M21-1 Manual  /  Part VIII, Subpart ii, Chapter 2, Section A

General Information on Claims Based on Exposure to Burn Pits and Other Toxins, Including Fine Particulate Matter (BPOT)

M21-1, Part VIII, Subpart ii, Chapter 2, Section A

Overview

In This Section

This section contains the topic, “General Information Associated With BPOT Exposure.”

1. General Information Associated With BPOT Exposure

Introduction

This topic contains general information on presumptive service connection (SC) for disabilities resulting from BPOT exposure, including
  • history of BPOT exposure policies
  • current provisions relevant to BPOT exposure claims
  • definition of fine particulate matter
  • establishing presumption of SC for qualifying disabilities
  • definition of covered Veteran, and
  • presumptive disabilities under
    • 38 U.S.C. 1120
    • 38 CFR 3.320a, and
    • 38 CFR 3.320b.

Change Date

June 6, 2025

VIII.ii.2.A.1.a. History of BPOT Exposure Policies

The table below discusses the history of burn pits and other toxins, including fine particulate matter (BPOT) exposure.
ProvisionEffective Date of Change
Under the direct service connection (SC) provisions, the Department of Veterans Affairs (VA) implemented procedural concessions of exposure to environmental hazards, to include burn pits and particulate matter, based on service in specific locations.April 26, 2010
VA created 38 CFR 3.320, which established a presumption of
  • exposure to fine particulate matter for Veterans with qualifying service, and
  • SC for specific, chronic respiratory conditions that become manifest within 10 years of separation from a period of active duty.
August 5, 2021
VA amended 38 CFR 3.320 to extend presumptive SC to include specific rare respiratory cancers that become manifest to any degree at any time after separation from service, as discussed in the attachment, Historical_M21-1VIII_ii_2_SecA_5-4-22.docx. April 26, 2022
Public Law (PL) 117-168, Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act of 2022 created
  • 38 U.S.C. 1119, which creates a presumption that any covered Veteran was exposed to substances, chemicals, and airborne hazards identified in a list created by the Secretary of VA, and
  • 38 U.S.C. 1120, which allows for presumptive SC for specific disabilities that become manifest at any time after service.
Important: The presumptions established in 38 U.S.C. 1119 and 38 U.S.C. 1120 by the PACT Act superseded 38 CFR 3.320 and procedural concessions of burn pit exposure. 		August 10, 2022
VA published the final rulemaking for asthma, rhinitis, and sinusitis (to include rhinosinusitis), which included the following regulatory provisions:
  • removed the requirement for these specific, chronic respiratory conditions to manifest within a presumptive period of time after service, and
  • clarified the definition of qualifying service.
Important:
  • This rulemaking removed from regulation the required 10-year manifestation period for asthma, rhinitis, and sinusitis, which was already effectuated by the PACT Act in August 2022. Therefore, the October 2023 rulemaking provides no basis on which to grant an effective date or an earlier effective date under 38 CFR 3.114.
  • Apply this guidance for any claims where a Survivor
    • is claiming the principal or contributory cause of the Veteran's death is, or is secondary to, asthma, rhinitis, or sinusitis, to include rhinosinusitis, or
    • has a specific allegation of eligibility under the new regulation.
October 31, 2023
VA issued an interim final rule which added 38 CFR 3.320a, establishing presumptive SC for covered Veterans with specific genitourinary cancers due to exposure to fine particulate matter.January 2, 2025
VA issued an interim final rule which added 38 CFR 3.320b, establishing presumptive SC for covered Veterans with certain blood cancers due to exposure to fine particulate matter.January 10, 2025
References: For more information on

VIII.ii.2.A.1.b. Current Provisions Relevant to BPOT Exposure Claims

As noted in M21-1, Part VIII, Subpart ii, 2.A.1.a, VA previously established procedural concessions of burn pit exposure based on locations of military service and later created a presumption of fine particulate matter exposure in 38 CFR 3.320. The presumptive provisions created by the PACT Act superseded these burn pit and particulate matter practices and created a presumption of SC for covered Veterans based on toxic exposure to substances, chemicals, and airborne hazards.The PACT Act further directed VA to create a list of recognized toxic substances. VA implemented this requirement by expanding the presumptive fine particulate matter provisions in 38 CFR 3.320. The presumption now includes all covered Veterans who served in the locations listed in 38 U.S.C. 1119(c) and those previously recognized in 38 CFR 3.320.Notes:

VIII.ii.2.A.1.c. Definition: Fine Particulate Matter

Fine particulate matter is a form of air pollution (also called particle pollution) that is comprised of a complex mixture of extremely small particles and liquid droplets that results from primary sources of dust storms and emissions from local industries. These microscopic particles can be inhaled and travel into the lungs and bloodstream, causing disease. Fine particulate matter, also referred to as PM2.5 , is made up of a number of components including
  • acids (such as nitrates and sulfates)
  • organic chemicals
  • metals, and
  • soil or dust particles.
Notes:
  • Primary sources of particulate matter include the following:
    • dust storms and other wind-borne suspension of organic and inorganic particles
    • diesel engine emissions from generators and military vehicles and trucks
    • burn pit emissions, and
    • industrial pollutants.
    • If a Veteran claims a disability related to exposure to burn pits, claims processors must consider the claim under the presumption of exposure to fine particulate matter.

VIII.ii.2.A.1.d. Establishing Presumption of SC For Qualifying Disabilities

Veterans who served in a qualifying location as listed in M21-1, Part VIII, Subpart ii, 2.A.1.e and are suffering from a recognized BPOT presumptive disability may receive compensation benefits. Effective August 10, 2022, the presumption of SC does not require the disability to manifest within any time frame after service nor to any degree of disability.
Exception: Presumptive SC cannot be established if there is affirmative evidence the disability(ies) was
  • caused by another condition or event that occurred between the Veteran’s qualifying service and the onset of the disability, or
  • the result of the Veteran’s own willful misconduct or the abuse of alcohol or drugs.
References: For more information on presumptive disabilities under

VIII.ii.2.A.1.e. Definition: Covered Veteran

A covered Veteran means any Veteran who performed active military, naval, air, or space service while assigned to a duty station as shown in the table below. VA will presume BPOT exposure for any Veteran who served during the applicable timeframe in one of the locations as listed in the table below.
Time period38 CFR 3.320 Locations

38 U.S.C. 1119 Locations

Active service on or after August 2, 1990Duty station in, including airspace above,
  • Bahrain
  • Iraq
  • Kuwait
  • Oman
  • Qatar
  • Saudi Arabia
  • United Arab Emirates
  • the neutral zone between Iraq and Saudi Arabia
  • the Gulf of Aden
  • the Gulf of Oman
  • the Persian Gulf
  • the Arabian Sea, or
  • the Red Sea.
Duty station in, including airspace above, Somalia.
Active service on or after September 11, 2001Duty station in, including airspace above,
  • Afghanistan
  • Djibouti
  • Syria, or
  • Uzbekistan.
Duty station in, including airspace above,
  • Egypt
  • Jordan
  • Lebanon, or
  • Yemen.
Note: There is no minimum duration of exposure required for VA to concede BPOT exposure.Important:
  • The definition of covered Veteran in 38 U.S.C. 1119 does not include all locations currently recognized in 38 CFR 3.320 for presumptive fine particulate matter exposure. Claims processors should include all locations listed above recognized in the statute as well as the regulation when considering presumptive claims based on BPOT exposure
  • VA’s rulemakings for 38 CFR 3.320a and 38 CFR 3.320b recognize service in all locations noted in the table above.
  • While several locations in 38 U.S.C. 1119 overlap with 38 CFR 3.317 and 38 U.S.C. 1117 locations, not all locations qualify under both statutes.
References: For more information on

VIII.ii.2.A.1.f. Presumptive Disabilities Under 38 U.S.C. 1120

Effective August 10, 2022, the PACT Act created 38 U.S.C. 1120, which allows for presumptive SC for certain diseases associated with exposure to burn pits and other toxins. Under 38 U.S.C. 1120, the recognized presumptive conditions are
  • 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
  • kidney cancer
  • brain cancer
  • melanoma
  • pancreatic cancer
  • chronic bronchitis
  • chronic obstructive pulmonary disease
  • constrictive bronchiolitis or obliterative bronchiolitis
  • emphysema
  • granulomatous disease
  • interstitial lung disease
  • pleuritis
  • pulmonary fibrosis
  • sarcoidosis
  • glioblastoma
  • asthma diagnosed after service
  • chronic sinusitis, or
  • chronic rhinitis.
References: For more information on
  • a list of diagnoses that qualify as one of the above covered diseases, see VBA Letter 20-24-06
  • the definition of covered Veteran, see
  • historical guidance on the required manifestation period, see the attachment, Historical_M21-1VIII_ii_2_SecA_5-4-22.docx.

VIII.ii.2.A.1.g. Presumptive Disabilities Under 38 CFR 3.320a

Effective January 2, 2025, VA established 38 CFR 3.320a, which created presumptive SC for covered Veterans for the following disabilities:
  • urinary bladder cancer, including over-lapping sites of the bladder, and
  • ureter cancer, including the ureteric orifice and urachus.
References: For more information on

VIII.ii.2.A.1.h. Presumptive Disabilities Under 38 CFR 3.320b

Effective January 10, 2025, VA established 38 CFR 3.320b, which created presumptive SC for covered Veterans for the following disabilities:
  • acute leukemias
  • chronic leukemias
  • multiple myelomas, including monoclonal gammopathy of undetermined significance
  • myelodysplastic syndromes, and
  • myelofibrosis.
References: For more information on

Source: VA M21-1 Adjudication Procedures Manual, M21-1, Part VIII, Subpart ii, Chapter 2, Section A (U.S. government work, reproduced for reference). Browse all sections →