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Agent Orange & Toxic Exposure

A comprehensive guide to toxic exposure programs for veterans — covering Agent Orange, burn pits, Camp Lejeune water contamination, radiation, and Gulf War illness. Each program has different eligibility rules, conditions, and filing processes.

Overview of Toxic Exposure Programs

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.

Summary of five major VA toxic exposure programs
ProgramLegal AuthorityExposure Type
Agent Orange / Herbicides38 CFR 3.309(e)Herbicide agents (dioxin)
Burn Pits (PACT Act)P.L. 117-168; 38 CFR 3.320Airborne toxins from open burn pits
Camp LejeuneCLJA (part of PACT Act)Contaminated drinking water (TCE, PCE, benzene)
Radiation38 CFR 3.309(d)Ionizing radiation
Gulf War Illness38 CFR 3.317Unknown environmental hazards (Southwest Asia)

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

Agent Orange Presumptive Conditions

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)

Time-Limited Conditions

Three conditions must manifest to a degree of 10% or more within one year of last herbicide exposure: chloracne, early-onset peripheral neuropathy, and porphyria cutanea tarda.

Important Distinction

Bladder cancer, parkinsonism, and hypothyroidism were added by the FY2021 NDAA (P.L. 116-283), not the PACT Act. Hypertension and MGUS were added by the PACT Act (P.L. 117-168). This distinction matters because effective dates differ.

Herbicide Exposure Locations

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:

U.S. herbicide test and storage sites with dates
LocationStateDates
Avon Park Air Force RangeFL1951–1967
Eglin AFBFL1952–1969
Fort DrumNYMay–Oct 1959
Fort DetrickMD1946–1970
Aberdeen Proving GroundMD1963–1969
Fort GordonGA1967–1968
NCBC GulfportMSJun 1968–Jun 1977
Kelly AFBTXNov 1970 onward
Dugway Proving GroundUT1963–1964
Fort ChaffeeAR1967
Davis-Monthan AFBAZ1973–1977

Blue Water Navy — Agent Orange Act of 2019

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 Crew Exposure

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.

Active-Duty Bases (1962–1973)

  • Hurlburt / Eglin AFB, FL
  • Luke AFB, AZ
  • England AFB, LA
  • Langley AFB, VA
  • Davis-Monthan AFB, AZ
  • Howard AFB, Panama
  • Osan Air Base, South Korea
  • Clark AFB, Philippines

Reserve Bases (1969–1986)

  • Westover & Hanscom Field AFB, MA
  • Pittsburgh International Airport, PA
  • Lockbourne/Rickenbacker AFB, OH

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

PACT Act — Burn Pit Presumptive Conditions

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

Brain, Head & Neck

Glioblastoma, astrocytoma, head/neck cancers, eye cancers, cervical spine cancers

Gastrointestinal

Colorectal, esophageal, liver, pancreatic, stomach, small intestine, tongue cancers

Genitourinary

Renal cell carcinoma, bladder cancer, ureter cancer

Hematologic / Lymphatic

Leukemias, multiple myeloma, myelodysplastic syndromes, Hodgkin's and Non-Hodgkin's lymphomas

Melanoma

Skin melanoma (all subtypes), eye melanomas, mucosal melanoma

Reproductive

Breast, cervical, ovarian, uterine, prostate, testicular cancers

Respiratory

Lung (NSCLC and SCLC), laryngeal, trachea, nasopharyngeal, pharyngeal 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.

Camp Lejeune Water Contamination

This is a separate program from Agent Orange. Camp Lejeune involves contaminated drinking water (industrial solvents and benzene), not herbicide exposure. Different conditions, eligibility, and filing processes apply.

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)

  • Allows individuals exposed for 30+ days to file administrative claims with the Department of the Navy
  • Can pursue litigation in the U.S. District Court for the Eastern District of North Carolina
  • Court awards are offset by related VA disability payments already received
  • Elective Navy settlement options do not trigger offsets
  • Filing a CLJA claim does not affect VA benefit eligibility
  • DOJ contact: (202) 353-4426 / camplejeune.pactact@usdoj.gov

Radiation Exposure — Atomic Veterans

Separate program from Agent Orange. Governed by 38 CFR 3.309(d), not 3.309(e). For our full radiation guide, see Radiation Exposure.

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.

Gulf War Illness

Separate from burn pit cancer claims. Gulf War illness under 38 CFR 3.317 covers undiagnosed illness and chronic multisymptom illness. Burn pit cancers are covered under the PACT Act (38 CFR 3.320).

Deadline Removed by PACT Act

The PACT Act (Section 405) amended 38 USC 1117 to remove the prior December 31, 2026 manifestation deadline. Gulf War illness may now manifest at any time and to any degree. Note: 38 CFR 3.317 has not yet been updated to reflect this statutory change, but the law controls.

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

Within 1 year of separation:

  • Brucellosis
  • Campylobacter jejuni
  • Q fever
  • Malaria
  • Nontyphoid salmonella
  • Shigella
  • West Nile virus

Any time after separation:

  • Mycobacterium tuberculosis
  • Visceral leishmaniasis

Children of Exposed Veterans — Spina Bifida Benefits

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)

Spina bifida monthly compensation rates for 2026
LevelDescriptionMonthly Rate
Level ILeast disabling$430
Level IIModerate$1,457
Level IIIMost disabling$2,479

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.

How to File a Toxic Exposure Claim

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.

Airborne Hazards and Open Burn Pit Registry

  • 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

Agent Orange Registry Health Exam

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.

DIC for Toxic Exposure Deaths

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

Other Site-Specific Environmental Hazards

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.