Burn pits were a common method of waste disposal used by the U.S. military in Iraq, Afghanistan, and other operational areas throughout the Southwest Asia theater. These large, open-air pits were used to burn massive quantities of refuse, including plastics, medical waste, paint, unexploded ordnance, and chemicals. The resulting plumes of toxic smoke and particulate matter exposed thousands of service members to harmful airborne contaminants. For years, veterans who developed serious illnesses often faced significant obstacles trying to connect their diagnosis directly to this military exposure. The difficulty lay in providing the medical evidence, known as a nexus, to establish a service connection. The conditions listed in this article represent a major policy shift, which now automatically recognizes a link between military service and certain diseases.
Understanding the Presumptive Status
The term “presumptive” in the context of Veterans Affairs (VA) claims is a powerful legal designation that changes the burden of proof. Normally, a veteran must submit comprehensive medical evidence showing that their current illness was directly caused by an event or exposure during their time in service.
Presumptive status means the VA automatically assumes a service connection exists if a veteran has a specific condition and served in a qualifying location during a specified timeframe. This removes the requirement for the veteran to provide a medical nexus between the toxic exposure and their diagnosis. The Honoring Our Promise to Address Comprehensive Toxics Act, commonly known as the PACT Act, established this list of presumptive conditions for burn pit and other toxic exposures.
The Full List of Covered Conditions
The PACT Act established 23 categories of conditions that are now presumed to be connected to burn pit and other airborne toxic exposures. These conditions primarily affect the respiratory system and various organ systems susceptible to cancer.
Presumptive Respiratory Conditions
The presumptive respiratory conditions cover 12 diagnoses, including asthma that was diagnosed after service. These conditions are often persistent and debilitating lung diseases.
- Asthma (diagnosed after service)
- Chronic bronchitis
- Chronic obstructive pulmonary disease (COPD)
- Chronic rhinitis (long-term inflammation of the nasal passages)
- Constrictive or obliterative bronchiolitis (scarring of the small airways)
- Emphysema
- Interstitial lung disease (ILD)
- Pulmonary fibrosis
- Pleuritis
- Sarcoidosis
- Granulomatous disease
Presumptive Cancers
The presumptive cancers cover 11 distinct types, reflecting the carcinogenic nature of the compounds released from the burn pits.
- All forms of respiratory cancer (lung, bronchus, larynx, and trachea)
- Brain cancer (including glioblastoma)
- Gastrointestinal cancer of any type (from the esophagus to the colon)
- Head and neck cancer
- Kidney cancer
- Pancreatic cancer
- Lymphatic cancer (including lymphoma)
- Melanoma
- Reproductive cancer of any type
Qualifying Service Criteria
To qualify for presumptive status, a veteran must have served in a location and during a timeframe where burn pit exposure is assumed to have occurred. This qualification is based entirely on the veteran’s service records, not on proving direct exposure to a specific burn pit. The criteria broadly cover two theaters of operation.
Group 1: Southwest Asia Theater (On or after August 2, 1990)
This group includes service in the Southwest Asia theater of operations on or after August 2, 1990.
- Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, Somalia, and the United Arab Emirates
- The Arabian Sea, Gulf of Aden, Gulf of Oman, Persian Gulf, and the Red Sea
Group 2: Other Locations (On or after September 11, 2001)
This group includes service on or after September 11, 2001, in the following countries.
- Afghanistan
- Djibouti
- Egypt
- Jordan
- Lebanon
- Syria
- Uzbekistan
- Yemen
Filing a Claim Based on Presumption
The first step in using the presumptive status is to file a claim with the VA, typically using VA Form 21-526EZ, or by filing an intent to file. An intent to file is a critical action because it locks in the potential start date for retroactive benefits. The veteran must provide their service records to confirm they meet the qualifying location and date criteria for exposure.
The second piece of necessary documentation is medical evidence that confirms the diagnosis of a presumptive condition. This means submitting private or VA medical records that clearly state the diagnosis, such as chronic rhinitis or pancreatic cancer. Veterans Service Officers (VSOs) are trained professionals who can assist with gathering documentation and navigating the administrative process at no cost. If a claim was previously denied, veterans should file a Supplemental Claim so the VA can review it under the new presumptive rules.