The PACT Act – What Does it Do?

The Honoring Our PACT Act, bipartisan legislation signed into law by President Joe Biden on August 10, 2022, includes many complex provisions.

Below are a few takeaways on some of what the PACT Act does.

1.  Adds “presumptive” conditions to streamline VA service-connected disability for qualified veterans and their survivors related to Agent Orange.

For veterans presumed by VA to have been exposed to Agent Orange:

    • Hypertension
    • A blood condition that can result in cancer, called Monoclonal gammopathy of undetermined significance (MGUS)

The PACT Act also expanded locations presumed for Agent Orange exposure, including:

    • Any U.S. or Royal Thai military base in Thailand from January 9, 1962, through June 30, 1976
    • Laos from December 1, 1965, through September 30, 1969
    • Cambodia at Mimot or Krek, Kampong Cham Province from April 16, 1969, through April 30, 1969
    • Guam or American Samoa or in the territorial waters off of Guam or American Samoa from January 9, 1962, through July 30, 1980
    • Johnston Atoll or on a ship that called at Johnston Atoll from January 1, 1972, through September 30, 1977

2.  Adds “presumptive” conditions for “covered veterans”* who served since August 2, 1990 or September 11, 2001.

The following conditions with the effective dates below are now “presumptive” as passed by Congress.  However, instead of the Congressionally directed phase-in dates shown below in parentheses following each condition, President Biden announced at the bill signing that he has ordered all conditions to be effective immediately.


      • Brain cancer (effective now)
      • Gastrointestinal cancer of any type (effective Oct. 1, 2024)
        Glioblastoma (effective now)
      • Head cancer of any type (effective Oct. 1, 2024)
      • Kidney cancer (effective Oct. 1, 2025)
      • Lymphoma/lymphomatic cancer of any type (effective Oct. 1, 2024)
      • Melanoma (effective Oct. 1, 2025)
      • Neck cancer of any type (effective Oct. 1, 2024)
      • Pancreatic Cancer (effective Oct. 1, 2024)
      • Reproductive cancer of any type (effective Oct. 1, 2024)
      • Respiratory cancer of any type (effective now)

Respiratory Conditions:

      • Asthma (already in effect)
      • Chronic bronchitis (effective Oct. 1, 2023)
      • Chronic obstructive pulmonary disease (COPD) (effective Oct. 1, 2023)
      • Constrictive bronchiolitis or obliterative bronchiolitis (effective now)
      • Emphysema (effective now)
      • Granulomatous disease (effective now)
      • Interstitial lung disease (effective now)
      • Pleuritis (effective now)
      • Pulmonary fibrosis (effective now)
      • Sarcoidosis (effective now)
      • Chronic Sinusitis (already in effect)
      • Chronic Rhinitis (already in effect)

Covered Veterans“* for the presumptive conditions above include those who:

On or after August 2, 1990, performed active military, naval, or air, or space service while assigned to a duty station in, including airspace above: Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, Somalia, United Arab Emirates (UAE).

On or after September 11, 2001, performed active military, naval, or air, or space service while assigned to a duty station in, including airspace above: Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Uzbekistan, Yemen, and any other country determined relevant by the Secretary of VA.

3.  Expands provisions related to service-connection for Chronic Multisymptom Illnesses and Undiagnosed Illness.  

The Honoring Our PACT Act:

  • Expands eligibility to include veterans who served in Afghanistan, Egypt, Israel, Jordan, Syria, or Turkey between Aug. 2, 1990 and an ending date to the “Persian Gulf War” as yet to be determined (previously, included solely the following locations: Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, United Arab Emirates (U.A.E.), the neutral zone between Iraq and Saudi Arabia, the Arabian Sea, the Gulf of Aden, the Gulf of Oman, the waters of the Persian Gulf,  the Red Sea, and the airspace above these locations).
  • Mandates VA use a Disability Benefits Questionnaire (DBQ) for Gulf War Illness
  • Permanently eliminates the expiration date for when eligible veterans can file these types of claims with the VA (previously, expired at the end of 2026)

4. Expands VA healthcare eligibility for toxic-exposed veterans.

This is a complex expansion with various phase-in dates and broad qualifying criteria.  Watch from updates on

The Honoring Our PACT Act also requires VA to provide a toxic exposure screening to every veteran enrolled in VA health care.


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