PACT Act, effective August 10, 2022, is a seminal change in VA disability. It opened up an entirely new avenue for Vets to seek service connection for conditions that previously put undue burden on Vets to prove occured in service. Here is a summary of the major changes brought in by PACT Act.

1. Added New Presumptive Locations for Agent Orange Exposure

1. Thailand

• Location: Any U.S. or Royal Thai military base
• Dates: January 9, 1962 – June 30, 1976

Under prior rules, many veterans had to prove “duty on or near the base perimeter” to receive presumptive exposure. The PACT Act expands this to cover any service at these installations during the listed dates.

---

2. Laos

• Location: Anywhere in Laos
• Dates: December 1, 1965 – September 30, 1969

Previously, Laos was not recognized for presumptive exposure unless veterans had clear documentation of specific missions or flight paths. The PACT Act removes that requirement.

---

3. Cambodia

• Locations: Mimot or Krek districts
• Dates: April 16, 1969 – April 30, 1969

Service in these specific border areas of Cambodia during this short window now automatically qualifies as presumptive exposure.

---

4. Guam (Including Territorial Waters)

• Location: The island of Guam or its territorial waters
• Dates: January 9, 1962 – July 31, 1980

This is a significant expansion; many veterans who served at Naval and Air Force installations on Guam now qualify under presumptive rules.

---

5. American Samoa (Including Territorial Waters)

• Location: The island of American Samoa or its territorial waters
• Dates: January 9, 1962 – July 31, 1980

Similar to Guam, this covers veterans stationed on American Samoa or on ships in its surrounding waters.

---

6. Johnston Atoll

• Location: Johnston Atoll (including service on ships that called there)
• Dates: January 1, 1972 – September 30, 1977

Johnston Atoll was known for storing and disposing of toxic substances, including Agent Orange stockpiles; the PACT Act now makes that exposure presumptive for the above timeframe.

2. New Presumptive Conditions for Agent Orange Exposure

• Hypertension
• Monoclonal gammopathy of undetermined significance (MGUS)

3. New Cancers Covered Under PACT Act

Presumptive service connection is granted for any of these new cancers under PACT Act:

• Brain cancer (of any type)
  • Example include glioblastoma
• Gastrointestinal cancer (of any type)
• Head cancer (of any type)
• Kidney cancer
• Lymphatic cancer (of any type)
• Lymphoma (of any type)
• Pancreatic cancer
• Respiratory (breathing) cancers of any type
• Reproductive cancer (of any type, including cancers of the breast, cervix, uterus, ovaries, prostate, testes, etc.)
  • This also includes male breast cancer

If and only if you served in any of these locations:

Gulf War Era: August 2, 1990, to Present

Southwest Asia theater of operations – including all airspace above these areas:

• Iraq
• Kuwait
• Saudi Arabia
• The neutral zone between Saudi Arabia and Iraq
• Bahrain
• Qatar
• United Arab Emirates (UAE)
• Oman
• Gulf of Aden
• Gulf of Oman
• Persian Gulf
• Arabian Sea
• Red Sea
• Somalia

Post-9/11 Era: September 11, 2001, to Present

Service in these countries—plus the airspace above them—also qualifies for presumptive exposure to burn pits and other toxic hazards:

• Afghanistan
• Djibouti
• Egypt
• Jordan
• Lebanon
• Syria
• Uzbekistan
• Yemen
• Israel
• Turkey

Note: Somalia, Israel, Turkey, and Egypt were previously not presumptive locations prior to PACT Act.

4. New Illnesses that are now presumptive of BPOT

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

Note: There is no longer a 10-year limit for these conditions, as was previously restricted under 38 CFR 3.320.

Again, these conditions are presumptive if and only if, you served in the following locations:

If and only if you served in any of these locations:

Gulf War Era: August 2, 1990, to Present

Southwest Asia theater of operations – including all airspace above these areas:

• Iraq
• Kuwait
• Saudi Arabia
• The neutral zone between Saudi Arabia and Iraq
• Bahrain
• Qatar
• United Arab Emirates (UAE)
• Oman
• Gulf of Aden
• Gulf of Oman
• Persian Gulf
• Arabian Sea
• Red Sea
• Somalia

Post-9/11 Era: September 11, 2001, to Present

Service in these countries—plus the airspace above them—also qualifies for presumptive exposure to burn pits and other toxic hazards:

• Afghanistan
• Djibouti
• Egypt
• Jordan
• Lebanon
• Syria
• Uzbekistan
• Yemen
• Israel
• Turkey

Note: Somalia, Israel, Turkey, and Egypt were previously not presumptive locations prior to PACT Act.

5. New Requirement for VA to Develop for Toxic Exposure During Active Service

PACT Act placed a requirement on VA to develop for inservice exposure to toxins. Inservice exposure to toxins is now considered an inservice event. So even if you do not have one of the disabilities listed above or served in one of the locations above, you can still qualify for service connection under PACT Act if medical evidence shows that your current disability is due to toxic exposure in service.