ATSDR
PFAS health-effects overview
What it supports: Summarizes evidence by compound and endpoint, including immune outcomes.
Limit / honest caveat: Causal relationships are not established for many outcomes.
Verify at ATSDRCondition evidence file
Immune & Autoimmune Conditions
PFAS evidence supports decreased antibody response; evidence for ulcerative colitis and thyroid outcomes is limited or suggestive in cited assessments. Each endpoint and compound requires separate analysis.
All condition files
Medical education
What this means for your claim
PFAS and related exposures affect the immune system, but the evidence differs by disease and by compound. A sound claim names the exact autoimmune diagnosis and the specific chemical rather than arguing “autoimmune disease” in the abstract.
Exposure routes
Ingestion — PFAS in drinking waterDermal and inhalation — AFFF, solvents, industrial chemicals
Interactive pathway
How exposure becomes Immune & Autoimmune Conditions
Step 1 of 4PFAS, solvents, industrial chemicals
PFAS / AFFF, solvents, industrial chemicals, and combined occupational exposures.
Where this exposure comes from in service
PFAS / AFFFSolventsIndustrial chemicalsCombined occupational exposures
Strength of the evidence
Each row shows how strong the cited evidence is for that specific statement, using the National Academies scale.
PFAS and decreased antibody (vaccine) response
SufficientCited assessments support an immune-suppression association.
PFAS and ulcerative colitis
Limited or suggestiveLimited or suggestive in cited assessments.
PFAS and thyroid disease
Limited or suggestiveLimited or suggestive in cited assessments.
Inadequate or insufficientLimited or suggestiveSufficient
Categories follow the National Academies framework and reflect the general evidence for each statement — not a determination about any individual veteran’s claim.
The examiner shortcut this rebuts
“Autoimmune disease” is discussed without naming the disease or PFAS compound.
Know the signs
Tap the signs that sound like you. This is a private learning tool — nothing is saved or sent. Bring what you mark to a clinician and to a free review.
Nothing marked yet.
General education about Immune & Autoimmune Conditions — not a diagnosis or medical advice.
Studies and authoritative evidence
Each source is paired with an honest limitation. A study establishes biological plausibility; a qualified clinician still has to apply it to your specific service and medical facts.
Go deeper
VA Benefits: Toxic Exposure & the PACT Act
A plain-English overview from the U.S. Department of Veterans Affairs on toxic-exposure benefits and how the PACT Act expanded them — useful background before you take an examiner’s opinion apart.
What a sound opinion should do
- Use the precise autoimmune diagnosis
- Identify source, route, and period
- Distinguish blood level from historical source
- Address compound-specific evidence
Have this condition and a denial or low rating?
Send the examiner’s exact wording. An accredited claims agent will tell you honestly whether the opinion answered the real question — and what evidence rebuts it. General information, not legal or medical advice.
Registries and screening
The registries and the screening that put this in VA's own records
VA's registries are keyed to where and when you served, not to your diagnosis. There is no registry for immune & autoimmune conditions — there is a registry for the exposure that may have caused it. Which one fits you depends on the theater, the base and the years on your discharge papers, so the six programs below are organized by exposure rather than by illness. For most veterans on this page, at least one of them covers their service.
None of these is a claim, and none of them is required in order to file one. If anyone tells you your claim depends on being in a registry, they are wrong. What a registry evaluation actually does is put a dated exposure history and a clinician's findings into VA's own record, in VA's own words — and years later, that entry is what shows your concern predated the diagnosis. That is far harder for an examiner to wave away than a memory.
Start here · five to ten minutes
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 six exposure programs, and who each one covers
Read the eligibility line first. If it describes your service, the program is open to you whether or not you have ever filed a claim, and whether or not anyone has connected your illness to the exposure yet.
Agent Orange Registry
Who it covers
Veterans who may have been exposed to herbicides, including Agent Orange, during service.
What happens
A free, exposure-focused health examination by a VA clinician, with your exposure history documented and a written summary of the findings.
It is not a disability exam, it is not a claim, and taking part does not commit you to filing anything.
Agent Orange Registry on VA Public Health
Airborne Hazards and Open Burn Pit Registry
Who it covers
Veterans and service members who served in the listed operations and locations. Since August 1, 2024, VA and the Defense Department enroll eligible people automatically, from deployment records, for service between August 2, 1990 and August 31, 2021.
What happens
Nothing to sign up for, in most cases. If you enrolled yourself before the redesign, your enrollment carried over. To check your status, ask the environmental health coordinator at your facility.
The registry holds deployment and demographic data only — no medical information. It is optional, it is not required to file a claim, and it is not evidence of exposure on its own.
Open the burn pit registry
Gulf War Registry
Who it covers
Veterans who served in the Gulf War and the Southwest Asia theater of operations.
What happens
A free registry examination and a documented exposure history, with a written summary of what was found and what to follow up on.
It is not the same thing as a claim, and it does not replace filing one. It also does not affect your eligibility for care or benefits either way.
Gulf War Registry on VA Public Health
Ionizing Radiation Registry
Who it covers
Veterans who took part in a radiation-risk activity during service.
What happens
A free registry examination with your radiation exposure history documented in VA’s own record, plus a written summary.
It is not a claim and it is not a rating decision. It is a clinical assessment and a research record.
Radiation registry exam on VA Public Health
Depleted Uranium Follow-Up Program
Who it covers
Veterans who were in or on a vehicle struck by depleted uranium rounds, who were near a fire or an explosion involving depleted uranium munitions or armor, or who were deployed to Karshi-Khanabad Air Base in Uzbekistan.
What happens
Urine testing for uranium plus a clinical evaluation. Call VET-HOME at 833-633-8846 and ask to speak with a nurse about depleted uranium urine testing.
A normal result does not erase the exposure from your history, and it does not decide a claim.
Depleted uranium program on VA Public Health
Toxic Embedded Fragment Surveillance
Who it covers
Veterans carrying retained fragments from a blast injury — metal that was never removed.
What happens
Long-term surveillance and evaluation through VA’s Toxic Embedded Fragment Surveillance Center, because embedded metal can keep releasing into the body for decades.
It is a surveillance and evaluation program, not a claim, and not a substitute for treatment of the injury itself.
Embedded fragment center on VA Public HealthOne number starts all of this
VET-HOME — the VA exposure team
The Veterans Exposure Team — Health Outcomes Military Exposures runs the registry evaluations, and a registry evaluation does not require you to be enrolled in VA health care. Call and say you want an exposure evaluation and the registry exam that fits your service. Monday to Friday, 9:00 a.m. to 7:30 p.m. Eastern. They do not prescribe medication and they do not complete claim forms.
Call 833-633-8846The words to use, and your coordinator
The doctor page has the direct phone number and VA email of the environmental health coordinator at your own VA medical center, state by state.
Need this looked at by a doctor?
Bring this condition to a clinician and get the exposure written into your record. Our doctor page has the words to use, 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.