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BIDEN PACT ACT: Landmark Act Moves Veterans With Toxic Exposure Cancer to Front of Line


November 8, 2022~The Department of Veterans Affairs (VA) will give priority to veterans with cancer when it begins processing benefits claims under the landmark toxic exposure law signed this summer, VA Secretary Denis McDonough announced Monday. 

 On Jan. 1, the VA will start processing claims for benefits filed under the Honoring Our Promise to Address Comprehensive Toxics (PACT) Act. 

The law, signed by President Biden in early August, expands benefits for millions of veterans who were exposed to toxins during service and are suffering illnesses as a result. 

The legislation designates 23 diseases, half of them types of cancers, presumed to be linked to burn pits used in the post-9/11 era and other pollutants and environmental hazards from earlier wars such as the Vietnam War-era Agent Orange.  

The law is meant to give veterans with those illnesses an easier way to claim health care and disability benefits through the VA. 

The program, initially launched while Biden was vice president, is personal to the commander in chief, as his son Beau Biden died of glioblastoma, an aggressive type of brain cancer, in 2015 at the age of 46. 

The president has spoken often about how he suspects his son’s glioblastoma stemmed from his time in the Delaware National Guard, when he was exposed to burn pits while serving in Iraq and Kosovo. 

The VA is also undertaking several other initiatives ahead of its claims processing start date for the PACT Act. 

Beginning Tuesday, veterans making their first visit to VA health care facilities for any reason will undergo a new toxic exposure screening. The effort, mandated under the PACT Act, is meant to check individuals for any signs of illness and inform them of new benefits they may qualify for, with officials to conduct the screening for veterans once every five years. 

The VA is also in the midst of major efforts to recruit additional health and benefits personnel and keep current employees, no easy feat at a time of nationwide nursing and medical staff shortages.  

To that end, the department was given more than four months from the time the PACT Act was signed to when it will start processing benefits claims, time to hire more personnel to tackle and try to stay ahead of any backlogs and long wait times for benefits.  

Even so, veterans have filed nearly 137,000 claims under the PACT Act since August.

That means the VA has received 24,000 additional claims in less than two weeks, up from the 113,000 filed as of Oct. 27. 

To keep such issues at bay, the VA set a goal earlier this year to hire 2,000 new claims processors. 

Named in honor of Sergeant First Class Heath Robinson, a decorated combat medic who died from a rare form of lung cancer, this historic legislation will help deliver more timely benefits and services to more than 5 million veterans—across all generations—who may have been impacted by toxic exposures while serving our country. Danielle Robinson, the widow of Sergeant First Class Robinson, was a guest of the First Lady at President Biden’s first State of the Union address when he called on Congress to pass a law to make sure veterans devastated by toxic exposures – like her husband – finally get the health care and benefits they deserve.

The PACT Act will:

  • To ensure veterans can receive high-quality health care screenings and services related to potential toxic exposures, the PACT Act expands access to VA health care services for veterans exposed during their military service. For post-9/11 combat veterans, the bill extends the period of time they have to enroll in VA health care from five to ten years post-discharge. For those combat veterans who do not fall within that window, the bill also creates a one-year open enrollment period. These expansions mean that more veterans can enroll in VA health care without having to demonstrate a service connected disability.
  • The PACT Act codifies VA’s new process for evaluating and determining presumption of exposure and service connection for various chronic conditions when the evidence of a military environmental exposure and the associated health risks are strong in the aggregate but hard to prove on an individual basis. PACT requires VA to seek independent evaluation of this process as well as external input on the conditions it will review using this framework. The new process is evidence-based, transparent, and allows VA to make faster policy decisions on crucial exposure issues. This new process has already fundamentally changed how VA makes decisions on environmental exposures and ensures more veterans have access to the care they need.
  • The legislation removes the need for certain veterans and their survivors to prove service connection if they are diagnosed with one of 23 specific conditions. This greatly reduces the amount of paperwork and need for exams that veterans diagnosed with one of these conditions must complete before being granted access to health care and disability compensation, thereby speeding up their receipt of the benefits they have earned. This list includes 11 respiratory related conditions, along with several forms of cancer, including reproductive cancers, melanoma, pancreatic cancer, kidney cancer, and brain cancers such as glioblastoma. Survivors of veterans who died due to one of these conditions may now also be eligible for benefits.
  • To better understand the impact of toxic exposures, the PACT Act requires VA to conduct new studies of veterans who served in Southwest Asia during the Gulf War and analyses of post-9/11 veterans’ health trends. The new law also directs the Secretary of Veterans Affairs to convene a new interagency working group to develop a five-year strategic plan on toxic exposure research.
  • Ensuring veterans get the care they need includes ensuring that they are screened for toxic exposure and that VA personnel have the appropriate education and training. The PACT Act requires that veterans enrolled in VA health care be screened regularly for toxic exposure related concerns. This new law also requires VA to establish an outreach program for veterans regarding toxic exposure related benefits and supports, and to require additional toxic exposure related education and training for VA personnel.
  • This bill also delivers critical resources to VA to ensure it can deliver timely access to services and benefits for all veterans eligible – including those already enrolled. The PACT Act provides VA with mechanisms to enhance claims processing and to increase the workforce. The bill also invests in VA health care facilities by authorizing 31 major medical health clinics and research facilities in 19 states.

Biden-Harris Administration Record of Action on Military Toxic Exposures

This historic legislation builds on the Biden-Harris Administration’s existing efforts to address the harmful effects of environmental exposures affecting service men and women:

  • Established Presumption for Rare Respiratory Cancers: In April 2022, VA defined presumptive service connection for several rare respiratory cancers for certain veterans – a step that marked progress toward President Biden’s commitment to end cancer as we know it. Since this change, VA has been able to complete more claims for veterans and survivors involving a possible presumption of rare respiratory cancer. With VA taking steps to raise awareness of these benefits, we expect the number of claims to rise in the months ahead.
  • Processing Claims for New Presumptive Respiratory Conditions: In August 2021, VA began processing disability claims for asthma, rhinitis, and sinusitis based on presumed exposure to particulate matter. Veterans who served in the Southwest Asia theater of operations and other areas and who developed these conditions within ten years of military service are now eligible to apply for disability benefits and access to VA health care. Since August, VA has completed 33,276 claims, granting over 25,000 veterans and their survivors benefits for one or more conditions, leading to over $93 million in retroactive benefit payments.
  • Raising Awareness of VA Benefits Related to Military Exposures: Many veterans remain unaware of their eligibility for benefits and services related to potential military exposures. Beginning in November 2021, VA launched a proactive campaign to inform and encourage veterans to file claims related to military environmental exposures.
  • Requiring Training for VA and Non-VA Providers: Health care providers and compensation and pension examiners sometimes do not have the training to understand or treat veterans’ exposure concerns. To address this challenge, VA directed compensation and pension providers and Veterans Health Administration clinicians to complete a training module on assessing deployment related to environmental exposures. VA is also encouraging all providers who care for veterans outside of VA through the Community Care Network contract to complete training on the TRAIN Learning Network, VA’s publicly available training site. Furthermore, VA employees and community care providers have been directed to utilize the Exposure Ed App to help providers provide information to veterans on health effects associated with certain exposures during military service. More information on the app is available here.
  • Implementing a Network of Specialized Providers and Call Center: Veterans with concerns about the health outcomes of military exposures experience inconsistent care to address these specific issues, especially outside of VA. Earlier this year, VA launched VET-HOME, The Veterans Exposure Team-Health Outcomes of Military Exposures. VA plans to hire health professionals, including physicians, nurse practitioners, and physician assistants who will specialize in conducting patient assessments regarding the health effects of military exposures. By January 2023, VA expects to have a fully operational call center and network of experts to help veterans concerned about environmental exposure and provide consultative services to veterans in primary care clinics.