Veterans' Health: Duckworth Proposes Faster Toxic Exposure Review for Combat Zones

The Department of Veterans Affairs currently lacks a standardized process for determining when troops in new conflict zones should receive presumptive healthcare benefits. Sen. Tammy Duckworth, D-Illinois, plans to address this gap on Tuesday by introducing a bill that would force the agency to evaluate environmental hazards within a fixed timeframe.

The proposed legislation requires the VA to complete an assessment of toxic threats in any new combat zone within 180 days. These threats include intense pollution, radiation, and chemical exposure. Based on the findings, the department would recommend whether service members in those areas should be presumed to have been exposed, making them eligible for healthcare and disability compensation.

There is currently no clear mechanism for adding new regions to the existing list of more than a dozen countries and territories where troops are already presumed to have faced toxic exposure. The bill would also require the VA to revisit overseas assignments at least every five years to identify hazards that may have gone unrecognized.

The proposal expands on the PACT Act, which took effect in 2022. That law opened VA care and benefits to millions of veterans following years of pressure from advocacy groups. Comedian Jon Stewart, who had previously advocated for similar assistance for 9/11 first responders, supported the expansion. The PACT Act marked one of the largest expansions of veterans' health care and disability benefits in U.S. history.

An analysis from the Congressional Budget Office projected nearly $280 billion in new spending over a decade for the PACT Act. The law eased the burden on veterans seeking disability benefits by reducing the need to prove that specific cancers or respiratory illnesses were directly caused by toxic exposure. Qualifying service alone was enough to establish the link.

The PACT Act covered veterans of Iraq and Afghanistan who were exposed to smoke from burn pits. These makeshift sites were used to burn trash, medical waste, jet fuel, and plastics. The VA has linked that smoke to a series of respiratory issues and cancers. The law also expanded presumptions of Agent Orange exposure for veterans who served in Laos, Cambodia, and other parts of Southeast Asia during the Vietnam War era. It included radiation exposure among troops who responded to the 1968 crash of a nuclear-armed B-52 near Thule Air Force Base in Greenland.

Duckworth’s bill would add Iran to the list of covered combat zones as a proactive measure. No specific toxic threat has been identified yet, but the provision accounts for potential exposure to environmental hazards as the conflict continues. These potential hazards include damage to oil facilities, chemical spills, or the use of chemical weapons.

With a new generation of troops entering another war in the Middle East, Duckworth stated in a statement to ABC News that the nation must learn from previous conflicts. She said the goal is to proactively ensure Iran veterans do not suffer from the same mistakes made in prior engagements.

Previously, veterans faced a difficult evidentiary hurdle. They had to document exposure that may have occurred decades earlier and prove it caused an illness that surfaced years after leaving the military. Claims were often tangled in legal disputes or stuck in a bureaucratic process.

By May 2024, the VA had approved 1 million claims for healthcare and disability compensation tied to the PACT Act, according to agency data.