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PACT Act Guidance from the National Veterans Legal Services Program: What Veterans Need to Know About the PACT Act

March 03, 2023 (4 min read)

By the National Veterans Legal Services Program

PACT Act 2022

In August 2022, President Biden signed into law one the most significant bills affecting veterans benefits in decades. The Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 (the PACT Act) expands health care and disability benefits for millions of veterans, particularly those who were exposed to burn pits and other toxins during their military service. The law was the culmination of years of efforts to ensure that these veterans received the benefits they earned and deserve.

To help veterans and their advocates understand the numerous ways the PACT Act may impact them, the National Veterans Legal Services Program (NVLSP) has written a supplement to its renowned Veterans Benefits Manual that summarizes the key provisions of the new law. Initially published in 1991 and known as the “VA Benefits Bible,” the experienced attorneys at NVLSP update the Veterans Benefits Manual annually with the important developments in veterans law.

The PACT Act, however, became law after the manuscript for the 2022-2023 edition of the Veterans Benefits Manual was finalized. NVLSP worked with LexisNexis to prepare a supplement to the Veterans Benefits Manual that is devoted exclusively to the PACT Act. Any individuals who purchase the 2022-2023 edition of the Veterans Benefits Manual, including those who previously purchased this edition of the manual, will receive the PACT Act Supplement.

PACT Act Guidelines

As explained in the PACT Act Supplement, the PACT Act:

  • Makes certain combat veterans eligible for VA health care who were not previously eligible;
  • Greatly expands the definition of a “toxic-exposed veteran” who is eligible for VA health care;
  • Requires the VA to presume that veterans were exposed to toxins from burn pits and other sources if they served in Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, Somalia, or the United Arab Emirates, including the airspace above these locations, on or after August 2, 1990; or served in Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Yemen, or Uzbekistan, including the airspace above these locations, on or after September 11, 2001;
  • Requires the VA to presume that numerous cancers and respiratory diseases were caused by toxic exposure and thus qualify for service-connected disability benefits if the veteran was exposed to toxins in the aforementioned locations during the relevant periods;
  • Makes it easier for veterans to establish service connection for Gulf War Illness (undiagnosed illnesses and medically unexplained chronic multi-symptom illnesses);
  • Adds to the list of “radiation-risk activities” that will qualify a veteran for the presumption of service connection for numerous cancers that are associated with radiation exposure;
  • Adds Thailand, Laos, Cambodia, Guam, American Samoa, and Johnston Atoll to the list of locations where veterans are presumed to have been exposed to Agent Orange;
  • Requires the VA to presume that hypertension and monoclonal gammopathy of undetermined significance (MGUS) were caused by a veteran’s exposure to Agent Orange and thus qualify for service-connected disability benefits;
  • Provides a favorable exception to the VA rule that limits the payment of retroactive benefits for survivors of veterans whose claims for Dependency and Indemnity Compensation were previously denied, but would now qualify for that benefit under the Act (or future changes in law);
  • Establishes a framework for the VA to create new presumptions of service connection related to toxic exposure; and
  • Creates a new way for veterans and others to file claims against the U.S. government for harm caused by being exposed to contaminated water at Camp Lejeune.

To help fill some of the gaps in the coverage of the PACT Act, NVLSP’s Burn Pits Claims Assistance Program (Burn Pits CAP) is focusing on providing free representation to veterans who were previously denied service connection for a burn-pit-related condition that is not presumptively service-connected under the PACT Act, including sleep apnea, GERD, and gastrointestinal issues.

NVLSP will also consider applicants whose claims for a PACT Act condition were denied after passage of the PACT Act on August 10, 2022, despite the fact that the new law requires their condition be presumptively service connected. Interested veterans are encouraged to go to NVLSP’s Burn Pits CAP intake page, where they can access an intake form and apply for free representation.

This page also includes two self-help guides, one for veterans seeking to file an initial claim for a condition made presumptive under the PACT Act, and one for veterans whose claims were previously denied, but whose condition is now covered under the PACT Act.

About the National Veterans Legal Services Program

NVLSP is an independent, nonprofit veterans service organization that has served active duty military personnel and veterans since 1981. NVLSP strives to ensure that our nation honors its commitment to its 22 million veterans and active duty personnel by ensuring they have the benefits they have earned through their service to our country.

NVLSP has represented veterans in lawsuits that compelled enforcement of the law where the VA or other military services denied benefits to veterans in violation of the law.

NVLSP’s success in these lawsuits has resulted in more than $5.4 billion dollars being awarded in disability, death, and medical benefits to hundreds of thousands of veterans and their survivors.

NVLSP offers training for attorneys and other advocates; connects veterans and active duty personnel with pro bono legal help when seeking disability benefits; publishes the nation’s definitive guide on veterans benefits; and represents and litigates for veterans and their families before the VA, military discharge review agencies and federal courts. For more information on NVLSP, go to