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

Revised June 6, 2025

VIII.ii.2.C.1.a#Establishing SC for a Qualifying Presumptive Disability

Establish presumptive service connection (SC) due to fine particulate matter exposure if the evidence establishes

• service in a qualifying location as described in M21-1, Part VIII, Subpart ii, 2.A.1.e, and
• the Veteran has been diagnosed with a condition listed in
  • 38 U.S.C. 1120
  • 38 CFR 3.320a, or
  • 38 CFR 3.320b.

Important:

• Presumptive SC for the conditions listed in 38 U.S.C. 1120 became effective August 10, 2022, based on Public Law 117-168 , Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act of 2022.
• Under current rules, the presumption of SC does not require the disability to manifest within any time frame after service nor to any degree of disability.
• Presumptive SC for cancer associated with exposure to burn pits and other toxins, including fine particulate matter (BPOT) may only be established if the cancer in consideration is the primary or originating site of the cancer.

References: For more information on

• the history of BPOT exposure policies, see M21-1, Part VIII, Subpart ii, 2.A.1.a
• which diagnoses qualify as a presumptive under 38 U.S.C. 1120, see
  • VBA Letter 20-24-06, Updated Guidance on Processing Claims Involving PACT Act, and
  • M21-1, Part VIII, Subpart ii, 2.A.1.f
• presumptive SC for metastatic cancer, see M21-1, Part V, Subpart ii, 2.B.1.b, and
• presumptive BPOT disabilities, see M21-1, Part VIII, Subpart ii, 2.A.1.f-h.

VIII.ii.2.C.1.b#Date Disabilities Became Subject to Presumptive SC Based on BPOT Exposure

The table below shows the dates on which the BPOT disabilities became subject to presumptive SC.

VIII.ii.2.C.1.c#Presumptive SC for Asthma

The PACT Act provided for presumptive SC for, “asthma that was diagnosed after service of the covered Veteran.” This means the presumption only applies when asthma is diagnosed after service. Asthma is also a presumptive condition presumed to be associated with exposure to fine particulate matter per 38 CFR 3.320. The Department of Veterans Affairs has implemented the PACT Act presumption for asthma as shown in the table below for all decisions made.

VIII.ii.2.C.1.d#BPOT General Rating Decision Requirements

In order to properly document decisions based on BPOT exposure in Veterans Benefits Management System-Rating (VBMS-R), claims processors must use a combination of applicable system-generated language, analysis fragments, and glossary text fragments to adequately explain the basis of all decisions. If awarding or denying a claim for presumptive SC based on BPOT exposure, apply the following guidelines:

• cite the applicable regulatory or statutory authority for the decision, when applicable
• list favorable findings, if applicable, specific to the facts of the case, and
• assign the appropriate special issue and special issue basis to each decided issue.

References : For more information on

• completing the rating decision, see

• * [M21-1, Part V, Subpart iv, 1.A](</system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/554400000001018/content/554400000180523/M21-1-Part-V-Subpart-iv-Chapter-1-Section-A-Completing-the-Rating-Decision-Narrative>), and 
  

  • the VBMS Rating User Guide , and
• historical rating requirements for particulate matter claims, see the attachment, Historical_M21-1VIII_ii_2_SecC_5-4-22.docx.

VIII.ii.2.C.1.e#Establishing an Effective Date for Disabilities Due to BPOT Exposure

When assigning an effective date, follow the guidance in M21-1, Part V, Subpart ii, 4.A relevant to the facts of the claim.In addition to the general principles governing the assignment of effective dates, consider the following relevant factors when awarding presumptive SC based on BPOT exposure:

• When did the disability become subject to presumptive SC?
• Did the Veteran’s service qualify under 38 CFR 3.320 or under a location added in 38 U.S.C. 1119?
• Did the qualifying disability manifest within any applicable manifestation period?

Use the table below when assigning an effective date based on presumptive BPOT SC requirements being met.

Note: If warranted by the facts of the case, award retroactive benefits under 38 CFR 3.114(a).

Reference: For more information on assigning effective dates, see

• 38 CFR 3.400

• 38 CFR 3.114, and

• 38 CFR 3.156(c).

2Denying SC for Disabilities Associated With BPOT Exposure

This topic contains information about denying SC for disabilities associated with BPOT exposure, including

• when presumptive SC cannot be established, and
• requirement to provide adequate explanation of decisions to deny.

Revised December 7, 2023

VIII.ii.2.C.2.a#When Presumptive SC Cannot Be Established

As discussed in M21-1, Part VIII, Subpart ii, 2.A.1.d, SC cannot be established on a presumptive basis if

• the Veteran
  • did not serve in a qualifying location as listed in M21-1, Part VIII, Subpart ii, 2.A.1.e, or
  • is not diagnosed with a presumptive BPOT disability
• there is affirmative evidence that the BPOT disability
  • was caused by another condition or event that occurred between the Veteran’s qualifying service and the onset of the disability, or
  • was the result of the Veteran’s own willful misconduct or the abuse of alcohol or drugs.

Reference: For more information on establishing SC under 38 U.S.C. 1120, see

• M21-1, Part VIII, Subpart ii, 2.A, and
• VBA Letter 20-24-06.

VIII.ii.2.C.2.b#Requirement to Provide Adequate Explanation of Decisions to Deny

When denying SC for a condition based on BPOT exposure, the decision and decision notice must provide adequate reasons for the decision. Decision makers must include a discussion of the specific provisions that were not met under the relevant presumptive provisions, as well as any other avenue of SC raised by the claimant or evidence.In order to properly document decisions to deny benefits based on BPOT exposure in VBMS-R, claims processors must:

• use a combination of any applicable system-generated language, glossary text fragments, and free text to ensure the decision and decision notice adequately explain why the claim could not be granted under all applicable provisions, and
• apply the appropriate special issue and special issue basis for each decided contention.

Important: If the system-generated text options do not adequately cover the reason a claim is being denied, decision makers must use glossary text or free text to supplement the explanation of the decision.References: For more information on

• BPOT general rating decision requirements, see M21-1, Part VIII, Subpart ii, 2.C.1.d
• system-generated text and glossary fragments, see the VBMS Rating User Guide
• considering unclaimed theories of SC, see M21-1, Part II, Subpart iii, 1.A.2.e, and
• decision notification requirements, see 38 CFR 3.103(f).

3Additional Rating Considerations

Revised December 7, 2023

VIII.ii.2.C.3.a#Special Provisions Regarding the Evaluation of Respiratory Conditions

The rating activity must consider the provisions of 38 CFR 4.96 when granting entitlement to SC for certain respiratory disabilities. These provisions include

• prohibitions for separately evaluating certain coexisting respiratory conditions
• entitlement to special monthly compensation in specific cases, and
• requirements for pulmonary function tests.

Reference: For more information on evaluating respiratory disabilities, see

• 38 CFR 4.97, and
• M21-1, Part V, Subpart iii, 4.A.