The VA defines a Presumptive Condition as a medical condition that is automatically assumed to be service connected. In other words, if you served in a qualifying time period and location, and then developed a particular health condition, the VA automatically “presumes” that it is a service related disability and recognizes your right to VA benefits.
We consider Presumptive Conditions to be win-win cases. To verify a Presumptive Condition, all you need is your Certificate of Release or Discharge from Active Duty (DD214), which indicates where and when you served. The VA then matches this information to the qualifying location and dates.
Rates for Presumptive Conditions
Technically, VA disability rates for Presumptive Conditions range between 0% and 100%. But because Presumptive Conditions are not included in the Schedule for Rating Disabilities, the rating procedure is not always well defined. Instead, Presumptive Conditions are rated based on similar conditions in the Schedule that have like symptoms
Ultimately, the VA disability rate of a Presumptive Condition depends on the judgment of the professional handling the case, which makes the overall rating procedure quite subjective, and it can be difficult to even estimate the rate in advance.
Applying for Presumptive Conditions
The VA uses presumptive service connection to simplify and expedite the claims process for Veterans who were exposed to an environmental hazard or served in geographic locations that presented a major health risk.
The process of applying for Presumptive Disability Benefits from the VA is similar to claiming other VA Disability compensation – You’ll need to complete the VA Form 21-526EZ, gather relevant military service records and medical documentation, and submit your application to the VA.
Categories for Presumptive Service Connection
Based on scientific and medical evidence that establishes a connection between a particular condition and exposure to hazards or circumstances during military service, the VA has identified 9 categories for presumptive service connection.
Once the time and circumstances of your military service as well as your diagnosis fall into one of these categories, you may be eligible for Presumptive Disability benefits:
- Agent orange exposure
Conditions associated with exposure to Agent Orange, a herbicide used during the Vietnam War. This category includes various cancers, respiratory disorders, and other health conditions. - Radiation exposure
Conditions related to exposure to ionizing radiation during military service, such as certain cancers and non-malignant thyroid disorders.
- Gulf War service
Medical conditions linked to service during the Gulf War included chronic fatigue syndrome and fibromyalgia. - Post-9/11 service
Certain cancers and respiratory disorders may be presumptive for Veterans who served in the aftermath of the September 11, 2001 terrorist attacks. - Asbestos exposure
Conditions associated with exposure to asbestos, such as mesothelioma and asbestos-related lung diseases.
- Tropical diseases
Infectious diseases that veterans may contract while serving in tropical areas, including malaria and certain tropical skin diseases.
- Prisoner of War (POW) status
POWs who were interned for a certain period may be eligible for presumptive service connection for various physical conditions such as arthritis, irritable bowel syndrome, or osteoporosis as well as mental disorders like anxiety, depression, and psychotic disorders. Note that to qualify for Presumptive Conditions in some cases you would have to be a POW for at least 30 days. - Combat related
Conditions like post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI), may be presumptive for veterans who experienced combat or military sexual trauma during their service.
- Camp Lejeune water contamination
Exposure to contaminated drinking water at Camp Lejeune, North Carolina, is also associated with several Presumptive Conditions including various cancers.
The PACT Act and Expanded Presumptive Disabilities Benefits
From time to time, the VA aexpands the list of conditions eligible for a presumptive service connection. As of the latest update for 2023–2024, this list includes over 200 conditions.
The Promise to Address Comprehensive Toxics Act of 2022, known as the PACT Act of 2022 is a law that expands VA health care and benefits for Veterans exposed to burn pits, Agent Orange, and other toxic substances.
The 2022 PACT Act is the largest health care and benefit expansion in VA history, which has added 26 Presumptive Conditions for exposure to those hazardous factors.
Here is the latest list of the Presumptive Conditions expanded by the PACT Act with the diagnostic codes:
- Asthma, code 6602
- Brain cancer, code 8002
- Chronic bronchitis, code 6600
- Chronic obstructive pulmonary disease, code 6604
- Chronic rhinitis, code 6522
- Chronic sinusitis codes 6510-6514
- Constrictive or obliterative bronchiolitis, code 6600
- Emphysema, code 6603
- Gastrointestinal cancer, code 7343
- Glioblastoma, code 8002 or code 8021
- Granulomatous disease, code 6524
- Head cancer, various codes
- Interstitial lung diseases, various codes
- Kidney cancer, code 7528
- Lymphatic cancer, various codes
- Lymphoma, code 7709 or code 7715
- Melanoma, code 7833
- Neck cancer, code 6819
- Pancreatic Cancer, code 7343
- Pleuritis, code 6845
- Pulmonary fibrosis, code 6825
- Reproductive cancer, code 7628 or code 7528
- Respiratory cancer, code 6819
- Rhinitis, code 6522
- Sarcoidosis, code 6846
- Sinusitis, codes 6510-6514
Think you Qualify for a Presumptive Condition?
VCU can help you determine this if you qualify, answer any questions you may have and explain the potential VA disability rating for your condition.
Schedule a free 30-minute call with one of our Veteran Specialists today!
