Presumptive Conditions
For certain conditions, the VA presumes that the disability is connected to military service — removing the requirement for a nexus letter entirely.
What does "presumptive" mean?
If you have a qualifying condition and served in a qualifying location or time period, the VA will automatically accept the service connection without requiring you to prove a direct link (nexus) between your condition and your service. This significantly simplifies the claims process for these conditions.
Important
Even with presumptive conditions, you still need a current medical diagnosis. The presumption only removes the nexus requirement — you must still prove you have the condition today.
Presumptive Categories
PACT Act / Toxic Exposure
Burn pits, Camp Lejeune water contamination, and other toxic exposures
The PACT Act (2022) is the most significant expansion of VA benefits in decades. It covers veterans exposed to burn pits, Agent Orange, and other toxins during military service. If you served in a location with toxic exposures, you may qualify for presumptive service connection.
Gulf War Illness
Undiagnosed or medically unexplained chronic multi-symptom illnesses
Applies to veterans who served in the Southwest Asia theater of operations during the Gulf War era. Covers conditions such as chronic fatigue syndrome, fibromyalgia, and functional gastrointestinal disorders that cannot be attributed to a known clinical diagnosis.
Agent Orange
Conditions linked to herbicide agent exposure in Vietnam and other locations
Includes a specific list of presumptive conditions such as Type 2 diabetes, ischemic heart disease, Parkinson's disease, and several cancers. Applies to veterans who served in Vietnam, Thailand, or other locations where herbicide agents were used or tested.
Radiation Exposure
Conditions linked to ionizing radiation during service
Covers veterans who participated in nuclear weapons testing, cleanup operations (such as Enewetak Atoll), or served in certain locations like Hiroshima or Nagasaki. Includes various cancers and other conditions linked to radiation exposure.
Camp Lejeune Water Contamination
Veterans and family members exposed to contaminated water at Camp Lejeune (1953–1987)
If you served at Camp Lejeune for at least 30 cumulative days between August 1, 1953 and December 31, 1987, you may be eligible for VA health care and disability benefits for conditions linked to the contaminated water supply. The PACT Act expanded these benefits. Qualifying conditions include kidney cancer, liver cancer, non-Hodgkin's lymphoma, bladder cancer, and more.
The PACT Act (2022)
The Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act is the most significant expansion of VA health care and benefits for toxic-exposed veterans in over 30 years. It expands presumptive conditions for burn pit exposure, Agent Orange, and other toxic substances.
If you served in any location with known toxic exposures, you should review the PACT Act provisions to see if your conditions qualify for presumptive service connection.
Learn About Toxic Exposure BenefitsChronic Conditions (Within One Year of Discharge)
Certain chronic conditions that manifest to a degree of 10% or more within one year of discharge may also qualify for presumptive service connection. These include:
See 38 CFR § 3.309 for the full list of chronic presumptive conditions.