PACT Act Misconceptions: Conditions Veterans Think Are Presumptive—But Aren’t

The PACT Act was one of the most impactful pieces of legislation for veterans in decades. It opened the doors to benefits for those exposed to burn pits, Agent Orange, and other toxic hazards during their service. But with the flood of new information came a wave of misunderstandings—especially around what’s actually considered a “presumptive condition.”

At Veteran’s Promise Consulting, we’ve helped thousands of veterans sort through the noise and confusion. A big part of that involves setting the record straight on conditions that veterans commonly think are presumptive—but aren’t (at least not yet).

Here’s a clear look at some of the most misunderstood conditions when it comes to PACT Act presumptives:

1. Sleep Apnea

The Myth: “I was around burn pits, so my sleep apnea is automatically covered.”

The Truth: Sleep apnea is not a presumptive condition under the PACT Act.

It continues to be one of the most frequently claimed—and denied—conditions. The VA requires a diagnosis confirmed by a sleep study and a medical nexus linking it to your service or a service-connected condition like PTSD, TBI, or sinus issues.

2. Erectile Dysfunction (ED)

The Myth: “ED is a common issue after deployment—must be presumptive, right?”

The Truth: ED is not presumptive. However, it’s often successfully claimed as a secondary condition, especially to PTSD, diabetes, prostate issues, or side effects of medication.

3. GERD (Acid Reflux)

The Myth: “I developed GERD while deployed, so it’s covered.”

The Truth: GERD is not a presumptive condition under the PACT Act or VA law. That said, it is frequently secondary to PTSD, anxiety, or certain medications prescribed for other service-connected issues.

4. Migraines or Chronic Headaches

The Myth: “I’ve had migraines since I was in, and they got worse after burn pit exposure—it must be presumptive.”

The Truth: These are not listed as presumptive. However, migraines can be directly service-connected or secondary to conditions like TBI, PTSD, or cervical spine issues.

5. Fibromyalgia

The Myth: “I heard this is covered under the Gulf War list, so I should be good.”

The Truth: Fibromyalgia is presumptive—but only for Gulf War Veterans under very specific criteria. If you didn’t serve in the Persian Gulf, Iraq, Kuwait, etc., between 1990 and now, it won’t be covered presumptively.

6. Anxiety and Depression

The Myth: “Mental health issues caused by burn pits are covered now.”

The Truth: While mental health conditions like anxiety and depression are commonly service-connected, they are not presumptive under the PACT Act. You must show an in-service stressor or symptoms starting in service, or link it to another service-connected condition.

7. High Cholesterol

The Myth: “I developed high cholesterol while in—I should get compensated.”

The Truth: High cholesterol by itself is not a ratable disability, and it’s not on any presumptive list. It becomes relevant only if it leads to another service-connected condition, such as heart disease.

8. Benign Prostatic Hyperplasia (BPH)

The Myth: “I’ve got prostate issues from exposure to toxins—it’s got to be covered.”

The Truth: BPH is not a presumptive condition. The VA recognizes prostate cancer as presumptive (especially for Vietnam Veterans exposed to Agent Orange), but not benign prostate conditions.

So What Is Covered Under the PACT Act?

The PACT Act adds over 20 new presumptive conditions for various exposure categories, including:

• Respiratory cancers and illnesses

• Gastrointestinal cancers

• Certain brain-related cancers

• Chronic sinusitis, rhinitis, and asthma

…and more, depending on the location and era of service.

To see the full presumptive list, visit VA.gov or let us walk you through it.

Why This Matters

When you file a claim based on incorrect assumptions, it can lead to:

• Unnecessary denials

• Delays in getting benefits you deserve

• Frustration and appeal backlogs

But here’s the good news: Just because a condition isn’t presumptive doesn’t mean it’s unclaimable.

With the right evidence, medical nexus, and guidance, you may still win your case.

Let Us Help You Cut Through the Confusion

At Veteran’s Promise Consulting, we’re veterans serving veterans. We don’t guess—we KNOW what the VA looks for. Whether your condition is on the presumptive list or not, we’ll help you build the strongest claim possible.

Call us today at 925-238-3344 or visit www.veteranspromiseconsulting.com to schedule your free consultation.