Toxic Exposure
TERA - Toxic Exposure Risk Activity
This is the earned, facts-found path, meant for real exposures that are not on any presumptive list. TERA is not a presumptive by itself, but it opens the door to a claim the VA must consider. From there, you connect the dots with your service records and a medical nexus linking your condition to the exposure. It takes more work than a presumptive claim, but for many veterans it is the only honest path to the rating they deserve.
TERA is NOT a presumptive
TERA stands for Toxic Exposure Risk Activity. It is a VA finding that you took part in an activity during service that carried a risk of toxic exposure - even if your condition is not on a presumptive list and your base or job is not named in any law. A TERA determination makes you eligible for expanded VA health care and lets you pursue a direct ("facts-found") claim - but you still have to show your diagnosis and a medical nexus tying it to that exposure.
Common exposures claimed through TERA
These are real, common exposures that are NOT automatically presumptive. If any of these describe your service, a TERA determination plus your records can support a claim.
Fuels, solvents & degreasers (JP-8 jet fuel, TCE, benzene)
Motor pool, flight line, aircraft and vehicle maintenance, and parts-cleaning work all carry chemical exposure - even when it was not your listed MOS.
Firefighting foam - PFAS / AFFF ("forever chemicals")
Crash-rescue, firefighting, and fuel-systems work exposed many veterans to PFAS from firefighting foam used on flight lines and ships.
Asbestos & lead
Shipboard duty, boiler and engine rooms, welding, demolition, and repair of older buildings and vessels are classic asbestos and lead exposures.
Contaminated bases not on a presumptive list
Fort McClellan (MP School / Chemical Corps - radiological, chemical-agent, PCBs), Anniston, and many installations with fuel, solvent, or PFAS contamination.
Depleted uranium (DU)
Armored-vehicle crews, recovery and salvage teams, and anyone near struck vehicles or DU munitions may have DU exposure that must be documented.
Industrial & maintenance chemicals
Paints, sandblasting, batteries, pesticides applied on base, and hazardous-waste handling - the exposure follows the work you actually performed.
Attached to a higher-exposure unit or mission
Pulled to an EOD, chemical, engineer, or field team, or embedded with a unit that had heavier exposure? If you worked alongside them, you often share their exposure.
What it takes to win a TERA claim
A TERA finding opens the door - a direct, facts-found claim does the rest. That means pulling your exposure records (the ILER), building the TERA memo, and lining up a medical nexus so the VA cannot wave the claim away. This is exactly the part we handle for you.
Watch & learn
Official VA videos on toxic exposure & presumptives
Straight from the VA - what a presumptive is and how toxic-exposure claims work. TERA is the path for everything these videos do not automatically cover.
What Is a Presumptive Condition? (VA Disability Claims)Official video - U.S. Department of Veterans Affairs - theSITREP
5 toxic-exposure facts veterans aren't aware of
What the PACT Act, TERA, and VA screening actually mean for your claim.
The PACT Act made many conditions presumptive
If your condition is on a presumptive list for your exposure, you do not have to prove it was caused by service - the VA presumes the link. This was greatly expanded in 2022.
TERA opens a path when nothing is presumptive
A Toxic Exposure Risk Activity determination lets you file a facts-found claim even when your condition is not on any presumptive list. Most veterans have never heard of it.
Every enrolled veteran gets a free toxic-exposure screening
The VA offers a no-cost toxic-exposure screening to all enrolled veterans - a simple way to get your exposure on the record before you file.
Exposure was not only overseas
Stateside bases, Gulf War theaters, and post-9/11 burn pits all count. Where and when you served can qualify you even if you never saw combat.
Survivors may be owed DIC
If a veteran died from a toxic-exposure condition, the surviving spouse or children may qualify for Dependency and Indemnity Compensation - even years later.
The pieces the VA actually weighs
Four things decide a toxic-exposure claim
Whether your exposure is presumptive or facts-found, the same four pieces decide how it lands. Get these right and the VA has little room to deny you; leave one weak and even a strong claim can stall. This is exactly the work an accredited agent does with you - and why the ILER and the TERA memo matter as much as the diagnosis itself.
Establish chronicity
Chronicity means showing your condition has been continuous or recurring since service - not a one-time complaint. A line of dated records, or even lay statements describing the same symptoms year after year, builds it. The VA leans on gaps in treatment to argue a condition "resolved" on its own; an unbroken timeline shuts that door before it opens.
Prove a nexus
A nexus is a medical opinion that links your condition to your service "at least as likely as not" - a 50 percent or better probability. For a presumptive you may not need one; for everything else, a clear nexus letter from a qualified provider is what wins the claim. Vague wording sinks it - the opinion has to state that standard in plain terms.
Make sure your ILER is accurate
Your ILER - the Individual Longitudinal Exposure Record - is the VA and DoD's official record of what you were exposed to, and where. The VA reads it before it reads your statement. If it is blank, wrong, or missing a deployment, the VA may decide you were never exposed - so you have the right to review it and request corrections, and doing so can make or break the claim.
Get a TERA memo
A TERA memo is the formal determination that you took part in a Toxic Exposure Risk Activity. It is what carries a claim that is not automatically presumptive: it establishes the exposure in the record, unlocks expanded VA health care, and gives your nexus opinion something official to attach to. Without it, a facts-found claim often has nothing solid to stand on.
The two words that decide your claim
Presumptive vs. TERA - what they mean, and why they are not the same thing
The VA handles toxic exposure two different ways. Getting these straight is the difference between a claim that moves and a claim that stalls - so here is exactly what each one means.
What a "presumptive" condition actually is
A presumptive condition is one the VA has already agreed is caused by a toxic exposure. If you have a listed condition and you served in a qualifying place and time, the VA presumes the link - you do not have to prove the exposure caused your illness. That is the whole point: it removes the hardest part of the claim. The 2022 PACT Act added more than 20 new presumptive conditions and new qualifying locations, which is why so many older veterans - and previously denied veterans - now qualify.
The PACT Act and TERA are two separate things - and one is NOT a presumptive
Do not let anyone blur these together. The PACT Act is the law behind the presumptive lists - it says the VA assumes certain conditions are service-connected. TERA - Toxic Exposure Risk Activity - is NOT a presumptive. A TERA finding only confirms that you took part in an activity that carried a risk of toxic exposure. It opens the door to expanded VA health care and a direct, "facts-found" claim - but it does not automatically connect your condition. You still prove it with your exposure records (the ILER), a TERA memo, and a medical nexus.
PACT Act / presumptive
Listed condition + qualifying service = the VA presumes the link. You do not prove causation.
TERA / facts-found
Not on a list, peacetime, or never deployed? TERA opens the door - you still prove the link with records and a nexus.
The expanded Agent Orange - it is part of the PACT Act
The PACT Act did not just cover burn pits. It expanded Agent Orange too - and this is still a presumptive path, not TERA. It added two new presumptive conditions for Agent Orange: high blood pressure (hypertension) and MGUS (monoclonal gammopathy of undetermined significance). It also added new qualifying locations - Thailand, Laos, Cambodia, Guam, American Samoa, and Johnston Atoll during set periods. If you were denied before for one of these, that denial was under the old rules - the claim can be reopened under the PACT Act now.
The filing plan
A dated plan you can actually follow to file
Now that you know your exposure (the facts-found / TERA path), here is the order to file in - with a realistic timeframe on each step. Follow it top to bottom and you will not leave money, dates, or evidence on the table.
FIG. 01 - FILE YOUR INTENT TO FILE
01Lock in your date - file an Intent to File first
DAY 1VA Form 21-0966
Before you gather a single record, put the VA on notice. An Intent to File freezes your effective date for up to one year.
The Intent to File (VA Form 21-0966) does one powerful thing: it sets your effective date today, then gives you up to one year to actually submit the claim. Back pay is calculated from your effective date - so filing the Intent to File on Day 1, before you have every document, can be worth months of retroactive benefits. File it online at va.gov, by phone, or on paper. Do this first, even if the rest of your evidence is weeks away.
FIG. 02 - PULL YOUR SERVICE RECORDS
02Prove where and when you served
WEEK 1The claim rises or falls on placing you in the exposure. Pull the paper that puts your boots on that ground.
For a presumptive exposure, the VA only needs to see that you served in a qualifying location during a qualifying time - so gather your DD-214, orders, and deployment records that name the place and the dates. Your service treatment records and personnel file matter too. If your exposure is not presumptive, this is also where you start building the TERA (facts-found) record - the documents that show the activity that carried the risk. Missing dates or the wrong base name is the most common reason a solid claim stalls, so get this right early.
FIG. 03 - GET A CURRENT DIAGNOSIS
03Get a current, written diagnosis
WEEKS 1-2A presumption connects an exposure to a condition - but you still have to show you actually have the condition, in writing, now.
The VA cannot rate a condition it cannot see. Get a current diagnosis from a doctor - VA or private - that names the condition exactly as it appears on the presumptive list. If you are already in VA health care, your records may already carry it; if not, get seen and get it documented. For a facts-found (TERA) claim, this diagnosis is one leg of the case and the medical nexus is the other. A claim with an exposure and a service history but no current diagnosis has a hole the rater will use to deny it.
FIG. 04 - FILE THE CLAIM
04File the claim itself
WEEKS 2-3VA Form 21-526EZ
This is the actual claim. File it inside your Intent-to-File year and attach everything you gathered.
The Application for Disability Compensation (VA Form 21-526EZ) is the claim. List every condition you are claiming - do not leave one off because you are unsure; an underclaimed condition is a benefit you walk away from. Attach your service records and your diagnosis, and file it within the one-year window your Intent to File opened. Filing a Fully Developed Claim - where you submit all your evidence up front - is usually the fastest lane to a decision.
FIG. 05 - ADD STATEMENTS & NEXUS
05Add buddy statements and a nexus where you need them
WEEKS 2-3VA Form 21-4138
For a presumptive claim you may not need a nexus at all. For a facts-found claim, this step is the whole ballgame.
If your condition and service are presumptive, the VA presumes the link - you do not have to prove causation, so a nexus is not required. Where records are thin, a buddy statement (VA Form 21-4138) from someone who served with you can place you at the exposure. For a TERA / facts-found claim, you do need a medical nexus - a doctor stating your condition is at least as likely as not caused by the exposure. Know which path you are on so you spend your effort where it actually counts.
FIG. 06 - ATTEND YOUR C&P EXAM
06Attend your C&P exam - and be ready
MONTH 2-4The VA will usually schedule a Compensation & Pension exam. This appointment can decide your rating - do not treat it as routine.
When the VA schedules a C&P exam, go - a missed exam can sink a claim. Describe your symptoms on your worst days, not your best, and be specific about how the condition limits your work and daily life. Bring a short written summary so nothing gets left out under pressure. If the examiner does not measure or ask about something the rating requires, say so on the record. An inadequate exam is one of the most common reasons a deserving claim comes back low - and it is a reason you can name in an appeal.
FIG. 07 - READ THE DECISION, PROTECT YOUR APPEAL
07Read the decision - and protect your one-year appeal window
DECISIONWhen the decision letter arrives, read the rating and the reasons closely. If it is wrong or too low, the clock starts now.
Your rating decision letter states what was granted, at what percentage, and why. If a condition was denied or rated too low, you generally have one year from the date of that decision to appeal - through a Higher-Level Review, a Supplemental Claim (with new evidence), or a Board appeal. Do not let that year lapse; a missed deadline can cost you the earlier effective date. A denial is not the end - many strong claims are won on appeal once the record is corrected. This is exactly the point where getting help pays for itself.
This is a general roadmap - your exact timeframes depend on the VA's workload and how complete your evidence is when you file. It is not legal advice. When you want a second set of eyes on any step, that is what we are here for.
Two ways to move forward — both free
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Information only - not legal advice
For information purposes only - this is not legal, financial, or medical advice. The Aging Veteran is a private service and is not part of, or endorsed by, the U.S. Department of Veterans Affairs. Benefits are subject to VA eligibility rules. Always confirm your specifics on va.gov or with a qualified professional.
