Burn Pits & the PACT Act
Burn Pit Cancer Nexus Letters Under the PACT Act
Open-air burn pits exposed Gulf War and post-9/11 veterans of every branch to toxic smoke across Iraq, Afghanistan, and the region. When your PACT Act cancer claim needs medical clarity — or your cancer isn't on the list — a board-certified oncologist can provide the specialty nexus opinion.
- Board-Certified Radiation Oncologist
- Retired U.S. Army Lieutenant Colonel
- Enlisted Former NBC / CBRNE Specialist
- Board-Certified Radiation Oncologist
- Retired U.S. Army Lieutenant Colonel
- Enlisted Former NBC / CBRNE Specialist
Led by Dr. C.M. Williams, MD
Your Claim, Reviewed by a Cancer Specialist Who Served
Dr. Williams is a board-certified radiation oncologist and a retired U.S. Army Lieutenant Colonel. She has spent her career treating cancer and translating complex medicine into plain language — and she understands military service and toxic exposure from the inside.
That combination is rare in the nexus-letter world, where many opinions come from clinicians who never treated cancer. Your case is reviewed by a specialist physician who can speak to your cancer type, stage, and biology with authority — and write the medical reasoning the VA needs to see.
How a Nexus Opinion Helps
How a Nexus Opinion Helps Your Burn Pit Claim
The PACT Act made many burn pit cancers presumptive — but presumptive claims still get denied on service details, diagnosis questions, and records gaps. A specialty opinion makes the medical evidence speak for itself.
Confirms the medical picture
Dr. Williams reviews your cancer type, stage, and treatment history and explains how airborne-hazard exposure relates to your diagnosis — translating complex oncology into the language a VA rater can act on.
Strengthens complex and secondary claims
Presumption helps with the primary cancer, but secondary conditions and treatment-related effects are often under-claimed. A specialty review captures the full medical picture of your case.
Addresses denials and unclear records
When a presumptive claim is denied on other grounds, or a diagnosis or record needs clearer interpretation, an independent oncologist's opinion can answer the exact medical questions the VA raised.
Exposure by Branch & MOS
Burn Pit Exposure by Branch & MOS
Burn pits touched every branch that deployed to the region. Your branch and MOS help establish where and how long you lived alongside the smoke.
Army & Marine Corps
Personnel at forward operating bases who lived and worked beside open-air burn pits in Iraq, Afghanistan, and the surrounding theater.
Air Force
Airbase personnel, crash-rescue, and firefighters exposed to burn-pit smoke and fine airborne particulates.
Navy & Coast Guard
Seabees, corpsmen, and sailors serving ashore at deployed locations near burn-pit operations.
Burn Pit Cancers the VA Now Considers Presumptive
The 2022 PACT Act added more than 20 presumptive conditions for qualifying burn pit and airborne-hazard exposure. These cancers are among them.
- Respiratory (breathing-related) cancers of any type
- Brain cancer and glioblastoma
- Head and neck cancers of any type
- Gastrointestinal cancers of any type
- Pancreatic cancer
- Kidney and genitourinary cancers
- Reproductive cancers of any type
- Melanoma
- Lymphoma and lymphatic cancers of any type
- Leukemias
- Multiple myeloma and myelodysplastic syndromes
Non-Presumptive Cancers
When Your Cancer Isn't on the PACT Act List
The PACT Act is broad but not complete, and pre-PACT claims were often denied. These situations turn on a direct service-connection opinion linking specific combustion toxins to your diagnosis.
Benzene & combustion byproducts
Bladder cancer
Not specifically named on the burn-pit list — a nexus opinion can link benzene exposure to a bladder cancer diagnosis.
Airborne particulates (PM2.5)
Prostate cancer
Outside the presumptive cancers; reviewed individually for a direct connection.
Burn-pit smoke
Pre-PACT denials of listed cancers
Claims denied before the 2022 PACT Act can be revisited with a medical opinion that addresses the original denial.
The PACT Act covers many burn-pit cancers — but not all, and a presumptive claim can still be denied on service or diagnostic grounds. Where a cancer sits outside the list, a direct service-connection opinion is the path.
Understanding Burn Pit & Airborne Hazard Exposure
Open-air burn pits were used to dispose of waste at military sites across Iraq, Afghanistan, and other deployed locations, releasing smoke and fine particulates that veterans breathed for months or years. The PACT Act — the Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 — expanded the cancers the VA presumes are connected to that exposure.
If you have a presumptive cancer and served in a qualifying location, you do not need to prove your service caused it. A specialty opinion is most valuable for complex cases, secondary conditions, or where a diagnosis or records need clearer medical interpretation.
An Honest, Evidence-Based Opinion
A nexus letter never guarantees approval, and Dr. Williams will tell you candidly whether the medical evidence reasonably supports a connection in your case. A formal opinion is only provided when it does — and final decisions always rest with the U.S. Department of Veterans Affairs.
Frequently Asked Questions
Burn Pits & the PACT Act Questions
I served in Iraq or Afghanistan after 9/11. Am I covered?
The PACT Act extends burn pit and airborne-hazard presumptions to Gulf War era and post-9/11 veterans who served in qualifying locations. The specific dates and places of your service determine eligibility, and a specialty review can help interpret how they apply to your diagnosis.
If my cancer is presumptive, why would I need a nexus letter?
Meeting a presumption still requires the right service and diagnosis details, and presumptive claims can be denied on other grounds. A clear medical opinion helps when there are secondary conditions, complex records, or questions a VA rater needs answered.
My burn pit claim was denied even though my cancer is on the list. Now what?
Denials of presumptive claims often turn on service documentation or diagnostic detail rather than the cancer itself. An independent oncologist can review the denial reasoning and address the specific medical points at issue. Each case is assessed individually.
What if my cancer isn't on the PACT Act list at all?
A cancer outside the presumptive list can still be service-connected on a direct basis. A causation opinion can link combustion toxins such as benzene or fine particulates to your specific diagnosis when the evidence supports it.
Does scheduling a consult guarantee a nexus letter?
No. The VA Case Strategy Consult helps determine whether a nexus opinion may be medically supportable. A formal opinion is only provided when the medical evidence reasonably supports a connection, and final decisions rest with the U.S. Department of Veterans Affairs.
Get in Touch
Have a Question About Your Case?
Send us a message and we’ll get back to you. If you’re ready to begin, you can also schedule a consult directly.