Gastrointestinal Cancer (Esophagus, Stomach, Pancreas, Liver, Colon): VA Presumptive Condition (PACT Act)
VeteranHQ lists Gastrointestinal Cancer (Esophagus, Stomach, Pancreas, Liver, Colon) as a presumptive condition in the PACT Act (Burn Pits and Airborne Hazards) group. The exposure it is tied to is: Airborne hazards, burn pit smoke, contaminated water, toxic chemical ingestion. The presumption is effective August 10, 2022. It is governed by PACT Act of 2022, Public Law 117-168, § 406(b); 38 USC § 1120(b)(2)(D).
A presumption removes one requirement and one only: the veteran does not have to prove a medical link between the condition and service. Everything else still applies. There must be a current diagnosis, the service has to meet the requirements below, and VA decides the claim on the evidence in the record.
What qualifies: Gastrointestinal Cancer (Esophagus, Stomach, Pancreas, Liver, Colon)
- Service era
- Post-9/11 (2001–present) or Post-Gulf War (1990–present)
- Service location
- Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, Somalia or the United Arab Emirates (on or after August 2, 1990); Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Yemen or Uzbekistan (on or after September 11, 2001); or another country the Secretary determines relevant
- Exposure
- Airborne hazards, burn pit smoke, contaminated water, toxic chemical ingestion
- Effective date
- August 10, 2022
- Filing deadline
- No statutory deadline
Service required for this presumption
Qualifying service is defined by 38 USC § 1119(c)(1): active military, naval, air, or space service while assigned to a duty station in, or in the airspace above, Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, Somalia or the United Arab Emirates on or after August 2, 1990; or Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Yemen, Uzbekistan or another country the Secretary determines relevant, on or after September 11, 2001. NO MINIMUM NUMBER OF DAYS IS REQUIRED: neither 38 USC § 1119 nor § 1120 sets one. Covers primary malignant neoplasms of the esophagus, stomach, small intestine, large intestine (colon), rectum, anus, liver, gallbladder, pancreas, and other digestive organs. Applicability under Public Law 117-168 § 406(d): August 10, 2022 for claimants for dependency and indemnity compensation and for veterans VA determines are terminally ill, homeless, under extreme financial hardship, more than 85 years old, or capable of demonstrating other sufficient cause; October 1, 2024 for everyone else.
About this presumption
Gastrointestinal cancers are presumptively service-connected for veterans with qualifying burn pit or airborne hazard exposure. Ingestion of contaminated food and water, as well as systemic absorption of carcinogens from inhaled smoke, are plausible biological mechanisms. Covered cancers include esophageal adenocarcinoma and squamous cell carcinoma, gastric cancer, pancreatic adenocarcinoma, hepatocellular carcinoma, colorectal cancer, and cancer of the gallbladder and bile ducts.
Evidence still needed
A presumption does not remove the evidence requirement. VA still needs a current diagnosis from a medical provider and service records that show the qualifying service above. What it removes is the medical opinion connecting the two.
Service records confirming covered location service; pathology/biopsy confirming gastrointestinal malignancy; endoscopy or imaging reports; must specify primary site to distinguish from metastatic disease.
Controlling legal authority
PACT Act of 2022, Public Law 117-168, § 406(b); 38 USC § 1120(b)(2)(D)
Related on VeteranHQ
Questions About Gastrointestinal Cancer (Esophagus, Stomach, Pancreas, Liver, Colon) and Presumptive Service Connection
Is Gastrointestinal Cancer (Esophagus, Stomach, Pancreas, Liver, Colon) a VA presumptive condition?
Yes. VeteranHQ lists Gastrointestinal Cancer (Esophagus, Stomach, Pancreas, Liver, Colon) as presumptive in the PACT Act (Burn Pits and Airborne Hazards) group, effective August 10, 2022, under PACT Act of 2022, Public Law 117-168, § 406(b); 38 USC § 1120(b)(2)(D). A presumption removes the requirement to prove a medical link to service. A current diagnosis and qualifying service are still required, and VA decides the claim.
What service qualifies for the Gastrointestinal Cancer (Esophagus, Stomach, Pancreas, Liver, Colon) presumption?
Qualifying service is defined by 38 USC § 1119(c)(1): active military, naval, air, or space service while assigned to a duty station in, or in the airspace above, Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, Somalia or the United Arab Emirates on or after August 2, 1990; or Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Yemen, Uzbekistan or another country the Secretary determines relevant, on or after September 11, 2001. NO MINIMUM NUMBER OF DAYS IS REQUIRED: neither 38 USC § 1119 nor § 1120 sets one. Covers primary malignant neoplasms of the esophagus, stomach, small intestine, large intestine (colon), rectum, anus, liver, gallbladder, pancreas, and other digestive organs. Applicability under Public Law 117-168 § 406(d): August 10, 2022 for claimants for dependency and indemnity compensation and for veterans VA determines are terminally ill, homeless, under extreme financial hardship, more than 85 years old, or capable of demonstrating other sufficient cause; October 1, 2024 for everyone else. Service era: Post-9/11 (2001–present) or Post-Gulf War (1990–present). Service location: Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, Somalia or the United Arab Emirates (on or after August 2, 1990); Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Yemen or Uzbekistan (on or after September 11, 2001); or another country the Secretary determines relevant.
What evidence is still needed for a Gastrointestinal Cancer (Esophagus, Stomach, Pancreas, Liver, Colon) claim?
Service records confirming covered location service; pathology/biopsy confirming gastrointestinal malignancy; endoscopy or imaging reports; must specify primary site to distinguish from metastatic disease. A presumption removes the requirement to prove a medical link to service. A current diagnosis and qualifying service are still required, and VA decides the claim.
Is there a filing deadline for Gastrointestinal Cancer (Esophagus, Stomach, Pancreas, Liver, Colon)?
No statutory deadline
VeteranHQ publishes VA rules and the citations behind them. It does not prepare, file, or represent claims, and nothing here is legal advice or a prediction of what VA will decide.