Presumptive Conditions, Where You Don't Prove the Link

Step 4 of the method is presumptive conditions. A presumption is the one place where you don't have to prove the link. If you qualify and don't know it, that's the easiest claim you'll ever file, unfiled.

A presumption turns on where and when you served, and the free Claim Map asks you exactly that.

What a presumption does, and what it doesn't

The general rule covers five kinds of disease. They're chronic, tropical, prisoner of war related, herbicide, and the water at Camp Lejeune. Each has to be on a list of presumptive diseases. Then the clause that does it.

… will be considered to have been incurred in or aggravated by service under the circumstances outlined in this section even though there is no evidence of such disease during the period of service.

Nothing in your service records, nothing on your separation exam, and the claim still stands. It doesn't hand you the condition or the service. You still need a diagnosis today, and you still have to show the right place and years. The opening of the chronic disease list sets the rest.

The following diseases shall be granted service connection although not otherwise established as incurred in or aggravated by service if manifested to a compensable degree within the applicable time limits …

On the list, bad enough to rate, inside the window. Every one can be knocked down, and the words for that are affirmative evidence.

The chronic disease window

The chronic disease list is long: arthritis, hypertension, diabetes, multiple sclerosis, peptic ulcers, the psychoses, and more.

The window is the part I've seen veterans told wrong more than any other. There are three, not one.

• One year from separation for almost everything on the list.
• Three years for Hansen's disease, which you may know as leprosy, and for tuberculosis.
• Seven years for multiple sclerosis.

Count from the day you separated. You also need 90 days or more of service during a war period or after December 31, 1946.

The diagnosis doesn't have to land inside the window. The symptoms do, bad enough to rate, and the diagnosis has to follow without unreasonable delay.

Herbicides, and the places the PACT Act added

Here the rule presumes the exposure itself, from where and when you served.

A veteran who, during active military, naval, or air service, served in the Republic of Vietnam during the period beginning on January 9, 1962, and ending on May 7, 1975, shall be presumed to have been exposed during such service to an herbicide agent, unless there is affirmative evidence to establish that the veteran was not exposed to any such agent during that service.

The PACT Act, short for Promise to Address Comprehensive Toxics, went further than the regulation. VA applies its own wider list, which adds these places.

• Any U.S. or Royal Thai military base in Thailand, January 9, 1962 through June 30, 1976.
• Laos, December 1, 1965 through September 30, 1969.
• Cambodia at Mimot or Krek in Kampong Cham Province, April 16, 1969 through April 30, 1969.
• Guam or American Samoa or their territorial waters, January 9, 1962 through July 31, 1980.
• Johnston Atoll or a ship that called there, January 1, 1972 through September 30, 1977.

VA lists them on its Agent Orange eligibility page, the same places and dates the nine steps carries.

The same rule also covers a unit near the Korean Demilitarized Zone (DMZ) and Air Force crews who worked on C-123 aircraft. The regulation still opens the DMZ window on April 1, 1968 and closes it on August 31, 1971. VA's page opens it earlier, on September 1, 1967, and VA's page is the one VA goes by. If you were near the DMZ in late 1967, read VA's dates before you decide you missed it.

The herbicide list names fourteen diseases, among them type 2 diabetes, ischemic heart disease, Parkinson's disease, and prostate cancer. Most can appear at any time after service. Three can't. Those are chloracne or another acneform disease like it, porphyria cutanea tarda, and early-onset peripheral neuropathy. Each has to show badly enough to rate at 10 or more within a year. The year runs from the last day you were exposed to an herbicide agent in service.

VA adds two the regulation doesn't carry, high blood pressure and monoclonal gammopathy of undetermined significance (MGUS). Both are on its PACT Act page.

Camp Lejeune

The rule presumes exposure if you had at least 30 days at Camp Lejeune between August 1, 1953 and December 31, 1987. The days don't have to be in a row, and reservists and National Guard members count.

Eight diseases are on the list, with no deadline on when they appear. They are kidney cancer, liver cancer, non-Hodgkin's lymphoma, adult leukemia, multiple myeloma, Parkinson's disease, aplastic anemia and other myelodysplastic syndromes, and bladder cancer.

The Gulf War and burn pits

Service in Southwest Asia, and in Afghanistan and other listed countries since 2001, has its own rules. The Gulf War rule, for service in the Southwest Asia theater, has a deadline. A disability has to show during service there, or badly enough to rate at 10 by December 31, 2026. VA has moved that date before, so check the current rule. Gulf War illness and burn pits has both rules, their lists, and their dates.

Radiation, prisoners of war, and the rest

For veterans exposed to radiation, the list names 21 cancers. It covers anyone who took part in a radiation-risk activity, from an atmospheric nuclear test to the occupation of Hiroshima or Nagasaki. The Enewetak Atoll, Palomares and Thule cleanups count too.

Former prisoners of war have a list that applies at any time after discharge. A second list applies if they were held 30 days or more. Tropical diseases have a list too. And ALS, amyotrophic lateral sclerosis, is presumed at any time after discharge for a veteran with 90 days or more of continuous active service.

What our counts show

We index the public Board of Veterans' Appeals decisions and read the heading over each issue. Here's the count across every year we have indexed, then since 2019.

• Herbicide exposure or Agent Orange: 88,377 issues, and 27,366 since 2019.
• An undiagnosed illness: 39,140, and 6,574 since 2019.
• Radiation: 12,935, and 2,077 since 2019.
• Camp Lejeune: 6,000, and 4,068 since 2019.
• A burn pit: 237, and 216 since 2019.

The burn pit record is almost all new, because the rule is new.

Since 2019 the Board sent 15,727 of those 27,366 herbicide issues back for more work, which is 57 percent of them. A remand isn't a yes and it isn't a no. If you're appealing one, plan on the long version.

Two things those counts are not. Every decision counted here is an appeal, so the regional office decided first and the veteran disagreed. These are not the odds on a first claim. And a heading names the theory a veteran raised, not the reason the Board decided. A mention is not a reason for the outcome.

What to do with it

A presumption runs on dates and places, and your DD-214 is what proves yours.

1. Send VA an intent to file first. If your complete claim reaches VA within a year of it, VA counts the claim as filed on the day the intent to file arrived. It doesn't have to name a condition. It doesn't work for a supplemental claim, where you add evidence and ask VA to decide again.
2. Then pull your DD-214 and personnel file, the way Step 1 lays out. Read the dates, the locations, and the unit.
3. Read them against the rules in Sources below and in part two, then against VA's lists, which run wider on herbicides and burn pits. The Claim Map asks the same where and when questions.
4. If you got out in the last seven years, read the chronic disease list against your records.
5. Get the diagnosis in writing, and name the presumption in the claim. Say the section and the service that opens it.

If the dates or places don't line up, you're not finished. A presumption is the shortcut, not the only road. Service connection is still possible for a disease first diagnosed after discharge, when the evidence shows it began in service.

This is education. It isn't legal advice and I'm not your representative.