Presumptive Doesn’t Mean Automatic: Why PACT Act Claims Still Get Denied

The PACT Act was a significant milestone for veterans who were exposed to toxic substances, such as burn pits and Agent Orange. With the addition of more than 20 new conditions, the law eliminated the need for many veterans to prove that their illnesses were directly related to their military service. This is a major victory after years of advocacy for these veterans.

But here’s the truth: “Presumptive” does not mean “automatic.” Despite the promises of the PACT Act, thousands of valid claims are still being denied each year. At Veterans Benefits Law Group, PLLC, we have seen how technical errors, missing documentation, or misunderstandings about eligibility can ruin even the strongest cases.

What “Presumptive” Really Means

Under VA regulations, a presumptive condition is a condition that the government assumes is connected to military service if certain criteria are met. For example, if you served in Iraq between 2003 and 2011 and were later diagnosed with glioblastoma, the VA will assume that your cancer was caused by exposure to burn pits.

However, this presumption applies only when all eligibility requirements have been met. The VA still requires proof of:

• Your diagnosis from a qualified medical provider
• Your service in a qualifying location during the covered time period
• That your claim was filed correctly and completely

If you fail to meet any of these requirements, your claim may be denied, even for a listed presumptive condition.

Common Reasons PACT Act Claims Are Denied

Incomplete or Missing Medical Evidence

The VA will not accept self-reported symptoms as proof of potential conditions. You must provide current, documented medical records showing a formal diagnosis from a doctor. For example, “trouble breathing” is not enough – you need a diagnosis of COPD, pulmonary fibrosis, or another specific respiratory illness from your doctor.

Service Location or Dates Don’t Match Presumption Rules

Not all overseas service is eligible. The PACT Act specifically lists exact locations and time frames for exposure to burn pits (for example, Djibouti after September 11, 2001). If your DD-214 does not clearly show service in an eligible area, or if your dates do not fall within the specified window, the presumption will not apply, even if you were actually exposed to the hazard.

Failure to File a Formal Claim

Many veterans mistakenly believe that simply enrolling in the VA Burn Pit Registry or receiving VA healthcare will automatically trigger benefits. This is not the case. You must still file a separate disability compensation claim using VA Form 21-526EZ or through the VA’s online portal in order to receive benefits.

Misclassification of Condition

Some cancers or illnesses may sound similar, but they are not listed in the official list of conditions covered by the PACT Act. For example, all gastrointestinal cancers are included, but irritable bowel syndrome, even if it is severe, is not considered a presumptive condition. Precision is important.

Survivors Face Additional Hurdles

The PACT Act also provides benefits for surviving spouses and dependents of veterans who died from conditions presumed to be related to service. However, claims require additional documentation such as a death certificate listing the covered illness as primary or contributing cause of death. Without this, VA may refuse dependency benefits even if the veteran was waiting for a decision on claim at time of death.

Don’t Accept a Denial Without Review

If your PACT Act claim has been denied, you have the right to appeal the decision. The VA’s initial decision is not final. Errors can happen, especially as the agency adapts to sweeping changes in the law. In fact, the VA acknowledges ongoing challenges in consistently processing PACT Act claims across regional offices.

At Veterans Benefits Law Group, PLLC, our lawyers in Ridgeland, MS specialize in helping veterans with toxic exposure cases. We review denial letters line by line, looking for missing evidence, fixing filing errors, and representing our clients before the VA to help them get the benefits they deserve.

Take Action—Even If You’ve Been Denied

The PACT Act was created to remove barriers and not to create false hope. However, its protections can only be effective if your claim is properly constructed from the beginning.

If you or a loved one have served in a high-risk area and are now suffering from cancer, respiratory disease, or any other condition listed, please do not assume that approval is guaranteed. If you are denied, do not give up.
Contact Veterans Benefits Law Group, PLLC today at (601) 414-3707 for a free, no-obligation consultation. We are proud to serve veterans in Jackson, Ridgeland and throughout Mississippi. Your service is unquestioned, and your benefits should not be either.