What are presumptive conditions, and how do veterans get VA disability benefits for them?

If you're a veteran, you've probably heard of presumptive conditions – but what are they, which conditions are included, and what does that mean for your VA disability benefits claim? Getting informed about the basics of presumptive conditions can save veterans a lot of time and energy, making your claim filing experience an easy one. In this blog, we'll go over the basics of presumptive conditions and cover a few of the most common ones.

Here's what veterans should know about presumptive conditions:

Presumptive conditions, defined

Presumptive conditions are specific illnesses or medical conditions that the VA acknowledges have sufficient proof in the medical literature of being caused by service or an exposure from service. These conditions are listed on the VA website by category so you can clearly see what conditions qualify and what is the criteria for qualification.

Click here for the main eligibility page, where you can navigate to the presumptives on the left hand side:

So, if a veteran has a condition listed on the presumptive list and meets the qualifying criteria, then they don't have to prove a medical nexus (connection to military service) – they will automatically be granted VA disability benefits with a current diagnosis.

The most common presumptive conditions

The VA's list of presumptive conditions changes from time to time. You can find the current list within this link, but these are typically the most common:

• Conditions related to Agent Orange exposures

  • Certain cancers, diabetes, hypertension, heart disease, Parkinson's, chloracne, peripheral neuropathy, hypothyroidism, and more listed here.

• Conditions related to the Gulf War, such as 

  • Chronic fatigue syndrome, fibromyalgia, functional gastrointestinal disorders, MUCMI, and other undiagnosed conditions.

  • Note: There's a difference between structural and functional conditions related to the Gulf War; read about that here.

• Burn pit exposure related conditions

  • Lung cancers, asthma, chronic bronchitis, COPD, granulomatous disease.

• Conditions diagnosed within a year from leaving active duty service

Differences between presumptives and other service-connected conditions

Many veterans assume their conditions qualify as presumptives, but unfortunately, the VA's list is not inclusive of many common conditions. For example, toxic exposure risk activities (TERA) are not presumptive conditions – they're not qualified for service-connection, either (read more about how you can get VA healthcare for TERA related conditions here). Under the same TERA umbrella, Shipboard Hazard and Defense (SHAD) related conditions are also not considered presumptives.

CBRNE (Chemical Biological Radiological Nuclear and Explosives) related conditions are another common point of confusion among veterans. Exposures such as Agent Orange and burn pits DO qualify as presumptives – but these two areas are actually specific enough of exposures to have their own categories independent of CBRNE. So, the rest of the CBRNE related conditions require medical documentation to earn VA disability benefits.

Also, if you do end up earning VA disability benefits for a presumptive condition – be sure to review how the VA determines effective dates for these conditions. This category falls under TERA as well.

Start with a comprehensive chart review

At the end of the day, the VA disability process is confusing, frustrating, and feels like a lot of red tape to get the benefits you deserve. Hopefully we've provided some clarity and resources to point you in the right direction to understand if your conditions are presumptive to service. As part of our process with veterans, we perform a comprehensive chart review that can help identify if you qualify for a presumptive, or if there are conditions that you have proof of a nexus in your medical documentation.  

Sign up for a chart review, or view other services here. One of our professional medical experts will get back to you soon to get exactly what you need.