8320-01
DEPARTMENT OF VETERANS AFFAIRS
38 CFR Part 8
Processing Claims under the Sergeant First Class Heath Robinson Honoring Our
Promise To Address Comprehensive Toxics Act of 2022, or the Honoring Our
Pact Act of 2022
AGENCY: Department of Veterans Affairs.
ACTION: Notification of modification of sub-regulatory guidance.
SUMMARY: On August 10, 2022, the President signed the Sergeant First Class Heath
Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022, or the
Honoring our PACT Act of 2022 (PACT Act) into law, establishing substantial legislative
changes in laws administered by the Department of Veterans Affairs (VA). VA began
processing PACT Act-related claims on January 1, 2023, and provided sub-regulatory
guidance while it drafts regulations to implement the PACT Act. The sub-regulatory
guidance is now being updated to reflect recent policy changes.
DATES: [INSERT DATE OF PUBLICATION IN THE FEDERAL REGISTER].
FOR FURTHER INFORMATION CONTACT: Carla Ryan, Assistant Director, Military
Exposures Team, Compensation Service, Department of Veterans Affairs, 810 Vermont
Avenue NW, Washington, DC, 202-461-9700. (This is not a toll-free number.)
SUPPLEMENTARY INFORMATION: VA is drafting regulations to implement the PACT
Act. In the interim, VA has provided sub-regulatory guidance to claims processors in the
form of a Policy Letter. The Policy Letter was included as a supporting document to the
Federal Register Notification published on December 22, 2022 (87 FR 78543). As
discussed below, the Policy Letter is hereby revised. The revised Policy Letter can be
found as a supporting document at https://www.regulations.gov.
I. Background

On August 10, 2022, the PACT Act of 2022 was signed into law. This historic,
multifaceted law, which triggers changes to disability compensation examination
requirements when there is evidence a Veteran has participated in a toxic exposure risk
activity, also expands the list of locations eligible for a presumption of exposure to
radiation, expands the list of conditions subject to presumptions of service connection
associated with herbicide exposure, amends the statute involving certain benefits for
Persian Gulf War Veterans, establishes presumptions of service connection for
conditions associated with exposure to burn pits and other toxins, and provides an
avenue for a claimant-elected reevaluation of previously denied dependency and
indemnity compensation (DIC) claims that can result in retroactive effective dates for
benefits.
VA currently is drafting regulations to implement the PACT Act and to address any gaps
and ambiguity in the statutory language. Due to the time required to promulgate
regulations, VA implemented the law and began processing PACT Act-related claims on
January 1, 2023, based on the sub-regulatory guidance contained in the Policy Letter
issued in December 2022.
II. Update
The Policy Letter has been revised to (1) clarify that under 38 U.S.C. 1168(b) a medical
examination and opinion is not warranted where the only participation in a toxic
exposure risk activity (TERA) that is established is based on an entry in an exposure
tracking record system, such as the Individual Longitudinal Exposure Record (ILER),
that does not corroborate or substantiate potential exposure to toxic substances,
chemicals, or airborne hazards in service; (2) add breast cancer as a disease that the
Secretary has determined has no indication of an association with herbicide exposure,
so it is included on the list of conditions not warranting a medical examination and
opinion under 38 U.S.C. 1168 when the only TERA is related to herbicide exposure; (3)

remove renal cancer (kidney and renal pelvis) from the list of conditions established
pursuant to 38 U.S.C. 1168(b) for which a medical examination and opinion is not
warranted when the only TERA is related to herbicide exposure; (4) indicate that the
expanded list of locations eligible for a presumption of radiation exposure under
sections 401 and 402 of the PACT Act have been added to VA regulations; (5) specify
that for entitlement to spina bifida benefits under 38 U.S.C. 1822, covered service in
Thailand means service in Thailand at any United States or Royal Thai base during the
period beginning on January 9, 1962, and ending on May 7, 1975, without regard to
where on the base the Veteran was located or what military job specialty the Veteran
performed; (6) add male breast cancer, urethral cancer, and cancer of the paraurethral
glands as reproductive cancers under section 406 of the PACT Act; (7) remove
references to “Lymphomatic cancer of any type” due to a recent law change under the
National Defense Authorization Act for Fiscal Year 2023; and (8) make non-substantive
edits for clarity. The revised Policy Letter allows VA to better operationalize the PACT
Act and deliver earned benefits to Veterans and their dependents as quickly as possible
while simultaneously continuing efforts to promulgate the implementing regulations.

Signing Authority:
Denis McDonough, Secretary of Veterans Affairs, approved and signed this document
on June 7, 2024, and authorized the undersigned to sign and submit the document to
the Office of the Federal Register for publication electronically as an official document of
the Department of Veterans Affairs.

Jeffrey M. Martin,
Assistant Director,
Office of Regulation Policy & Management,
Office of General Counsel,
Department of Veterans Affairs.
[FR Doc. 2024-13010 Filed: 6/14/2024 8:45 am; Publication Date: 6/17/2024]