Primary Liver Cancer (Radiation): VA Presumptive Condition (Ionizing Radiation)
VeteranHQ lists Primary Liver Cancer (Radiation) as a presumptive condition in the Ionizing Radiation group. The exposure it is tied to is: Ionizing radiation: gamma radiation, neutron radiation, and alpha or beta particle exposure. The presumption is effective May 1, 1988. It is governed by 38 CFR § 3.309(d); 38 USC § 1112(c).
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: Primary Liver Cancer (Radiation)
- Service era
- WWII era through 1990s (varies by specific radiation-risk activity)
- Service location
- Atmospheric nuclear weapons test sites; Hiroshima or Nagasaki, Japan (occupation between August 6, 1945 and July 1, 1946); Enewetak Atoll (cleanup, January 1, 1977 through December 31, 1980); Palomares, Spain (January 17, 1966 through March 31, 1967); Thule Air Force Base, Greenland (January 21, 1968 through September 25, 1968); the gaseous diffusion plants at Paducah, Kentucky, Portsmouth, Ohio, and the K25 area at Oak Ridge, Tennessee; Amchitka Island, Alaska (before January 1, 1974)
- Exposure
- Ionizing radiation: gamma radiation, neutron radiation, and alpha or beta particle exposure
- Effective date
- May 1, 1988
- Filing deadline
- No statutory deadline
Service required for this presumption
Participation in a "radiation-risk activity" as 38 CFR § 3.309(d)(3) defines it, with the rebuttable-presumption provisions of 38 CFR § 3.307 also satisfied. The listed radiation-risk activities are: onsite participation in a test involving the atmospheric detonation of a nuclear device (atmospheric detonation includes underwater detonation); occupation of Hiroshima or Nagasaki, Japan by United States forces between August 6, 1945 and July 1, 1946; internment as a prisoner of war in Japan, or active duty in Japan immediately following that internment, during World War II where it gave an opportunity for comparable exposure; at least 250 days of official duty before February 1, 1992 on the grounds of the gaseous diffusion plants at Paducah, Kentucky, Portsmouth, Ohio, or the K25 area at Oak Ridge, Tennessee, with dosimetry monitoring or a comparably exposed position; service before January 1, 1974 on Amchitka Island, Alaska in duty related to the Long Shot, Milrow, or Cannikin underground tests; service that would qualify the individual for the Special Exposure Cohort under 42 USC § 7384l(14); cleanup of Enewetak Atoll between January 1, 1977 and December 31, 1980; onsite participation in the response after the B-52 accident near Palomares, Spain between January 17, 1966 and March 31, 1967; and onsite participation in the response after the B-52 crash near Thule Air Force Base, Greenland between January 21, 1968 and September 25, 1968.
About this presumption
38 CFR § 3.309(d)(2)(xiii) lists "Primary liver cancer (except if cirrhosis or hepatitis B is indicated)" among the diseases presumptively service-connected for radiation-exposed veterans. Two limits are part of the listing itself. First, the cancer must be a PRIMARY liver cancer, meaning it arose in the liver rather than spreading to it from another organ. Second, the presumption does not apply where cirrhosis or hepatitis B is indicated, because the regulation excludes those cases by its own terms. Veterans with burn-pit or airborne-hazard service should also read the PACT Act gastrointestinal cancer entry in this catalog, which reaches the same organ through a different presumption.
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 or DD-214 establishing the radiation-risk activity; DTRA dose reconstruction records if available; imaging or biopsy pathology confirming a PRIMARY hepatic malignancy rather than metastatic disease; hepatitis B serology and any liver biopsy or elastography addressing cirrhosis, since the listing turns on whether cirrhosis or hepatitis B is indicated; hepatology and oncology records.
Controlling legal authority
38 CFR § 3.309(d); 38 USC § 1112(c)
Related on VeteranHQ
Questions About Primary Liver Cancer (Radiation) and Presumptive Service Connection
Is Primary Liver Cancer (Radiation) a VA presumptive condition?
Yes. VeteranHQ lists Primary Liver Cancer (Radiation) as presumptive in the Ionizing Radiation group, effective May 1, 1988, under 38 CFR § 3.309(d); 38 USC § 1112(c). 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 Primary Liver Cancer (Radiation) presumption?
Participation in a "radiation-risk activity" as 38 CFR § 3.309(d)(3) defines it, with the rebuttable-presumption provisions of 38 CFR § 3.307 also satisfied. The listed radiation-risk activities are: onsite participation in a test involving the atmospheric detonation of a nuclear device (atmospheric detonation includes underwater detonation); occupation of Hiroshima or Nagasaki, Japan by United States forces between August 6, 1945 and July 1, 1946; internment as a prisoner of war in Japan, or active duty in Japan immediately following that internment, during World War II where it gave an opportunity for comparable exposure; at least 250 days of official duty before February 1, 1992 on the grounds of the gaseous diffusion plants at Paducah, Kentucky, Portsmouth, Ohio, or the K25 area at Oak Ridge, Tennessee, with dosimetry monitoring or a comparably exposed position; service before January 1, 1974 on Amchitka Island, Alaska in duty related to the Long Shot, Milrow, or Cannikin underground tests; service that would qualify the individual for the Special Exposure Cohort under 42 USC § 7384l(14); cleanup of Enewetak Atoll between January 1, 1977 and December 31, 1980; onsite participation in the response after the B-52 accident near Palomares, Spain between January 17, 1966 and March 31, 1967; and onsite participation in the response after the B-52 crash near Thule Air Force Base, Greenland between January 21, 1968 and September 25, 1968. Service era: WWII era through 1990s (varies by specific radiation-risk activity). Service location: Atmospheric nuclear weapons test sites; Hiroshima or Nagasaki, Japan (occupation between August 6, 1945 and July 1, 1946); Enewetak Atoll (cleanup, January 1, 1977 through December 31, 1980); Palomares, Spain (January 17, 1966 through March 31, 1967); Thule Air Force Base, Greenland (January 21, 1968 through September 25, 1968); the gaseous diffusion plants at Paducah, Kentucky, Portsmouth, Ohio, and the K25 area at Oak Ridge, Tennessee; Amchitka Island, Alaska (before January 1, 1974).
What evidence is still needed for a Primary Liver Cancer (Radiation) claim?
Service records or DD-214 establishing the radiation-risk activity; DTRA dose reconstruction records if available; imaging or biopsy pathology confirming a PRIMARY hepatic malignancy rather than metastatic disease; hepatitis B serology and any liver biopsy or elastography addressing cirrhosis, since the listing turns on whether cirrhosis or hepatitis B is indicated; hepatology and oncology records. 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 Primary Liver Cancer (Radiation)?
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.