The PACT Act for Women Who Served at Balad, Bagram, and K2

If you served near a burn pit in Iraq, Afghanistan, or Uzbekistan and you have since developed a respiratory illness, a rare cancer, or an unexplained chronic condition, the PACT Act of 2022 may have already done the hardest part of your claim for you.

What "presumptive" actually means

Normally, to win a claim you must prove three things: a current diagnosis, an in-service event, and a medical nexus linking the two. The nexus is where most toxic-exposure claims used to die, because how do you prove that the smoke you breathed a decade ago caused the cancer you have now?

A presumption removes that burden. When a condition is presumptive for a location and time period, the VA presumes the exposure caused it. You no longer have to prove the nexus — you only have to show you were there and that you have the condition.

Balad, Bagram, and K2

All three of these installations sat next to some of the largest open-air burn pits of the wars:

• Joint Base Balad (Iraq) — home to one of the most notorious burn pits in the entire theater, burning waste around the clock within sight of living quarters.
• Bagram Airfield (Afghanistan) — massive, long-running operations with sustained airborne particulate exposure.
• Karshi-Khanabad, "K2" (Uzbekistan) — a former Soviet base with documented contamination from fuels, solvents, and radiological material, now recognized under PACT Act airborne-hazard coverage.

Under the PACT Act, service in these locations during the covered periods makes you a veteran with a recognized toxic exposure risk activity, and it makes a long list of conditions presumptive.

Conditions the PACT Act made presumptive

The list is long and it grows, but it includes many conditions that hit women veterans:

• Asthma, chronic bronchitis, chronic rhinitis and sinusitis (diagnosed after service).
• COPD and chronic obstructive respiratory disease.
• A range of cancers — including reproductive cancers, breast cancer, respiratory cancers, and several rare cancers.
• Constrictive bronchiolitis and pulmonary fibrosis.

The trap: exposure is never limited to your job

Here is what a lot of representatives get wrong. Toxic exposure is not driven by your MOS. It is driven by your unit, every place you were stationed or deployed, and every job you actually did. A supply clerk who slept two hundred meters from the Balad pit breathed the same smoke as the airman working the flight line. If someone tells you that you were not exposed because of your job title, they are wrong.

What to do now

File a claim for the condition and make the location clear. If your condition is on the presumptive list and your records show you were there, this can move quickly. If your situation is less clean — a non-presumptive base, a job-specific exposure, or a condition not yet on the list — that is a facts-found case that needs your exposure records and a medical opinion, and it is exactly the kind of case worth having an accredited representative build. A review is free, and asking costs you nothing.