Agent Orange was a herbicide used during the Vietnam War, and its health effects have been recognized for decades. What many veterans do not realize is that both the list of presumptive conditions and the list of qualifying locations have expanded. This guide covers the 2026 picture.
Who is presumed exposed
Presumed exposure covers veterans who served in specific locations during specific periods. The best-known is service in Vietnam during the war. The PACT Act added several more presumptive locations, including certain service in Thailand, Laos, Cambodia, Guam, American Samoa, and Johnston Atoll during defined periods.
If you served in a qualifying location during the covered period, exposure is presumed. You do not have to prove you personally handled or contacted the herbicide.
What conditions qualify
The Agent Orange presumptive list includes a range of conditions: certain cancers, type 2 diabetes, ischemic heart disease, Parkinson's disease, and others. The PACT Act added two more: hypertension (high blood pressure) and monoclonal gammopathy of undetermined significance (MGUS).
The addition of hypertension is significant because it is so common among aging veterans.
Secondary conditions are the opportunity
Many Agent Orange conditions cause others. Type 2 diabetes, for example, can lead to peripheral neuropathy, kidney disease, and eye conditions. Ischemic heart disease can lead to related complications. These secondary conditions are rated separately and can raise your combined rating.
This is where a nexus letter earns its place, connecting the secondary condition to the presumptive primary one (38 CFR 3.310).
If you were denied before
If you were previously denied for a condition that is now presumptive, such as hypertension, you can file a Supplemental Claim (VA Form 20-0995). Filing promptly can protect your effective date.
A real-world example
A Vietnam veteran had been managing type 2 diabetes for years and had a related nerve condition in his feet he never connected. A provider tied the neuropathy to his presumptive diabetes as a secondary claim, and it was rated separately.