This marked what hopefully will be a historic victory for multiple groups of long-overlooked Veterans and their families. 

The Honoring Our Promise To Address Comprehensive Toxins Act (“Honoring Our PACT Act”) passed the United States Senate by a substantial margin, and now heads to the House, where swift passage is anticipated. Some commentators say that this bill could be signed into law by President Biden as early as next week. 

This bill includes a wide range of long-awaited and long-overdue improvements, including:  

New Presumptive Conditions for Veterans Exposed to Toxic Fumes from Burn Pits

The Honoring Our Pact Act will, if enacted as is, recognize the following medical conditions as presumptive to burn pit exposure, culminating a long-fought battle for the recognition of these conditions: 

Chronic bronchitis.
Chronic obstructive pulmonary disease.
Constrictive bronchiolitis or obliterative bronchiolitis.
Granulomatous disease.
Interstitial lung disease.
Pulmonary fibrosis.
Chronic sinusitis.
Chronic rhinitis.
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 cancer of any type.
Lymphomatic cancer of any type.
Kidney cancer.
Brain cancer.
Pancreatic cancer.

Veterans who will be covered within this presumption include:

** Veterans who served on or after August 2, 1990, on active duty in any of the following locations (including the airspace above those locations): 

Saudi Arabia
United Arab Emirates

** Veterans who served on or after September 11, 2001, on active duty in any of the following locations (including the airspace above those locations): 


“Any other country determined relevant by the VA Secretary.”

Adding Hypertension and Monoclonal Gammopathy As Presumptive Conditions for Vietnam War Veterans

This has been a long-fought battle for Vietnam War Veterans, especially concerning hypertension. After years of the VA saying that the medical evidence was inconclusive and certain members of Congress saying that it “would cost too much,” hypertension will finally be recognized as an Agent Orange Presumptive Condition. The same will hold true for monoclonal gammopathy, a condition in which abnormal proteins are found in the bloodstream, a condition that the VA claimed for a long time was due to “old age” rather than Agent Orange exposure. For Vietnam War Veterans, this is a huge victory. 

The bad news is that the Honoring Our PACT Act does not extend full Nehmer provisions to these conditions. For both conditions, Congress specifies in the bill that the VA “shall award retroactive claims [for these conditions] only to claimants for dependency and indemnity compensation.” So, the surviving spouse, eligible surviving children, etc. will be able to get retroactive DIC benefits, but a Vietnam War Veteran who was previously denied a claim for hypertension or for monoclonal gammopathy will not be able to get benefits back to the original date of claim. 

Still, this is a win, and frankly an unexpected one, particularly regarding the addition of hypertension. 

Extending Geographic Eligibility for Presumption to Radiation Exposures

Veterans who were engaged in the response effort following the collision of a United States Air Force B–52 bomber and refueling plane that caused the release of four thermonuclear weapons in the vicinity of Palomares, Spain, during the period beginning January 17, 1966, and ending March 31, 1967, will now qualify as being presumed to have been exposed to the effects of harmful radiation. 

The same will hold true for Veterans who were engaged  response effort following the on-board fire and crash of a United States Air Force B–52 bomber that caused the release of four thermonuclear weapons in the vicinity of Thule Air Force Base, Greenland, during the period beginning January 21, 1968, and ending September 25, 1968. 

Recognizing New Geographic Areas For The Presumption of Agent Orange Exposure 

The Honoring Our PACT Act extends the presumption of Agent Orange exposure during Vietnam War service to multiple new geographic areas, including:  

** In Thailand at any United States or Royal Thai base during the period beginning on January 9, 1962, and ending on June 30, 1976, without regard to where on the base the Veteran was located or what military job specialty the Veteran performed! (No more fretting about how to point out to the VA that a Veteran was on the perimeter of a Royal Thai Air Base!) 

** In Laos during the period beginning on December 1, 1965, and ending on September 30, 1969

** In Cambodia at Mimot or Krek, Kampong Cham Province during the period beginning on April 16, 1969, and ending on April 30, 1969

** On Guam or American Samoa, or in the territorial waters surrounding these areas, during the period beginning on January 9, 1962, and ending on July 31, 1980

** On Johnston Atoll, or on a ship that called at Johnston Atoll, during the period beginning on January 1, 1972, and ending on September 30, 1977

Expanding Health Care Eligibility For Veterans Exposed In Service To Toxins

The Honoring Our PACT Act opens the gates for an additional 3.5 million Veterans nationwide to become eligible for Priority Group 6 in Veterans Health Administration care. All of the Veterans covered under this expansion will be Veterans who were exposed to toxins in service, from Agent Orange exposures to burn pit exposures.  

Requiring New Data Collection & Analysis from VA and DoD

The bill requires VA and DoD to engage in multiple new data collection and analysis efforts. It commissions studies focusing on the data concerning cancer among Veterans, medical trends relating to Post-9/11 Veterans, and the feasibility of someday providing Veterans Health Administration care to dependents of Veterans. It requires the VA to conduct outreach and provide resources to toxic-exposed Veterans, and likewise requires the VA to provide standardized training within their own ranks to improve the quality of adjudications of disability compensation claims for medical conditions related to toxic exposures. Lastly, it requires the VA to submit to Congress 180 days after enactment of the law, and annually thereafter, a report detailing the VA’s efforts on behalf of Veterans who were exposed to toxic fumes from burn pits, including details about the number of burn pit-related claims the VA has approved and denied and a comprehensive list of “the top 10 conditions from each body system for which the [VA] awarded service connection for covered Veterans.”