The 2022 PACT Act was supposed to close the door on decades of denied burn-pit claims. It expanded the list of illnesses the Department of Veterans Affairs will presume were caused by military service, and it opened the benefits system to a generation of post-9/11 veterans who breathed the smoke of open-air waste pits in Iraq, Afghanistan and elsewhere. On paper, it was one of the largest expansions of veterans’ health benefits in a generation.
The reality on the ground is more complicated. Even with the law in place, a large share of veterans who file burn-pit-related disability claims are still turned down the first time they apply. The reasons are rarely about whether the illness is real. They are about paperwork, evidence, and the way the claim is built. For veterans coping with cancer, chronic respiratory disease or other serious conditions, a first-round denial can feel like the system is calling the exposure into question all over again.
The numbers behind the denials
The scale of the demand is not in dispute. The VA has received more than 450,000 burn-pit-related claims across the 2024 through 2026 period, according to figures compiled in a review of burn-pit exposure and VA benefits. That volume reflects both the size of the exposed population and the outreach that followed the PACT Act, which encouraged veterans who had never filed, or who had been denied years earlier, to come forward.
What happens to those claims is where the frustration sets in. The initial-claim approval rate tied specifically to burn-pit causation runs at roughly 40 to 45 percent. That means more than half of the veterans who submit a burn-pit claim receive a denial on their first attempt. The rejection is not the end of the road, but it does put the burden back on the claimant to prove a connection between an old deployment and a present-day diagnosis.
Why the first try so often fails
Understanding the denial rate requires understanding what a decision-maker is actually looking for. A disability claim generally rests on three pieces: a current diagnosed condition, an in-service event or exposure, and a medical link between the two. Burn-pit claims tend to stumble on the middle and final pieces. Deployment records may not spell out proximity to a specific pit. Medical files may document the illness without ever tying it back to service. When that connective tissue is missing, an examiner can deny the claim even when the underlying facts would support it.
This is where the PACT Act was meant to help. The law added a roster of presumptive conditions, meaning illnesses the VA will accept as service-connected without forcing the veteran to prove the exposure caused them. A guide to PACT Act presumptives and burn-pit claims lays out how those conditions are supposed to smooth the path: if a diagnosis is on the presumptive list and the veteran served in a qualifying location and time frame, the causation question is largely settled in the veteran’s favor.
The gap is that not every illness is on the list, and not every claim is filed in a way that makes the presumptive status obvious. A veteran with a condition that falls just outside the presumptive categories, or whose service dates are documented imprecisely, can still draw a denial. So can a veteran who files a bare-bones claim without the medical records and service documentation that would let a reviewer connect the dots quickly.
A denial is a starting point, not a verdict
The most important thing for veterans to absorb is that a first-round denial does not close the case. The VA system is built with appeal and review options precisely because first decisions are so often incomplete. A denied claimant can request higher-level review, submit a supplemental claim with new evidence, or appeal to the Board of Veterans’ Appeals. Each of those paths gives the veteran a chance to fill the gaps that sank the initial filing.
In practice, the veterans who succeed on a second attempt usually do so by strengthening the evidence rather than by arguing louder. That can mean obtaining a clear diagnosis from a treating physician, gathering deployment records that establish presence near a burn pit, or securing a medical opinion that explicitly links the illness to the exposure. Buddy statements from fellow service members, unit records and the veteran’s own account of conditions during deployment can all help build the picture a reviewer needs.
What this means for older veterans and their families
For older veterans, and for surviving spouses handling a late veteran’s affairs, the stakes are practical. A granted claim can mean monthly compensation and access to VA health care for the condition in question. A denial that goes unchallenged can mean walking away from benefits the law was designed to provide. Because many of the illnesses tied to burn-pit exposure develop slowly, the population filing these claims skews older, and the paperwork burden can be heaviest for those least equipped to fight it alone.
Building the file before the second decision
The mechanics of a stronger claim are less mysterious than they sound. Much of the work is administrative: assembling the records that establish where a veteran served and when, pairing them with the medical files that document the current diagnosis, and adding a professional opinion that ties the two together. Veterans who keep copies of their own service documents, discharge paperwork and treatment histories tend to move faster than those who have to reconstruct a paper trail from scratch after a denial arrives.
The emotional side of the process deserves acknowledgment too. A denial letter can read as an accusation, and for a veteran already managing a serious illness, the impulse to walk away is understandable. Family members often carry the load at that point, tracking deadlines, requesting records and coordinating with a representative on the veteran’s behalf. Surviving spouses in particular may inherit an unfinished claim and have to decide whether to continue it. Knowing that the review stages exist specifically to correct incomplete first decisions can make that decision easier to face.
The broad lesson from the current approval numbers is that persistence pays. The PACT Act changed the law, but it did not change the fact that a claim has to be documented to win. Veterans who treat a first denial as a signal to gather stronger evidence, rather than as a final answer, are the ones most likely to see the outcome flip on review. Accredited veterans service organizations and VA-accredited representatives can assist with that process at no cost, and using them can be the difference between a rejected first try and an approved second one.
This article was produced with AI assistance and fact-checked against the primary and official sources linked above.
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