A cancer diagnosed decades after service often feels impossible to connect to it. For the recognized exposures, the law expects the delay: Agent Orange, burn pits, Camp Lejeune water, and ionizing radiation each carry presumptive cancer lists, and an active cancer on one of them is generally rated 100 percent during treatment without a separate nexus opinion.
The concept
Cancers can develop years after a military exposure. VA recognizes certain cancers as presumptively connected to qualifying exposures, including Agent Orange, burn pits, contaminated water at Camp Lejeune, ionizing radiation, and other hazards. Presumption means VA presumes the link without requiring the veteran to separately prove it.
Categories of recognized exposures
- Agent Orange and other herbicides, including expansions under the PACT Act.
- Burn pits and airborne hazards during service in Southwest Asia and certain other locations under the PACT Act.
- Camp Lejeune contaminated water between August 1953 and December 1987.
- Ionizing radiation, including atmospheric nuclear testing and certain occupational exposures.
- Gulf War service connected to undiagnosed and chronic multisymptom illnesses.
What you usually need
A current cancer diagnosis from a qualifying medical provider, evidence of qualifying service such as DD-214 and service personnel records, and confirmation that the diagnosis appears on the relevant presumptive list.
Active cancer rating
Most cancers are rated 100 percent during active treatment under the appropriate diagnostic code. After active treatment ends, VA schedules a residuals examination, and the rating may be reduced based on residuals.
Working with an accredited representative
Presumptive lists are detailed and change over time. An accredited representative can confirm coverage, identify residuals worth rating separately, and watch for connected claims such as survivor benefits.