Claims and appeals

PACT Act claim errors: what to check on a denial

VA's own Inspector General found staff mishandled PACT Act presumptive claims. Here is what to look at in your decision and how to ask VA to look again.

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What the Inspector General found

On 3 December 2024, the VA Office of Inspector General reported that VA staff incorrectly processed claims when denying presumptive disabilities under the PACT Act. It reviewed denials from April to September 2023 and found examination and medical opinion overdevelopment errors in an estimated 6,900 denials (36 percent), at about $1.4 million in unneeded costs. It also found an estimated minimum of 870 potential errors that could affect veterans' benefits, including underpayments of about $56,700 to two veterans who were improperly denied service connection. Staff sometimes ordered unnecessary exams or opinions for presumptive conditions, and sometimes denied before getting clarification on unclear exam results. VA was given two recommendations and OIG lists both as implemented (27 March 2025 and 9 July 2025). (VA OIG report page, report PDF)

That is a finding about groups of claims. It does not say anything about your claim. Use it as a reason to check your letter.

What the Inspector General found

36 percent6,900 denialsestimated minimum870 potential errorsunneeded costs$1.4 million$56,700
The VA Office of Inspector General reported examination and medical opinion overdevelopment errors in an estimated 6,900 denials (36 percent), at about $1.4 million in unneeded costs, and an estimated minimum of 870 potential errors.VA Office of Inspector General ยท Page reviewed September 2026.

The Vietnam-era hypertension question

High blood pressure is a PACT Act Agent Orange presumptive condition for veterans with qualifying service. The service dates and places, and how VA rates it (Diagnostic Code 7101), are on the high blood pressure and your VA rating page. Service connection and the rating percentage are different questions, so a low rating can be correct even when service connection is granted.

Why an exam? The OIG found VA staff sometimes ordered exams and medical opinions they did not need for presumptive conditions, so it is fair to ask VA in writing what the exam was for.

What to check on your decision letter

  1. Was the condition on the presumptive list, and which service requirement did VA say you did not meet (place, dates, diagnosis)?
  2. Did VA say you have no current diagnosis? Then look at what medical record it had.
  3. Did it rely on an exam that was unclear or that contradicts your records?
  4. Was service connection denied, or granted with a low percentage? They are different problems.
  5. Was the denial before the PACT Act took effect? VA says if it denied your claim in the past and your condition is now presumptive, submit a Supplemental Claim, and that it will try to contact you but you do not need to wait.

How to ask VA to look again

PACT Act claims have no filing deadline. VA says Veterans and survivors can file anytime. A Supplemental Claim is for a claim VA already decided when you have new and relevant evidence or are asking for review because the law changed (VA names the PACT Act as an example). VA says you file online, or by mail, in person or through a Veterans Service Organization on VA Form 20-0995. Your other options are a Higher-Level Review (no new evidence) or the Board of Veterans' Appeals. (VA: Supplemental Claim, VA: Decision reviews)

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