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2022 PACT ACT: UNDERSTANDING
HEALTH CARE ELIGIBILITY AND BENEFITS
What is the PACT Act? Why is it important?
The PACT Act is a new law that expands VA health care and benets
for Veterans exposed to burn pits and other toxic substances. This law
helps us provide generations of Veterans—and their survivors—
with the care and benets they’ve earned and deserve.
The Act (1) expands and extends eligibility for VA health care for
Veterans with toxic exposures and Veterans of the Vietnam era,
Gulf War era, and Post-9/11 era, and (2) expands eligibility for
benets for Veterans exposed to toxic substances.
What does the acronym, PACT, stand for?
Sergeant First Class Heath Robinson Honoring Our Promise to
Address Comprehensive Toxics (PACT) Act of 222.
When does the law go into eect?
While some provisions take eect at dierent times, VA considers
the presumptive conditions established in the PACT Act to be
applicable on the date the PACT Act was signed into law (August
1, 222). All Veterans and survivors who believe they may be
entitled to benets are encouraged to apply today.
What are the PACT Act key components?
» The Act expands and extends eligibility for VA health care for
Veterans with toxic-exposures and Veterans of the Vietnam era,
Gulf War era, and Post-9/11 era.
» VA will improve the decision-making process for determining
what medical conditions will be considered for presumptive status.
» Every enrolled Veteran will receive an initial toxic exposure
screening and a follow-up screening at least every ve years.
Veterans who are not enrolled, but who are eligible to enroll, will
have an opportunity to enroll and receive the screening.
» VA health care sta and claims processors will receive toxic
exposure-related education and training.
» The Act requires research studies on mortality of Veterans who
served in Southwest Asia during the Gulf War, Post-9/11 Veteran
health trends, and Veteran cancer rates.
» The Act will help VA build a stronger, more skilled workforce
to meet the growing demand for benets and services.
» The Act authorizes 31 new facilities across the country,
providing greater access to VA health care.
What is Toxic Exposure?
As a general matter, there are several types of possible
exposures or hazards Veterans may have experienced during
their military service, including:
AIR POLLUTANTS: Burn pits, oil well res, sulfur re, sand, dust,
and particulates
CHEMICALS: Agent Orange or other herbicides, burn pits, Camp
Lejeune water supplies, pesticides, depleted uranium, chromium,
or industrial solvents
RADIATION: Nuclear weapons testing, x-rays, or depleted uranium
WARFARE AGENTS: Chemical warfare agents, nerve agents,
mustard gas, herbicide tests, and storage
OCCUPATIONAL HAZARDS: Asbestos, lead, fuels, industrial
solvents, radiation, vibration, noise, special paint on military
vehicles, and some coolants or insulating uids
PACT ACT OVERVIEW
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What is a presumption of service connection?
VA assumes certain diseases or illnesses can be related to a Veteran’s
military service. Veterans and their survivors may be eligible for
benets and health care services for these conditions.
What new or expanded presumptions will the Act create
and when will they be in eect?
Veterans and survivors can le claims for all conditions outlined in
the PACT Act immediately.
For Gulf War and Post-9/11 Veterans, that includes:
Brain cancer, Glioblastoma, Respiratory (breathing-related) cancer
of any type, Gastrointestinal cancer of any type, Head cancer of any
type, Lymphoma of any type, Lymphomatic cancer of any type, Neck
cancer, Pancreatic cancer, Reproductive cancer of any type, Kidney
cancer, Melanoma, Asthma that was diagnosed after service, Chronic
rhinitis, Chronic sinusitis, Constrictive bronchiolitis or obliterative
bronchiolitis, Emphysema, Granulomatous disease, Interstitial lung
disease (ILD), Pleuritis, Pulmonary brosis, Sarcoidosis, Chronic
bronchitis, Chronic obstructive pulmonary disease (COPD).
For Vietnam Veterans and other Veterans exposed to tactical
herbicides, that includes two Agent Orange presumptive
conditions:
Monoclonal gammopathy of undetermined signicance (MGUS),
High blood pressure (also called hypertension).
Can Veterans apply now?
VA is considering the presumptive conditions established in the
PACT Act to be applicable on the date the bill becomes law. We
encourage all Veterans who believe they may be entitled to
benets to apply now.
What evidence must Veterans submit when ling a claim?
Veterans should submit any supportive evidence along with
their claims. The PACT Act states that in processing claims for
compensation related to toxic exposure, VA may consider any
Veteran record in an exposure tracking record system. If no
record exists, VA may consider the totality of circumstances. Claims
processors can also assist Veterans ling a claim by gathering any
identied medical evidence and requesting an examination or
medical opinion to substantiate the claim.
Veterans now eligible for benets based on a presumption of
service connection are encouraged to le a claim using VA Form
21-526EZ, Application for Disability Compensation and Related
Compensation Benets, or a supplemental claim using VA Form
20-0995, Decision Review Request: Supplemental Claim.
If a Veteran was previously denied a claim for any of these
conditions, what can they do?
VA will contact Veterans when a presumption of service connection
is established or changed. However, Veterans previously denied a
toxic-exposure related claim are encouraged to le a supplemental
claim. Once a supplemental claim is received, VA will review the
claim under the new law.
What actions should Veterans take who have never led a
claim for one of these conditions?
Veterans who are diagnosed with one of the new presumptive
conditions and meet eligibility requirements should submit a new
claim for consideration using VA Form 21-526EZ, Application for
Disability Compensation and Related Compensation Benets.
2022 PACT ACT: UNDERSTANDING
HEALTH CARE ELIGIBILITY AND BENEFITS
How can a Veteran le a disability claim?
Learn more at
VA.gov/disability/how-to-le-claim/
Call the Benets hotline (for specic questions)
at 1-800-827-1000
Visit a VBA Regional Oce
VA.gov/benets/oces.asp
Work with an accredited VSO
VA.gov/ogc/apps/accreditation/index.asp
PACT ACT BENEFITS
JANUARY 1, 2023:
VBA will begin processing claims.
EFFECTIVE NOW:
Adds 20+ new presumptive conditions. Applies to benets
eligibility for Veterans and survivors.
For Gulf War and Post-9/11 Veterans: Brain cancer,
Glioblastoma, Respiratory (breathing-related) cancer of any type,
Gastrointestinal cancer of any type, Head cancer of any type,
Lymphoma of any type, Lymphomatic cancer of any type, Neck
cancer, Pancreatic cancer, Reproductive cancer of any type, Kidney
cancer, Melanoma, Asthma (diagnosed after service), Chronic
rhinitis, Chronic sinusitis, Constrictive bronchiolitis or obliterative
bronchiolitis, Emphysema, Granulomatous disease, Interstitial
lung disease (ILD), Pleuritis, Pulmonary brosis, Sarcoidosis,
Chronic bronchitis, Chronic obstructive pulmonary disease (COPD).
For Vietnam Veterans and other Veterans exposed to tactical
herbicides, that includes two Agent Orange presumptive
conditions: Monoclonal gammopathy of undetermined
signicance (MGUS), High blood pressure (hypertension).
AUGUST 10, 2022:
PACT Act signed into law.
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PACT ACT BENEFITS
2022 PACT ACT: UNDERSTANDING
HEALTH CARE ELIGIBILITY AND BENEFITS
Will family members or dependents—those who lost a
loved one during the re-adjudication process or those
who lost a loved one who was previously denied a claim—
receive any benets because of the PACT Act?
Family members or dependents of a deceased Veteran may qualify
for various VA benets due to the additional disabilities dened in
the PACT Act if they meet eligibility requirements. Benets available
include Dependency and Indemnity Compensation (DIC), Accrued,
and Burial benets.
» DIC is a monthly payment for the eligible surviving spouse,
dependent child(ren) or parent(s) of a deceased Veteran who
died in the line of duty or from a service-connected disability or
disabilities. Evidence must show the Veteran’s death was caused
by, or related to, the Veteran’s time in service. Survivors who wish
to le a claim must complete VA Form 21P-534EZ to apply for
benets and submit any supportive evidence.
» Accrued benets are one-time payments to an eligible surviving
spouse, dependent child(ren) or dependent parent(s) of a
deceased Veteran based on the relationship when the evidence
of record shows benets, such as disability compensation or
Veterans pension, were due but unpaid prior to the Veteran’s
passing. A family member of the deceased Veteran may also
qualify by providing evidence of payment for the Veteran’s
nal expenses or burial. Survivors who wish to le a claim must
complete VA Form 21P-534EZ OR VA Form 21P-601 to apply for
benets and submit any supportive evidence.
» Burial benets are a at-rate payment to assist in covering
eligible Veteran burial in a national cemetery and funeral
costs. VA may provide burial benets to a family member or
dependent of a deceased Veteran who met the qualications
at the time of their passing. VA pays service-connected burial,
non-service-connected burial, plot or interment allowance, and
transportation reimbursement. Individuals who wish to le a
claim must complete VA Form 21P-530EZ to apply for benets
and submit any supportive evidence.
» Health care through the Civilian Health and Medical
Program of the Department of Veterans Aairs (CHAMPVA)
may also be available for survivors and dependents of Veterans
who are now, or who would have been, eligible for a service-
connected disability.
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2022 PACT ACT: UNDERSTANDING
HEALTH CARE ELIGIBILITY AND BENEFITS
What are the new health care eligibility criteria?
The PACT Act helps advance a top VA priority: getting more Veterans
into VA care by expanding eligibility for, and the availability of, health
care services for Veterans. The law expands health care eligibility to
several groups of Veterans who may not have been eligible before and
requires VA to phase in hospital care, medical services, and nursing
home care for any illness to three new categories of Veterans.
CATEGORY 1: Veterans who participated in a toxic exposure risk
activity (as dened by law) while serving on active duty, active
duty for training, or inactive duty training.
CATEGORY 2: Veterans who were assigned to a duty station
in (including airspace above) certain locations during specic
periods of time:
• On or after August 2, 1990, in: Bahrain, Iraq, Kuwait, Oman,
Qatar, Saudi Arabia, Somalia, or the United Arab Emirates
• On or after September 11, 2001, in: Afghanistan, Djibouti,
Egypt, Jordan, Lebanon, Syria, Yemen, Uzbekistan, or any other
country determined relevant by VA.
CATEGORY 3: Veterans who deployed in support of Operation
Enduring Freedom, Operation Freedom’s Sentinel, Operation Iraqi
Freedom, Operation New Dawn, Operation Inherent Resolve, or
Resolute Support Mission.
EFFECTIVE ON ENACTMENT AUGUST 10, 2022:
Veterans who served in the Republic of Vietnam (from 1/9/62–
5/7/75), Thailand at any US or Royal Thai base (from 1/9/62–
6/30/76), Laos (from 12/1/65–9/30/69), certain provinces in
Cambodia (from 4/16/69–4/30/69), Guam, or American Samoa
or their territorial waters (from 1/9/62–7/31/80), or the Johnston
Atoll or a ship that called there (from 1/1/72–9/30/77) may enroll
in VA health care.
BETWEEN OCTOBER 1, 2022, AND OCTOBER 1, 2023:
Veterans who served on active duty in a theater of combat
operations during a period of war after the Persian Gulf War
or in combat against a hostile force during a period of hostilities
after November 11, 1998, and who were discharged or released
between September 11, 2001, and October 1, 2013, may enroll in
VA health care. Enrollment is free, there are no annual costs, and
care may be free as well.
PACT ACT HEALTH CARE ELIGIBILITY
NOVEMBER 8, 2022:
Begin incorporating toxic exposure screening for enrolled
Veterans.
ON ENACTMENT AUGUST 10, 2022:
Veterans who served in the Republic of Vietnam, Thailand, Laos,
certain provinces in Cambodia, Guam, or American Samoa (or
their territorial waters), or the Johnston Atoll (or a ship that
called there) during specic time periods may enroll in VA
health care.
AUGUST 10, 2022:
PACT Act signed into law.
OCTOBER 1, 2022 OCTOBER 1, 2023:
Veterans who served on active duty in a theater of combat
operations during a period of war after the Persian Gulf War or
in combat against a hostile force during a period of hostilities
after 11/11/98, and who were discharged or released between
9/11/01–10/1/13 may enroll in VA health care.
OCTOBER 1, 2024:
Phase in enrollment for health care for Veterans identied
in Categories 1 and 2 who were discharged or released
August 2, 1990 - September 11, 2001.
OCTOBER 1, 2026:
Phase in enrollment for health care for Veterans identied
in Categories 1 and 2 who were discharged or released
September 12, 2001 - December 31, 2006.
OCTOBER 1, 2028:
Phase in enrollment for health care for Veterans identied
in Categories 1 and 2 who were discharged or released
January 1, 2007 - December 31, 2012.
OCTOBER 1, 2030:
Phase in enrollment for health care for Veterans identied
in Categories 1 and 2 who were discharged or released
January 1, 2013 - December 31, 2018.
OCTOBER 1, 2032:
Phase in enrollment for health care for Veterans identied in
Category 3.
PACT ACT ELIGIBILITY KEY DATES
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PACT ACT HEALTH CARE ELIGIBILITY
2022 PACT ACT: UNDERSTANDING
HEALTH CARE ELIGIBILITY AND BENEFITS
Learn more and sign up at VA.gov
Download the VA Health and Benets App
Call us at 1-800-MyVA411 (1-800-698-2411)
Find a VA at VA.gov/nd-locations/
What is a toxic exposure screening?
How will it help Veterans?
Veterans will be asked questions about potential exposure to an
open burn pit or other hazards commonly associated with military
environmental exposure. This will help VA identify other potential
risks for Veterans and inform future policy decisions.
How will a Gulf War or Post-9/11 Combat Veteran’s
eligibility be impacted?
The PACT Act extends and expands VA health care eligibility.
All Veterans are encouraged to apply for VA health care,
regardless of separation date. VA health care eligibility depends
on service history and other factors.
Veterans who served on active duty in a theater of combat
operations during a period of war after the Persian Gulf War or in
combat against a hostile force during a period of hostilities after
November 11, 1998, and who were discharged or released:
» Between September 11, 2001, and October 1, 2013, will have a
special enrollment period between October 1, 2022, and October
1, 2023 (if not previously enrolled in VA health care). During this
one-year period, Veterans will have another opportunity to apply
for enrollment. We strongly encourage them to do so to ensure
health care is available now and in the future. Enrollment is free,
there are no annual costs, and care may be free as well.
» After October 1, 2013, are eligible to enroll in VA health care
during the 10 year period from the most recent discharge or
separation date.
What is the Burn Pit Registry? How can a Veteran register?
The VA Airborne Hazards and Open Burn Pit Registry aims to help
VA better understand potential health eects of exposures and
proactively identify health concerns Veterans can discuss with their
health care providers for follow-up care.
Veterans deployed to Southwest Asia or Egypt after August 2,
1990, or Afghanistan, Djibouti, Syria, or Uzbekistan on or after
September 11, 2001, are eligible to participate in the registry.
Participation is voluntary and cannot negatively impact VA
health care access or compensation and benets claims.
Exposure to specic airborne hazards or having related health
concerns is not required to participate in the registry.
How can a Veteran apply for VA health care?
Apply online at
VA.gov/health-care/apply/application/introduction
Call the toll-free hotline at 877-222-8387
Monday – Friday, 8:00 a.m. – 8:00 p.m. ET
Mail a completed, signed Application for Health Benets
VA Form 10-10EZ
Bring a completed, signed VA Form 10-10EZ to the
nearest VA Medical Center or clinic.
