PACT Act Year 3: What’s Changed and What to File Now

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By CombatProse | USMC

Today we honor the fallen. Now let’s make sure the living collect every dollar they’ve earned.

Three years in, the PACT Act is still the biggest expansion of VA benefits in a generation — and too many veterans who qualify still haven’t filed. On top of that, the VA issued an interim rule in February 2026 that could quietly cut disability ratings for veterans who manage their conditions with medication. Both things matter, and both require action on your end. Here’s the direct version.

PACT Act Year 3: Where Claims Stand in 2026

Signed into law August 10, 2022, the PACT Act added more than 20 new presumptive conditions tied to burn pit exposure, expanded Agent Orange presumptions, and opened VA health care to millions of veterans who had been locked out for decades. According to a February 2025 VA press release, the department processed over 1 million disability claims in Fiscal Year 2025 alone — the fastest pace in VA history — with more than 375,000 of those being PACT Act claims. Grant rate: over 60%.

Key point: there is no deadline to file under the PACT Act. If you’ve been sitting on this, file now. See the VA’s step-by-step claim filing guide to start today.

Conditions Now Presumptive — No Proof of Exposure Required

If you deployed to a qualifying post-9/11 location (Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Uzbekistan, Yemen, or other designated combat zones) and have one of these diagnoses, the VA presumes your service caused it. Full eligibility details are on the VA’s PACT Act resource page.

Cancers (burn pit / post-9/11 era): brain, glioblastoma, GI cancers of any type, head/neck cancers, kidney, lymphoma, melanoma, pancreatic, reproductive, respiratory.

Respiratory illnesses: asthma (diagnosed after service), chronic bronchitis, COPD, constrictive or obliterative bronchiolitis, emphysema, interstitial lung disease, pulmonary fibrosis, sarcoidosis.

Agent Orange additions (added by PACT Act): hypertension, monoclonal gammopathy of undetermined significance (MGUS).

If you were previously denied for any of these conditions, you can now file a Supplemental Claim — the change in law is itself new evidence the VA must consider. The VA’s February 2026 presumptive conditions document covers all categories: Agent Orange, Gulf War, burn pits, radiation, POW, and more. Print it. Read it against your diagnosis history.

The February 2026 Rating Rule: What Happened and What It Means

On February 17, 2026, the VA issued an interim final rule — RIN 2900-AS49, “Evaluative Rating: Impact of Medication” — that changed how C&P examiners rate your disability. Under the old standard, examiners had to assess how severe your condition is without the beneficial effects of medication when the diagnostic code didn’t mention meds. The new rule reverses that: you get rated on your current medicated state.

What that means in practice: if your blood pressure or PTSD symptoms are well-controlled by medication, you could receive a lower rating — or face a reduction — even though your underlying service-connected condition hasn’t improved or been cured. The rule affects over 500 diagnostic codes. The VA Secretary halted enforcement within hours under pressure from veterans groups, but the rule was not rescinded. As the Florida American Legion noted in February: enforcement could be reinstated at any time.

This directly connects to what we covered in Post 347 on the VA’s medication rule and how to protect your rating. If you haven’t read it, do it before your next C&P exam.

What to Do Right Now

  1. Document symptoms even when medicated. Keep a symptom journal — breakthrough symptoms, side effects, how your condition limits daily function (sleep, work, physical activity). If a C&P examiner asks how you’re doing, “better, I guess” is not an answer. Ninety days of notes is an answer.
  2. Know your protections. Ratings in place 10+ years can’t be severed from service connection. Ratings in place 20+ years can’t be reduced except for fraud. Permanent and Total (P&T) ratings are the hardest to touch and come with additional benefits: CHAMPVA for dependents, exemption from future exams. If your condition is genuinely permanent and you’re not P&T, that designation is worth pursuing.
  3. File supplemental claims if previously denied. If the VA denied a condition now presumptive under PACT Act, a Supplemental Claim gets you a fresh look. This is one of the most commonly missed opportunities.
  4. Use your VSO. VFW, DAV, American Legion — free claims assistance. VA Stand Downs in your area often include on-site claims help. VA mental health screenings are another on-ramp — mental health ratings connect directly to compensation decisions.

The Three Appeal Lanes — Pick the Right One

If the VA denies your claim or rates you low, you have three options. Picking wrong wastes months.

Higher-Level Review (HLR): A senior rater reviews your existing file — no new evidence. Best for clear legal or factual errors by the original rater. Processing time has dropped from 141 days in 2024 to around 81 days in 2025.

Supplemental Claim: You submit new evidence — new records, nexus letter, buddy statements, or conditions added to the presumptive list since your denial. The VA must reconsider based on the new evidence. This is the right lane for most PACT Act reconsiderations.

Board of Veterans’ Appeals (BVA): A Veterans Law Judge reviews your case. Slower, but gives maximum flexibility and is right for complex cases or when the HLR keeps coming back wrong.

One rule applies to all three: you have one year from a rating decision to file an appeal without losing your effective date. Miss that window and you restart from scratch — which can mean years of lost back pay.

This Week: One Action

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