Agent Orange & Toxic Exposure

VA recognizes several categories of toxic exposure, each governed by different regulations. Understanding which program applies to your service is the first step to filing a successful claim.

For in-depth PACT Act coverage, see our full PACT Act guide. For radiation-specific details, see Radiation Exposure.

Under 38 CFR 3.309(e), if you were exposed to an herbicide agent during active service, the following 19 conditions are service-connected even without evidence the disease started during service (provided the requirements of 38 CFR 3.307(a)(6) are met):

1. AL Amyloidosis — Rare disease caused by abnormal protein (amyloid) entering tissues or organs
2. Bladder Cancer (added by FY2021 NDAA, P.L. 116-283)
3. Chloracne (or similar acneform disease) *Must manifest within 1 year of last exposure
4. Chronic B-cell Leukemias — Includes hairy-cell leukemia and chronic lymphocytic leukemia
5. Diabetes Mellitus Type 2
6. Hodgkin's Disease
7. Hypertension (added by PACT Act, effective 2022)
8. Hypothyroidism (added by FY2021 NDAA, P.L. 116-283)
9. Ischemic Heart Disease — Includes coronary artery disease and coronary bypass surgery. Does NOT include hypertension or peripheral artery disease.
10. Monoclonal Gammopathy of Undetermined Significance (MGUS) (added by PACT Act, effective 2022)
11. Multiple Myeloma
12. Non-Hodgkin's Lymphoma
13. Parkinsonism (added by FY2021 NDAA, P.L. 116-283)
14. Parkinson's Disease
15. Peripheral Neuropathy, Early-Onset *Must manifest within 1 year of last exposure
16. Porphyria Cutanea Tarda *Must manifest within 1 year of last exposure
17. Prostate Cancer
18. Respiratory Cancers — Cancer of the lung, bronchus, larynx, or trachea
19. Soft Tissue Sarcomas (other than osteosarcoma, chondrosarcoma, Kaposi's sarcoma, or mesothelioma)

VA presumes herbicide exposure for veterans who served at specific locations during specific dates. The PACT Act significantly expanded this list.

Vietnam (January 9, 1962 – May 7, 1975)

• Served on land in the Republic of Vietnam
• Served on inland waterways of Vietnam ("Brown Water Navy")
• Served on a vessel within 12 nautical miles of shore ("Blue Water Navy" — see below)

Thailand Military Bases (January 9, 1962 – June 30, 1976)

PACT Act expansion: VA now presumes exposure for any veteran who served on any U.S. or Royal Thai military base in Thailand during this period. Before the PACT Act, only Air Force veterans near the perimeter and Army veterans providing perimeter security qualified.

Specific bases: U-Tapao, Ubon, Nakhon Phanom, Udorn, Takhli, Korat, and Don Muang RTAFBs.

Korean DMZ (September 1, 1967 – August 31, 1971)

Veterans who served in a unit in or near the Korean Demilitarized Zone. Official records document use of 21,000 gallons of Agent Orange in Korea in 1968–1969.

PACT Act Location Additions

• Laos (December 1, 1965 – September 30, 1969) — Defoliation along Ho Chi Minh Trail
• Cambodia, Mimot or Krek, Kompong Cham Province (April 16–30, 1969)
• Guam, American Samoa, and territorial waters (January 9, 1962 – July 31, 1980)
• Johnston Atoll and ships calling there (January 1, 1972 – September 30, 1977) — Agent Orange stored here; leakage equivalent of 405 drums between 1974–1977

U.S. Herbicide Test & Storage Sites

DoD records document herbicide testing and storage at multiple U.S. locations:

Public Law 116-23 (effective January 1, 2020) extended the presumption of herbicide exposure to veterans who served on vessels operating not more than 12 nautical miles seaward from Vietnam and Cambodia between January 9, 1962 and May 7, 1975.

• Veterans do not need to prove actual contact with Agent Orange — exposure is presumed
• Must have one of the 19 presumptive conditions listed above
• Spouses and dependents may qualify for DIC
• Children with spina bifida whose Blue Water Navy veteran parent was exposed are eligible for benefits

How to File

• New claims: VA Form 21-526EZ
• Previously denied claims: VA Form 20-0995 (Supplemental Claim)
• Survivors/Dependents: VA Form 21P-534EZ

C-123 aircraft were used in Operation Ranch Hand to spray Agent Orange in Vietnam. After Vietnam service, some contaminated aircraft were reassigned to active-duty and Reserve units in the United States.

Who Qualifies

Active-duty personnel and Reservists who had regular contact with contaminated C-123 aircraft through flight, ground maintenance, or medical duties.

File using VA Form 21-526EZ. Submit USAF Forms 2096, 5, or 781 as supporting documentation.

The PACT Act (P.L. 117-168), signed August 10, 2022, added presumptive conditions for veterans exposed to burn pits and other airborne hazards. For full PACT Act details, see our dedicated PACT Act page.

Qualifying Service Locations

• Post-9/11: Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Uzbekistan, Yemen (September 11, 2001 onward)
• Gulf War era: Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, Somalia, UAE, Arabian Sea, Gulf of Aden, Gulf of Oman, Persian Gulf, Red Sea (August 2, 1990 onward)

Presumptive Cancers

Presumptive Respiratory & Chronic Conditions

• Asthma (diagnosed after service)
• Chronic bronchitis
• COPD
• Chronic rhinitis and sinusitis
• Bronchiolitis
• Emphysema
• Granulomatous disease
• Interstitial lung disease
• Pleuritis
• Pulmonary fibrosis
• Sarcoidosis

Healthcare Expansion

• Combat veteran healthcare eligibility extended from 5 to 10 years post-separation
• Mandatory toxic exposure screening for all enrolled veterans, with follow-up every 5 years

Processing Impact

In its first year, VA processed 458,659 PACT Act claims, disbursing over $1.85 billion.

Contamination Period & Eligibility

• Period: August 1, 1953 – December 31, 1987
• Locations: Marine Corps Base Camp Lejeune and MCAS New River, North Carolina
• Minimum service: 30 days total (cumulative) at eligible locations during the contamination period
• Contaminants: Trichloroethylene (TCE), perchloroethylene (PCE), and benzene

8 Presumptive Conditions (VA Disability)

1. Adult leukemia
2. Aplastic anemia and other myelodysplastic syndromes
3. Bladder cancer
4. Kidney cancer
5. Liver cancer
6. Multiple myeloma
7. Non-Hodgkin's lymphoma
8. Parkinson's disease

15 Covered Conditions (VA Healthcare, No Copays)

The 8 presumptive conditions above, plus:

• Breast cancer
• Esophageal cancer
• Female infertility
• Hepatic steatosis (fatty liver disease)
• Lung cancer
• Miscarriage
• Neurobehavioral effects
• Renal toxicity
• Scleroderma

Family Member Benefits

Family members (spouses, children, legal dependents) who lived at or were in utero at these locations for 30+ days during the contamination period may receive care reimbursement for the 15 covered conditions. Apply using VA Form 10-10068. Help line: 866-372-1144 (TTY: 711).

Camp Lejeune Justice Act of 2022 (CLJA)

Radiation-Risk Activities

1. Onsite participation in atmospheric nuclear weapons tests (1945–1962)
2. Occupation of Hiroshima or Nagasaki, Japan (August 6, 1945 – July 1, 1946)
3. POW internment in Japan during WWII with comparable radiation exposure
4. Service at Nevada Test Site for 250+ days (1963–1992)
5. Enewetak Atoll radiological cleanup (January 1, 1977 – December 31, 1980) (PACT Act)
6. Palomares, Spain B-52 bomber recovery (January 17, 1966 – March 31, 1967) (PACT Act)
7. Thule AFB, Greenland fire response (January 21, 1968 – September 25, 1968) (PACT Act)
8. DoE gaseous diffusion plants (Paducah KY, Portsmouth OH, Oak Ridge TN) for 250+ days before February 1, 1992
9. Proximity to underground tests at Amchitka Island, Alaska before January 1, 1974
10. Nasopharyngeal radium treatments during military service

Presumptive Cancers

Under 38 CFR 3.309(d):

• Leukemia (except chronic lymphocytic leukemia)
• Lymphomas (except Hodgkin's disease)
• Multiple myeloma
• Cancer of the: bile ducts, bone, brain, breast, colon, esophagus, gallbladder, liver (primary site, not if cirrhosis or hepatitis B indicated), lung, ovary, pancreas, pharynx, salivary gland, small intestine, stomach, thyroid, urinary tract

Eligible veterans receive Priority Group 6 status and free health screenings through the Ionizing Radiation Registry.

Qualifying Service

Active service in the Southwest Asia theater of operations (August 2, 1990 and after): Iraq, Kuwait, Saudi Arabia, Bahrain, Qatar, UAE, Oman, Gulf of Aden, Gulf of Oman, Persian Gulf, Arabian Sea, Red Sea, and airspace above. Also includes Afghanistan (from September 19, 2001), Egypt, Israel, Jordan, Syria, Turkey, and specified waters.

Undiagnosed Illness

VA presumes service connection for a "qualifying chronic disability" that cannot be attributed to any known clinical diagnosis and has existed for 6+ months. Listed signs and symptoms include:

• Fatigue
• Skin signs or symptoms
• Headache
• Muscle pain / joint pain
• Neurological or neuropsychological signs
• Respiratory signs or symptoms
• Sleep disturbances
• Gastrointestinal signs or symptoms
• Cardiovascular signs or symptoms
• Abnormal weight loss
• Menstrual disorders

Chronic Multisymptom Illness

Diagnosed illness without conclusive pathophysiology, characterized by overlapping symptoms. Specifically includes:

• Chronic fatigue syndrome
• Fibromyalgia
• Functional gastrointestinal disorders (irritable bowel syndrome, functional dyspepsia)

Presumptive Infectious Diseases

Under 38 USC 1805, biological children of certain exposed veterans who have spina bifida (excluding spina bifida occulta) are eligible for benefits.

Eligibility

• Biological child of a veteran who served in Vietnam or Thailand (January 9, 1962 – May 7, 1975)
• Or a veteran who served in or near the Korean DMZ (September 1, 1967 – August 31, 1971)
• Child was conceived after the parent first entered the qualifying location
• Child has spina bifida (excluding spina bifida occulta)
• Children of Blue Water Navy veterans are also eligible under P.L. 116-23

Monthly Compensation (2026 Rates)

Rates effective December 1, 2025. Adjusted annually with COLA.

Additional Benefits

• Healthcare through the Spina Bifida Health Care Benefits Program (SBHCBP)
• Vocational training through Veteran Readiness and Employment (VR&E), available ages 14–31

Apply using VA Form 21-0304.

Standard Filing (VA Form 21-526EZ)

1. Online: File at VA.gov disability portal
2. By mail: Department of Veterans Affairs Claims Intake Center, PO Box 4444, Janesville, WI 53547-4444
3. In person: At a VA regional office
4. With help: Accredited attorney, claims agent, or VSO representative

Required Documentation

• DD-214 or discharge papers
• Medical records documenting the diagnosed condition
• Evidence of service in qualifying location/time period (ship name, unit assignment, orders)
• For C-123 claims: USAF Forms 2096, 5, or 781

For Presumptive Conditions

You do not need to prove the condition was caused by exposure. You only need to show: (1) service in a qualifying location during the qualifying time period, and (2) a diagnosed presumptive condition.

Previously Denied Claims

If your claim was denied before the PACT Act, file a Supplemental Claim (VA Form 20-0995) for re-evaluation under the new presumptive rules.

Toxic Exposure Screening

Every veteran enrolled in VA health care receives a mandatory initial screening, with follow-ups at least every 5 years. Covers burn pits, Gulf War exposures, Agent Orange, radiation, Camp Lejeune water, and other hazards. Available via telehealth.

• Not required to file a claim — participation is optional
• Veterans from qualifying operations (Desert Shield/Storm, Iraqi Freedom, Enduring Freedom, New Dawn) are automatically enrolled based on DoD records
• The registry collects deployment data only — no medical information
• Has no impact on VA health care or benefits eligibility
• Verify enrollment: contact your local VA Environmental Health Coordinator

A comprehensive, completely free health exam that alerts veterans to possible long-term health problems related to Agent Orange exposure.

Key Facts

• No VA enrollment required
• Not a C&P exam — it is not a disability exam
• Does not confirm Agent Orange exposure
• Does not automatically file a claim
• Based on the veteran's recollection of service, not military records

Who Is Eligible

• Vietnam veterans (1962–1975, any duration)
• Brown Water Navy and Blue Water Navy veterans
• Korean DMZ veterans (September 1, 1967 – August 31, 1971)
• Royal Thai Air Force base veterans (January 9, 1962 – June 30, 1976)
• C-123 aircraft crew (1969–1986)
• PACT Act expansion locations: Laos, Cambodia, Guam, American Samoa, Johnston Atoll
• Veterans involved in herbicide testing, transport, or spraying operations

Contact your local VA Environmental Health Coordinator or call 877-222-8387 to request an exam.

Dependency and Indemnity Compensation (DIC) is available to surviving spouses, dependent children, and dependent parents of veterans who died from a disease related to toxic exposure.

• Covers deaths from Agent Orange, burn pit, radiation, and other toxic exposure-related conditions
• Also available if veteran was totally disabled from service-connected conditions at time of death
• PACT Act expanded eligibility — conditions not previously presumptive may now qualify
• Surviving spouses and children of veterans who died from a VA-rated, service-connected disability may qualify for CHAMPVA healthcare (1-800-733-8387)

How Survivors File

• DIC: VA Form 21P-534EZ
• Contact: 1-800-827-1000
• Survivors' assistance: va.gov/survivors

VA recognizes several other site-specific environmental hazard exposures with separate eligibility criteria:

• Sulfur fire at Mishraq Mine, Iraq
• Hexavalent chromium at Qarmat Ali water treatment plant, Basra, Iraq
• Waste incinerator near Naval Air Facility, Atsugi, Japan

These have separate eligibility criteria from general burn pit and Agent Orange programs. See VA's specific environmental hazards page for details.

Soft tissue sarcomas are listed as a single entry in the 19 presumptive conditions above, but 38 CFR 3.309(e) identifies the following specific subtypes as presumptive for herbicide exposure:

The Nehmer v. U.S. Department of Veterans Affairs class-action settlement (1991) is one of the most important legal protections for Agent Orange veterans. It requires VA to automatically readjudicate claims whenever a new condition is added to the herbicide presumptive list.

What Is the Nehmer Settlement?

In 1986, Vietnam veterans filed a class-action lawsuit challenging VA's refusal to recognize Agent Orange-related diseases. The resulting settlement (finalized 1991, amended multiple times) established that when VA adds a new herbicide presumptive condition under 38 CFR 3.309(e), it must review all previously denied or pending claims for that condition. The implementing regulation is 38 CFR 3.816.

How Retroactive Effective Dates Work

Under 38 CFR 3.816, if you are a Nehmer class member and VA previously denied your claim for a condition that later became presumptive, your effective date may go back to:

• The date of your original claim — if you filed a claim for the condition that was denied before it became presumptive
• The date the disability arose — if you had the condition but had not yet filed a claim, and the condition existed before the new presumptive rule took effect
• The date the presumptive rule became effective — if the condition arose after the new rule took effect

This means veterans (or their survivors) can receive years of retroactive back pay for conditions that were denied before being added to the presumptive list.

Who Is a Nehmer Class Member?

Per 38 CFR 3.816(b), a Nehmer class member is any Vietnam veteran (or survivor of a Vietnam veteran) who has a claim for disability compensation for a disease covered by the herbicide presumption. This includes:

• Veterans who served "boots on the ground" in Vietnam (1962–1975)
• Blue Water Navy veterans within 12 nautical miles of Vietnam's coast
• Brown Water Navy veterans on inland waterways
• Thailand military base veterans (1962–1976)
• Korean DMZ veterans (1967–1971)
• C-123 aircraft crew members
• Veterans who served at PACT Act expansion locations with presumed herbicide exposure

Conditions With Nehmer Implications

Every time a new condition is added to the 38 CFR 3.309(e) presumptive list, Nehmer applies. Recent additions that triggered Nehmer readjudication include:

• Bladder cancer, parkinsonism, hypothyroidism — added by FY2021 NDAA (P.L. 116-283)
• Hypertension, MGUS — added by PACT Act (P.L. 117-168)

In addition to the Spina Bifida program (which covers children of all Vietnam-era veterans), a separate program under 38 USC 1811–1816 covers birth defects in biological children of women who served in Vietnam.

Eligibility

• Biological child of a woman veteran who served in Vietnam
• Mother served between February 28, 1961 and May 7, 1975
• Child was conceived after the mother first entered Vietnam
• Child has a covered birth defect that caused a permanent physical or mental disability

18 Covered Birth Defects (per 38 CFR 3.815)

The following conditions are identified in 38 CFR 3.815 as covered birth defects:

Monthly Compensation (2026 Rates)

Rates effective December 1, 2025. Adjusted annually with COLA. Source: VA.gov birth defect rates.

Additional Benefits

• Healthcare through the Children of Women Vietnam Veterans (CWVV) Health Care Benefits Program — no copays, no deductibles, 100% of allowable amounts
• Vocational training through VR&E, ages 14–31

How to Apply

• Form: VA Form 21-0304
• Mail: Claims Intake Center, PO Box 4444, Janesville, WI 53547-4444
• Fax: 844-531-7818
• Benefits questions: bdefects.vbaden@va.gov | TTY: 711
• Healthcare program: 833-930-0816 (TTY: 711) | sb.hac@va.gov

If your condition is not on the presumptive list under 38 CFR 3.309(e), you can still file a claim. You will need to establish direct service connection under 38 CFR 3.303.

What Direct Service Connection Requires

Without the presumptive shortcut, you must provide evidence of all three elements:

1. An in-service event or exposure — evidence you were actually exposed to herbicides during service
2. A current diagnosis — medical records showing you have the claimed condition now
3. A nexus — a medical opinion (typically from a doctor) linking your current condition to your in-service herbicide exposure

The Importance of Nexus Letters

For non-presumptive Agent Orange claims, a nexus letter from a qualified medical professional is often the most critical piece of evidence. The letter should state that it is "at least as likely as not" (50% or greater probability) that the condition is related to herbicide exposure during service. Private medical opinions are acceptable — you are not limited to VA doctors.

Common Denial Reasons

• No proof of qualifying service — DD-214, personnel records, or ship logs don't confirm service at a qualifying location. Request records from NPRC or use buddy statements as supporting evidence.
• Condition not currently diagnosed — A past diagnosis that has resolved is insufficient. You need evidence of a current, active condition.
• Missing nexus for non-presumptive conditions — Without a medical opinion linking your condition to exposure, VA will likely deny the claim.
• Time-limited condition filed too late — Chloracne, early-onset peripheral neuropathy, and porphyria cutanea tarda must manifest within 1 year of last exposure.

Herbicide Exposure at Non-Presumptive Locations

Veterans who were exposed to herbicides at locations not listed in 38 CFR 3.307(a)(6) can still file claims. Examples include:

• Service at bases where herbicides were used for vegetation control (not on the official DoD test/storage list)
• Exposure during transport, handling, or disposal of herbicide agents
• Service at locations where commercial herbicides containing dioxin were used

For these claims, you must prove actual exposure (the presumption does not apply). Evidence can include service records, unit histories, buddy statements, and DoD herbicide usage records.

Forms for This Topic

The official VA forms relevant to this page, in one place. Select a form to view, download, or add it to your report.

• VA Form 21-526EZ — Application for Disability Compensation and Related Compensation BenefitsUse VA Form 21-526EZ when you want to apply for VA disability compensation (pay) and related benefits.
• VA Form 20-0995 — Decision Review Request: Supplemental ClaimUse VA Form 20-0995 if you disagree with a VA decision and want to provide new evidence to support your claim.
• VA Form 21P-534EZ — Application for DIC, Survivors Pension, and/or Accrued BenefitsUse VA Form 21P-534EZ if you want to submit evidence along with your claim, using the Fully Developed Claim (FDC) program to get a decision on your claim faster.
• VA Form 10-10068 — Camp Lejeune Family Member Program Application
• VA Form 21-0304 — Application for Benefits for a Qualifying Veteran's Child Born with Disabilities
• VA Form 20-0996 — Decision Review Request: Higher-Level ReviewUse this form to request a Higher-Level review of the decision you received by the Department of Veterans Affairs based on the evidence of record at the time VA issued of the prior decision.
• VA Form 10182 — VA Form 10182 ↗(opens VA.gov in a new tab)Board Appeal — the Notice of Disagreement that sends your case to a Veterans Law Judge