Original research

Presumptive & Toxic-Exposure Claims at the Board

A presumption lets a veteran skip proving the medical link when service and a qualifying exposure are established. Across the published record, Board grant rates for these pathways range from 45.3% for PACT Act conditions down to 21.8% for radiation, against a site-wide baseline of 35.4%. When a presumptive claim is denied, one element is missing far more often than the others.

45.3%PACT Act grant rate

35.4%all claims baseline

48.4%of denials: no qualifying service or exposure

How this research is built: every Board of Veterans' Appeals decision published by VA is public, and anyone can read one at a time. RateMyVSO downloads and analyzes the complete published record, flagging which claims involve a presumptive exposure pathway, PACT Act, Agent Orange, Camp Lejeune, Gulf War, and tracking their outcomes separately from the rest of the record. The result is one of the largest structured research datasets built from the published Board record. It updates automatically every week as new decisions publish.

Updated September 2026

Grant rates by presumptive pathway

Each bar is the Board grant rate among decided appeals involving that exposure or status. Gold marks the pathways that grant above the 35.4% site-wide baseline:

PACT Act conditions45.3%

57,618 decided issues, 44.7% of all issues remanded. The 2022 law that added new presumptive conditions for toxic exposure.

Burn pits43.9%

28,752 decided issues, 46.8% of all issues remanded. Airborne hazards from open-air burn pits in Iraq, Afghanistan, and Southwest Asia.

Camp Lejeune water36.2%

29,893 decided issues, 43.9% of all issues remanded. Contaminated drinking water at the base between 1953 and 1987.

Agent Orange & herbicides33.6%

234,978 decided issues, 38.1% of all issues remanded. Vietnam, the Korean DMZ, and other herbicide-exposure claims.

Gulf War illness33.6%

98,044 decided issues, 43.7% of all issues remanded. Undiagnosed and medically unexplained chronic multisymptom illness.

Former prisoners of war28.3%

61,033 decided issues, 17% of all issues remanded. Conditions presumed service connected for former POWs.

Asbestos27%

38,815 decided issues, 40.8% of all issues remanded. Insulation, shipyards, and other occupational asbestos exposure.

Ionizing radiation21.8%

25,156 decided issues, 40.7% of all issues remanded. Atmospheric nuclear testing, Hiroshima/Nagasaki occupation, and other exposure.

Important context: these are contested appeals at the Board, not all presumptive claims. A presumption that plainly applies is usually granted by the VA long before a case reaches the Board, so the appeals counted here are the harder, disputed cases where the presumption was in question. Read the rates as the difficulty of the contested tail, not the odds of a straightforward presumptive claim.

Why presumptive claims are denied

To win, even a presumptive claim still needs three things: a current diagnosis, qualifying service or exposure, and a link between them. The presumption is meant to supply that last link automatically. When the Board denied a presumptive claim and the record showed which element fell short, this is what was missing, across 54,933 classified denials:

No qualifying service or exposure48.4%

26,594 denials, the record did not place the veteran in the covered time, place, or exposure

No current diagnosis28.6%

15,736 denials, no present diagnosis of a condition on the presumptive list

No medical nexus22.9%

12,603 denials, the presumption did not apply and no independent medical link was shown

What this means: no qualifying service or exposure is the single most common gap, at 48.4% of classified denials. The record could not place the veteran in the covered time, place, unit, or exposure the presumption requires. No current diagnosis is the next most common gap, at 28.6%.

These claims are remanded often

Presumptive and toxic-exposure appeals are sent back for more development at a high rate, 42.4% of presumptive-theory issues were remanded rather than decided outright. Exposure questions frequently require the Board to order additional records, a medical opinion, or verification of service before it can decide, which is why so many are returned rather than granted or denied on the spot.

Methodology

This report aggregates published decisions of the Board of Veterans' Appeals at the issue level. A pathway's population is the decided issues on appeals carrying that exposure or status signal (for example Agent Orange, burn pits, PACT Act, Camp Lejeune, Gulf War illness, radiation, asbestos, or former prisoner of war), so an appeal is counted as involving the exposure, not necessarily decided solely on it. Grant rate is granted divided by granted-plus-denied; remand rate is remanded of all issues. The denial breakdown uses the element of service connection the Board identified as missing among presumptive-theory denials. Data as of September 2026; figures refresh weekly.

Cite this research

RateMyVSO. (September 2026). Presumptive and Toxic-Exposure Claim Outcomes at the Board of Veterans' Appeals. https://ratemyvso.net/dc/presumptive-outcomes

Free to cite and link with attribution. Figures derived from published Board of Veterans' Appeals decisions.

Educational and encyclopedic only, not legal advice, and not a prediction of any individual claim. Figures describe patterns in published Board decisions. For help with a claim, find a VA-accredited representative.