WASHINGTON — The Department of Veterans Affairs announced that it has screened 5 million Veterans for toxic exposures — a critical step to detecting, understanding, and treating potentially life-threatening health conditions. Of the 5 million Veterans who have received the screening, 2.1 million (43%) reported at least one potential exposure.

The screening takes five to 10 minutes and begins with VA health providers asking Veterans if they believe they experienced any toxic exposures while serving in the armed forces. Veterans who answer yes are then asked follow-up questions and offered connections to information on benefits, registry-related medical exams, and other clinical resources, as indicated. Their responses to the screenings are then added to their VA medical record to be included as part of their future care.

This milestone comes just 13 months after the screening launched at VA medical centers and clinics nationwide as a part of the PACT Act. The PACT Act expanded VA health care and benefits to millions of Veterans, paving the way for VA to deliver more care and more benefits to more Veterans than ever before in 2023.

“By screening Veterans for toxic exposures, we can improve their health care and detect potential health challenges as early as possible,” said VA Secretary Denis McDonough. “This leads to better health outcomes — and better quality of life — for these heroes who were exposed to toxins while serving our country.”

“We have made significant progress toward our goal to screen all Veterans enrolled in VA health care for toxic exposures at least once every five years,” said VA Under Secretary for Health Shereef Elnahal, M.D. “But most importantly, this milestone means we’ve had 5 million opportunities to provide Veterans with the exposure-informed care they deserve.”

The screening covers a variety of different types of toxic exposures, but the two most reported exposures are burn pits and Agent Orange, which together make up more than 60% of Veteran responses. More than half of the Veterans screened (2.6 million) are 65 years old or older, with Veterans under 45 making up just over 900,000 of those screened. Of the nearly 650,000 Women Veterans who regularly use VA care, more than 535,000 have been screened for toxic exposures.

While the toxic exposure screening does not play a role in determining disability compensation, it does provide an opportunity to connect Veterans with the resources they need to file a claim. Each Veteran who reports a potential exposure receives a letter with information about how to apply for benefits.

To fulfill the goal of screening every Veteran enrolled in VA health care at least once every five years, VA is exploring new and innovative ways to reach out to Veterans, including those who are vulnerable or don’t routinely access VA care. The Department is also in the pilot stages of developing a self-screening tool that will make the initial question of the screening even more easily accessible to Veterans with access to web-based electronic communications.

The PACT Act has expanded and extended access to VA health care for Veterans. Thanks to the PACT Act and other new laws, many groups of Veterans are now able to enroll directly in VA health care without first applying for VA benefits – including World War II Veterans, Vietnam Veterans, Gulf War Veterans, Veterans who deployed to a combat zone and transitioned out of the service less than 10 years ago, and more. As President Biden directed, all remaining toxic-exposed Veterans will be eligible to enroll directly in VA health care next year under the PACT Act – including any Veteran who served in Iraq, Afghanistan, and many other combat zones during the Persian Gulf War or after 9/11. Veterans who aren’t currently enrolled can submit an application and receive their toxic exposure screening after enrollment.

The PACT Act also expanded VA benefits for millions of Veterans, making more than 300 health conditions “presumptive” for service connection. This means that if an eligible Veteran has one of these health conditions, VA automatically assumes that the condition was caused by the Veteran’s service and provides compensation and care accordingly. VA encourages Veterans and their survivors to apply for these benefits now at VA.gov/PACT. 

For more information about how the PACT Act is helping Veterans and their survivors, visit VA’s  PACT Act Dashboard. To apply for care or benefits today, visit VA.gov/PACT or call 1-800-MYVA411. 

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Veterans are eligible for these screenings regardless of age, symptoms, family history, and whether they are enrolled in VA health care. Generally, VA follows American Cancer Society guidelines for breast cancer screenings, meaning that — aside from those covered by this new policy — most Veterans become eligible for screenings and mammograms at age 40. This potentially life-saving expansion advances President Biden’s Unity Agenda and drives progress toward the goals of the Biden Cancer Moonshot.

VA is expanding eligibility for breast cancer risk assessments and clinically appropriate mammograms as a part of implementing the Dr. Kate Hendricks Thomas SERVICE Act. Dr. Hendricks Thomas was a Marine Corps Veteran who deployed to Iraq in 2005, where she was exposed to burn pits. In 2018, she was diagnosed with stage 4 breast cancer. She tragically passed away April 5, 2022, at the age of 42. 

“We at VA are expanding breast cancer screenings for toxic-exposed Veterans because early detection saves lives,” said VA Secretary Denis McDonough. “This is an important step toward making sure that breast cancer is diagnosed early, treated early, and — hopefully — sent into remission early.”

These services are available to Veterans who served in the following places and timeframes:

• Iraq between Aug. 2, 1990, and Feb. 28, 1991, and from March 19, 2003, until VA determines burn pits are no longer used in Iraq.
• The Southwest Asia theater of operations, including Kuwait, Saudi Arabia, Oman, and Qatar (but not including Iraq), from Aug. 2, 1990, until VA determines burn pits are no longer used in such locations.
• Afghanistan, Djibouti, Syria, Jordan, Egypt, Lebanon, and Yemen from Sept. 11, 2001, until VA determines burn pits are no longer used in such locations.
• Other locations and time periods as determined by the Airborne Hazards and Open Burn Pit Registry.

The risk assessment is a series of questions about a patient’s toxic exposure(s), family medical history, and other risk factors to determine whether they should have a mammogram. Getting screened for breast cancer is an important part of maintaining overall health, and mammograms are the best way to find and treat breast cancer early, when there is a 99% survival rate. That’s why early detection is a central pillar of the Biden Cancer Moonshot, which is mobilizing efforts toward achieving two clear goals: to prevent more than 4 million cancer deaths by 2047, and to transform the experience of people who are touched by cancer.

Breast cancer is also a presumptive condition under the PACT Act, the largest expansion of Veterans care and benefits in generations. Since President Biden signed the PACT Act into law Aug. 10, 2022, VA has delivered more than $1.6 billion in PACT Act-related benefits to Veterans and their survivors, and more than 4 million Veterans have received VA’s new toxic exposure screening. VA encourages all toxic-exposed Veterans and their survivors to apply for their PACT Act-related benefits today at VA.gov/PACT.

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This scientific review will help VA determine whether these conditions become presumptive conditions for Veterans. When a condition is considered presumptive, eligible Veterans do not need to prove that their service caused their disease to receive benefits for it; instead, VA automatically assumes service-connection for the disease and provides benefits accordingly.

This review is a part of the Biden-Harris Administration’s efforts to expand benefits and services for toxic-exposed Veterans and their families. These three conditions will go through VA’s new and improved process for establishing presumptive conditions, which was codified by President Biden’s signing of the PACT Act — the largest expansion of Veteran care and benefits in generations. This process considers all available science and data — including Veteran claims data — to establish new presumptives, when appropriate, for Veterans as quickly as possible.

“We won’t rest until we understand whether there’s a connection between these deadly conditions and the service of our nation’s heroes,” said VA Secretary Denis McDonough. “But make no mistake: Veterans shouldn’t wait for this review process to conclude to apply for the support they deserve. If you’re a Veteran living with acute leukemia, chronic leukemia, or multiple myeloma, don’t wait — apply for your VA care and benefits today.”

Although these conditions are not yet considered presumptive, it’s important to note that VA does not require a condition or location to be presumptive to grant benefits for it. When a Veteran applies for benefits (in the absence of a presumptive condition), VA considers their claim on a case-by-case basis and grants disability compensation benefits if sufficient evidence shows the Veteran has a disability related to their military service. VA encourages Veterans who live with these conditions to apply for VA health care and benefits today.

Cancers of the head and neck are already considered presumptive under the PACT Act, so this research will focus solely on acute leukemias, chronic leukemias, and multiple myeloma originating outside of the head and neck.

These conditions were chosen for scientific review based on existing scientific data and close consultations with Veterans, Veteran Service Organizations, Congress, and other key stakeholders. While these are the first conditions to be announced for scientific review since the PACT Act passed into law, VA will review many additional conditions moving forward.

In addition to codifying the new presumptive review process, the PACT Act added presumptives for more than 20 presumptive disease categories. Since Biden signed the PACT Act into law Aug. 10, VA has delivered more than $1.6 billion in PACT Act-related benefits to Veterans and their survivors. Additionally: 

• More than 700,000 Veterans have applied for PACT Act-related benefits.
• More than 4 million Veterans have received the new toxic exposure screening.
• More than 300,000 Veterans have enrolled in VA health care (43,000 more enrollments than the same time frame last year, including 98,000 enrollees from the PACT Act target population).

VA is soliciting public comment about this decision via the Federal Register. The public will have a 30-day period to provide comments. View the notice and submit comments here.

VA encourages all eligible Veterans and survivors to file a claim — or submit their intent to file a claim — for PACT Act-related benefits now. Veterans who do so on or before Aug. 9 may have their benefits, if granted, backdated to Aug. 10, 2022.

For more information about the PACT Act and a full list of presumptive conditions covered under the law, visit VA.gov/PACT.

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