Original research

Presumptive & Toxic-Exposure Claims at the Board

A presumption lets a veteran skip proving the medical link when service and a qualifying exposure are established. Across the published record, Board grant rates for these pathways range from 45.5% for PACT Act conditions down to 21.4% for radiation, against a site-wide baseline of 35.2%. When a presumptive claim is denied, one element is missing far more often than the others.

45.5%PACT Act grant rate

35.2%all claims baseline

63.3%of denials: missing nexus

Grant rates by presumptive pathway

Each bar is the Board grant rate among decided appeals involving that exposure or status. Gold marks the pathways that grant above the 35.2% site-wide baseline:

PACT Act conditions45.5%

52,915 decided issues, 45.3% of all issues remanded. The 2022 law that added new presumptive conditions for toxic exposure.

Burn pits43.8%

26,732 decided issues, 47.5% of all issues remanded. Airborne hazards from open-air burn pits in Iraq, Afghanistan, and Southwest Asia.

Camp Lejeune water36%

28,995 decided issues, 44.1% of all issues remanded. Contaminated drinking water at the base between 1953 and 1987.

Gulf War illness33.4%

95,053 decided issues, 43.9% of all issues remanded. Undiagnosed and medically unexplained chronic multisymptom illness.

Agent Orange & herbicides33.3%

231,377 decided issues, 38.2% of all issues remanded. Vietnam, the Korean DMZ, and other herbicide-exposure claims.

Former prisoners of war28.1%

60,187 decided issues, 17.2% of all issues remanded. Conditions presumed service connected for former POWs.

Asbestos26.5%

37,373 decided issues, 40.6% of all issues remanded. Insulation, shipyards, and other occupational asbestos exposure.

Ionizing radiation21.4%

24,760 decided issues, 40.8% of all issues remanded. Atmospheric nuclear testing, Hiroshima/Nagasaki occupation, and other exposure.

Important context: these are contested appeals at the Board, not all presumptive claims. A presumption that plainly applies is usually granted by the VA long before a case reaches the Board, so the appeals counted here are the harder, disputed cases where the presumption was in question. Read the rates as the difficulty of the contested tail, not the odds of a straightforward presumptive claim.

Why presumptive claims are denied

To win, even a presumptive claim still needs three things: a current diagnosis, qualifying service or exposure, and a link between them. The presumption is meant to supply that last link automatically. When the Board denied a presumptive claim and the record showed which element fell short, this is what was missing, across 51,317 classified denials:

No medical nexus63.3%

32,459 denials, the presumption did not apply and no independent medical link was shown

No qualifying service or exposure20.1%

10,336 denials, the record did not place the veteran in the covered time, place, or exposure

No current diagnosis16.6%

8,522 denials, no present diagnosis of a condition on the presumptive list

What this means: nearly two in three denials turn on the medical link. In practice the presumption did not apply, because the condition was not on the list for that exposure, or it did not appear in the required window, and without the presumption no independent nexus was shown. The next most common gap is qualifying service or exposure itself: the record could not place the veteran in the covered time, place, or unit.

These claims are remanded often

Presumptive and toxic-exposure appeals are sent back for more development at a high rate, 42.4% of presumptive-theory issues were remanded rather than decided outright. Exposure questions frequently require the Board to order additional records, a medical opinion, or verification of service before it can decide, which is why so many are returned rather than granted or denied on the spot.

Methodology

This report aggregates published decisions of the Board of Veterans' Appeals at the issue level. A pathway's population is the decided issues on appeals carrying that exposure or status signal (for example Agent Orange, burn pits, PACT Act, Camp Lejeune, Gulf War illness, radiation, asbestos, or former prisoner of war), so an appeal is counted as involving the exposure, not necessarily decided solely on it. Grant rate is granted divided by granted-plus-denied; remand rate is remanded of all issues. The denial breakdown uses the element of service connection the Board identified as missing among presumptive-theory denials. Data as of July 2026; figures refresh weekly.

Cite this research

RateMyVSO. (July 2026). Presumptive and Toxic-Exposure Claim Outcomes at the Board of Veterans' Appeals. https://ratemyvso.net/dc/presumptive-outcomes

Free to cite and link with attribution. Figures derived from published Board of Veterans' Appeals decisions.

Educational and encyclopedic only, not legal advice, and not a prediction of any individual claim. Figures describe patterns in published Board decisions. For help with a claim, find a VA-accredited representative.