The VA’s New Toxic Exposure Working Group

VA

While the PACT Act was a significant piece of legislation and a huge win for veterans, we are cognizant to the fact that it does not cover many other known military toxic exposures, such as the NAF Atsugi Incinerator. There is still much work to be done to ensure all military toxic exposure cohorts receive proper attention, medical surveillance, and benefits. Fortunately, the PACT Act authors had the foresight to add a section to the bill that created a new toxic exposure working group and presumption process.

Sec. 202, Title II

Section 202 “Improvements to Ability of Department of Veteran Affairs to Establish Presumptions of Service Connection Based on Toxic Exposure” under Title II - Toxic Exposure Presumptive Process of the PACT Act mandates that the VA Secretary shall establish a working group within the Department which shall include personnel of the Veterans Health Administration and the Veterans Benefits Administration.

The Secretary shall consult with, and seek the advice of, the Working Group with respect to cases in which -

  • A veteran may have, during active military, naval, air, or space service, experienced a toxic exposure; or

  • A dependent of a veteran may have experienced a toxic exposure during the active military, naval, air, or space service of the veteran.

How will an assessment be initiated?

This new working group, now known as the Military Environmental Exposure Sub-Council (MEESC), will assess cases of toxic exposure of veterans and their dependents, “including by conducting ongoing surveillance and reviewing such exposure described in scientific literature, media reports, information from veterans, and information from Congress.” Other paths to select conditions for assessment include VA Leadership priorities and recommendations by Veteran Service Organizations (VSOs), Department of Defense (DoD), or other partners.

The working group may also conduct an assessment in response to a public comment received for a proposed formal evaluation of military environmental exposure and adverse health outcome(s), either through a Federal Register comment or comment provided in a public listening session.

Development of Recommendations

Following an assessment of a case of a toxic exposure of veterans or dependents during active duty military service, “the working group may develop a recommendation for formal evaluation to conduct a review of the health effects related to the case of exposure if the working group determines that the research may change the current understanding between an exposure to an environmental hazard and adverse health outcomes in humans.”

At least once per year, the working group will submit a report to the VA Secretary, Committee on Veterans Affairs of the Senate, Committee on Veterans’ Affairs of the House of Representatives, and make publicly available a report on:

  • recommendations developed from toxic exposure assessments

  • recommendations for legislative or administrative action as the working group considers necessary for the working group to be more effective in carrying out their duties.

Initiating a Formal Evaluation

In response to each recommendation made by the working group, the VA Secretary, not later than 30 days after receiving the report, will initiate the process to conduct a formal evaluation.

This will include providing public notice and giving the public an opportunity to comment on the proposed formal evaluation. For each notice published, the VA will also hold an open meeting for members of the public to voice their comments in response to the proposed formal evaluation.


The PACT Act grants the VA broad authority to investigate toxic exposures impacting veterans or their dependents arising from active duty service. In instances where the PACT Act does not explicitly address certain exposures or conditions, the toxic exposure working group, MEESC, will offer a potential avenue for further evaluation. With the ability to initiate assessments from diverse sources, such as veterans, veteran service organizations, and public commentary, we encourage you to share your concerns. Your input is invaluable in shaping the understanding of potential hazards and health clusters arising from military service.

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VA’s First Formal Evaluation Under the New Presumptive Process

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The PACT Act