VA Presumptive Conditions for Veterans: Complete 2026 Guide to Agent Orange, Gulf War, PACT Act & More

What Are VA Presumptive Conditions?

When you file a VA disability claim, you typically need to prove three things:

1. A current diagnosed condition
2. An in-service event, injury, or exposure
3. A medical link (nexus) between the two

Presumptive conditions eliminate the third requirement. The VA "presumes" your condition is connected to your service based on where and when you served. You still need a diagnosis, but you do not need to prove the connection—the VA accepts it automatically.

As of early 2026, the VA has processed over 2 million PACT Act-related claims with a 74.4% approval rate, demonstrating how presumptive status significantly improves your chances of approval.

Why Presumptive Status Matters

Without presumptive status, many conditions would be nearly impossible to prove service-connected:

• How do you prove burn pit smoke caused your cancer 15 years later?
• How do you show Agent Orange exposure from 50 years ago caused your illness?
• How do you link Gulf War service to unexplained chronic symptoms?

Presumptive conditions recognize these scientific and practical realities, giving veterans the benefit of the doubt when evidence shows strong associations between service and illness.

Vietnam Era / Agent Orange

Locations Covered

You are presumed exposed to Agent Orange if you served in:

Vietnam (Boots on Ground)

• Republic of Vietnam between January 9, 1962 and May 7, 1975
• Including inland waterways

Blue Water Navy

• Offshore waters of Vietnam (within 12 nautical miles)
• Effective January 1, 2020

Thailand

• Certain U.S. Air Force bases along the perimeter
• U.S. Army bases in Thailand

Other Locations (Added by PACT Act)

• Laos (September 1964 – September 1973)
• Cambodia (at Mimot or Krek, Kampong Cham Province, April 16, 1969 – April 30, 1969)
• Guam or American Samoa (January 9, 1962 – July 31, 1980)
• Johnston Atoll (January 1, 1972 – September 30, 1977)

Agent Orange Presumptive Conditions

Agent Orange Children's Benefits

Children of Vietnam veterans may qualify for benefits if born with certain conditions:

• Spina bifida (any form except spina bifida occulta)
• Certain birth defects (for children of female Vietnam veterans)

Gulf War Era

Locations Covered

Service in the Southwest Asia theater of operations since August 2, 1990:

• Iraq
• Kuwait
• Saudi Arabia
• Bahrain
• Oman
• Qatar
• United Arab Emirates
• Gulf of Aden
• Gulf of Oman
• Persian Gulf
• Red Sea
• Airspace above these locations

Gulf War Presumptive Conditions

Chronic Multisymptom Illness (CMI)

If you have a cluster of unexplained symptoms lasting 6+ months, you may qualify under CMI. Symptoms include:

• Fatigue
• Pain (muscle, joint)
• Cognitive difficulties
• Gastrointestinal symptoms
• Skin conditions
• Respiratory symptoms

Undiagnosed Illnesses

Conditions that exist but have not been diagnosed with a specific name. Signs and symptoms may include:

• Abnormal weight loss
• Cardiovascular symptoms
• Fatigue
• Gastrointestinal signs
• Headaches
• Joint pain
• Menstrual disorders
• Muscle pain
• Neurological symptoms
• Neuropsychological symptoms
• Respiratory symptoms
• Skin conditions
• Sleep disturbances

Specific Conditions

• Functional gastrointestinal disorders (including IBS)
• Chronic fatigue syndrome
• Fibromyalgia
• Hypertension (added by PACT Act)

Time Limits for Gulf War Conditions

• Undiagnosed illness: Must manifest by December 31, 2026
• Chronic multisymptom illness: Must manifest by December 31, 2026
• Symptoms must have existed for at least 6 months and be at least 10% disabling

Post-9/11 / PACT Act

Locations Covered

Service on or after August 2, 1990 in:

• Afghanistan
• Iraq
• Kuwait
• Saudi Arabia
• Bahrain
• Oman
• Qatar
• United Arab Emirates
• Djibouti
• Egypt
• Jordan
• Lebanon
• Somalia
• Syria
• Yemen
• Uzbekistan
• Airspace above these locations

PACT Act Presumptive Conditions

Respiratory Conditions

• Asthma (diagnosed during or after service)
• Chronic bronchitis
• Chronic obstructive pulmonary disease (COPD)
• Chronic rhinitis
• Chronic sinusitis
• Constrictive bronchiolitis
• Emphysema
• Granulomatous disease
• Interstitial lung disease
• Pleuritis
• Pulmonary fibrosis
• Sarcoidosis

Cancers

• Brain cancer (including glioblastoma)
• Gastrointestinal cancers (esophagus, stomach, small intestine, colon)
• Head and neck cancers
• Kidney cancer
• Lymphatic cancer
• Lymphoma (any type)
• Melanoma
• Pancreatic cancer
• Reproductive cancers (prostate, testicular, ovarian)
• Respiratory cancers (lung, bronchus, trachea, larynx)
• Male breast cancer (added 2025)
• Urethral cancer (added 2025)
• Cancer of the paraurethral glands (added 2025)

Blood Cancers (Added 2025)

• Additional leukemias
• Additional myelomas
• Myelofibrosis

Other Conditions

• Monoclonal gammopathy of undetermined significance (MGUS)

Camp Lejeune Water Contamination

Eligibility Period

You may be eligible if you served at Marine Corps Base Camp Lejeune or Marine Corps Air Station (MCAS) New River, North Carolina for at least 30 cumulative days between August 1, 1953 and December 31, 1987.

8 Presumptive Conditions for VA Disability

These conditions qualify for presumptive service connection for disability compensation:

• Adult leukemia
• Aplastic anemia and other myelodysplastic syndromes
• Bladder cancer
• Kidney cancer
• Liver cancer
• Multiple myeloma
• Non-Hodgkin's lymphoma
• Parkinson's disease

Additional Conditions for Healthcare

Beyond the 8 presumptive conditions above, the VA provides healthcare benefits for 15 additional conditions associated with Camp Lejeune service, including various cancers and other serious illnesses.

Camp Lejeune Family Members

Family members who lived at Camp Lejeune during the contamination period may also qualify for healthcare benefits through the VA, even if the veteran has passed away.

Camp Lejeune Justice Act

The Camp Lejeune Justice Act (2022) also allows veterans and family members to file lawsuits against the government for harm caused by the contaminated water—separate from VA benefits.

Radiation Exposure

Eligibility (Radiation-Risk Activities)

You may be a "radiation-exposed veteran" if you:

• Participated in a nuclear test (atmospheric, above ground, underground)
• Were part of the occupation of Hiroshima or Nagasaki
• Were a prisoner of war in Japan
• Cleaned up after nuclear tests
• Participated in certain DOE activities

Locations

• Hiroshima/Nagasaki occupation (August 6, 1945 – July 1, 1946)
• Nuclear test sites (Pacific, Nevada, Alaska)
• Enewetak Atoll cleanup
• Certain DOE facilities

Presumptive Conditions

All forms of cancer are presumptive for radiation-exposed veterans, including:

• All forms of leukemia (except CLL)
• Cancers of the bile ducts, bone, brain, breast
• Cancer of the colon, esophagus, gall bladder
• Liver cancer (primary)
• Lung cancer
• Multiple myeloma
• Lymphomas
• Ovarian cancer
• Pancreatic cancer
• Pharynx cancer
• Prostate cancer
• Salivary gland cancer
• Small intestine cancer
• Stomach cancer
• Thyroid cancer
• Urinary tract cancer

How to File a Presumptive Claim

Step 1: Verify Your Service Dates and Locations

Gather documentation showing you served in qualifying locations:

• DD-214
• Personnel records
• Deployment orders
• Unit records

Step 2: Get Diagnosed

You still need a current diagnosis. See a doctor and get your condition documented. VA will accept:

• Private medical records
• VA medical records
• C&P exam diagnosis

Step 3: File Your Claim

File VA Form 21-526EZ through:

• VA.gov online
• Mail
• In person at VA regional office
• Through an accredited VSO

Step 4: Reference Presumptive Status

In your claim, specifically reference:

• The presumptive condition by name
• Your qualifying service location and dates
• The regulation that establishes presumption

Step 5: Attend C&P Exam

The exam will focus on:

• Confirming your diagnosis
• Assessing current severity
• Verifying service dates/locations

For presumptive conditions, the examiner should not need to provide an opinion on service connection—it is already presumed.

Previously Denied? How to Reopen

If you were denied in the past for a condition that is now presumptive:

Supplemental Claim

File VA Form 20-0995 if:

• You have new and relevant evidence
• The condition became presumptive after your denial (PACT Act, etc.)
• There was clear and unmistakable error in the original decision

Higher-Level Review

File VA Form 20-0996 if:

• You believe the original decision was wrong based on evidence available
• No new evidence is required

New Claim

In some cases, you can file a brand new claim, especially if:

• Years have passed since original denial
• Your condition has worsened
• New presumptive status applies

State Benefits by Condition Type

Some states offer additional benefits for veterans with specific conditions:

Frequently Asked Questions

Do I need to prove I was exposed to burn pits/Agent Orange?

No. If you served in qualifying locations during qualifying dates, exposure is presumed. You do not need specific documentation of exposure.

What if I have a condition not on the presumptive list?

You can still file a claim and attempt to prove direct service connection with medical evidence. The presumptive list is not exclusive—it just makes approval easier.

Can I get back pay if my condition became presumptive after denial?

Potentially. If you had an intent to file or pending claim when the condition became presumptive, you may receive back pay. Otherwise, your effective date is typically when you file the new/supplemental claim.

How long do presumptive claims take?

Generally 3-6 months, though complex cases may take longer. Presumptive claims often move faster because service connection is already established.

What conditions were recently added to the presumptive list?

In 2025, the VA added hypertension and MGUS for Agent Orange exposure, plus male breast cancer, urethral cancer, and cancer of the paraurethral glands for PACT Act coverage. The list continues to expand as new research emerges.

Take Action Now

Presumptive conditions represent one of the clearest paths to VA disability compensation. If you served in any of the locations mentioned and have one of these conditions:

1. File an Intent to File immediately to protect your effective date
2. Get your condition diagnosed if you have not already
3. Gather service records showing locations and dates
4. File your claim referencing presumptive status
5. Check state benefits that may add to your federal compensation

Critical Deadlines to Remember:

• Gulf War undiagnosed illness and chronic multisymptom illness claims must manifest by December 31, 2026
• There is no deadline for PACT Act toxic exposure claims
• There is no deadline for Agent Orange presumptive claims

Your service in these hazardous locations has been recognized. The presumptive conditions list is the government's acknowledgment that your service may have caused lasting harm. Do not hesitate to claim what you have earned—over 1.5 million veterans have already been approved under the PACT Act alone.