Presumptive Conditions
PACT Act, burn pits, Agent Orange, Camp Lejeune, water and plume bases, and what a 0% rating already means.
This is a study guide. Not a rater. Not a claims agent. Not a doctor. Lists of presumptive conditions change. Use the VA pages linked here for the list that applies to your service. DBQPrep is not a VSO.
What a presumptive is
A presumptive means: if your service and your condition are both on VA’s list, you do not have to prove the exposure caused that disease. Lawsuit money is separate from a VA rating. Only Camp Lejeune has both a paid individual compensation program and full VA presumptive recognition. Everywhere else is one, the other, or neither.
PACT Act and burn pits
The PACT Act added presumptive service connection for veterans with qualifying toxic exposures, including burn pits and other airborne hazards. It also expanded some locations and conditions for radiation, Gulf War, and Agent Orange service. If your service and your condition are both on the list, you do not have to prove the burn pit or airborne hazard caused that disease.
If VA denied you before on something that is now presumptive, file a Supplemental Claim (VA Form 20-0995) citing the new presumption. Old denials do not reopen themselves.
VA.gov — the PACT Act and your VA benefits
VA Form 20-0995 — Supplemental Claim
Agent Orange and herbicides
Agent Orange and other herbicide presumptives apply to qualifying service, locations, and dates (including expansions under the PACT Act for places such as Thailand and Guam — check the current VA list for your dates). The disease has to be on the presumptive list. A condition that is not on that list is not presumed from herbicide exposure.
VA.gov — Agent Orange exposure
Not on the list? TERA is the other door.
Presumptive is the fast door: your service and your condition are both on VA’s list, and the link is conceded. But the list is not the whole exposure story.
TERA stands for toxic exposure risk activity. If your duties put you around fuel, solvents, exhaust, chemicals, or burn pits — on a deployment or in a stateside motor pool — VA records that as an exposure risk activity in your file. You do not need a deployment for it. Training bases count. Motor pools count.
When you claim a condition that is not on the presumptive list and your file shows a TERA, VA has to order a medical opinion on whether your exposure caused your condition — an examiner has to answer the exposure question directly, not just the diagnosis question. That opinion is where non-presumptive exposure claims are won and lost.
Your exposure shows up in VA’s records as a TERA memorandum during your claim. If you were exposed in service and VA never wrote it down, say so in your claim — where you were, what the work was, what was in the air.
My exposure memo came back positive and I never deployed. Training bases and a motor pool. It still counted.
~Veteran
A 0% rating already won the nexus
A 0% rating means VA granted service connection. The nexus — that the condition is related to service — is already decided for that condition. 0% is a rating of severity. It is not a denial, and it is not a finding that nothing is wrong.
Compensation at 0% does not pay a monthly amount for that condition. The condition is still on the record. Health care eligibility and later claims can use that grant. For DIC planning, a 0% service-connected vital-organ or top-cause condition still matters. File while you can. Severity can be increased later.
Free accredited VSO
Charging for help with an initial VA claim is illegal (38 U.S.C. § 5904(c)(1)). Use a free accredited representative — a Veterans Service Organization, an accredited attorney, or a claims agent VA recognizes. DBQPrep is not a VSO and does not file claims.
Homepage Step 6 — free accredited VSO
VA.gov — get help from an accredited representative
Gulf War and MUCMI
For qualifying Southwest Asia and certain post-9/11 service, 38 CFR § 3.317 covers undiagnosed illness and medically unexplained chronic multisymptom illness (MUCMI). Chronic joint pain (arthralgia) is one of the signs VA lists under that rule. It is not a single diagnostic code for “full-body joint pain.” Each joint that hurts is still its own claim.
Joint pain / bilateral joints study interview
Camp Lejeune
Camp Lejeune is the rare case with both lanes. VA grants presumptive service connection for listed conditions tied to contaminated water (1953–1987), plus a separate healthcare list under the 2012 Act. The VA claim is still open. The Camp Lejeune Justice Act (CLJA) lawsuit program had its own filing deadline (8/10/2024). That lawsuit deadline has passed. Missing the lawsuit door does not block the VA presumptive claim. File VA Form 21-526EZ for the VA path. Track a timely CLJA filing in the CLJA claims portal if you already filed.
VA.gov — Camp Lejeune water contamination
An increase claim
When a service-connected condition is worse than the percent on the rating decision, the next step is an increase claim. That asks VA to rate current severity. It is not a new fight over whether service caused the condition, unless VA separately proposes to sever service connection.
VA.gov — how to file a disability claim
PFAS and TCE plumes
Many bases have PFAS (AFFF firefighting foam) or TCE/PCE plumes. As of the September 2026 review used for the DIC guide, VA lists no PFAS presumptives. Kidney cancer has been under review — confirm the current VA page before you treat any PFAS condition as presumptive. This page does not invent a PFAS disease list.
For these bases the usual VA lane is a direct claim with strong evidence and a nexus letter, plus a free accredited VSO (homepage Step 6). A lawsuit and a VA claim can run in parallel when both apply. One does not replace the other.
Other bases
Fort McClellan, Fort Ord, George Air Force Base, the Kelly / Joint Base San Antonio cluster, Cannon, Wright-Patterson, Red Hill, and K-2 each have their own story. Most of them are not a Camp Lejeune-style presumption. The full ranked chart — lawsuit or settlement versus VA status — is in the Protect Your Family DIC guide, not on this page.
Protect Your Family DIC guide — toxic exposure bases chart
Marketing averages are ads
Law-firm dollar averages for bases (for example George Air Force Base or Fort Ord) are advertising, not VA precedent and not a guaranteed settlement. Treat them as ads. The settlement table stays in the DIC guide so it is not confused with a VA benefit.