Two of the eight water treatment plants serving Camp Lejeune — Tarawa Terrace and Hadnot Point — delivered water contaminated with industrial solvents for thirty-four years. Tarawa Terrace was poisoned by an off-base dry cleaner discharging perchloroethylene into the groundwater. Hadnot Point was poisoned by leaking underground fuel storage and on-base industrial degreasing, which put trichloroethylene, benzene, and vinyl chloride into the supply. Measured concentrations reached hundreds of times the current maximum contaminant levels, and the water went to the barracks, the family housing, the schools, the hospital, and the mess halls.
This is the clearest exposure case in the VA system and it is still routinely mishandled, because two completely different lists of conditions exist and they are constantly confused. One list — fifteen conditions — governs eligibility for VA health care. A different, shorter list — eight conditions — governs disability compensation. Being told you qualify for health care for a condition is not the same as being told you will be paid for it, and a veteran who does not know the difference walks into a denial expecting a grant.
What you were actually breathing, drinking, or touching
Eight conditions are presumptive for disability compensation. A separate, longer list of fifteen conditions governs VA health care eligibility only — the two are not interchangeable.
Where it was, when it was, and who was standing there
The exposure, in specifics
A claim is decided on specifics. Location, date range, and duty — in that combination — are what turn an assertion of exposure into a documented one.
The location and the window
Marine Corps Base Camp Lejeune or Marine Corps Air Station New River, North Carolina, between August 1, 1953 and December 31, 1987. Both installations drew from the affected systems.
The thirty-day rule
You must have served, resided, or worked there for no less than 30 days, cumulative, inside that window. Cumulative means it does not have to be consecutive — three separate two-week schools add up. Reservists and National Guard members on drill or annual training at Lejeune are counted the same way.
Family members and civilian employees
Spouses, children, and in-utero exposures are covered for health care reimbursement, and civilian workers were exposed alongside the Marines. Family member coverage runs through a separate reimbursement program, not through the veteran’s disability claim.
The Camp Lejeune Justice Act lawsuit — window closed
The Camp Lejeune Justice Act created a separate federal lawsuit route in the Eastern District of North Carolina. That filing window closed on August 10, 2024. It was never the same thing as a VA disability claim, and the closing of the lawsuit window has no effect whatsoever on your right to file a VA compensation claim — which has no deadline at all.
How you qualify
The routes available on this exposure
Work out which route your case is on before you gather a single document. Preparing the wrong evidence is the most common reason a truthful claim comes back denied.
Presumptive route
Route one — the eight compensation presumptives
Thirty cumulative days at Camp Lejeune or MCAS New River in the window, plus a diagnosis from the list of eight. That is the presumptive route and it is clean when it applies. Everything turns on documenting the thirty days, which for a school, a TDY, or a Reserve period is not always on the DD-214 and has to be pulled from orders or personnel records.
Thirty days is cumulative, not consecutive.
Reserve and Guard duty at Lejeune counts toward the thirty days.
The diagnosis may come from any credentialed physician.
There is no VA filing deadline. The closed lawsuit window is a different program.
Facts-found route
Route two — the other conditions the water caused
The solvents in that water are associated with far more than eight diseases. Breast cancer in men and women, esophageal cancer, lung cancer, scleroderma, hepatic steatosis, renal toxicity, cardiac defects, female infertility, and miscarriage all appear in the ATSDR and National Academies work on Lejeune. None of them is presumptive for compensation, and every one of them is claimable direct with a nexus opinion that cites the water modelling for your specific housing area and dates.
ATSDR water modelling gives estimated monthly contaminant concentrations by housing area — that is exposure evidence with numbers on it.
The nexus opinion should reference the specific solvent and the specific disease mechanism.
A denial on a non-presumptive condition is a normal first step here, not the end of the case.
Secondary route
Route three — downstream of a granted cancer
A granted Lejeune cancer rarely stands alone. Treatment produces lasting damage that is separately ratable — chemotherapy-induced peripheral neuropathy, radiation fibrosis, surgical scarring, hypothyroidism after neck radiation, and the depression and anxiety that follow a cancer diagnosis. Residuals are rated after the active cancer period ends and they are where a large share of the long-term value sits.
Active malignancy carries a temporary total rating; the residuals are rated when it ends.
Chemotherapy neuropathy is rated per affected extremity.
Mental health conditions secondary to a service-connected cancer are compensable.
Two different things — never combine them
A presumption and a TERA determination are not the same thing
These two get mixed together constantly — by veterans, by service officers, and sometimes in the decision letter itself. They are separate mechanisms that answer separate questions. One asks where and when you served. The other asks what you did while you were there. Treating either one as a substitute for the other is how a winnable claim gets prepared the wrong way and comes back denied.
Here is the fastest way to tell which lane you are standing in. A presumption almost always comes out of a deployment or an assignment to a place that has already been named — Vietnam, the Gulf, the Korean DMZ, the burn-pit countries, Camp Lejeune. Congress or VA drew a box around a region and a set of dates, and if your service falls inside that box and your diagnosis is on the list attached to it, you are in the presumptive lane and the law does the connecting for you. TERA is for everything else. If your exposure did not come from being sent to one of those named locations — if it came from the aircraft you turned wrenches on, the fuel you pumped, the foam you sprayed, the paint and solvent you stripped with, the engine room you stood watch in, the stateside installation where the work itself was the hazard — then no list is ever going to carry your claim. That is a TERA case, and it is proved with your duties.
Read both columns before you decide what to gather. If you are in the presumptive lane, the work is proving your service facts — orders, dates, locations. If you are in the TERA lane, the work is documenting what you actually did and then getting a medical opinion that ties it to the diagnosis. Those are two entirely different piles of paper, and preparing the wrong one costs months. And plenty of veterans are standing in both lanes at the same time — one condition that qualifies off a deployment, another that only ever gets connected through the work.
Set by law — where and when you served
A presumption
A presumption is written into statute and regulation. It has three moving parts and all three have to line up: a specific place, a specific date range, and a diagnosis that appears on the list attached to that place. When they do, VA presumes the exposure and presumes the connection — you never have to produce a medical opinion tying the disease to the service.
It is decided on service records, not on medical evidence.
Miss the location or the date window by anything at all and the presumption simply does not apply.
The condition list is closed — a diagnosis that is not on it is not presumptive, however strong the science behind it.
If you do qualify, it is the fastest route to a decision that exists.
Based on what you actually did
A TERA determination
TERA stands for Toxic Exposure Risk Activity. It is VA’s finding that your service involved an activity that put you at risk of a hazard, and it comes out of your duties, your assignments, and the work you actually performed — not out of a list of places and dates. It is not a presumption, and on its own it does not grant service connection.
What it does: it puts the exposure into the record, and under 38 U.S.C. § 1168 it generally obligates VA to obtain an exam and a medical opinion when there is a current disability and the file is otherwise short of proof.
What it does not do: it does not concede the medical link. VA can find TERA and still deny the claim for “no nexus.”
It is also used on the health care side, to establish eligibility to enroll and to get the toxic exposure screening.
It is frequently missing from the file, or built off your primary job code alone — which misses the duties that actually exposed you.
Keep them apart — four rules that decide claims
No presumption does not mean no claim. It means your claim is facts-found, and the link gets built with evidence instead of handed to you by regulation.
A TERA finding is not a presumption. It never removes the need for a nexus opinion — it is what forces VA to go get one.
You can be in both lanes at once. Presumptive on one condition and facts-found on another, inside the same application.
Serving somewhere with a documented hazard is not the same as qualifying for a presumption. The presumption needs the exact place, the exact dates, and a listed condition — all three.
The condition lists
What is on a list, and what is not
Read the label above each list carefully. A presumptive list and a health-care eligibility list are two different things, and confusing them costs veterans claims every single day.
Presumptive for disability compensation — eight conditions
This is the compensation list. It is the shorter one.
Adult leukemia
Aplastic anemia and other myelodysplastic syndromes
Bladder cancer
Kidney cancer
Liver cancer
Multiple myeloma
Non-Hodgkin's lymphoma
Parkinson's disease
VA health care eligibility only — fifteen conditions
This list opens VA health care for the condition. It does NOT establish disability compensation. Do not let anyone tell you otherwise.
Esophageal cancer
Breast cancer
Kidney cancer
Multiple myeloma
Renal toxicity
Female infertility
Scleroderma
Non-Hodgkin’s lymphoma
Lung cancer
Bladder cancer
Adult leukemia
Myelodysplastic syndromes
Hepatic steatosis
Miscarriage
Neurobehavioral effects
How to apply
The filing order, with the actual forms
Order matters. Filing in the wrong sequence is how veterans lose months of back pay on a claim that was always going to be granted.
1
VA Form 21-0966
Lock the effective date
Intent to File holds your date for one year while you chase the thirty-day proof, which is frequently the slowest part of a Lejeune claim.
2
Pull the records that prove thirty days
Request your Official Military Personnel File from the National Personnel Records Center. Ask specifically for orders, assignment history, and any base housing record. This is the step that decides the claim.
3
VA Form 21-526EZ
File the compensation claim
State the base, the dates, and the cumulative days. Claim the presumptive condition and any non-presumptive condition in the same filing so they share the effective date.
4
VA Form 21-4142
Release the oncology and treatment records
Private cancer treatment records are usually the most detailed medical evidence in the file and they establish both diagnosis date and severity.
5
VA Form 21-22a
Appoint an accredited agent
Get a representative on the file with full access before the decision, not after it. Speak with us before signing so it is filed correctly.
Evidence to gather
What belongs in the file before you file
Orders, personnel records, or housing records establishing thirty cumulative days at Camp Lejeune or MCAS New River.
For a school or TDY, the training completion certificate or the orders themselves — short assignments often never reach the DD-214.
For Reserve or Guard service, the annual training and drill records.
Base housing assignment showing which water system served your quarters.
ATSDR water modelling for your housing area and your months on base.
Pathology reports establishing the diagnosis and the date it was made.
Full oncology and treatment records, because the residuals drive the long-term rating.
Statements from family members who lived on base with you — they establish residence when the paper record is thin.
What you will be told, and the answer
The shortcuts to expect
“"Your condition is on the Camp Lejeune list, so you are covered."”
Ask which list. The fifteen-condition list is health care eligibility. The eight-condition list is disability compensation. Being told you are covered under the wrong one produces a denial that feels like a betrayal and is actually just the wrong list.
“"You were only there for training."”
Thirty days is cumulative. Two weeks at one school plus two weeks at another plus a Reserve annual training period reaches the threshold. The records that prove it usually sit in the personnel file, not on the DD-214.
“"The Camp Lejeune deadline passed."”
The deadline that passed on August 10, 2024 was the Camp Lejeune Justice Act lawsuit filing window — a federal court case, not a VA claim. VA disability compensation claims have no deadline. You can file today.
“"There is no proof the water reached your building."”
ATSDR reconstructed the distribution system and published modelled monthly concentrations by housing area. That modelling is the government’s own work product and it is admissible evidence in your file.
Why representation changes the odds
Register with us on your camp lejeune contaminated water claim
Tell an accredited agent what happened and we will review your situation first, then tell you honestly whether we can help. One form, one click, and a real person reads it.
The thirty-day proof is where these claims live or die, and the documents that establish it are usually in a personnel file most veterans have never requested.
The health care list versus compensation list confusion causes avoidable denials every single week. Knowing which list you are on before filing changes the strategy.
Non-presumptive Lejeune conditions are winnable on the ATSDR modelling, but only with a nexus opinion built around it.
Cancer residuals are rated separately after the active period. Files closed without claiming residuals leave permanent money on the table.
VA-Accredited Claims Agent #45147
Albert Thombs
An accredited agent personally reviews every request — we’ll reach out within 48 hours.
Registering opens the secure sign-up form of the advocate who is next to take a new file, in a new tab. If you would rather have someone look at your situation before you decide anything, ask for the free case review instead.
Office hours: Mon–Fri, 11am–6pm Pacific
Keep building the case
The era, the job, and the medical evidence that go with this exposure
Presumptive conditions and the 30-day rule: 38 CFR 3.307(a)(7) and 3.309(f). Health care eligibility: the Honoring America’s Veterans and Caring for Camp Lejeune Families Act of 2012. Water modelling: ATSDR, Agency for Toxic Substances and Disease Registry. General information for education, not legal or medical advice.
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What happens after you register
You register. This simply starts the conversation — you are not our client yet, and you owe us nothing.
You sign and return VA Form 21-22a. It appoints us as your accredited representative and gives us access to your VA file.
Once we have your signed 21-22a and access to your case, we verify everything is in order.
We review your case in full and conduct your interview with an accredited agent.
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