If you were exposed to burn pits, Agent Orange, or other toxic substances during service, the PACT Act may mean the VA now assumes your condition is connected — no extra proof required. Here's what it actually covers, and what it doesn't.
Check My Readiness For FreeNormally, a VA disability claim requires you to prove your condition is connected to your service. A presumptive condition flips that: if you served in a qualifying place and time and you have one of the listed conditions, the VA assumes it's connected — you don't have to individually prove the link. The PACT Act (signed into law in 2022) is the largest expansion of presumptive conditions and qualifying exposures in VA history.
If you served in a location with burn pit operations during the Gulf War or post-9/11 era, these are now presumptive:
Brain, head & neck, and nervous system cancers; gastrointestinal cancers (colorectal, esophageal, liver, pancreatic, stomach); genitourinary cancers (kidney, bladder, ureter); leukemias, lymphomas (Hodgkin's & non-Hodgkin's), multiple myeloma; melanoma; reproductive cancers (breast, prostate, testicular, cervical, ovarian); and respiratory cancers (lung, bronchial, laryngeal, nasopharyngeal).
Asthma (diagnosed after discharge), chronic bronchitis, COPD, constrictive or obliterative bronchiolitis, emphysema, granulomatous disease, interstitial lung disease, pleuritis, pulmonary fibrosis, sarcoidosis, chronic sinusitis, and chronic rhinitis.
Source: VA.gov — Presumptive cancers related to burn pit exposure
Qualifying service: Vietnam (Jan 9, 1962 – May 7, 1975), inland waterways of Vietnam, or the Korean DMZ (Sep 1, 1967 – Aug 31, 1971). The PACT Act added five more locations: Thailand military bases (1962–1976), Laos (1965–1969), Cambodia's Mimot and Krek areas (Apr 1969), Guam and American Samoa (1962–1980), and Johnston Atoll (1972–1977).
Bladder, prostate, and respiratory (lung) cancers; non-Hodgkin's lymphoma; Hodgkin's disease; chronic B-cell leukemia; multiple myeloma; certain soft tissue sarcomas; type 2 diabetes; heart disease; Parkinson's disease; hypothyroidism; early-onset peripheral neuropathy; high blood pressure (hypertension); and monoclonal gammopathy of undetermined significance (MGUS).
Source: VA.gov — Agent Orange exposure and disability compensation
This is the part people get wrong most often. Sleep apnea is not a presumptive condition under the PACT Act, even though it's extremely common among veterans and often shows up alongside burn pit exposure. That doesn't mean it can't be service-connected — it just means it has to be claimed a different way:
A sleep study diagnosis, an in-service event or exposure, and a medical nexus opinion linking the two.
Sleep apnea is frequently claimed as secondary to PTSD, anxiety, chronic sinus/nasal conditions, or weight gain linked to another service-connected condition. This is exactly the kind of connection our free readiness check and secondary-condition review are built to catch.
The lesson: not being on the presumptive list doesn't mean a condition isn't connected to your service — it just means it needs real medical evidence instead of an assumption. That's true for a lot of conditions beyond sleep apnea too.
Our free readiness check looks at your service history and conditions against presumptive lists like these — and flags secondary connections even when nothing is automatically presumed.
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NEXUS