Imagine breathing in burning plastic for days and days on end. Unfortunately, that is the experience that many of our veterans have endured. The PACT Act is the Sergeant First Class Heath Robinson Honoring Our Promise to Address Comprehensive Toxics (PACT) Act. The Act was signed into effect by President Biden on August 8, 2022, and aims to significantly extend healthcare benefits (VA benefits) to members of the military who were exposed to toxins during their time of service by adding over 20+ more presumptive conditions for burn pits and other toxic exposures, like Agent Orange during the Vietnam War.  It also offers monetary benefits to spouses and children of exposed veterans. 

Adding 20+ presumptive conditions to the list allows veterans to receive medical care without the burden of proof. In other words, for specific medical conditions, it is now presumed for example, that the cause was the location of their service and proximity to a burn pit.  Burn pit exposure is particularly dangerous as materials are often burned using JP-8 jet fuel, which contains benzene. This produces a large amount of toxic smoke that can travel through the air for miles. In June 2014, the VA launched the Airborne Hazards and Open Burn Pit Registry as an initial response to reports that veterans exposed to burn pits were experiencing various respiratory illnesses and in some cases, rare cancers. This voluntary registry helps researchers study the long-term effects of exposure to airborne hazards during deployments in Southwest Asia.

Rosie Torres, a senior advisor to 4DMedical and the co-founder and executive director of BurnPits 360, a non-profit organization that advocates Congress to help veterans suffering from injuries caused by military exposures, shared in an opinion piece on The Hill that, “Previously, veterans would have to prove beyond a shadow of a doubt that their illnesses are service-connected. That was extremely difficult with limited screening options and a lack of established processes at the Department of Veterans Affairs. The entire burden of proof was on the veteran. But under the PACT Act, there is now a presumption that a veteran’s illness is service-connected. By removing the burden of proof, the new law should help veterans exposed to toxic substances and airborne hazards gain access to health care options and benefits they have earned.”  

The VA offers a complete list of medical conditions and service locations that now fall under presumptive conditions. For example, a veteran who fought in Afghanistan in 2008 and then developed lung cancer several years later, is eligible for health coverage without needing to prove a link between their time and location of service and the cancer. Those who meet the requirements can receive free VA health care for any condition related to their service for up to 10 years from the date of their most recent discharge or separation. 

The addition of 20+ presumptive conditions also provides an opportunity for the dependents of veterans whose claims were previously denied to receive owed compensation. For example, if a veteran who was exposed to burn pits in Egypt later died of kidney cancer (a condition that was not previously covered or thought to be connected to their time of service) their dependent could now be eligible for Dependency and Indemnity Compensation.

While the concept of presumptive conditions is most often discussed concerning Veterans or the 9/11 compensation fund, some states have begun offering healthcare benefits to individuals like firemen, police officers, certain federal workers exposed to asbestos, and more. There is even emerging legislation that COVID-19 exposure for healthcare workers during the initial outbreak could fall under presumptive conditions and exposure for those suffering from long-COVID symptoms today. 

However, there is still much work to be done across the board in terms of diagnosis and treatment. “Veterans deserve better than having to rely on risky and invasive biopsies to diagnose their breathing issues,” said Dr. Andreas Fouras, founder of 4DMedical. “For the PACT Act to reach its full potential, the VA must scale up the evaluation and diagnosis process, without sending every veteran for an invasive biopsy, which will take a long time and pose additional health risks. We look forward to working with Congress on new and emerging technologies that can help this process.”