Burn pits and particulate matter
Risk varied by distance, work and living location, materials burned, wind, frequency, duration, and respiratory protection.
2001–present qualifying service
GWOT / Post-9/11 Exposures
Burn pits disposed of plastics, chemicals, paint, medical and human waste, and petroleum products—sometimes using JP-8. Veterans also encountered sand, dust, diesel exhaust, industrial pollution, sulfur-fire smoke, and task-specific hazards.
All wartime eras
Hazards and evidence questions
PACT Act conditions
More than 20 cancers and respiratory illnesses are presumptive for qualifying service, including asthma after service, COPD, rhinitis, sinusitis, fibrosis, sarcoidosis, and constrictive bronchiolitis.
Qarmat Ali
About 830 U.S. service members were potentially exposed to sodium dichromate dust containing hexavalent chromium at the Iraqi facility in 2003.
Mishraq sulfur fire
Sulfur dioxide can cause airway injury. Unit position, plume proximity, acute symptoms, and other inhalants must be separated and documented.
Watch this first
VA disability claims for burn pits, Agent Orange, and more under the PACT Act
VA explains how the PACT Act presumptions work for burn-pit and airborne-hazard claims. Treat this as the floor, not the ceiling. The presumption gets the condition service-connected; the percentage still turns on measured test results and on how bad your worst weeks actually are, and that is where post-9/11 veterans lose money without ever being denied.
Source: U.S. Department of Veterans Affairs, official channel
Accuracy safeguard: A presumptive exposure does not make every diagnosis presumptive. Match the exact disease to the current list.
Unique and shared
What this generation is up against
Post-9/11 veterans got the widest presumptive expansion in the history of the compensation system, and they are still being denied inside it. The PACT Act made 23 respiratory conditions and cancers presumptive for covered service, with no exposure proof and no nexus opinion required. Yet claims come back denied because the decision used the wrong location list, applied pre-2022 rules, or fixed on a diagnosis that is close to the list without being on it. “Reactive airway disease” is not “asthma” on paper. “Chronic cough” is not “chronic bronchitis.” That one word has cost veterans years, and correcting the wording of the diagnosis is often the entire fix.
The second problem is the small airways. The disease that burn pits and fine desert particulate produce sits deep in the lung, in airways too small for routine spirometry to see. Biopsy-confirmed constrictive bronchiolitis has been reported in symptomatic deployers whose noninvasive testing looked relatively unremarkable, and a specialty referral series found deployment-related distal lung disease in 68.5 percent of the deployers evaluated. So when an examiner writes “pulmonary function testing within normal limits,” that finding proves very little without post-bronchodilator values, diffusing capacity, and exercise testing. That is the argument to make — the adequacy of the examination, not the credibility of the veteran.
Two veterans of the same conflict rarely carry the same claim, and veterans of different conflicts often carry the same one. The first panel is what belongs to this era alone. The second is the layer this era shares with the rest of the site — and it is the layer that reopens old denials.
Only this era
Unique to post-9/11 service
Named sites and named exposures. When your file identifies the specific installation and what was burning or spilled there, the claim stops being generic.
- The Balad burn pit, roughly ten acres at its peak. Plastics, styrofoam, metals, paint, solvents, batteries, medical waste, human waste, and unexploded ordnance, burned in the open and accelerated with JP-8 jet fuel, upwind of housing units.
- Qarmat Ali water treatment plant, 2003. Roughly 830 service members were present at a site contaminated with sodium dichromate, a source of hexavalent chromium — a known human carcinogen.
- The Al Mishraq sulfur plant fire, June 2003. One of the largest sulfur dioxide releases ever recorded, burning for weeks near deployed units.
- Karshi-Khanabad, Uzbekistan — K2. Jet-fuel-contaminated soil, chemical-weapons decontamination residue, and processed uranium at a former Soviet base. Covered through the Uzbekistan entry in the PACT Act location list.
- Extremely fine desert particulate combined with continuous diesel generator exhaust vented into living and working areas — an inhalation profile that has no civilian equivalent.
Crosses eras
Shared with veterans of other eras
Two of these will surprise you, and the last one is the mistake that gets post-9/11 files answered under the wrong law entirely.
- The 23-condition burn pit list is shared with 1990 to 1991 Gulf War veterans. Only the covered locations and start dates differ — August 2, 1990 for the Gulf countries, September 11, 2001 for Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Uzbekistan, and Yemen.
- The § 3.317 Gulf War pathway covers post-9/11 Southwest Asia service too, including undiagnosed illness, chronic fatigue syndrome, fibromyalgia, and functional gastrointestinal disorders. It is not a Desert Storm-only regulation.
- Camp Lejeune water contamination between August 1, 1953 and December 31, 1987, PFAS and firefighting foam on flight lines, asbestos in older buildings and ships, industrial solvents, and lead — all still live in post-9/11 files.
- Automatic entry in the Airborne Hazards and Open Burn Pit Registry for service between August 2, 1990 and August 31, 2021, added by VA from service records since August 1, 2024.
- Agent Orange is not shared. Herbicide presumptions do not reach this era, and a post-9/11 claim that raises Agent Orange gets answered under a regulation that cannot help it — while the regulation that could help it goes unaddressed.
Conditions
What these exposures can cause
The presumptive list in this era is long enough that most veterans stop reading after it. That is a mistake, because the ratings that change a household’s income are usually the secondary conditions nobody claimed — the sleep apnea behind the sinusitis, the depression behind the years of breathlessness.
Presumptive
The 23 PACT Act presumptive conditions
Covered service on or after September 11, 2001 in Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Uzbekistan, or Yemen, or on or after August 2, 1990 in Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, Somalia, or the United Arab Emirates — including the airspace above those countries. No exposure proof, no nexus opinion:
- Asthma that was diagnosed after service
- Chronic bronchitis
- Chronic obstructive pulmonary disease
- Constrictive or obliterative bronchiolitis
- Emphysema
- Granulomatous disease
- Interstitial lung disease
- Pleuritis
- Pulmonary fibrosis
- Sarcoidosis
- Chronic rhinitis
- Chronic sinusitis
- Head cancer of any type
- Neck cancer of any type
- Respiratory cancer of any type
- Gastrointestinal cancer of any type
- Reproductive cancer of any type
- Lymphoma of any type
- Lymphomatic cancer of any type
- Kidney cancer
- Brain cancer
- Melanoma
- Pancreatic cancer
Facts-found
Site-specific exposures argued on the facts
When your disease is not on the list, the site itself becomes the argument. These claims are won by naming the installation, the date range, and the specific contaminant — not by describing deployment in general.
- Hexavalent chromium exposure at Qarmat Ali in 2003, and the respiratory disease, sinonasal disease, and cancers associated with it
- Sulfur dioxide injury after the Al Mishraq fire, including persistent airway hyperreactivity
- Uranium and solvent exposure at K2, and the cancers and kidney disease claimed from it
- Neurologic and cognitive complaints following heavy solvent, fuel, and pesticide handling
- Autoimmune and thyroid disease reported after prolonged particulate and chemical exposure
- Bladder and kidney disease after long-term degreaser and fuel work in maintenance and fuel-handling jobs
Secondary
Secondary conditions — where the rating usually is
Every one of these requires a service-connected condition first, then a diagnosis, then an opinion tying the two together. They are rated separately and combined — they are not absorbed into the first rating.
- Obstructive sleep apnea secondary to service-connected chronic rhinitis, chronic sinusitis, or asthma
- Depression and anxiety secondary to chronic breathing disease or chronic pain
- Gastroesophageal reflux disease secondary to medication or to respiratory disease
- Hypertension secondary to obstructive sleep apnea
- Chronic headache secondary to chronic sinusitis
- Erectile dysfunction secondary to medication, which also opens special monthly compensation under 38 CFR § 3.350
One phrase confuses more veterans than any other in this era: asthma is presumptive when it is “diagnosed after service.” That is part of the presumption, not a bar to it. A diagnosis that came five or fifteen years after you got out is exactly what the list describes.
Rating criteria
Possible ratings, spelled out
Breathing conditions dominate this era, and two of the three codes below can be met by the treatment you take rather than by any number on a breathing test. That is not a loophole — it is what the schedule says, in the schedule’s own words.
DC 6602PACT Act presumptive when diagnosed after service
Asthma
38 CFR § 4.97
THE NOTE THAT FOLLOWS DIAGNOSTIC CODE 6602
NoteIn the absence of clinical findings of asthma at the time of examination, a verified history of asthmatic attacks must be of record.
100%
FEV-1 or FEV-1/FVC under 40% predicted, or more than one attack per week with episodes of respiratory failure, or daily use of systemic (oral or injected) high-dose corticosteroids or immunosuppressive medication.
60%
FEV-1 or FEV-1/FVC of 40 to 55% predicted, or at least monthly visits to a physician for required care of exacerbations, or intermittent courses — at least three per year — of systemic corticosteroids.
30%
FEV-1 or FEV-1/FVC of 56 to 70% predicted, or daily inhaled or oral bronchodilator therapy, or inhaled anti-inflammatory medication.
In plain terms: Read that last clause again. A daily inhaler meets this criterion on its own — your breathing test does not have to be abnormal at all.
10%
FEV-1 or FEV-1/FVC of 71 to 80% predicted, or intermittent inhaled or oral bronchodilator therapy.
That note is the answer to the most common denial in this era. If your breathing test on the day of the examination was normal, a verified history of attacks still carries the claim — refill records, urgent care visits, and a provider statement all qualify as that history.
DC 6510–6514PACT Act presumptive
Chronic sinusitis
38 CFR § 4.97, General Rating Formula for Sinusitis
CONDITIONS RATED ON THIS FORMULA
6510Sinusitis, pansinusitis, chronic
6511Sinusitis, ethmoid, chronic
6512Sinusitis, frontal, chronic
6513Sinusitis, maxillary, chronic
6514Sinusitis, sphenoid, chronic
NoteAn incapacitating episode of sinusitis means one that requires bed rest and treatment by a physician.
50%
Following radical surgery with chronic osteomyelitis, or near-constant sinusitis with headaches, pain and tenderness of the affected sinus, and purulent discharge or crusting after repeated surgeries.
30%
Three or more incapacitating episodes a year requiring four-to-six-week antibiotic treatment, or more than six non-incapacitating episodes a year with headaches, pain, and purulent discharge or crusting.
10%
One or two incapacitating episodes a year requiring four-to-six-week antibiotic treatment, or three to six non-incapacitating episodes a year.
0%
Detected by X-ray only.
Sinusitis is rated on counted episodes, not on imaging. If your flares are treated with a five-day antibiotic and never charted as episodes, the record will not support 30 percent no matter how often they come. Ask your provider to document each episode, its duration, and the length of the antibiotic course.
DC 6522PACT Act presumptive
Chronic rhinitis
38 CFR § 4.97
30%
Allergic or vasomotor rhinitis with polyps.
10%
Allergic or vasomotor rhinitis without polyps, but with greater than 50 percent obstruction of the nasal passage on both sides, or complete obstruction on one side.
Ten or 30 percent is the whole code, which is why rhinitis matters most as the anchor for what it causes. Chronic nasal obstruction is one of the most commonly accepted bases for secondary obstructive sleep apnea — and sleep apnea, rated under diagnostic code 6847 and combined with everything else, is frequently the largest single rating in a post-9/11 file.
The full breathing schedule — all 61 diagnostic codes in 38 CFR § 4.97, including the general formula for COPD and bronchitis, interstitial lung disease, and the sleep apnea criteria — is reproduced in plain language on our respiratory evidence page, along with the medical literature on deployment lung disease.
Combine your ratingsEligibility
Who qualifies — and how to file
Three doors. Most post-9/11 veterans qualify through more than one and file under only the first.
Door 1 — The PACT Act presumptions
Covered service on or after September 11, 2001 in Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Uzbekistan, or Yemen, or on or after August 2, 1990 in the listed Gulf countries. A diagnosis on the 23-condition list is presumed service-connected.
What the file needs
Covered location and dates from your recordThe diagnosis, worded exactly as the list words itNothing else — no exposure proof, no nexus opinionPrior denial letters if you were denied before August 2022
Door 2 — The § 3.317 Gulf War pathway
Southwest Asia service also opens 38 CFR § 3.317 for undiagnosed illness and medically unexplained chronic multisymptom illness — chronic fatigue syndrome, fibromyalgia, and functional gastrointestinal disorders. No nexus opinion required.
What the file needs
Qualifying Southwest Asia serviceEach symptom domain named, dated, and trackedPersistence of six months or moreA request that the rater apply § 3.317 by name
Door 3 — Direct and secondary service connection
For site-specific exposures like Qarmat Ali, Al Mishraq, and K2, and for every secondary condition — sleep apnea, depression, reflux, hypertension. This is the door that produces the largest rating increases and gets used the least.
What the file needs
Unit, every location, and every duty actually performedThe named site, dates, and contaminantThe primary service-connected condition, for a secondary claimA medical opinion that addresses the link in writing
The filing sequence, in order
Order matters more than speed. Every step below is free, and the first one protects money you have not been awarded yet.
- 1
File the Intent to File first, today
VA Form 21-0966An Intent to File locks your effective date for one year. Everything you are later awarded is paid back to the date VA received that form, not the date you finished gathering evidence. It takes minutes and costs nothing.
- 2
File the claim and name every diagnosis separately
VA Form 21-526EZOne form can carry many conditions, but each one has to be named. "Breathing problems" is not a claim; asthma, chronic sinusitis, and chronic rhinitis are three claims with three sets of criteria, and each is rated on its own before the ratings are combined.
- 3
Pull the exposure record VA already holds
The Individual Longitudinal Exposure Record compiles what the government already knows about where you served and what was there. For exposure that is not on a presumptive list, ask for a Toxic Exposure Risk Activity determination under 38 U.S.C. § 1168 — that determination is what turns an unlisted exposure into a developed one.
- 4
Decide whether you want representation
VA Form 21-22aForm 21-22a appoints an accredited agent or attorney; form 21-22 appoints a veterans service organization. Representation is never required. No one may lawfully charge you a fee to prepare or file an original claim.
- 5
If a decision is already wrong, choose the correct lane
VA Form 20-0995 / 20-0996 / 10182A Supplemental Claim (20-0995) is for new and relevant evidence. Higher-Level Review (20-0996) is for a decision that got the existing evidence wrong and allows no new evidence. A Board appeal (10182) is for the law itself. Choosing the wrong lane can cost a year and, in the worst case, an effective date.
If you were denied for asthma, sinusitis, rhinitis, or a listed cancer before August 10, 2022, that decision was issued under a law that no longer exists. A Supplemental Claim with the new presumption named is the correct route. Filing is free, and no one may lawfully charge a fee to prepare or file an original claim.
Sign up for the VA registry
The registry you are already in — and the exam you still need
Post-9/11 veterans are the one group VA enrolls in a registry automatically. That enrollment does nothing for your claim by itself, and it is not a substitute for the health examination that actually documents your lungs.
- The Airborne Hazards and Open Burn Pit Registry. Since August 1, 2024, VA adds eligible veterans automatically using Department of Defense records for service between August 2, 1990 and August 31, 2021 in the covered operations and locations. No exposure and no symptoms are required, and self-enrollments filed before the redesign carried over.
- The registry holds deployment and demographic information only — it does not contain your medical data. Participation is optional and you may opt out. It is not required in order to file a claim.
- The Gulf War Registry health exam. Free, no copay, no requirement to be enrolled in VA health care. Eligibility covers service on or after August 2, 1990 in Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, or the United Arab Emirates, in the Persian Gulf, Arabian Sea, Gulf of Aden, Gulf of Oman, or Red Sea, or in the associated airspace. Note carefully: that country list does not include Afghanistan, although the burn pit registry does.
- The toxic exposure screening required by section 603 of the PACT Act. Every enrolled veteran is offered an initial screening and then a screening at least every five years. It takes five to ten minutes. Answering “I don’t know” triggers a re-screen in one year. It is optional, and declining does not affect your care or your benefits.
- A civilian provider cannot perform the toxic exposure screening. Ask your VA primary care team, or ask for your facility’s Toxic Exposure Screening Navigator.
- Family members are not eligible for these exams.
How to get on the registry
To confirm you are in the burn pit registry, to schedule the Gulf War Registry exam, or to ask for the toxic exposure screening, contact the Environmental Health Coordinator at your VA medical center, or call MyVA411 at 800-698-2411, available 24 hours a day, seven days a week.
MyVA411, 24 hours a day800-698-2411
Being in a registry is not evidence that you were exposed, and no registry entry has ever granted a claim. Use the registry and the screening to build a documented medical record — then file the claim, which is the only thing that pays.
Need this looked at by a doctor?
Registry exams and exposure evaluations start with a clinician. Our doctor page has the words to use at the appointment, the direct phone number and VA email of the exposure coordinator at your own VA medical center, and every VA registry you can sign up for.
Who else this touched
The family this era reached
As the PACT Act moves more burn-pit and airborne-hazard diseases onto the presumptive list, more post-9/11 deaths become service-connected — and that directly widens the door to survivor benefits. Dependents of a permanently and totally disabled veteran can use health care and education benefits while the veteran is still living.
- DIC for survivors when a PACT Act presumptive condition causes or contributes to death (38 C.F.R. §§ 3.5, 3.22).
- CHAMPVA and Chapter 35 (DEA) education benefits for dependents of a permanently and totally disabled post-9/11 veteran.
- Needs-based Survivors Pension for eligible low-income surviving spouses and children of wartime veterans.