The PACT Act: Presumptive Reasoning
The PACT Act is a law that expands VA health care and benefits for Veterans exposed to burn pits, Agent Orange, and other toxic substances.
The PACT Act adds to the list of health conditions that we assume (or "presume") are caused by exposure to these substances. This law helps provide generations of Veterans and their survivors with the care and benefits they've earned and deserve.
Presumptive reasoning refers to a legal principle that allows certain assumptions to be made in specific situations. These presumptions simplify the process of decision-making or determining eligibility for benefits.
In VA law, presumptive reasoning allows certain disabilities to be considered service-connected even without direct evidence. This is based on the understanding that some conditions are more likely than not caused by military service.
This shifts the burden of proof from the Veteran to the VA, helping ensure timely and fair access to benefits.
For example, if a veteran served in a combat zone and later develops post-traumatic stress disorder (PTSD), the VA uses presumptive reasoning to conclude that the PTSD is related to their military service. This means that the burden of proof is shifted from the veteran to the VA, and the veteran is not required to provide explicit evidence linking their PTSD to specific incidents during their service.
Presumptive reasoning in VA law helps simplify the claims process and ensures that veterans receive timely and appropriate benefits for conditions that are likely related to their military service.
Current List of VA Presumptive Situations
As of early 2026
PACT Act Presumptive Conditions (Toxic / Burn Pit Exposure)
Respiratory & Lung-Related Conditions (Non-Cancer)
- Asthma (diagnosed after service)
- Chronic bronchitis
- Chronic obstructive pulmonary disease (COPD)
- Chronic rhinitis
- Chronic sinusitis
- Constrictive or obliterative bronchiolitis
- Emphysema
- Granulomatous disease
- Interstitial lung disease (ILD)
- Pleuritis
- Pulmonary fibrosis
- Sarcoidosis
Cancers (Any Time After Service)
- Brain cancer
- Gastrointestinal cancers (all types)
- Head cancers (all types)
- Kidney cancer
- Lymphatic and hematologic cancers
- Lymphoma (all types)
- Melanoma
- Neck cancers
- Pancreatic cancer
- Reproductive cancers (all types)
- Respiratory cancers (all types)
- Male breast cancer
- Urethral cancer
- Cancer of the paraurethral glands
Agent Orange / Herbicide Presumptive Conditions
Cancer & Blood Disorders
- Bladder cancer
- Chronic B-cell leukemias
- Hodgkin's disease
- Multiple myeloma
- Non-Hodgkin's lymphoma
- Prostate cancer
Other Presumptive Illnesses
- AL amyloidosis
- Chloracne
- Diabetes mellitus type 2
- Hypertension
- Hypothyroidism
- Ischemic heart disease
- MGUS
- Parkinson's disease and Parkinsonism
- Peripheral neuropathy (early onset)
- Porphyria cutanea tarda
Camp Lejeune Water Contamination
- Adult leukemia
- Aplastic anemia and myelodysplastic syndromes
- Bladder cancer
- Kidney cancer
- Liver cancer
- Multiple myeloma
- Non-Hodgkin's lymphoma
- Parkinson's disease
One-Year Post-Service Chronic Conditions (38 C.F.R. ??3.309)
- Hypertension and cardiovascular-renal diseases
- Diabetes mellitus
- Epilepsies
- Lupus erythematosus
- Sarcoidosis
- Tuberculosis (active)
- ALS
Key Notes:
- Presumptive status does not guarantee a disability rating.
- Service location, dates, and discharge status must qualify.
- VA lists change periodically; verify through VA.gov or a Veteran Service Officer.
