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, Section 3114; 38 USC § 1120(b)(5).
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
- Southwest Asia theater of operations, Afghanistan, Syria, Djibouti, or other covered locations
- 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
Active duty service in a covered location for at least 90 days. Covers primary malignant neoplasms of the esophagus, stomach, small intestine, large intestine (colon), rectum, anus, liver, gallbladder, pancreas, and other digestive organs.
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, Section 3114; 38 USC § 1120(b)(5)
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, Section 3114; 38 USC § 1120(b)(5). 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?
Active duty service in a covered location for at least 90 days. Covers primary malignant neoplasms of the esophagus, stomach, small intestine, large intestine (colon), rectum, anus, liver, gallbladder, pancreas, and other digestive organs. Service era: Post-9/11 (2001–present) or Post-Gulf War (1990–present). Service location: Southwest Asia theater of operations, Afghanistan, Syria, Djibouti, or other covered locations.
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.