Understanding the VA Presumptive List

The VA Presumptive List is a framework the Department of Veterans Affairs (VA) uses to automatically consider specific conditions service-connected. This is done when sufficient evidence suggests a strong correlation between military service under specific circumstances and the development of certain medical conditions. This system removes the burden of proving a direct connection between service and condition for qualifying veterans.

1. Why the VA Presumptive List Matters

Simplifies the Claim Process: Veterans do not need to provide extensive proof of service-connection for conditions on the presumptive list if they meet the service and location criteria.
Acknowledges Service Hazards: Recognizes patterns in conditions linked to specific exposures or deployments.
Offers Faster Access to Benefits: Ensures timely compensation and medical care for veterans suffering from related conditions.

2. Conditions and Criteria on the VA Presumptive List

Service Location and Timeframe: Veterans must show they served in qualifying areas during specific periods.
Manifestation Timeline: Some conditions must appear and meet a 10% disability threshold within a certain timeframe after exposure or discharge (e.g., 1 year or 3 years).
Exclusions: Conditions are presumed service-connected unless clear evidence suggests otherwise (e.g., a non-military-related accident causing the condition).

3. Example of Presumption in Practice

Agent Orange Exposure:

Veterans exposed to Agent Orange in Vietnam (January 9, 1962 – May 7, 1975) are presumed to have service-connection for certain cancers and diabetes (among other conditions) if they later develop these diseases. Proof of exposure is not required beyond records showing service in Vietnam.

Manifestation Timeline Example:

Porphyria Cutanea Tarda (skin condition): Must manifest to at least 10% (e.g., affecting 5–20% of the skin) within 1 year of the last date of exposure to Agent Orange. If symptoms appear later or do not meet the severity threshold, the presumption may not apply.

4. Challenges and Limitations

Manifestation Window: Many conditions must appear within a strict timeline (e.g., 1–7 years), which can be a challenge for veterans whose symptoms manifest later.
Documentation: Veterans still need to provide basic proof of deployment, exposure, or service records matching presumptive criteria.
Complex Symptom Overlap: Some conditions (e.g., Gulf War Syndrome) are collections of symptoms without a single clear diagnosis, complicating evaluation.

5. How to Use the Presumptive List

Understand Eligibility:
- Confirm your service location and dates match the presumptive criteria.
- Identify if your medical condition is on the presumptive list for your service circumstances.
Submit Evidence:
- Include service records showing qualifying service location/dates.
- Provide medical records that detail the onset and severity of the condition.
Apply for Benefits:
- Use the VA Disability Claim process to apply for compensation and medical coverage.
- Attach all relevant documentation to streamline the process.

Key Takeaways

The VA Presumptive List is an invaluable resource for veterans exposed to specific hazards.
Understanding the criteria (location, timeframe, condition) is critical for maximizing benefits.
Even without direct proof of connection, eligible veterans can receive benefits for conditions “presumed” to be caused by their service.

This system recognizes the sacrifices and risks of military service, ensuring veterans receive the support they deserve.

1. Chronic Diseases Diagnosed After Discharge

Chronic Diseases Diagnosed After Discharge
- These conditions must manifest to 10% or more within one year after discharge (exceptions noted). Applies universally without specific locations unless otherwise stated.
- The Blood
  - Anemia: Codes 7716–7723
  - Hodgkin’s Disease: Code 7709
  - Leukemia: Code 7703
  - Thrombocytopenia: Code 7705
- Cardiovascular System
  - Arteriosclerosis: Code 7005
  - Hypertension: Code 7101
  - Endocarditis: Code 7001
  - Valvular Heart Disease: Code 7000
  - Raynaud’s Syndrome: Code 7117
  - Buerger’s Disease: Code 7115
- Digestive System
  - Gallstones: Code 7314
  - Cirrhosis of the Liver: Code 7312
  - Gastric Ulcer: Code 7304
  - Duodenal Ulcer: Code 7305
- Endocrine System
  - Diabetes: Code 7913
  - Diseases of the Thyroid, Parathyroid, Pituitary, or Adrenal Glands
- Genitourinary System
  - Calculus of the Bladder: Code 7515
  - Kidney Stones: Code 7508
  - Nephrosclerosis: Code 7507
  - Nephritis: Code 7502
- Infectious or Immune Diseases
  - Hansen’s Disease (Leprosy): Code 6302 (manifests within 3 years)
  - Lupus: Code 6350
  - Tuberculosis: Must manifest within 3 years
- Mental Disorders
  - Any Psychotic Disorder
- Musculoskeletal System
  - Arthritis: Degenerative (Code 5003) or Systemic (Code 5002)
  - Osteitis Deformans (Paget’s Disease): Code 5016
  - Osteomalacia: Code 5014
- Nervous System
  - ALS (Amyotrophic Lateral Sclerosis): Code 8017 (no time limit after discharge)
  - Multiple Sclerosis: Code 8018 (must manifest within 7 years)
  - Parkinson’s Disease: Code 8004
- Respiratory System
  - Bronchiectasis: Code 6601
  - Sarcoidosis: Code 6846
- Skin
  - Collagen-Vascular Disease: Code 7821

2. Tropical Diseases

Applies to veterans who served in tropical regions.
Conditions must manifest to 10% within one year of exposure unless incubation periods are documented.
Locations:
- Southeast Asia
- Africa
- South America
Conditions:
- Amebiasis: Code 7321
- Blackwater Fever: Code 6329
- Cholera: Code 6300
- Dracontiasis: Code 6320
- Dysentery: Code 7322
- Filariasis: Code 6305
- Leishmaniasis: Code 6301
- Malaria: Code 6304
- Onchocerciasis: Code 6320
- Plague: Code 6307
- Schistosomiasis: Code 6320
- Yellow Fever: Code 6329

3. Prisoners of War (POWs)

No specific locations required; conditions depend on duration of imprisonment. Applies to all POWs irrespective of service length.
Any Length of Imprisonment
- Psychotic Disorders
- Chronic Depression: Code 9433
- Atherosclerotic Heart Disease: Code 7005
Imprisonment Over 30 Days
- Avitaminosis: Code 6313
- Chronic Dysentery: Code 7322
- Peptic Ulcer Disease: Codes 7304, 7305
- Avitaminosis, code 6313
- Beriberi, code 6314
- Chronic dysentery, code 7322
- Helminthiasis, code 6320
- Pellagra, code 6315
- Any other Nutritional Deficiency
- Irritable Bowel Syndrome, code 7319
- Peptic Ulcer Disease, codes 7304 or 7305
- Peripheral neuropathy (unless caused by infection not related to service)
- Cirrhosis of the liver, code 7312
- Osteoporosis, code 5013 (must be after September 28, 2009. No PTSD requirement here, though.)

4. Herbicides (Agent Orange) Exposure Locations & Timeframes

Vietnam: January 9, 1962 – May 7, 1975
Korea (DMZ): September 1, 1967 – August 31, 1971
Thailand: January 9, 1962 – June 30, 1976
Johnston Atoll: Veterans who served on the Johnston Atoll between January 1, 1972, and September 30, 1977, are presumed to have been exposed to Agent Orange.
Guam or American Samoa: Veterans who served in Guam or American Samoa between January 9, 1962, and July 31, 1980, are presumed to have been exposed to Agent Orange.
C-123s: Veterans who had repeated contact with contaminated C-123s after the war also qualify as having been exposed to Agent Orange (see the VA’s list of Air Force Specialty Codes and Units for specifics on C-123 qualifications).
Testing, Storage, or Disposal: Other veterans exposed to Agent Orange can qualify if they can show proof that they served where herbicides were tested or stored outside of Vietnam or were involved in the testing, storage, or disposal of herbicides in the US (see the full list of locations).
Agent Orange Exposure for Reservists

Reservists may qualify for presumptive service-connection for conditions related to Agent Orange exposure if they performed flight, ground, or medical crew duties at the following locations and timeframes:
Lockbourne/Rickenbacker Air Force Base (Ohio)

Years: 1969–1986
Units:

906th Tactical Air Group
907th Tactical Air Group
355th Tactical Airlift Squadron
356th Tactical Airlift Squadron

Pittsburgh International Airport (Pennsylvania)

Years: 1972–1982
Units:

758th Airlift Squadron

Westover Air Force Base (Massachusetts)

Years: 1972–1982
Units:

731st Tactical Air Squadron
74th Aeromedical Evacuation Squadron
901st Organizational Maintenance Squadron

Eligibility Requirements

Reservists who served at these locations during the specified periods and in these units are presumed to have been exposed to Agent Orange. If they later develop conditions on the VA Presumptive List for Agent Orange Exposure, they can file for VA Disability benefits under the presumptive service-connection criteria.

5. Conditions:

Type 2 Diabetes: Code 7913
Hodgkin’s Disease: Code 7709
Parkinson’s Disease: Code 8004

Organized Agent Orange Presumptive Conditions

This list is categorized by disorder type and contains the conditions in alphabetical order within each category, along with their VASRD codes.

1. Cancers

Adult Fibrosarcoma: Code 5329
Bladder Cancer: Code 7528 (Added January 2021)
Bronchial Cancer: Code 6819
Clear Cell Sarcoma of Tendons and Aponeuroses: Code 5329
Congenital and Infantile Fibrosarcoma: Code 5329
Dermatofibrosarcoma Protuberans: Code 5329
Ectomesenchymoma: Code 5329
Epithelioid Leiomyosarcoma (Malignant Leiomyoblastoma): Code 5329
Epithelioid Sarcoma: Code 5329
Extraskeletal Ewing’s Sarcoma: Code 5329
Larynx Cancer: Code 6819
Leiomyosarcoma: Code 5329
Liposarcoma: Code 5329
Lung Cancer: Code 6819
Malignant Fibrous Histiocytoma: Code 5329
Malignant Ganglioneuroma: Code 5329
Malignant Giant Cell Tumor of Tendon Sheath: Code 5329
Malignant Glomus Tumor: Code 5329
Malignant Granular Cell Tumor: Code 5329
Malignant Hemangiopericytoma: Code 5329
Malignant Mesenchymoma: Code 5329
Malignant Schwannoma: Code 5329
Non-Hodgkin’s Lymphoma: Code 7715 (Blue Water Veterans eligible)
Proliferating (Systemic) Angioendotheliomatosis: Code 5329
Prostate Cancer: Code 7528
Rhabdomyosarcoma: Code 5329
Synovial Sarcoma (Malignant Synovioma): Code 5329
Trachea Cancer: Code 6819

2. Neurological and Endocrine Disorders

Hypothyroidism: Code 7903 (Added January 2021)
Monoclonal Gammopathy of Undetermined Significance: Code 7712 (Added August 10, 2022)
Parkinson’s Disease: Code 8004
Parkinsonism: Code 8004 (Added January 2021)

3. Blood and Lymphatic Disorders

All Chronic B-Cell Leukemias: Code 7703
Hodgkin’s Disease: Code 7709
Multiple Myeloma: Code 7709 or 7703
Primary Amyloidosis: Code 7717

4. Skin Conditions

Chloracne or Similar Acneform Disease: Code 7829 (Must manifest to 10% within 1 year of last exposure)
Porphyria Cutanea Tarda: Code 7815 (Must manifest to 10% within 1 year of last exposure)

5. Cardiovascular and Circulatory Disorders

High Blood Pressure (Hypertension): Code 7101 (Added August 10, 2022)
Ischemic Heart Disease: Code 7005 (Excludes high blood pressure, peripheral vascular disease, or stroke)

6. Nervous System and Peripheral Disorders

Peripheral Neuropathy: (Must manifest to 10% within 1 year of last exposure)

Radiation Exposure - Organized Conditions

1. Qualifying Service and Locations

Nuclear Testing Participation:
- Present at nuclear test sites, on ships, aircraft, or equipment in support of the nuclear test.
- At nuclear test sites within six months after the test.
- Participated in the decontamination of equipment used during nuclear tests.
Hiroshima/Nagasaki Proximity:
- Within 10 miles of Hiroshima or Nagasaki between August 4, 1945, and July 1, 1946.
POWs in Japan:
- Within 75 miles of Hiroshima or 150 miles of Nagasaki.
- Repatriated through Nagasaki between August 6, 1945, and July 1, 1946.
Gaseous Diffusion Plants:
- Monitored with dosimetry badges or had equivalent exposure at:
- Served for at least 250 days before February 1, 1992.
Amchitka Island Nuclear Tests:
- Exposed to underground nuclear tests before January 1, 1974.
Enewetak Garrison/Maintenance:
- Served between:
Nuclear Cleanup and Responses:
- Locations and dates:

2. Conditions Qualifying Under Radiation Exposure

Blood and Lymphatic Disorders:
- Leukemia (excluding chronic lymphocytic leukemia), Code 7703
- Multiple Myeloma, Code 7709 or 7703
- Non-Hodgkin’s Lymphoma, Code 7715
Endocrine Disorders:
- Thyroid Cancer, Codes 7901, 7902, or 7919
Respiratory and Thoracic Cancers:
- Bronchiolo-Alveolar Carcinoma, Code 6819
- Lung Cancer, Code 6819
Digestive System Cancers:
- Bile Duct Cancer, Code 7343
- Colon Cancer, Code 7343
- Esophageal Cancer, Code 7343
- Gallbladder Cancer, Code 7343
- Pancreatic Cancer, Code 7343
- Small Intestine Cancer, Code 7343
- Stomach Cancer, Code 7343
- Primary Liver Cancer (except when caused by cirrhosis or Hepatitis B), Code 7343
Reproductive and Breast Cancers:
- Breast Cancer, Code 7627
- Ovarian Cancer, Code 7627
- Genitourinary Cancer, Code 7528
Head and Neck Cancers:
- Pharynx Cancer, Code 7343
- Salivary Gland Cancer, Code 7343
Nervous System and Skeletal Cancers:
- Brain Cancer, Code 8002
- Bone Cancer, Code 5012

3. Persian Gulf Veterans - Presumptive Qualifying Conditions

Qualifying Service Locations

Persian Gulf War veterans must have served anytime from August 2, 1990, to the
present in Southwest Asia, including the following locations:

Afghanistan
Bahrain
Egypt
Kuwait
Iraq
Israel
Jordan
Oman
Qatar
Saudi Arabia
Syria
Turkey
United Arab Emirates (UAE)
Gulf of Aden
Gulf of Oman
Neutral zone between Iraq and Saudi Arabia
Waters of the Persian Gulf, Arabian Sea, or Red Sea
Airspace above these locations

4. VA Presumptive List for Persian Gulf Veterans

The conditions for Persian Gulf veterans are divided into three categories:
- Gulf War Syndrome
- Multi-Symptom Illnesses
- Infectious Diseases
Gulf War Syndrome
- Gulf War Syndrome refers to a collection of unrelated chronic symptoms experienced by many Persian Gulf veterans. These symptoms:
  - Must last for at least six months ("chronic").
  - Must not result from service outside Southwest Asia or the veteran’s misconduct.
- Symptoms associated with Gulf War Syndrome:
  - Fatigue
  - Skin symptoms
  - Headaches
  - Muscle pain
  - Joint pain
  - Neurological symptoms
  - Mental symptoms
  - Respiratory symptoms
  - Trouble sleeping
  - Cardiovascular symptoms
  - Abnormal weight loss
  - Menstrual disorders
  - Gastrointestinal symptoms
- If a clinical diagnosis can be made for these symptoms, they no longer fall under Gulf War Syndrome.
Multi-Symptom Illnesses
- These conditions present a higher level of disability than justified by clinical findings and are chronic. They must not have known or partially-known causes.
- Qualifying Multi-Symptom Illnesses:
  - Fibromyalgia, Code 5025
  - Chronic Fatigue Syndrome, Code 6354
  - Functional Gastrointestinal Disorders, such as:
    - Irritable Bowel Syndrome (IBS), Code 7319
    - Functional Dyspepsia
    - Functional Constipation
Infectious Diseases
- Persian Gulf veterans who served in Southwest Asia or Afghanistan (after September 19, 2001) and develop these diseases within 1 year of discharge are presumed service-connected unless proven otherwise.
- Qualifying Infectious Diseases and VASRD Codes:
  - Brucellosis, Code 6316
  - Campylobacter Jejuni, Code 6630
  - Coxiella Burnetii (Q fever), Code 6331
  - Malaria, Code 6304 (Symptoms must manifest within 1 year or during service)
  - Tuberculosis, Code varies (No time limit for manifestation)
  - Nontyphoid Salmonella, Code 6333
  - Shigella, Code 6334
  - Visceral Leishmaniasis, Code 6301 (No time limit for manifestation)
  - West Nile Virus, Code 6335

5. Secondary Conditions from Infectious Diseases

Some infectious diseases may cause secondary conditions to develop. These
secondary conditions must be directly tied to the infectious disease and meet specific
timelines for manifestation.

Brucellosis:
- Arthritis, Code 5002
- Chronic meningitis, Code 8019
- Fatigue, depression, and neurological symptoms.
Campylobacter Jejuni:
- Guillain-Barre Syndrome, Code 8011 (within 2 months)
- Reactive Arthritis, Code 5002 (within 3 months)
Coxiella Burnetii:
- Chronic Hepatitis, Code 7345
Endocarditis, Code 7001
Malaria:
- Guillain-Barre Syndrome, Code 8011
- Renal Disease, various codes.
Shigella:
- Reactive Arthritis, Code 5002 (within 3 months)

6. Secondary Conditions from Gulf War Infectious Diseases

Brucellosis (Code 6316)

Secondary Conditions:
- Arthritis, Code 5002
- Infections of the Cardiovascular, Nervous, or Respiratory Systems
- Chronic Meningitis or Meningoencephalitis, Code 8019 or 8000
- Deafness, Code 6100
- Demyelinating Meningovascular Syndromes, Code 8014
- Episcleritis, Code 6017
- Fatigue, Inattention, Amnesia, and Depression
- Guillain-Barre Syndrome, Code 8011
- Hepatic Abnormalities (e.g., Granulomatous Hepatitis), Code 7345
- Multifocal Choroiditis, Code 6011
- Myelitis-Radiculoneuritis, Code 8010
- Nummular Keratitis, Code 6001
- Papilledema, Code 6026
- Optic Neuritis, Code 6026
- Infections of the Genitourinary System
- Sensorineural Hearing Loss, Code 6100
- Spondylitis, Code 5240
- Uveitis, Code 6000
- Campylobacter Jejuni (Code 6630)
Secondary Conditions:
- Guillain-Barre Syndrome, Code 8011 (Must manifest within 2 months of infection)
- Reactive Arthritis, Code 5002 (Must manifest within 3 months of infection)
- Uveitis, Code 6000 (Must manifest within 1 month of infection)
Coxiella Burnetii (Q Fever, Code 6331)
- Secondary Conditions:
  - Chronic Hepatitis, Code 7345
  - Endocarditis, Code 7001
  - Osteomyelitis, Code 5000
  - Chronic Fatigue Syndrome, Code 6354
  - Vascular Infections
Malaria (Code 6304)
- Secondary Conditions:
  - Demyelinating Polyneuropathy (Code varies based on affected nerves)
  - Guillain-Barre Syndrome, Code 8011
  - Hematologic Manifestations, Codes 7714-7723 (e.g., Anemia after Falciparum Malaria) or Splenic Rupture, Code 7707 (after Vivax Malaria)
  - Immune-Complex Glomerulonephritis, Code 7536
  - Neurologic Disease
  - Neuropsychiatric Disease
  - Retinal Hemorrhage and Scarring, Code 6011
  - Renal Disease
Tuberculosis
- Secondary Conditions:
  - Active Tuberculosis (Rated by affected tissue)
  - Tissue Damage from Pulmonary or Active Tuberculosis
Nontyphoid Salmonella (Code 6333)
- Secondary Conditions:
  - Reactive Arthritis, Code 5002 (Must manifest within 3 months of infection)
Shigella (Code 6334)
- Secondary Conditions:
  - Hemolytic-Uremic Syndrome, Code 7732 (Must manifest within 1 month of infection)
  - Reactive Arthritis, Code 5002 (Must manifest within 3 months of infection)
Visceral Leishmaniasis (Code 6301)
- Secondary Conditions:
  - Dermal Leishmaniasis, Codes 7807 or 7808 (Must manifest within 2 years of infection)
  - Reactivation of Visceral Leishmaniasis
West Nile Virus (Code 6335)
- Secondary Conditions:
  - Various Physical, Functional, or Cognitive Disabilities

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