Burn Pit Presumptive Conditions List

The U.S. military long used open-air sites as makeshift waste combustion facilities. In the 21st century, these areas became known as “burn pits” and gained attention for their frequent use during the Global War on Terror. While Iraq and Afghanistan were home to some of the more recent burn pits, they are far from the only ones. 

Since 2001, burn pits have also been used in Saudi Arabia, Djibouti, Qatar, and many other locations throughout the region. Most of these sites have now been closed out by the Department of Defense, with the rest soon to follow suit. However, the noxious fumes that these disposal areas created are now linked to a range of cancers and respiratory conditions. 

What are burn pits?

As their name implies, burn pits are areas of open ground that the U.S. military would use to dispose of on-site waste while downrange. Some were the size of football fields while others covered many acres of open land.

The types of waste burned in these areas include but was not limited to:

• Paint
• Plastics
• Rubber
• Metal
• Wood
• Chemicals
• Food
• Aluminum cans
• Medical and human waste
• Petroleum and lubricants

As these materials burned, they released toxins that affected service personnel in various ways. As it can take a while for these reactions to appear, veterans might not realize that they are suffering from long-term health consequences of exposure to burn pits in Iraq and Afghanistan. 

Burn pit presumptive conditions

The VA assumes that there are certain conditions linked to the unique circumstances of a veteran’s military service. If you’re diagnosed with a presumptive condition, you do not need to prove the medical nexus (connection) between your condition and your service to be eligible for VA compensation.

There are now more than 30 conditions on the list of presumptive conditions related to burn pits. The VA added the first three (asthma, rhinitis, and sinusitis) in August 2021 and expanded the list to include nine rare respiratory cancers in April 2022. Many more cancers and conditions were added to the list a year later when Congress passed the PACT Act.

The VA recommends veterans who were previously denied benefits for these conditions file a supplemental claim.

Here is the complete list of presumptive conditions for burn pits:

Types of Cancer	Other Diseases
Adenocarcinoma of the trachea	Asthma that was diagnosed after service
Adenosquamous carcinoma of the lung	Chronic bronchitis
Bladder cancer	Chronic obstructive pulmonary disease (COPD)
Brain cancer	Chronic rhinitis
Breast cancer (male or female)	Chronic sinusitis
Gastrointestinal cancer of any type	Constrictive or obliterative bronchiolitis
Glioblastoma	Emphysema
Head cancer of any type	Granulomatous disease
Kidney cancer	Interstitial lung disease
Large cell carcinoma of the lung	Pleuritis
Lymphatic cancer of any type	Pulmonary fibrosis
Lymphoma of any type	Sarcoidosis
Melanoma
Neck cancer of any type
Pancreatic cancer
Reproductive cancer of any type
Respiratory cancer of any type
Salivary gland-type tumors of the lung
Salivary gland-type tumors of the trachea
Sarcomatoid carcinoma of the lung
Squamous cell carcinoma of the larynx
Squamous cell carcinoma of the trachea
Typical and atypical carcinoid of the lung
Ureter cancer
Urethral cancer and cancer of the paraurethral glands

Where and when veterans served also affects their eligibility for VA disability benefits for burn pits. Here is the list that has been expanded in recent years:

Veterans who served after Aug. 2, 1990 in any of these locations:	Veterans who served after Sept. 11, 2001 in any of these locations:
Bahrain	Afghanistan
Iraq	Djibouti
Kuwait	Egypt
Oman	Jordan
Qatar	Lebanon
Saudi Arabia	Syria
Somalia	Uzbekistan
The United Arab Emirates (UAE)	Yemen
The airspace above any of these locations	The airspace above any of these locations

VA Airborne Hazards and Open Burn Pit Registry

If you were exposed to burn pits during your time in service, you can join the VA’s Airborne Hazards and Open Burn Pit Registry (AHOBPR). By joining this registry, you can provide information to the VA about your experiences with burn pits. Even if you have not had any symptoms or illnesses related to your burn pit exposure, participating in this registry can help the VA understand the long-term effects of burn pits. Things to remember:

• You do not have to participate in the registry to file a claim or to be enrolled in VA health care.
• Participation in this registry is separate from and cannot negatively affect your ability to receive VA health care or ability to file a claim.
• You can save and submit your registry questionnaire and notes from the optional health evaluation to support your claim.
• You can still participate in the registry even if you do not remember any exposure to airborne hazards during your military service.

We will go into detail on each of the presumptive conditions for burn pits below. If you were exposed to burn pits and later diagnosed with one of these conditions, you may be entitled to compensation. 

Non-cancerous conditions and burn pits

The VA currently considers the following non-cancerous conditions presumptive conditions of exposure to burn pits. They are primarily respiratory conditions, often caused by veterans breathing in the toxic smoke and fumes of burn pits over time. 

Asthma caused by burn pits

Asthma is an obstructive lung disease categorized under diagnostic code 6602. People with this condition suffer from airways and bronchi that swell up and close. 

A spirometry test can be used to determine the severity of a person’s asthma. The subsequent results and ratings are as follows:

Description	Rating
FEV-1 less than 40% predicted, or; FEV-1/FVC less than 40%, or; more than one attack per week with episodes of respiratory failure, or; requires daily use of systemic (oral or parenteral) high dose corticosteroids or immuno-suppressive medications	100%
FEV-1 of 40- to 55% predicted, or; FEV-1/FVC of 40 to 55%, or; at least monthly visits to a physician for required care of exacerbations, or; intermittent (at least three per year) courses of systemic (oral or parenteral) corticosteroids	60%
FEV-1 of 56- to 70% predicted, or; FEV-1/FVC of 56 to 70%, or; daily inhalational or oral bronchodilator therapy, or; inhalational anti-inflammatory medication	30%
FEV-1 of 71- to 80% predicted, or; FEV-1/FVC of 71 to 80%, or; intermittent inhalational or oral bronchodilator therapy	10%

The diagnostic code also notes that “in the absence of clinical findings of asthma at time of examination, a verified history of asthmatic attacks must be of record.”

Chronic bronchitis caused by burn pits

Chronic bronchitis is a respiratory condition that causes long-term inflammation of the breathing tubes. The condition causes a person to cough up mucus persistently, wheeze, and feel short of breath.

Chronic bronchitis is related under diagnostic code 6600 as follows:

Description	Rating
FEV-1 less than 40% of predicted value, or; the ratio of Forced Expiratory Volume in one second to Forced Vital Capacity (FEV-1/FVC) less than 40%, or; Diffusion Capacity of the Lung for Carbon Monoxide by the Single Breath Method (DLCO (SB)) less than 40% predicted, or; maximum exercise capacity less than 15 ml/kg/min oxygen consumption (with cardiac or respiratory limitation), or; cor pulmonale (right heart failure), or; right ventricular hypertrophy, or; pulmonary hypertension (shown by Echo or cardiac catheterization), or; episode(s) of acute respiratory failure, or; requires outpatient oxygen therapy	100%
FEV-1 of 40- to 55% predicted, or; FEV-1/FVC of 40 to 55%, or; DLCO (SB) of 40- to 55% predicted, or; maximum oxygen consumption of 15 to 20 ml/kg/min (with cardiorespiratory limit)	60%
FEV-1 of 56- to 70% predicted, or; FEV-1/FVC of 56 to 70%, or; DLCO (SB) 56- to 65% predicted	30%
FEV-1 of 71- to 80% predicted, or; FEV-1/FVC of 71 to 80%, or; DLCO (SB) 66- to 80% predicted	10%

Chronic rhinitis caused by burn pits

Rhinitis is inflammation of the mucous membrane of the nose, caused by a viral infection, like the common cold, or by an allergic reaction (hay fever). Here are the VA ratings for the three types of rhinitis are:

Allergic or vasomotor rhinitis (diagnostic code 6522):

Description	Rating
With polyps	30%
Without polyps, but with greater than 50% obstruction of nasal passage on both sides or complete obstruction on one side	10%

Bacterial rhinitis (diagnostic code 6523):

Description	Rating
Rhinoscleroma	50%
With permanent hypertrophy of turbinates and greater than 50% obstruction of nasal passage on both sides or complete obstruction on one side	10%

Granulomatous rhinitis (diagnostic code 6524):

Description	Rating
Wegener’s granulomatous, lethal midline granuloma	100%
Other types of granulomatous infection	20%

Chronic sinusitis caused by burn pits

Sinusitis is inflammation or swelling of the tissue lining of the sinuses. Sinuses are hollow spaces within the bones between your eyes, behind your cheekbones, and in your forehead. The general rating for sinusitis includes diagnostic codes 6510 through 6514 and are as follows:

Description	Rating
Following radical surgery with chronic osteomyelitis, or; near constant sinusitis characterized by headaches, pain, tenderness of affected sinus, and purulent discharge or crusting after repeated surgeries	50%
Three or more incapacitating episodes per year of sinusitis requiring prolonged (lasting four to six weeks) antibiotic treatment, or; more than six non-capacitating episodes per year of sinusitis characterized by headaches, pain, and purulent discharge or crusting	30%
One or two incapacitating episodes per year of sinusitis requiring prolonged (lasting four to six weeks) antibiotic treatment, or; three to six non-incapacitating episodes per year of sinusitis characterized by headaches, pain, and purulent discharge or crusting	10%
Detected by X-ray only	0%

Constrictive or obliterative bronchiolitis caused by burn pits

Constrictive bronchiolitis, also called obliterative bronchiolitis, is a rare respiratory condition that causes a person’s airways to narrow. This causes coughing, shortness of breath, and other symptoms that are often confused for COPD or asthma. Because of this, it is difficult to diagnose. It also has no designated treatment or cure.

Constrictive bronchitis does not have its own diagnostic code. Instead, the VA references codes 6600 – 6604, diseases of the trachea and bronchi to find the best analogous rating for the condition. Each of these DCs rates at a 10%, 30%, 60%, and 100% rating.

COPD caused by burn pits

Chronic obstructive pulmonary disease, more commonly known as simply COPD, refers to multiple respiratory conditions that affect breathing and airflow to the lungs. While emphysema and chronic bronchitis are considered to be types of COPD, each has their own slightly different diagnostic code in the VA’s Schedule of Ratings.

COPD is rated under diagnostic code 6604 as follows:

Description	Rating
FEV-1 less than 40% of predicted value, or; the ratio of Forced Expiratory Volume in one second to Forced Vital Capacity (FEV-1/FVC) less than 40%, or; Diffusion Capacity of the Lung for Carbon Monoxide by the Single Breath Method (DLCO (SB)) less than 40% predicted, or; maximum exercise capacity less than 15 ml/kg/min oxygen consumption (with cardiac or respiratory limitation), or; cor pulmonale (right heart failure), or; right ventricular hypertrophy, or; pulmonary hypertension (shown by Echo or cardiac catheterization), or; episode(s) of acute respiratory failure, or; requires outpatient oxygen therapy	100%
FEV-1 of 40- to 55% predicted, or; FEV-1/FVC of 40 to 55%, or; DLCO (SB) of 40- to 55% predicted, or; maximum oxygen consumption of 15 to 20 ml/kg/min (with cardiorespiratory limit)	60%
FEV-1 of 56- to 70% predicted, or; FEV-1/FVC of 56 to 70%, or; DLCO (SB) 56- to 65% predicted	30%
FEV-1 of 71- to 80% predicted, or; FEV-1/FVC of 71 to 80%, or; DLCO (SB) 66- to 80% predicted	10%

Emphysema caused by burn pits

Emphysema is a condition that causes wheezing, shortness of breath, fatigue, and the feeling of not being able to get enough air. It is caused by damage to the alveoli, which are the small air sacs in the lungs. This damage affects the body’s ability to get oxygen into the bloodstream. 

Like chronic bronchitis, while emphysema is a form of COPD, it has its own designation in the Schedule of Ratings. It is rated under diagnostic code 6603 as follows:

Description	Rating
FEV-1 less than 40% of predicted value, or; the ratio of Forced Expiratory Volume in one second to Forced Vital Capacity (FEV-1/FVC) less than 40%, or; Diffusion Capacity of the Lung for Carbon Monoxide by the Single Breath Method (DLCO (SB)) less than 40% predicted, or; maximum exercise capacity less than 15 ml/kg/min oxygen consumption (with cardiac or respiratory limitation), or; cor pulmonale (right heart failure), or; right ventricular hypertrophy, or; pulmonary hypertension (shown by Echo or cardiac catheterization), or; episode(s) of acute respiratory failure, or; requires outpatient oxygen therapy	100%
FEV-1 of 40- to 55% predicted, or; FEV-1/FVC of 40 to 55%, or; DLCO (SB) of 40- to 55% predicted, or; maximum oxygen consumption of 15 to 20 ml/kg/min (with cardiorespiratory limit)	60%
FEV-1 of 56- to 70% predicted, or; FEV-1/FVC of 56 to 70%, or; DLCO (SB) 56- to 65% predicted	30%
FEV-1 of 71- to 80% predicted, or; FEV-1/FVC of 71 to 80%, or; DLCO (SB) 66- to 80% predicted	10%

Granulomatous disease caused by burn pits

Chronic granulomatous is a condition which affects the immune system. People with granulomatous disease have improperly-working phagocytes, a type of white blood cell which fights bacterial and fungal infections. This leaves people diagnosed with this condition at a higher risk of infection to the lungs, skin, stomach, and other parts of the body.

Chronic granulomatous does not have its own diagnostic code. However, the disease is referenced in multiple DCs. A few of the codes that may be used to rate granulomatous disease include:

• 6521 Pharynx, injuries to: Stricture or obstruction of pharynx or nasopharynx, or; absence of soft palate secondary to trauma, chemical burn, or granulomatous disease, or; paralysis of soft palate with swallowing difficulty (nasal regurgitation) and speech impairment at 50%
• 6524 Granulomatous rhinitis: Wegener’s granulomatosis, lethal midline granuloma at 100% or Other types of granulomatous infection at 20%
• 6828 Eosinophilic granuloma of lung, which is rated under the General Rating Formula for Interstitial Lung Disease.

Granulomatous Disease VA Rating

Interstitial lung disease caused by burn pits

Interstitial lung disease refers to more than 100 disorders of the lung. These disorders all cause inflammation and pulmonary fibrosis, which is scarring of the lungs. An interstitial lung disease is typically characterized by difficulty breathing, fatigue, and coughing, among other symptoms. These symptoms can range from mild to severe.

Interstitial lung diseases are rated under the General Rating Formula for Interstitial Lung Disease as follows:

Description	Rating
Forced Vital Capacity (FVC) less than 50% predicted, or; Diffusion Capacity of the Lung for Carbon Monoxide by the Single Breath Method (DLCO (SB)) less than 40% predicted, or; maximum exercise capacity less than 15 ml/kg/min oxygen consumption with cardiorespiratory limitation, or; cor pulmonale or pulmonary hypertension, or; requires outpatient oxygen therapy	100%
FVC of 50- to 64% predicted, or; DLCO (SB) of 40- to 55% predicted, or; maximum exercise capacity of 15 to 20 ml/kg/min oxygen consumption with cardiorespiratory limitation	60%
FVC of 50- to 64% predicted, or; DLCO (SB) of 40- to 55% predicted, or; maximum exercise capacity of 15 to 20 ml/kg/min oxygen consumption with cardiorespiratory limitation 60 FVC of 65- to 74% predicted, or; DLCO (SB) of 56- to 65% predicted	30%
FVC of 75- to 80% predicted, or; DLCO (SB) of 66- to 80% predicted	10%

Pleuritis caused by burn pits

Pleuritis, or pleurisy, is a respiratory condition that causes inflammation of the pleura. The pleura are the thin layers of tissue separating the lungs from the inner wall of the chest. 

These layers help the lungs smoothly move as a person breathes and their lungs expand and contract. A person with pleurisy will have inflamed pleura that will rub instead of gliding smoothly when a person breathes. This causes painful, uncomfortable breathing and shortness of breath.

The Schedule of Ratings calls for pleurisy to be rated under Ratings for inactive nonpulmonary tuberculosis either initially entitled after Aug. 19, 1968, or in effect on Aug. 19, 1968, based on the veteran’s effective date.

The VA may also rate pleurisy under diagnostic code 6845 for Chronic pleural effusion or fibrosis, which is rated using the General Rating Formula for Restrictive Lung Disease as follows:

Description	Rating
FEV-1 less than 40% of predicted value, or; the ratio of Forced Expiratory Volume in one second to Forced Vital Capacity (FEV-1/FVC) less than 40%, or; Diffusion Capacity of the Lung for Carbon Monoxide by the Single Breath Method (DLCO (SB)) less than 40% predicted, or; maximum exercise capacity less than 15 ml/kg/min oxygen consumption (with cardiac or respiratory limitation), or; cor pulmonale (right heart failure), or; right ventricular hypertrophy, or; pulmonary hypertension (shown by Echo or cardiac catheterization), or; episode(s) of acute respiratory failure, or; requires outpatient oxygen therapy	100%
FEV-1 of 40- to 55% predicted, or; FEV-1/FVC of 40 to 55%, or; DLCO (SB) of 40- to 55% predicted, or; maximum oxygen consumption of 15 to 20 ml/kg/min (with cardiorespiratory limit)	60%
FEV-1 of 56- to 70% predicted, or; FEV-1/FVC of 56 to 70%, or; DLCO (SB) 56- to 65% predicted	30%
FEV-1 of 71- to 80% predicted, or; FEV-1/FVC of 71 to 80 %, or; DLCO (SB) 66- to 80% predicted	10%

Pulmonary fibrosis caused by burn pits

Pulmonary fibrosis is a condition where the lungs are scarred and damaged, thus becoming thickened and hardened. This makes breathing more and more difficult over time.

The VA rates pulmonary fibrosis under the General Formula for Interstitial Lung Disease between 10% and 100%. The criteria for those ratings can be found above.

Sarcoidosis caused by burn pits

Sarcoidosis is a condition that causes tiny groups of granulomas to grow in the body, most commonly in the lungs or lymph nodes. Granulomas are very small inflammatory cells. 

Sarcoidosis may begin with similar symptoms — fatigue, joint pain, weight loss, and swollen, painful lymph nodes — but in later stages, symptoms depend on the part of the body affected. Sarcoidosis of the lungs is characterized by a dry cough, wheezing, and chest pain as well as feeling short of breath.

Sarcoidosis of the lungs is rated under diagnostic code 6846 as follows:

Description	Rating
Cor pulmonale, or; cardiac involvement with congestive heart failure, or; progressive pulmonary disease with fever, night sweats, and weight loss despite treatment	100%
Pulmonary involvement requiring systemic high dose (therapeutic) corticosteroids for control	60%
Pulmonary involvement with persistent symptoms requiring chronic low dose (maintenance) or intermittent corticosteroids	30%
Chronic hilar adenopathy or stable lung infiltrates without symptoms or physiologic impairment	0%

The rating for sarcoidosis includes a note that states the VA may also “rate active disease or residuals as chronic bronchitis (DC 6600) and extra-pulmonary involvement under specific body system involved.”

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Burn pits and respiratory cancers

Many respiratory cancers have been linked to exposure to toxins from burn pits. In April 2022, the VA added the following 9 rare respiratory cancers to the presumptive condition list:

• Squamous cell carcinoma of the larynx
• Squamous cell carcinoma of the trachea
• Adenocarcinoma of the trachea
• Salivary gland-type tumors of the trachea
• Adenosquamous carcinoma of the lung
• Large cell carcinoma of the lung
• Salivary gland-type tumors of the lung
• Sarcomatoid carcinoma of the lung
• Typical and atypical carcinoid of the lung

These cancers are associated with “exposure to fine particulate matter.” 

Other respiratory cancers

In addition to these rare types of cancer, the VA also considers “respiratory cancer of any type” to be a presumptive condition of burn pit exposure. 

Respiratory cancers are often characterized by a persistent cough, chest pain, and shortness of breath, among other symptoms. In the case of lung cancer, there are rarely any symptoms in the early stages.

Respiratory cancers are rated in the Schedule of Ratings under diagnostic code 6819, “Neoplasms, malignant, any specified part of respiratory system exclusive of skin growths” at 100%. This 100% rating will continue until six months after treatment for the cancer ends, at which point the veteran will be re-evaluated based on their current condition and residuals.

Burn pits and non-respiratory cancers

Although each type of cancer may be rated under a different diagnostic code within its corresponding body system, the VA treats them all the same way. As with respiratory cancers, other active cancers are temporarily rated at 100%. This rating continues until six months after cancer treatment ends. At that time, the veteran’s condition is assessed, residuals of the illness and treatment are considered, and the VA assigns a new rating.

The following cancers have been identified by the VA as presumptive conditions of exposure to toxins from burn pits:

• Brain cancer
• Breast cancer (male or female)
• Gastrointestinal cancer of any type (including esophageal)
• Glioblastoma
• Head cancer of any type
• Kidney cancer
• Lymphoma of any type
• Lymphatic cancer of any type
• Melanoma
• Neck cancer of any type (including pharyngeal)
• Pancreatic cancer
• Reproductive cancer of any type (including breast and testicular cancers)
• Urethral cancer and cancer of the paraurethral glands

How Woods & Woods can help

If you were exposed to a burn pit for any period of time during your military service and developed a health condition, you could be eligible to receive disability compensation from the VA.

Need a little help as you navigate your next steps? That’s why we’re here. Get in touch today for a free legal consultation. You won’t pay unless we win your case.

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