PACT Act: Agent Orange Toxic Exposure

Spraying Agent Orange in Mekong Delta near Can Tho, 1969. (U.S. Army)

When Congress created the PACT Act in 2022, it expanded the Department of Veterans Affairs health care and disability compensation available to Vietnam-era veterans who may have been exposed to the defoliant Agent Orange during the course of their service.

The PACT Act addresses illnesses that may stem from exposures to toxins during military service, particularly Agent Orange, burn pits and contaminated water on Marine Corps bases. It allows the VA to presume that a veteran's illness is service-connected if they served in a certain place at a certain time.

As a result, veterans may be newly eligible for VA health care and/or monthly disability payments. If a veteran died of one of the service-connected conditions established in the PACT Act, the veteran's surviving spouse or children may also be eligible for VA Dependency and Indemnity Compensation.

Related: Why the U.S. Used Agent Orange in Vietnam and What Makes It So Deadly

The act added two new presumptive medical conditions for Agent Orange exposure -- one of which has proven the most claimed new condition since the VA started processing PACT Act applications -- plus five new presumptive Vietnam-era locations.

New Presumptive Conditions for Agent Orange

If the veteran has, or has had, one of these conditions and served in a presumptive Agent Orange location, the PACT Act assumes it is service-connected:

  • High blood pressure (also called hypertension)
  • Monoclonal gammopathy of undetermined significance (a blood disorder)

As of the Aug. 18, 2023, edition of the VA PACT Act Performance Dashboard, the department reported more claims for hypertensive vascular disease, a result of high blood pressure, than any other condition since it began processing PACT Act claims. The department had granted benefits for 79% of those claims.

Altogether, the VA had completed processing 437,358 PACT Act-related claims by mid-August 2023. Across the board for all conditions, the most common reason for a claim denial was the lack of a medical diagnosis.

Prior to the PACT Act, the VA already presumed that certain cancers and other illnesses resulted from exposure to Agent Orange. They are:

  • Bladder cancer
  • Chronic B-cell leukemia
  • Hodgkin disease
  • Multiple myeloma
  • Non-Hodgkin lymphoma
  • Prostate cancer
  • Respiratory cancers (including lung cancer)
  • Some soft tissue sarcomas
  • AL amyloidosis
  • *Chloracne (or other types of acneiform disease like it)
  • Diabetes mellitus type 2
  • Hypothyroidism
  • Ischemic heart disease
  • Parkinsonism
  • Parkinson's disease
  • *Peripheral neuropathy, early onset
  • *Porphyria cutanea tarda

* Under VA rating regulations, this condition must be at least 10% disabling within one year of herbicide exposure.

New Presumptive Locations for Agent Orange

The PACT Act also added five new locations where it presumes a service connection to Agent Orange exposure if a veteran has or had a presumptive medical condition:

  • Military bases in Thailand, Jan. 9, 1962-June 30, 1976
  • Laos, Dec. 1, 1965-Sept. 30, 1969
  • Locations in Cambodia, April 16-30, 1969
  • Guam or American Samoa or territorial waters off either location, Jan. 6, 1962-July 31, 1980
  • Johnston Atoll or on a ship that called there, Jan. 1, 1972, through Sept. 30, 1977

Prior to the PACT Act, the VA already presumed a service connection to Agent Orange exposure for certain medical conditions if a service member served in Vietnam, nearby waters or the Korean Demilitarized Zone; engaged in certain activities to transport Agent Orange; or served in an eligible reserve location. Those activities and locations include:

  • In the Republic of Vietnam
  • On a U.S. military vessel in the inland waterways of Vietnam
  • On a vessel not more than 12 nautical miles seaward from the demarcation line of the waters of Vietnam and Cambodia
  • In or near the Korean Demilitarized Zone anytime from Sept. 1, 1967, to Aug. 31, 1971
  • On Air Force active duty in a location where a C-123 aircraft with traces of Agent Orange was assigned, and had repeated contact with the aircraft
  • Involvement in transporting, testing, storing or other activities associated with Agent Orange
  • Assignment as a reservist to certain duties at Lockbourne/Rickenbacker Air Force Base, Ohio, 1969 to 1986; Westover Air Force Base, Mass., 1972 to 1982; and Pittsburgh International Airport, 1972 to 1982

How to File a PACT Act Claim

Filing a PACT ACT claim begins with VA Form 21-526EZ. VA processors will then track down the evidence of past toxic exposure and subsequent illnesses by looking up the veteran's service records and military medical treatment records, as well as records from civilian doctor's offices, if needed.

Most patients will need a VA medical exam before receiving benefits. Those who aren't quite ready to file can instead formally declare their intent to do so and help ensure the earliest effective date once benefits are approved.

Find out more about what to expect when filing a PACT Act claim.

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