteran described in such subparagraph (I).”
38 U.S.C. § 1710(e)(6)(B):
“(B)(i) The Secretary may modify a date specified in subparagraph (A) to an earlier date, as the Secretary determines appropriate based on the number of veterans receiving hospital care, medical services, and nursing home care under subparagraphs (G), (H), and (I) of paragraph (1) and the resources available to the Secretary.
(ii) If the Secretary determines to modify a date under clause (i), the Secretary shall—
(I) notify the Committee on Veterans' Affairs of the Senate and the Committee on Veterans' Affairs of the House of Representatives of the proposed modification; and
(II) publish such modified date in the Federal Register.”
VA's page last updated June 2, 2026, states:
“And starting March 5, 2024, we're expanding VA health care to millions of Veterans—years earlier than called for by the PACT Act.”
Department of Veterans Affairs, *The PACT Act and your VA benefits*, https://www.va.gov/resources/the-pact-act-and-your-va-benefits/ (last updated June 2, 2026).
Keep both: the statutory phase-in in § 1710(e)(6)(A), the Secretary's authority to accelerate in § 1710(e)(6)(B), and VA's March 5, 2024 sentence. The Federal Register implementation notice is 89 FR 15753 (Mar. 5, 2024).
Health care under § 1710(e)(1)(G), (H), or (I) “may not be provided … with respect to a disability that is found, in accordance with guidelines issued by the Under Secretary for Health, to have resulted from a cause other than the service, testing, or activity described in such subparagraph.” 38 U.S.C. § 1710(e)(2)(B).
The PACT Act also expanded combat-veteran care under § 1710(e)(1)(D) to a 10-year period after discharge for veterans discharged after September 11, 2001, effective October 1, 2022. Pub. L. 117-168, § 111; 38 U.S.C. § 1710(e)(3)(A), (e) note.
Toxic exposure screening
Section 603 of the PACT Act is not a numbered section of title 38. Do not cite it as “38 U.S.C. § 603.” It is a statutory note under title 38, chapter 11 (the provision refers to enrollment under 38 U.S.C. § 1705). It requires:
“Beginning not later than 90 days after the date of the enactment of this Act [Aug. 10, 2022], the Secretary of Veterans Affairs shall incorporate a screening to help determine potential toxic exposures during active military, naval, air, or space service as part of a health care screening furnished by the Department of Veterans Affairs to veterans enrolled in the system of annual patient enrollment of the Department established and operated under section 1705 of title 38, United States Code ….”
Pub. L. 117-168, § 603(a), 136 Stat. 1793.
The Secretary “shall ensure that a veteran described in subsection (a) completes the screening required under such subsection not less frequently than once every five years.” Pub. L. 117-168, § 603(b). At a minimum the screening must include “a question about the potential exposure of the veteran to an open burn pit” and “a question regarding toxic exposures that are commonly associated with service in the Armed Forces.” Pub. L. 117-168, § 603(c)(2).
VA's public page states that every enrolled veteran will receive an initial screening and a follow-up at least once every five years, and that the screening asks about open burn pits and other airborne hazards, Gulf War-related exposures, Agent Orange, radiation, Camp Lejeune contaminated water, and other exposures. Department of Veterans Affairs, *The PACT Act and your VA benefits*, https://www.va.gov/resources/the-pact-act-and-your-va-benefits/ (last updated June 2, 2026). A screening is not itself a rating decision.
Claims that are not on a presumptive list: medical nexus examinations
38 U.S.C. § 1168, quoted in full (text in effect on August 15, 2026):
Ҥ 1168. Medical nexus examinations for toxic exposure risk activities
(a) Medical Examinations and Medical Opinions.—(1) Except as provided in subsection (b), if a veteran submits to the Secretary a claim for compensation for a service-connected disability under section 1110 of this title with evidence of a disability and evidence of participation in a toxic exposure risk activity during active military, naval, air, or space service, and such evidence is not sufficient to establish a service connection for the disability, the Secretary shall—
(A) provide the veteran with a medical examination under section 5103A(d) of this title; and
(B) obtain a medical opinion (to be requested by the Secretary in connection with the medical examination under subparagraph (A)) as to whether it is at least as likely as not that there is a nexus between the disability and the toxic exposure risk activity.
(2) When providing the Secretary with a medical opinion under paragraph (1)(B) for a veteran, the health care provider shall consider—
(A) the total potential exposure through all applicable military deployments of the veteran; and
(B) the synergistic, combined effect of all toxic exposure risk activities of the veteran.
(3) The requirement under paragraph (2)(B) shall not be construed as requiring a health care provider to consider the synergistic, combined effect of each of the substances, chemicals, and airborne hazards identified in the list under section 1119(b)(2) of this title.
(b) Exception.—Subsection (a) shall not apply if the Secretary determines there is no indication of an association between the disability claimed by the veteran and the toxic exposure risk activity for which the veteran submitted evidence.
(c) Toxic Exposure Risk Activity Defined.—In this section, the term ‘toxic exposure risk activity' has the meaning given that term in section 1710(e)(4) of this title.”
38 U.S.C. § 1168 (https://uscode.house.gov/view.xhtml?edition=prelim&req=granuleid:USC-prelim-title38-section1168; also https://www.law.cornell.edu/uscode/text/38/1168).
How a claim is filed (VA's current public instructions)
VA's public page (last updated June 2, 2026) states:
- A veteran who has not filed for the presumptive condition may file a new disability compensation claim.
- A veteran whose claim was denied in the past, and whose condition is now presumptive, may file a Supplemental Claim.
- If VA added the condition after the veteran already filed, VA states the veteran does not need to do anything further for that pending claim.
- “The PACT Act is here to stay, and Veterans and survivors can file for benefits anytime.”
Department of Veterans Affairs, *The PACT Act and your VA benefits*, https://www.va.gov/resources/the-pact-act-and-your-va-benefits/ (last updated June 2, 2026).
VA also states that an intent to file can be submitted. That is VA's description of its claims process, not a statutory deadline unique to the PACT Act.
Survivors
If a veteran died from a service-connected disability, a surviving spouse, child, or parent may be eligible for dependency and indemnity compensation under chapter 13 of title 38. A PACT Act presumption that would have established service connection for the cause of death can support a DIC claim. The hypertension and MGUS effective-date rules above treat chapter 13 DIC claimants as an immediate-application category. Pub. L. 117-168, § 404(d). VA's public page also describes accrued benefits, Survivors Pension, burial benefits, CHAMPVA, and other survivor programs. Those programs have their own statutes. This page does not restate them.
Claims filed before a presumption's date
Pub. L. 117-168, § 407, 136 Stat. 1785 (38 U.S.C. § 101 note) provides:
“(a) Generally.—Nothing in this Act shall be construed to prevent the Secretary of Veterans Affairs from processing claims for benefits under title 38, United States Code, for a condition or disease for which this Act establishes a presumption of service connection, as a claim for benefits for a condition or disease with direct service connection.
(b) Effective Dates and Applicability.—The Secretary shall not deny a claim for benefits under title 38, United States Code, for a condition or disease for which this Act establishes a presumption of service connection because the claimant filed the claim prior to the effective date or date of applicability for that particular condition or disease.”
This is a construction rule. It does not create a chapter 11 effective date earlier than 38 U.S.C. § 5110 and the specific applicability notes (for example the § 1120 note and the § 1116 note).
Previously denied claims: outreach (and a citation trap)
The PACT Act added 38 U.S.C. § 1167, “Outreach pursuant to changes in presumptions of service connection” (Pub. L. 117-168, § 203(a)):
“Whenever a law, including through a regulation or Federal court decision or settlement, establishes or modifies a presumption of service connection, the Secretary shall—
(1) identify all claims for compensation under this chapter that—
(A) were submitted to the Secretary;
(B) were evaluated and denied by the Secretary before the date on which such provision of law went into effect; and
(C) might have been evaluated differently had the establishment or modification been applicable to the claim; and
(2) pursuant to subsection (b), conduct outreach to the claimants.”
Outreach includes website notice, notice to veterans service organizations, and contact “in the same manner that the Department last provided notice of a decision,” telling claimants they “may submit a supplemental claim.” 38 U.S.C. § 1167. The section's note states that this does not require “a retroactively applied effective date of a supplemental claim earlier than the date a presumption of service connection is established or modified.”
There are two different sections numbered 38 U.S.C. § 1167. The second, “Mental health consultations,” was added by Pub. L. 117-328, div. V, § 404(a)(1) (Dec. 29, 2022), not by the PACT Act. Cite the PACT provision by name or by Public Law section.
Persian Gulf undiagnosed illness (amended, not created, by the PACT Act)
38 U.S.C. § 1117 was amended by Pub. L. 117-168, § 405. Current text (in effect on August 15, 2026):
“The Secretary may pay compensation under this subchapter to a Persian Gulf veteran with a qualifying chronic disability that became manifest to any degree at any time.”
38 U.S.C. § 1117(a)(1).
“Qualifying chronic disability” means a chronic disability resulting from an undiagnosed illness; a medically unexplained chronic multisymptom illness (such as chronic fatigue syndrome, fibromyalgia, and irritable bowel syndrome) that is defined by a cluster of signs or symptoms; or any diagnosed illness the Secretary determines by regulation warrants a presumption. 38 U.S.C. § 1117(a)(2).
“For purposes of this section, the term ‘Persian Gulf veteran' means a veteran who served on active duty in the Armed Forces in the Southwest Asia theater of operations, Afghanistan, Israel, Egypt, Turkey, Syria, or Jordan, during the Persian Gulf War.”
38 U.S.C. § 1117(f).
The verb is “may pay.” This is not a mandatory grant. The PACT Act also struck the former manifestation-period subsection.
Survivors: DIC reevaluation effective date
In addition to ordinary chapter 13 DIC, the PACT Act added 38 U.S.C. § 1305. When a presumption is established or modified, the Secretary shall identify previously denied DIC claims that might have been evaluated differently, allow reevaluation at the claimant's election, and—
“notwithstanding section 5110 of this title, with respect to claims approved pursuant to such reevaluation, provide compensation under this chapter effective as if the establishment or modification of the presumption of service connection had been in effect on the date of the submission of the original claim described in paragraph (1).”
38 U.S.C. § 1305.
This effective-date rule is a DIC rule. It is not a chapter 11 disability-compensation effective-date rule. It applies to presumptions established or modified on or after August 10, 2022.
Later cancer additions that are not in 38 U.S.C. § 1120(b)(1)–(14)
VA announced on June 14, 2024, that a sub-regulatory policy letter published in the Federal Register included three additional cancer types on the presumptive list: male breast cancer; urethral cancer; and cancer of the paraurethral glands. Department of Veterans Affairs, press release (June 14, 2024), https://news.va.gov/press-room/va-extends-presumptions-of-service-connection-for-three-new-cancer-types/. That announcement is VA material, not an amendment of § 1120(b)(1)–(14). Work Product should confirm the Federal Register policy letter before treating those three as current law.
VA's own consumer pages do not use one identical cancer list. The June 2, 2026 hub list matches § 1120(b). The Public Health PACT Act page (May 14, 2026) and the airborne-hazards page add leukemias, multiple myelomas, MDS, myelofibrosis, and bladder/ureter cancers, which match 38 C.F.R. §§ 3.320a and 3.320b. Quote the controlling Code or regulation. Do not collapse VA web lists into one list.
Definitions
38 U.S.C. § 101(37) defines “toxic exposure” as a toxic exposure risk activity under § 1710(e)(4), or exposure to a substance, chemical, or airborne hazard on the § 1119(b)(2) list. 38 U.S.C. § 101(38) defines “toxic-exposed veteran” as any veteran described in § 1710(e)(1). Those definitions do not themselves confer benefits. Added by Pub. L. 117-168, § 102(b).
Future presumptions
38 U.S.C. §§ 1171–1176 (added by Pub. L. 117-168, § 202) are the process for establishing or removing toxic-exposure presumptions after notice, evaluation, and rulemaking. They do not themselves add a disease. Section 1120(b)(15) is the disease-list hook for that process.
What the PACT Act is not, on this page
Pub. L. 117-168, § 804, created a federal cause of action relating to Camp Lejeune contaminated water. That is not a 38 U.S.C. chapter 11 compensation presumption. This firm's page is limited to veterans claims, appeals, and related VA benefits. § 804 is noted so the Act is not described as only a benefits statute. It is not restated here.
Korea DMZ herbicide coverage is 38 U.S.C. § 1116B (Pub. L. 116-23, 2019), not a PACT Act creation. Blue Water Navy herbicide coverage is 38 U.S.C. § 1116A (2019), not a PACT Act creation.
What this page does not say
- The PACT Act does not guarantee that VA will grant any particular claim.
- A presumption does not set a disability rating. Rating is a separate determination under 38 U.S.C. § 1155 and 38 C.F.R. part 4.
- A condition that is not listed can still be claimed. It is not presumed.
- Health-care enrollment under § 1710 is not a disability rating.
- This firm does not publish win rates, recovery amounts, or testimonials on this page.
The Jacks Law Group
The Jacks Law Group
1057 Whitney Ranch Drive, Suite 350
Henderson, NV 89014
702-834-6300
https://www.TheJacksLawGroup.com
Veterans claims, appeals, and related VA benefits.