Reproductive Cancers & the PACT Act
Breast, cervical, ovarian, uterine, and other reproductive cancers — rated at 100% during treatment and presumptive under the PACT Act.
Reproductive cancers — breast, cervical, ovarian, uterine, vaginal, and vulvar — are among the most serious conditions women veterans face. When cancer is service-connected, the VA rates it at 100% during active treatment (surgery, radiation, chemotherapy). After treatment ends and the cancer is in remission, the rating is based on residuals — which can include surgical compensation, secondary conditions, and ongoing treatment effects.
The PACT Act (Public Law 117-168, signed August 10, 2022) added reproductive cancers to the list of presumptive conditions for veterans with qualifying toxic exposures. Presumptive means you do not have to prove the exposure caused the cancer — the connection is presumed by law if you served in a qualifying location or role during a qualifying period. This is one of the most significant changes in VA benefits law for women veterans in decades.
Even without a PACT Act presumptive path, reproductive cancers can be service-connected through direct evidence, secondary connection (cancer caused by a service-connected immune condition), or through specific exposure programs (Camp Lejeune, Agent Orange, radiation risk activities). Below we explain every pathway and the steps to file.
DC 7627 · PACT Act Presumptive
Breast, cervical, ovarian, uterine, and other reproductive cancers — rated at 100% during treatment and presumptive under the PACT Act.
Use the eligibility criteria and claim steps on this page to pursue this claim without leaving the guide.
Understanding Reproductive Cancers
DC 7627 — Malignant neoplasms of the gynecological system
Any malignant (cancerous) tumor of the reproductive system — ovarian, uterine, cervical, vaginal, or vulvar cancer. Rated at 100% during active treatment. After treatment, rated on residuals (surgical codes, treatment side effects, secondary conditions).
DC 7628 — Benign neoplasms of the gynecological system
Benign tumors are rated on the basis of any impairment of function — urinary, bowel, or gynecological — using the appropriate diagnostic code for the specific symptoms they cause.
Breast cancer
Rated under 38 CFR §4.116, DC 7626 (mastectomy, rated 0-80% based on tissue removed), or analogous codes for treatment residuals. The PACT Act includes breast cancer as a presumptive condition for certain toxic-exposed veterans.
The PACT Act presumptive pathway
Under the PACT Act, veterans who served in qualifying locations (Southwest Asia, certain bases with documented toxic exposures) during qualifying periods are presumed to have service-connected cancers without proving the individual link. This includes reproductive cancers affecting women — breast, cervical, ovarian, uterine, vaginal, and vulvar.
Do you qualify for a Reproductive Cancers claim?
You have a current or past diagnosis of a reproductive cancer (breast, cervical, ovarian, uterine, vaginal, vulvar).
You served in a location or role with qualifying toxic exposures under the PACT Act — Southwest Asia, Camp Lejeune, Agent Orange zones, burn pit exposure, or radiation risk activities.
Alternatively, you can show direct service connection — the cancer was diagnosed in service, within a presumptive period after discharge, or is linked to a documented exposure.
Cancer secondary to a service-connected immune condition or treatment side effects (e.g., immune suppression from medication) qualifies under §3.310.
Camp Lejeune water contamination (1953-1987) carries its own presumptive cancers including breast and bladder cancer.
Not sure whether you qualify? Eligibility can be complex. An accredited representative can confirm exactly where you stand before you invest time in applications.
What a Reproductive Cancers claim actually gives you
100% during active treatment
Any active cancer treatment — surgery, radiation, chemotherapy, immunotherapy — earns a 100% rating for the duration of treatment and for a period after treatment ends (typically 6 months) to allow recovery.
Surgical compensation
Mastectomy (DC 7626: 0-80% based on tissue removed), hysterectomy (DC 7617/7618), oophorectomy (DC 7619), and other cancer surgeries each have their own rating codes.
SMC-K for loss of creative organ
Hysterectomy or oophorectomy as cancer treatment adds ~$130/month under SMC-K. Mastectomy with loss of breast tissue may also qualify for SMC considerations.
Treatment residuals
Lymphedema, neuropathy, fatigue, cognitive changes ("chemo brain"), scarring, hormonal changes, and early menopause are each separately ratable as residuals of cancer treatment.
Mental health secondaries
Depression, anxiety, PTSD related to cancer diagnosis and treatment, and body-image distress are ratable secondary conditions under §3.310.
VA cancer care
Comprehensive cancer treatment is covered: surgery, radiation, chemotherapy, immunotherapy, clinical trials, palliative care, and survivorship programs including fertility preservation counseling.
What this means for you
The PACT Act is one of the most significant expansions of VA benefits for women veterans in history. Reproductive cancers — breast, cervical, ovarian, uterine, vaginal, vulvar — are now presumptive for women who served in qualifying locations with toxic exposures. That means the burden of proof shifts: you do not have to prove the exposure caused the cancer, the law presumes it. If you have been diagnosed with a reproductive cancer and you served in a qualifying location, file. The 100% rating during treatment plus back pay plus residuals can total hundreds of thousands of dollars.
Filing a Reproductive Cancers claim, step by step
Confirm your exposure pathway
Identify your qualifying service: PACT Act presumptive locations/dates, Camp Lejeune (1953-1987), Agent Orange zones, radiation risk activities, or other documented exposures. Your DD-214 and service records establish the location and dates.
Gather medical records
Pathology reports confirming the cancer type, treatment records (surgery, chemo, radiation), and current status. For presumptive claims, the diagnosis plus qualifying service is often sufficient.
File an Intent to File (VA Form 21-0966)
Protects your effective date. For cancer claims, back pay from the effective date through the 100% treatment period can be substantial.
Submit VA Form 21-526EZ
List the specific cancer and treatment. For PACT Act claims, note the presumptive pathway. List every secondary condition and surgical residual separately.
Claim all residuals
After treatment: surgical codes (mastectomy, hysterectomy), lymphedema, neuropathy, fatigue, early menopause, mental health conditions, scarring — each is ratable separately.
Appoint an accredited representative
Cancer claims are high-value and complex. A representative ensures every residual is claimed, the correct codes are applied, and SMC-K is requested. VA Form 21-22a, no upfront cost.
Women Veterans Call Center
Staffed entirely by women. Call or text for help with cancer claims, PACT Act eligibility, or connecting to VA oncology.
1-855-829-6636What trips women veterans up
Not knowing about the PACT Act presumptive pathway — this eliminates the need to prove a causal link for qualifying veterans.
Filing only the cancer and not the treatment residuals — neuropathy, lymphedema, fatigue, and mental health conditions are each separately ratable.
Missing SMC-K after cancer surgery — hysterectomy, oophorectomy, and mastectomy each qualify.
Not filing until treatment is complete — the 100% rating applies DURING treatment, and filing early protects your effective date for back pay.
Assuming you need a direct link between a specific chemical and your cancer — presumptive means the law assumes the link.
Not claiming early menopause and its complications after cancer treatment — osteoporosis, cardiovascular changes, and mood disorders are secondary conditions.
Reproductive Cancers: your questions answered
Are reproductive cancers presumptive under the PACT Act?
Yes. Breast, cervical, ovarian, uterine, vaginal, and vulvar cancers are among the cancers added as presumptive conditions under the PACT Act for veterans with qualifying toxic exposures. Presumptive means you do not have to prove the exposure caused the cancer — the connection is presumed by law.
What is the VA rating during cancer treatment?
Active cancer in treatment is rated at 100%. This applies during surgery, radiation, chemotherapy, and immunotherapy, and for a period after treatment ends (typically 6 months) to allow recovery. After that, the rating is based on residuals.
What happens to my rating when cancer is in remission?
After the 100% treatment period, the VA rates based on residuals: surgical compensation (mastectomy, hysterectomy codes), treatment side effects (neuropathy, lymphedema, fatigue), secondary conditions (depression, early menopause), and any ongoing monitoring requirements.
Can I file a cancer claim years after treatment?
Yes. There is no time limit on filing a VA disability claim. If your cancer was service-connected — by direct evidence or PACT Act presumption — the effective date can go back to the date of your Intent to File or the date the condition was diagnosed, whichever is later (subject to AMA rules).
Does Camp Lejeune water contamination cover reproductive cancers?
Yes. Veterans and family members exposed to contaminated water at Camp Lejeune (1953-1987) may qualify for presumptive service connection for certain cancers including breast cancer and bladder cancer, under the Camp Lejeune Justice Act provisions.
Can I get VA cancer care even if my claim has not been decided?
Yes. Enrolled veterans can access VA cancer care regardless of whether a disability claim is pending. And veterans with toxic exposures can enroll in VA healthcare under expanded PACT Act eligibility even without a disability rating.
See every reproductive health condition rated by the VA, or estimate the rating that could expand your compensation.
Not sure where to start?
Whether you need help understanding your rating, building a nexus, or challenging a decision, a free review of your situation can put you on the right path.
