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Toxic Exposure Evidence Center shieldToxic ExposureEvidence Center
Authoritative source directory

Know what each source proves—and what it does not.

Use the strongest source for the question: peer-reviewed medicine for associations, toxicology for route and dose, environmental records for site pathways, and 38 C.F.R. Part 3 for entitlement rules.

Authoritative source directory of medical, scientific, and regulatory research
Researcher searching a peer-reviewed medical literature database on a monitor

Medical research

PubMed / National Library of Medicine

Find peer-reviewed systematic reviews, cohorts, case-control studies, and clinical research.

What it can establish for your claim

Use it to pull the specific study — cohort, case-control, or systematic review — showing your exposure is biologically capable of causing your diagnosis, then hand that citation to a clinician for the nexus opinion.

Use carefully: PubMed indexing does not make every study equally strong. Evaluate design, population, exposure measure, and applicability.
Expert consensus committee reviewing veteran health evidence around a conference table

Consensus evidence

National Academies Veterans Health

Independent consensus reviews on Agent Orange, Gulf War health, airborne hazards, PFAS, and other veteran issues.

What it can establish for your claim

Establishes the strength-of-evidence category (sufficient, limited/suggestive, inadequate) that VA and the courts already treat as authoritative — powerful for rebutting a flat “there is no evidence” statement.

Use carefully: Population evidence and policy review do not decide an individual claim.
Toxicologist working with substance samples and reference profiles in a laboratory

Toxicology

ATSDR Toxicological Profiles

Substance-specific effects by route and duration, dose-response evidence, and site public-health assessments.

What it can establish for your claim

Documents, substance by substance, which health effects a chemical is known to cause and by which route (inhalation, skin, ingestion) — the factual backbone for a route-specific exposure argument.

Use carefully: A site assessment may find contamination without a completed personal exposure pathway.
Oncologist reviewing a pathology report and imaging with a veteran patient

Cancer evidence

IARC Monographs

Determine whether an agent or exposure circumstance is carcinogenic or potentially carcinogenic.

What it can establish for your claim

Establishes whether an agent is a known, probable, or possible human carcinogen — enough to defeat a categorical “this chemical does not cause cancer” statement.

Use carefully: Hazard classification does not establish a veteran’s dose or individual nexus.
Groundwater monitoring well and cleanup signage at a contaminated federal facility

Installation records

EPA Federal Facility Superfund

Find cleanup status, Records of Decision, groundwater restrictions, and federal-facility documents.

What it can establish for your claim

Confirms documented contamination, cleanup orders, and use restrictions at a named federal facility — objective proof the hazard existed where you served.

Use carefully: Cleanup status proves environmental concern, not personal exposure.
Veteran in a telehealth appointment with a VA environmental health clinician

Clinical evaluation

VET-HOME

Telehealth military environmental exposure evaluation for enrolled veterans.

What it can establish for your claim

Puts a VA clinical environmental-exposure evaluation into your medical record — contemporaneous evidence a later examiner has to weigh.

Use carefully: Clinical evaluation does not automatically establish compensation exposure or nexus.
Veteran completing a VA environmental exposure registry questionnaire

Registries

VA Environmental Health Registries

Surveillance, outreach, health evaluation, and research programs for defined exposures.

What it can establish for your claim

Creates a dated, VA-held record that you reported a specific exposure and related symptoms — useful corroboration of onset and consistency.

Use carefully: Registry participation does not confirm exposure or grant compensation.
Exposure record database screen showing service dates and duty locations

Exposure records

ILER Official FAQ

Official purpose, access, source-data, and limitations of the Individual Longitudinal Exposure Record.

What it can establish for your claim

Explains, in plain agency language, what the ILER is, which data feeds it, and where it has documented gaps — so a "the ILER is negative" denial can be met with the known limitations of the record itself.

Use carefully: Actual ILER access is restricted to authorized channels; public screeners are not ILER.
Environmental restoration work underway on a military installation

Installation records

Defense Environmental Restoration Program

Installation restoration, munitions response, BRAC, and cleanup program information.

What it can establish for your claim

Shows a specific installation was in the environmental-restoration or munitions-response program — corroboration that a recognized hazard was present on that base.

Use carefully: Program inclusion does not prove personal contact.
Bound volumes of federal regulations open to the service connection rules

Law and regulation

38 C.F.R. Part 3

The governing entitlement rules for direct, presumptive, secondary, and aggravation theories.

What it can establish for your claim

The exact regulatory text for direct, presumptive, secondary, and aggravation service connection — quote it directly to hold an adjudicator to the correct legal standard.

Use carefully: Part 3 addresses service connection; rating questions generally arise after entitlement.

Turn this page into an appointment

How to get seen about this

Reading a symptom list changes nothing on its own. A dated note in your medical record does — for your health first, and years later for a claim. Below is every route to an appointment, the phrase that gets your exposure history written down, and the numbers to dial. Nothing on this page is a diagnosis, and none of it replaces your doctor.

A veteran at a VA medical center check-in counter making an appointment while a clerk types it into the system

Some things do not wait for a scheduler

Chest pain or pressure lasting more than a few minutes, or chest pain with sweating, nausea, or pain spreading to the jaw or arm

Sudden trouble breathing, or breathlessness while sitting still

Face droop, weakness or numbness on one side, slurred speech, or sudden confusion

Coughing up or vomiting blood, or bleeding that will not stop

A first seizure, or fainting you cannot explain

Call 911 or go to the nearest emergency room. Do not wait to reach a VA facility first, and do not drive yourself. Tell VA as soon as you can afterward — VA asks to be notified within 72 hours of emergency care received in the community — and keep every discharge paper and bill.

Call your VA medical center

Fastest
  • Calling your own VA facility is the quickest way to get an appointment. VA Health Connect gives you round-the-clock phone access to a scheduler, a nurse, and in many regions a provider.
  • Do not know your facility's number? Call MyVA411 at 800-698-2411, any hour, and ask to be connected to your VA medical center's scheduling line.
  • Say you are an established patient if you already have a primary care provider, and ask for the next available appointment with that provider.
  • If nothing is available soon, ask to be added to the cancellation list and ask whether a nurse can advise in the meantime.

Call VET-HOME — VA's exposure team

Exposure-specific
  • 833-633-8846, Monday to Friday, 9:00 a.m. to 7:30 p.m. ET. VET-HOME stands for Veterans Exposure Team — Health Outcomes Military Exposures, and it exists for exactly this conversation.
  • Say: I want a military environmental exposure assessment. The intake center schedules you with a clinician specially trained in military environmental exposures — by telehealth, so it does not matter how far you live from a medical center. Any veteran enrolled in VA health care, anywhere in the United States or its territories, can use it.
  • The clinician documents your exposure history, answers exposure-related questions, and recommends follow-up. If labs, imaging, breathing tests, or a specialty consult are needed, they say so. Afterward VA mails you a letter with your results, what they mean, and the recommendations.
  • Two limits, so you are not surprised: VET-HOME clinicians do not prescribe medication and do not complete disability claim forms. What they produce is a dated VA record of your exposure history — which is the piece most claims are missing.
  • They also handle the environmental health registry evaluations, and those do not require VA health-care enrollment. If you would rather be seen in person, ask for the environmental health coordinator at your own facility instead — the list is further down this site's Talk To Your Doctor page.

Schedule online or message your care team

  • Sign in on VA.gov to schedule or request many appointments yourself. What you can book online depends on your facility and the type of care.
  • You can also send your care team a secure message through My HealtheVet. Use it for non-urgent things — replies typically take up to three business days.
  • Secure messaging is not for anything urgent. If you need an answer today, call instead.
  • Locked out or cannot find the option? The My HealtheVet help desk is 877-327-0022.

Not enrolled in VA health care yet

  • Call the VA Health Benefits Hotline at 877-222-8387, Monday to Friday, 8:00 a.m. to 8:00 p.m. ET, and say you want to enroll in VA health care.
  • Enrollment is what unlocks VA primary care and the toxic exposure screening. Under the PACT Act many veterans who were turned away years ago are now eligible, so do not assume an old answer still applies.
  • Enrolling does not mean giving up your own doctor. Plenty of veterans keep a civilian provider and use VA alongside it.
  • Enrolling in health care is separate from filing a disability claim. One does not require the other.

You see a civilian or private doctor

  • Ask the front desk for the next available appointment and tell them why: a symptom that has lasted weeks, plus chemical and airborne exposure during military service.
  • Bring this page, or write the exposures and years on one sheet of paper. Hand it over and ask for it to be scanned into your chart.
  • A community provider can order tests, refer you, and write your exposure history down — all of which helps. What they cannot do is VA's toxic exposure screening, which only happens inside VA's own record system.
  • Ask for a copy of the visit note and every result. Those copies are yours, and they are what a claim is eventually built from.

If you are in crisis right now

24/7
  • Dial 988 and press 1, or text 838255. The Veterans Crisis Line is staffed around the clock.
  • You do not need to be enrolled in VA health care, and you do not need a service-connected rating, to use it.
  • You can also start a confidential chat from VA's crisis line website, or ask any VA staff member to walk you to someone.

Ask for your toxic exposure screening

The PACT Act requires VA to offer this to every veteran enrolled in VA health care. It takes about five to ten minutes, and it is the cheapest way to get your exposure history into VA's own record in VA's own words.

What it is

A short set of questions asking whether you believe you were exposed to open burn pits and other airborne hazards, Agent Orange, radiation, Gulf War-related hazards, or contaminated water at Camp Lejeune.

Who can get it

Every veteran enrolled in VA health care. If you are not enrolled yet, enrollment comes first — call 877-222-8387.

How often

An initial screening, then at least once every five years. If you answer that you do not know whether you were exposed, VA schedules you again a year later.

How to get one

It is often done during a primary care or specialty visit — but you can ask for it sooner. Ask your primary care team directly, or ask your facility for its Toxic Exposure Screening Navigator by name.

What it is not

It is not an exam for any specific illness, and it is not part of the disability claims process. It is optional, and declining it does not affect your health care or your benefits.

Why bother

It creates a dated VA record that you raised military exposure. Years later, that entry is evidence that the concern predated the diagnosis.

A civilian or community provider cannot perform this screening — it lives inside VA's own health record. If you only see a private doctor, that is a reason to enroll in VA health care as well.

The burn pit registry: you are probably already in it

Since August 1, 2024, VA and the Defense Department enroll eligible veterans and service members in the Airborne Hazards and Open Burn Pit Registry automatically, from deployment records. For most people there is nothing to sign up for.

Automatic enrollment covers service between August 2, 1990 and August 31, 2021 in the listed operations and locations — Desert Shield, Desert Storm, Iraqi Freedom, Enduring Freedom and New Dawn, the Southwest Asia theater, Egypt, Afghanistan, Djibouti, Jordan, Lebanon, Syria, Uzbekistan, Yemen, and the associated airspace and waters.

You do not need to have been knowingly exposed, and you do not need any current health problem, to be included.

If you enrolled yourself before the redesign, your enrollment carried over. There is nothing to redo.

To check your status, contact the Environmental Health Coordinator at your VA facility.

The registry holds deployment and demographic data only. No medical information is stored in it.

Participation is optional and you can opt out. Being in the registry is not required to file a claim, and it does not affect your eligibility for care or benefits either way.

Being in the registry is not evidence of exposure on its own, and it is not a claim. Treat it as a research tool, and do not let anyone tell you a claim depends on it.

What to take with you

  • A one-page list of the chemicals and hazards you worked around, with the years and the base or ship
  • Your job title and MOS or rating, written the way the military wrote it
  • The symptoms that brought you in, and roughly when each one started
  • Any breathing tests, blood work, or imaging you already have, including from civilian doctors
  • A short list of what you want out of the visit — usually: document the exposure, order these tests, refer me
  • Someone who has watched the change in you, if memory or breathing is the concern

Write the exposure and the job you are researching at the top of that sheet, in the words the military used for it.

Before you leave, and afterward

  • Ask for a copy of the visit note before you leave, and actually read it.
  • Check that your exposure history is in the note. If it is missing, say so and ask for it to be added — politely, but ask.
  • Get a copy of every test result, including the numbers, not just the word normal.
  • Keep your own folder. Paper you hold is worth more than paper you assume exists somewhere.
  • If a symptom persists after a normal test, go back. A normal result rules out some things, not everything.

The numbers, in one place

VET-HOME — VA's exposure team

833-633-8846

Monday to Friday, 9:00 a.m. to 7:30 p.m. ET

The number to call about a military environmental exposure specifically. VET-HOME books a free telehealth evaluation with a clinician trained in military exposures, and that clinician writes your exposure history into your VA record. Say you want a military environmental exposure assessment.

MyVA411 — VA main line

800-698-2411

24 hours a day, 7 days a week

The one number to call if you do not know who to call. Ask to be put through to your VA medical center's scheduling line, or press 0 for a person.

VA Health Benefits Hotline

877-222-8387

Monday to Friday, 8:00 a.m. to 8:00 p.m. ET

Enrolling in VA health care, health-care eligibility, VA medical bills, and community care billing.

Veterans Crisis Line

988, then press 1

24 hours a day, 7 days a week

Any crisis, and you do not need to be enrolled in VA health care to use it. You can also text 838255.

My HealtheVet help desk

877-327-0022

Monday to Friday

Trouble signing in, secure messaging, or online scheduling.

VA Benefits Hotline

800-827-1000

Monday to Friday, 8:00 a.m. to 9:00 p.m. ET

Claims, ratings, and back pay — the benefits side rather than the medical side.

TTY

711

Relay service

If you are deaf or hard of hearing.

These are VA's own published lines. If a number ever gives you a runaround, MyVA411 at 800-698-2411 will transfer you — it is staffed every hour of every day.

A veteran and an advocate reading through a stack of service and treatment records

Both options are free · No obligation

Not sure where you stand? Let us look at it.

Tell us what happened and what the VA said. An accredited agent reads it and tells you honestly what he sees — no cost, no obligation. When you are ready to have us fight it, register and we start.

An accredited agent personally reviews every request — we’ll reach out within 48 hours. Or call 702-992-4883.

Not sure which source proves your claim?

You do not have to build the evidence file alone. Tell an accredited agent what you are trying to prove and they will point to the right records — or handle it for you.

An accredited agent personally reviews every request — we’ll reach out within 48 hours.

Both options are free · No obligation

Two ways to work with us — both free

Talking to a VA-accredited claims agent costs nothing either way. Pick the one that fits: get answers to your questions, or register to hire us to take on your claim.

A VA-accredited claims agent talking across a desk with an older veteran in a ball cap, coffee mugs between them, nothing being signed

Free information — just ask

You can ask Albert, our AI claims assistant, anything about exposure, evidence, or the claims process — he answers instantly. If you would rather have a direct, personal answer, send your question below and an accredited agent will come back to you. No cost, no obligation.

Or send your question
A veteran and his wife at a conference table with an accredited representative pointing to the paperwork in front of them

Ready to hire us? Register with us

For veterans who have decided they want us on their claim. Registering is free too, and it takes the registration form plus a signed VA Form 21-22a.

Until VA Form 21-22a is signed we cannot accept your claim, access your VA file, or do any work on your behalf. That is federal law, not firm policy.

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.
  • Only then do YOU decide whether to move forward with us. If you choose not to, we will not proceed on your behalf — no pressure, no obligation.
Call us: 702-992-4883

An accredited agent personally reviews every request — we’ll reach out within 48 hours.