Asthma VA claims: burn pits, the PACT Act and what the Board grants

Where VA presumes the link

Is asthma presumptive for burn pit exposure?

Yes, for veterans with qualifying service. Asthma, rhinitis and sinusitis are presumed service connected when they appear to any degree at any time after service in the Southwest Asia theater of operations during the Persian Gulf War, or in Afghanistan, Syria, Djibouti or Uzbekistan since September 2001, and exposure to fine particulate matter is presumed for that service (38 CFR 3.320). The PACT Act also wrote asthma into law (38 U.S.C. 1120), and since August 2022 the asthma no longer has to appear within ten years of service (M21-1 VIII.ii.2.A). In decisions that name burn pits or other airborne hazards, the Board granted 55.3% of asthma claims (407 of 736), against 24.8% overall.

Granted

All asthma claims

24.8%

Burn pits or other airborne hazards

55.3%

Iraq

54.9%

Kuwait

50.8%

Afghanistan

53.0%

Saudi Arabia

57.6%

Any covered place

48.2%

No covered place named

18.5%

Share of decided claims granted; a remand counts as not granted. One count per veteran. Each row is what the decision mentions; rows overlap, and a mention is not proof of qualifying service or exposure. Covered places: the Southwest Asia theater, Afghanistan, Syria, Djibouti and Uzbekistan (38 CFR 3.320), plus the countries the PACT Act added.

Where did asthma claims do best?

In decisions that name a place covered by the presumption: 48.2% granted (569 of 1,181), against 18.5% where no covered place is named. By place, the Board granted 54.9% of asthma claims in decisions that name Iraq, 50.8% for Kuwait, 53.0% for Afghanistan and 57.6% for Saudi Arabia.

Decisions that name a covered placeAll other asthma claims

2020

22.8%

14.9%

2021

42.3%

13.6%

2022

58.7%

15.5%

2023

56.6%

18.2%

2024

56.7%

23.8%

2025

41.3%

22.5%

Share of decided claims granted; a remand counts as not granted. One count per veteran. Every claim kind under DC 6602. The PACT Act took effect in August 2022.

In 2020 decisions, asthma claims that named a covered place were granted 22.8%; in 2022, 58.7%. The share fell to 41.3% in 2025, a year with more of these claims than any before (303); the data does not show why. Claims that name no covered place rose too, from 14.9% to 22.5%.

Naming an exposure helps only where the law ties it to asthma. Asthma is not on the Agent Orange list or the Camp Lejeune list: in decisions that name Agent Orange or other herbicides the Board granted 15.1% of 477 asthma claims, and in decisions that name Camp Lejeune 12.9% of 93.

Asthma that started before or during service

What if the asthma started before or during service?

The presumption covers asthma diagnosed after service. Asthma first diagnosed before or during service is decided on other routes, direct service connection or aggravation (M21-1 VIII.ii.2.C.1.c). If the entrance exam did not note asthma, the veteran is presumed to have been sound at entry, and VA must show by clear and unmistakable evidence both that the asthma existed before service and that service did not aggravate it (38 CFR 3.304(b)). Where the decision discussed asthma before service, such as childhood asthma, the Board granted 33.6% of the claims (179 of 533), against 23.9% for the other asthma claims.

The decisions do not show why these claims did better. In the grants below, either VA could not rebut the presumption of soundness, or a medical opinion found that service worsened the asthma beyond its natural course. In the denials, the Board found clear and unmistakable evidence on both parts. For the 1,506 denied asthma claims overall, the Board's note named the medical link in 28.1%, the in-service event in 20.7% and the diagnosis in 15.1%.

Asthma claimed secondary to another condition

Can asthma be secondary to rhinitis or sinusitis?

Yes. A service-connected condition that causes or worsens asthma can carry it (38 CFR 3.310). Allergic rhinitis is the condition asthma is most often claimed secondary to: the Board granted 20 of 61 (32.8%). Asthma claimed secondary to sinusitis was granted 21.9%, and secondary to PTSD 3.0%.

Asthma claimed secondary to	Granted	Veterans	Share
Allergic rhinitis	20	61	32.8%
PTSD	1	33	3.0%
Sinusitis	7	32	21.9%
Sleep apnea	3	20	15.0%

How VA rates asthma

How does VA rate asthma?

Under DC 6602 in 38 CFR 4.97, from 10 percent, for an occasional inhaler or a mildly reduced breathing test, to 100 percent, for a severely reduced breathing test, attacks more than once a week with respiratory failure, or daily high-dose oral steroids or immune-suppressing drugs. Daily inhaler treatment or inhaled anti-inflammatory medicine supports a middle rating. Asthma is not rated separately from most other lung conditions or from sleep apnea: VA assigns one rating for the main condition and raises it a step when the overall disability warrants it (38 CFR 4.96(a)).

What follows from asthma

What conditions are claimed secondary to asthma?

Sleep apnea, by far: the Board granted 142 of 602 (23.6%). COPD came out at 25.0%, migraine at 32.0%, depression at 42.1%, acid reflux (GERD) at 16.1% and hypertension at 8.6%. Because asthma, COPD and sleep apnea are rated together under 38 CFR 4.96(a), a grant of sleep apnea secondary to asthma matters when it can raise that single rating.

Claimed secondary to asthma	Granted	Veterans	Share
Sleep apnea	142	602	23.6%
Hypertension	7	81	8.6%
COPD	12	48	25.0%
Acid reflux (GERD)	5	31	16.1%
Migraine	8	25	32.0%
Depression (major depressive disorder)	8	19	42.1%

Look up your client's group

Every base, exposure, job and medal with at least 15 decided asthma claims, 48 groups in all. Burn pits and other airborne hazards is the one group that falls under a presumption.

Bases 3Exposures 22Military jobs 9Medals 14

Bar: share of this group's asthma claims the Board granted. Red line: all asthma claims, 24.8% granted. A bar past the line won more often than usual.

×

More often than usual: how much more often asthma comes up in this group's decisions than in all Board decisions. It shows how common the condition is here, not how often it wins.

Set aside

For groups VA does not presume, veterans whose decision shows service VA already presumes for asthma (for example Vietnam or Thailand for Agent Orange) are left out, because for them the presumption is the answer.

Sort byGrant shareMore often than usualClaims decided

• Fort Jackson
  12.5% granted · 2 of 16 · 1 with presumptive service set aside

  1.8×more often

• Camp Lejeune
  11.5% granted · 10 of 87 · 6 with presumptive service set aside

  1.1×more often

• Fort McClellan, Alabama
  8.1% granted · 3 of 37 · 1 with presumptive service set aside

  1.9×more often

Read the decisions

Recent decisions, with the Board's reasoning as summarized by AI and checked against the decision text:

• A25107238, December 2025: asthma granted on the burn pit presumption for a veteran with Iraq service. VA examinations in 2024 found no diagnosis; private records from January 2025 diagnosed asthma, and the presumption supplied the link.
• A25109172, December 2025: asthma granted on the presumption for Southwest Asia service; the Board noted that the regulation's ten-year window is no longer enforced since the PACT Act.
• A25102008, November 2025: asthma denied for a veteran who reported burn pit exposure; the Board found no asthma and no chronic asthma symptoms during the appeal.
• 25014362, December 2025: asthma granted as aggravation of asthma that existed before service. The veteran had childhood asthma that had resolved; a VA examiner found that service worsened it beyond its natural progress.
• A25103697, December 2025: asthma denied; the Board found clear and unmistakable evidence that the asthma existed before service and that service did not aggravate it. The veteran had no Southwest Asia service, so the presumption did not apply.
• A25104820, December 2025: asthma granted secondary to service-connected allergic rhinitis, on a VA opinion that cited medical literature on rhinitis often coming before asthma; the evidence was evenly balanced.
• A25109639, December 2025: sleep apnea granted secondary to service-connected asthma, on a private opinion that asthma predisposes to sleep apnea.

What the data cannot tell you

The counts follow DC 6602, so they include some claims for related breathing problems coded there, such as reactive airway disease and shortness of breath, and every claim kind, including some rating appeals. The groups and places come from what each decision mentions; a mention is not proof of service or exposure, and a decision can fall in more than one group. Decisions that name a place only in a quote of the law are left out of the place counts. "Asthma before service" is found from words in the AI summary of each claim, such as pre-existing, childhood asthma or presumption of soundness, and misses some. Secondary counts include only claims the Board marked as secondary. These are historical outcomes, not predictions.

For representatives

• Prove the qualifying service and dates first: the Southwest Asia theater during the Gulf War, or Afghanistan, Syria, Djibouti or Uzbekistan since September 2001. The exposure is then presumed.
• Get a diagnosis of asthma made after service, with a breathing test. Shortness of breath alone is a symptom, not a diagnosis.
• If asthma was diagnosed before or during service, argue direct service connection or aggravation, and get an opinion on whether service worsened it beyond its natural course.
• If the entrance exam was clean, hold VA to clear and unmistakable evidence on both parts of the presumption of soundness.
• Before claiming sleep apnea secondary to asthma, check whether it can raise the single respiratory rating.