Honoring our PACT Act

The PACT Act has implemented several measures to enhance the process for establishing presumptive service connections related to toxic substance exposure:

• Procedures for Presumptive Service Connection: The Act outlines clear procedures for establishing and removing presumptions of service connection due to toxic exposures.
• VA Working Group: A dedicated Working Group within the VA has been established to recommend new presumptions for toxic exposures. The Secretary of Veterans Affairs is required to act on these recommendations within 160 days, either by initiating rulemaking or providing an explanation for inaction.
• Claimant Notification: The VA is mandated to inform claimants when new laws establish or modify a presumption of service connection.
• Public Engagement: An annual notice and public comment period concerning toxic-exposure presumptions have been instituted to involve the public in the decision-making process.
• Reevaluation of Denied Claims: The VA must reconsider previously denied claims whenever a new presumption is established, ensuring that Veterans receive due benefits under updated regulations.
• Comprehensive Evidence Assessment: In evaluating claims based on toxic exposure, the VA considers evidence from exposure tracking systems, such as the Burn Pit or Agent Orange Registries. In the absence of such evidence, the VA assesses the totality of the veteran’s service circumstances.
• Mandatory Medical Examinations: Even if a presumption is not established, the VA is required to provide a medical examination, with examiners considering cumulative exposures and overall deployments.

These provisions are designed to ensure that Veterans receive appropriate recognition and benefits for health conditions resulting from toxic exposures during their service.

The PACT Act significantly expands the presumptive list of conditions for Veterans exposed to burn pits, toxic substances, and Agent Orange. This expanded list simplifies the process for Veterans to receive benefits without needing to prove a direct connection between their illness and military service.

Burn Pit and Toxic Exposure Conditions

Veterans exposed to burn pits now have the following conditions added to the presumptive list:

• Asthma diagnosed after service
• Head cancer (of any type)
• Neck cancer (of any type)
• Respiratory cancer (of any type)
• Gastrointestinal cancer (of any type)
• Reproductive cancer (of any type)
• Lymphoma cancer (of any type)
• Lymphatic cancer (of any type)
• Kidney cancer
• Brain cancer
• Melanoma
• Pancreatic cancer
• Chronic bronchitis
• COPD
• Constrictive bronchiolitis or obliterative bronchiolitis
• Emphysema
• Granulomatous disease
• Interstitial lung disease
• Pleuritis
• Pulmonary fibrosis
• Sarcoidosis
• Chronic sinusitis
• Chronic rhinitis
• Glioblastoma

Agent Orange Exposure Conditions

In addition to the expanded burn pit list, the PACT Act also adds two new presumptive conditions for Veterans exposed to Agent Orange:

• Hypertension (High Blood Pressure)
• Monoclonal Gammopathy of Undetermined Significance (MGUS)

These changes reflect the government’s commitment to addressing the long-term health consequences of toxic exposures and providing Veterans with the support they deserve.

Veterans diagnosed with any of these conditions are encouraged to file new claims or reopen previously denied claims to secure the benefits they are entitled to under the expanded provisions of the PACT Act.

The PACT Act has expanded the presumption of service connection for Agent Orange and herbicide exposure to include additional locations and time periods. This expansion simplifies the process for affected Veterans to access benefits by presuming exposure based on their service in specific areas during designated times.

Expanded Presumptive Locations:

• Thailand: Any U.S. or Royal Thai military base from January 9, 1962 to June 30, 1976, regardless of the Veteran’s Military Occupational Specialty (MOS) or specific location on the base.
• Laos: From December 1, 1965 to September 30, 1969.
• Cambodia: Specifically at Mimot or Krek, Kampong Cham Province, from April 16, 1969 to April 30, 1969.
• Guam or American Samoa: Including the territorial waters thereof, from January 9, 1962 to July 31, 1980.
• Johnston Atoll: Or on a ship that called at Johnston Atoll from January 1, 1972 to September 30, 1977.

New Presumptive Conditions:

• Hypertension (High Blood Pressure): Recognized as a presumptive condition for Veterans exposed to herbicide agents.
• Monoclonal Gammopathy of Undetermined Significance (MGUS): Added to the list of presumptive conditions associated with herbicide exposure.

These updates reflect the government’s commitment to acknowledging the health impacts of herbicide exposure and ensuring that affected Veterans receive the benefits they deserve. Veterans who served in the specified locations and time frames, and who have been diagnosed with these conditions, are encouraged to file new claims or reopen previously denied claims under the PACT Act provisions.

Gulf War Era Veterans
The PACT Act broadens the definition of Persian Gulf War Veterans to include individuals who served in specific regions during designated timeframes, enhancing eligibility for presumptive benefits:

• Post-August 2, 1990: Veterans who served on or after this date in Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, Somalia, United Arab Emirates, or the airspace above these regions.
• Post-September 11, 2001: Veterans who served on or after this date in Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, or the airspace above these regions.

Radiation Exposure
The Act also expands the presumption of service connection to include Veterans involved in radiation exposure cleanup and response during specific incidents:

• Enewetak Atoll Cleanup (Marshall Islands): Service between January 1, 1977 and December 31, 1980.
• Palomares, Spain B-52 Crash Response: Service between January 17, 1966 and March 31, 1967.
• Thule Air Force Base, Greenland B-52 Crash Response: Service between January 21, 1968 and September 25, 1968.

These updates ensure that Veterans exposed to toxic substances or radiation in these periods and locations receive recognition for their service and access to appropriate VA benefits.

The PACT Act mandates a comprehensive modernization of the Department of Veterans Affairs (VA) information technology (IT) systems to enhance the efficiency and effectiveness of the claims process for Veterans. Key components of this modernization plan include:

• Automation Enhancements: Implementing advanced automation technologies to expedite the claims process, thereby increasing both speed and accuracy in handling Veterans’ claims.
• Employee Productivity Improvements: Upgrading IT infrastructure to provide VA employees with better tools and resources, leading to enhanced productivity and more consistent claims processing and rating.
• Standardized Claims Processing: Developing uniform procedures and systems to ensure consistency in the evaluation and rating of claims across the VA.
• Electronic Communication: Transitioning to electronic notifications for disability claim communications to facilitate timely and efficient information exchange with Veterans.
• Workforce Development: Establishing a strategic recruitment and hiring plan to attract and retain skilled professionals, thereby strengthening the VA workforce to meet the demands of the modernized claims process.

These initiatives are designed to create a more responsive and Veteran-centric claims process, ensuring that Veterans receive the benefits they have earned in a timely and efficient manner.

The PACT Act indeed expands healthcare eligibility for Veterans exposed to toxic substances, providing broader access to critical medical services. This expansion includes:

Healthcare Eligibility

The Act makes Veterans who were exposed to toxins eligible for:

• VA Hospital Care: Access to inpatient and outpatient services at VA facilities.
• Medical Care: Includes a wide range of treatments such as:
  • Mental Health Services: Support for PTSD, anxiety, depression, and other mental health conditions.
  • Counseling Services: Available to help Veterans cope with toxic exposure-related health impacts.
• Nursing Home Care: Long-term care for Veterans with chronic or severe conditions tied to toxic exposures.

Expanded Eligibility for Specific Operations

Veterans deployed in the following contingency operations now qualify under the expanded healthcare criteria:

• Operation Enduring Freedom
• Operation Freedom’s Sentinel
• Operation Iraqi Freedom
• Operation New Dawn
• Operation Inherent Resolve
• Resolute Support Mission

This expansion reflects the VA’s commitment to recognizing the long-term health effects of toxic exposures during these significant military operations.

The PACT Act directs the VA to enhance resources for Veterans and provide specialized training for VA employees. These improvements include:

• An Annual Resource List: Publishing an annual list of VA resources tailored for toxic-exposed Veterans, their families, caregivers, and survivors of Veterans who receive Dependency and Indemnity Compensation (DIC).
• Toxic Exposure Screening: Conducting annual toxic exposure screenings for enrolled Veterans to identify potential toxic exposures during their service.
• Staff Training: Establishing mandatory annual training for VA staff, focusing on the identification, assessment, and treatment of illnesses related to toxic exposure.

The PACT Act establishes the Toxic Exposure Research Working Group, tasked with developing and implementing a five-year plan to advance research on toxic exposure and its effects on Veterans. The act mandates the creation of a publicly accessible website where all related research and studies are published.

Additionally, the VA and other federal departments are directed to conduct and update several studies focused on toxic exposure, including:

• Annual Reports: Regular reports on the treatment of Veterans for medical conditions linked to toxic exposure.
• Burn Pit Exposure Mortality Study: Updates on the long-term mortality rates of Veterans exposed to burn pits.
• Health Trends Among Post-9/11 Veterans: A study focusing on the health patterns and challenges faced by Veterans of the post-9/11 era.
• Cancer Rate Studies: Research into cancer rates among Veterans, particularly those with known toxic exposure.
• Manhattan Project Waste: Health studies on Veterans exposed to waste related to the Manhattan Project.
• Toxic Exposure and Mental Health: Research exploring the connection between toxic exposure and mental health outcomes in Veterans.
• Jet Fuel Exposure: Investigations into the health effects of jet fuel used during military service.