What is the PACT Act?

Agent Orange Exposure Locations & Presumptive Conditions

Locations and Timeframes:

• Republic of Vietnam: January 9, 1962, to May 7, 1975
• Korean Demilitarized Zone (DMZ): September 1, 1967, to August 31, 1971
• Thailand: Any U.S. or Royal Thai base from January 9, 1962, to June 30, 1976
• Laos: December 1, 1965, to September 30, 1969
• Cambodia: At Mimot or Krek, Kampong Cham Province from April 16, 1969, to April 30, 1969
• Guam or American Samoa (and their territorial waters): January 9, 1962, to July 31, 1980
• Johnston Atoll (or a ship that called there): January 1, 1972, to September 30, 1977
• C-123 Aircraft: For those who operated, maintained, or served onboard specific C-123 aircraft.

Presumptive Cancers:

• Bladder Cancer
• Chronic B-cell Leukemias
• Hodgkin's Disease
• Multiple Myeloma
• Non-Hodgkin's Lymphoma
• Prostate Cancer
• Respiratory Cancers (including lung cancer)
• Soft Tissue Sarcomas (certain types)

Presumptive Other Illnesses:

• AL Amyloidosis
• Chloracne (or similar acneiform disease)
• Diabetes Mellitus Type 2
• High Blood Pressure (Hypertension)
• Hypothyroidism
• Ischemic Heart Disease
• Monoclonal Gammopathy of Undetermined Significance (MGUS)
• Parkinsonism
• Parkinson's Disease
• Peripheral Neuropathy, Early-Onset
• Porphyria Cutanea Tarda

Camp Lejeune Water Contamination

Locations and Timeframes: Marine Corps Base Camp Lejeune or MCAS New River, North Carolina: For at least 30 cumulative days from August 1, 1953, through December 31, 1987.

Presumptive Conditions:

• Adult leukemia
• Aplastic anemia and other myelodysplastic syndromes
• Bladder cancer
• Kidney cancer
• Liver cancer
• Multiple myeloma
• Non-Hodgkin's lymphoma
• Parkinson's disease

Radiation Exposure

Locations and Timeframes:

• Cleanup of Enewetak Atoll: January 1, 1977, to December 31, 1980.
• Cleanup of Palomares, Spain (B-52 bomber crash): January 17, 1966, to March 31, 1967.
• Thule Air Force Base, Greenland (B-52 bomber crash): January 21, 1968, to September 25, 1968

Presumptive Conditions for Radiation Exposure:

• Cancers of the bile ducts
• Cancer of the bone
• Brain cancer
• Breast cancer
• Colon cancer
• Esophagus cancer
• Gall bladder cancer
• Liver cancer (primary, not metastatic)
• Lung cancer
• Pancreas cancer
• Pharynx cancer
• Ovary cancer
• Salivary gland cancer
• Small intestine cancer
• Stomach cancer
• Thyroid cancer
• Urinary tract cancer (kidney/renal, bladder, and ureter)
• Leukemias (except for chronic lymphocytic leukemia)
• Lymphomas (except for Hodgkin's disease)
• Multiple myeloma

It is important to note that the cancer must have manifested within a certain period after exposure to be considered presumptive, and for some conditions, there is no time limit. For the most detailed and current information on eligibility, time limits, and how to file a claim, I strongly recommend visiting the VA's public health page on radiation exposure.

TERA (Toxic Exposure Risk Activities) Explained

The TERA memorandum is a significant part of the PACT Act that creates a new framework for the VA to concede that a veteran was exposed to toxic substances during their military service. It is a crucial tool designed to lower the burden of proof for veterans filing disability claims for conditions they believe were caused by toxic exposure.

TERA refers to specific circumstances or events where a veteran was **likely** exposed to toxic substances, chemicals, or environmental hazards during their service. The key here is that the exposure doesn't have to be tied to a specific location like the burn pits in the Middle East or Agent Orange in Vietnam. It focuses on the *activity* itself.

Key Advantages of the TERA Framework

• No Need to Prove Exposure: The biggest advantage is that a veteran no longer has the burden of proving that the exposure occurred. The TERA memorandum shifts that responsibility to the VA.
• Covers Non-Presumptive Conditions: This is a pathway for service connection for any condition, not just those on the PACT Act's presumptive lists. If you have a rare cancer or another illness you believe is from your service, the TERA process can help you make your case.
• Broader Application: It applies to veterans from all eras and locations, as long as they were involved in a toxic exposure risk activity.

Example of TERA activities:

1. Air Pollutants

• Burn Pits: Working at, living near, or being downwind from open-air burn pits.
• Oil Well & Sulfur Fires: Exposed to smoke and particulates from oil well fires in Kuwait or sulfur plant fire near Mosul.
• Sand and Dust Storms: Routinely operating in desert environments with high levels of fine particulate matter.
• Waste Incinerators: Service at locations with industrial waste incinerators, such as Atsugi, Japan.

2. Chemicals

• Herbicide Exposure: Handling or being in areas treated with herbicides like Agent Orange.
• Contaminated Water: Living or working at bases with known water contamination, like **Marine Corps Base Camp Lejeune**.
• Pesticide Application: Working in roles that required mixing or applying pesticides.
• Fuel and Solvent Exposure: Regularly handling fuels (like jet fuel JP-8), industrial solvents, degreasers, and special paints (like CARC). Common for **aircraft mechanics, vehicle maintenance crews, and some supply personnel.**

3. Occupational Hazards

• Asbestos Exposure: Working in construction, demolition, shipbuilding, or vehicle repair before the 1990s. Many Navy jobs have a high probability of asbestos exposure, such as **Machinist's Mate, Boilermaker, Hull Maintenance Technician, and Electrician's Mate**.
• Lead Exposure: Working with lead-based paints, at firing ranges, or in other industrial settings.
• Firefighting Foam (PFAS): Being a firefighter or part of emergency response teams that used AFFF.
• Shipyard Duty: Performing maintenance, repairs, or decommissioning of ships, involving toxins like lead paint, solvents, asbestos, and welding fumes. A **Damage Controlman (DC)** is an MOS with conceded TERA due to these activities.

4. Radiation

• Nuclear Weapons: Handling, maintaining, or being part of detonation/testing.
• Radiological Cleanup: Participating in cleanup operations at **Enewetak Atoll, Palomares (Spain), and Thule (Greenland)**.
• Nuclear Propulsion: Serving on a nuclear-powered submarine or ship.
• X-Ray Technician: Regularly operating x-ray equipment.

5. Warfare Agents

• Chemical/Biological Weapon Testing: Participating in testing programs like **Project 112/SHAD**.
• Mustard Gas Exposure: Involved in the German bombing of Bari, Italy (WWII).
• Handling Nerve Agents: Working in roles that required handling or disposal.

The VA must consider the specific circumstances of your service. If your job duties or deployment location made it likely that you were exposed to a hazardous substance, it can be considered a TERA.

The Most Important Thing to Know: The Burden of Proof Has Shifted

Under the TERA guidelines, the VA has a "duty to assist" and is required to review your service records to determine if a TERA occurred. You do not have to definitively *prove* the exposure; you have to show that your service likely placed you in a situation where exposure was possible.

Your primary job is to provide the "who, what, when, and where" of your service. The VA's job is to use that information to officially note or admit the exposure.

Personal/Buddy Statement (Lay Statement)

This is **extremely important**. Use **VA Form 21-4138 (Statement in Support of Claim)** or find a template from AFL here. **Be specific.**

Connect it to your job:

"As a 91B Wheeled Vehicle Mechanic, my duties included daily use of TCE and other solvents to clean engine parts in a poorly ventilated maintenance bay. We were not issued respirators and had direct skin contact with these chemicals."

"Buddy Statements" (Statements from fellow service members)

A statement from someone you served with can be incredibly useful. Ask them to be specific about what they remember, confirming your location, your duties, and the conditions you experienced together.

Photos or Personal Journals

Do you have any photos of yourself with the burn pit, a dust storm, or your work environment in the background? Visual evidence can be used. If you kept a journal that mentioned the conditions, that can also serve as evidence.