Part VIII, Subpart ii, Chapter 2, Section AGeneral Information on Claims Based on Particulate Matter Exposure Under 38 CFR 3.320

Revised 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.

References : For more information on

• establishing an effective date based on BPOT exposure, see M21-1, Part VIII, Subpart ii, 2.C.1.e, and
• future 38 CFR 3.320 updates based on the __ PACT Act, see VBA Letter 20-24-06, Updated Guidance on Processing Claims Involving PACT Act.

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 The presumptive provisions created by the PACT Act superseded these burn pit and particulate matter practices and created a presumption of SC for covered Veterans based on toxic exposure to substances, chemicals, and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:

• Procedurally, this presumption is referred to as presumptive BPOT exposure.
• Presumptive BPOT exposure under 38 U.S.C. 1119 applies to the presumptive disabilities recognized in
  • 38 U.S.C. 1120
  • 38 CFR 3.320a, and
  • 38 CFR 3.320b.

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

• 38 U.S.C. 1120, see M21-1, Part VIII, Subpart ii, 2.A.1.f
• 38 CFR 3.320a, see M21-1, Part VIII, Subpart ii, 2.A.1.g, and
• 38 CFR 3.320b, see M21-1, Part VIII, Subpart ii, 2.A.1.h.

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 period — 38 CFR 3.320 Locations — 38 U.S.C. 1119 Locations Active service on or after August 2, 1990 — Duty 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.

• 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

• claims that fall under more than one qualifying service location, see the Gulf War Era Service Areas Job Aid

• considering multiple theories of SC, see __

  • M21-1, Part II, Subpart iii, 1.A.2.e, and

  • the PACT Act Implementation SOP, and

• historical procedures under 38 CFR 3.320, see the attachment, Historical_M21-1VIII_ii_2_SecA_5-4-22.docx.

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
  • 38 U.S.C. 1119(c), and
  • M21-1, Part VIII, Subpart ii, 2.A.1.e, and
• 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

• presumptive SC under 38 CFR 3.320a, see Policy Letter 25-01, and
• the definition of covered Veterans, see M21-1, Part VIII, Subpart ii, 2.A.1.e.

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

• presumptive SC under 38 CFR 3.320b, see Policy Letter 25-02, and
• the definition of covered Veterans, see M21-1, Part VIII, Subpart ii, 2.A.1.e.