VA Disability for PFAS Exposure: How to Overcome Claim Denials

Imagine living on a military base, faithfully serving your country, only to discover years later that the water you drank and the firefighting foam you handled contained dangerous “forever chemicals” that may have caused your serious illness. This nightmare has been a harsh reality for thousands of veterans exposed to PFAS (Per- and Polyfluoroalkyl Substances) during their military service.

If you’re a veteran battling health issues you believe stem from PFAS exposure, you face a difficult challenge: unlike Agent Orange or burn pit exposures, PFAS-related conditions are not presumptively recognized by VA policy or law. Even the sweeping 2022 PACT Act didn’t add PFAS-related conditions to VA’s presumptive list. This means you must navigate the VA’s standard service connection process and prove your case individually on its own merits.

This comprehensive guide walks you through the challenges of proving a toxic exposure claim for PFAS and provides actionable strategies for strengthening your claim with compelling evidence.

PFAS – often called “forever chemicals” because they never break down in the environment – have been widely used in various products, including Aqueous Film Forming Foam (AFFF), a firefighting foam extensively used by the military since the 1970s. Scientific studies increasingly link PFAS exposure to serious health conditions including kidney cancer, testicular cancer, ulcerative colitis, thyroid disease, and other concerning health effects.

Alarmingly, studies have found PFAS in more than 97% of the U.S. population, with significantly higher concentrations in military communities. Over 700 military installations have documented PFAS contamination, with levels on bases often measuring 3,000 times higher than EPA safety guidelines – or even more in some locations.

Making a successful VA disability claim for a PFAS-related condition is currently difficult for a variety of reasons.

Unlike Agent Orange exposure in Vietnam, there is no automatic presumptive service connection for PFAS exposure. This means the burden falls entirely on you to prove both your exposure and its connection to your current medical condition. Even though hundreds of military bases have documented PFAS contamination, VA handles each claim individually, requiring veterans to build their own case from scratch.

There is pending legislation, known as the VET PFAS Act, that would establish presumptive service connection for certain PFAS-related conditions, but until this passes, veterans must navigate the standard claims process.

PFAS exposure typically isn’t recorded in service records. You likely were never formally “diagnosed” with PFAS exposure while in uniform – it’s an environmental hazard that might not have been recognized until years later.

Veterans who worked as firefighters or lived on bases with contaminated water must find ways to document this exposure when their personnel files contain no explicit mention of “PFAS” or “AFFF.”

In one Board of Veterans’ Appeals case, a veteran testified that he was “frequently exposed to a firefighting chemical known as ‘balm,’ also known as AFFF” during drills. His own statement was crucial because official records didn’t explicitly list that exposure.

Even if you establish exposure, you must then prove your current medical condition is “at least as likely as not” caused by that exposure. This medical nexus is often the most challenging part, especially since PFAS-related illnesses can take years or decades to appear.

VA examiners may be unfamiliar with the connections or cite inconclusive evidence, leading to claims being denied with statements like “there is insufficient evidence to link your condition to PFAS exposure in service.”

In 2022, the National Academies (NAS) published a comprehensive report titled Guidance on PFAS Exposure, Testing, and Clinical Follow-Up. This report categorizes the strength of evidence linking PFAS exposure to various health outcomes, providing valuable information for clinicians and policymakers. This report can be a critical resource when establishing a service connection for VA claims.

[You can access the full report HERE.]

VA disability claims linked to PFAS exposure generally follow the standard VA claims process and timelines.

In 2025, an initial disability claim takes roughly 4 to 5 months on average from submission to decision. However, PFAS claims can be complex, and if additional evidence or appeals are needed, the timeline can stretch much longer.

For example, a supplemental claim or higher-level review (if the initial claim is denied) may add several more months, and a Board of Veterans’ Appeals review can take 1–3+ years.

This happens because:

• VA raters must research your specific exposure history at your base locations
• Special C&P examiners with toxicology knowledge may need to be assigned
• Medical opinions often require multiple reviews and follow-ups

In one real case, the Board of Veterans’ Appeals specifically ordered the VA to conduct a detailed investigation into the veteran’s PFAS exposure, including verification of AFFF use at specific bases and obtaining specialized medical opinions. This demonstrates why these claims take longer, but also shows the VA’s obligation to thoroughly investigate your exposure—even when records are incomplete.

How to prepare: File your claim as completely as possible from the start, check your claim status online every 30 days, and consider requesting a Status Conference after 6 months if you see no movement. Contact your VSO or representative and ask them to formally request a Status Conference or file a VA Form 27-0820 (Report of General Information) to document the request. Remember that although frustrating, this extra development can ultimately strengthen your case by forcing VA to document your exposure.

Despite these challenges, veterans can and do win PFAS-related claims. The key is understanding what evidence is most persuasive to the VA and presenting it clearly.

Service Records and Military Documents: Gather any records that could help demonstrate exposure, including:

• Assignment orders
• Training records
• Duty titles (especially roles like firefighter or crash crew member)
• Personnel records placing you at contaminated bases

Official DoD and Environmental Reports: Leverage public information about PFAS contamination:

• DoD reports on PFAS investigations at military installations
• Environmental Protection Agency (EPA) studies
• Agency for Toxic Substances and Disease Registry (ATSDR) reports
• News articles from reputable sources naming your base as contaminated
• This list of installations with PFAS contamination can be particularly valuable if your base is included

Lay Statements: Your testimony or statements from fellow service members can fill gaps:

• Describe in detail how you were exposed: “During fire suppression training at Marine Corps Air Station Yuma in 1985, we sprayed AFFF on aircraft burn pits every week. I often got the foam on my uniform and skin.”
• Include buddy statements from others who served with you confirming your exposure.

Photographic or Physical Evidence: Submit any photos showing you in firefighting gear or training areas where foam was used, safety brief documentation, or base newsletter articles about firefighting demonstrations.

Clear Diagnosis: Ensure you have medical records clearly diagnosing your condition (e.g., cancer pathology reports, doctor’s notes for thyroid disease or ulcerative colitis). This documentation must be included with your VA Form 21-526EZ disability claim.

Severity and Treatment History: Document the seriousness of your condition through hospitalization records, surgeries, and ongoing treatment.

Scientific Research: Reference authoritative research linking PFAS to your illness. In 2022, NASEM published a report categorizing the strength of evidence linking PFAS exposure to various health outcomes. The report provides guidance for clinicians on PFAS testing and clinical follow-up: Guidance on PFAS Exposure, Testing, and Clinical Follow-Up.

When you file your VA claim (or a supplemental claim/appeal), include copies of the specific pages or tables from the NASEM report that link PFAS to your condition. Clearly label these as supporting scientific evidence. In your personal statements or any arguments made on your behalf, you can cite the NASEM findings to underscore that a respected, independent scientific body has recognized a link between PFAS and your type of illness. This can be particularly useful if a VA examiner tries to dismiss the connection.

Talk to Your Doctor: Share information about your service exposure with your physician and ask them to write an opinion letter stating your diagnosis, noting your military exposure, and giving an opinion on causation.

Independent Medical Opinion: Consider an independent medical expert experienced with military toxic exposures if your treating physician isn’t comfortable writing nexus letters.

VA C&P Examiner’s Opinion: Prepare thoroughly for your C&P exam:

• Explain your exposure and condition clearly
• Bring documents or research articles to show the examiner
• Be ready to politely mention that VA’s own public health information acknowledges links between PFAS and health issues

In one appeal case, a VA examiner supported the veteran’s claim by noting that “during the veteran’s time at Fort Ord and Fort Lewis, the fire suppressant AFFF was heavily used,” implicitly connecting the veteran’s later illness to that service environment.

C&P Examination: Come prepared to discuss your exposure history and health issues in detail. The examiner’s report will significantly influence your claim’s outcome.

VA’s Review of Evidence: The rater will examine your entire file to determine if you have a current diagnosed disability, evidence of in-service exposure, and a medical nexus linking them.

Rating Decision: VA will issue a decision either granting service connection (with a rating percentage) or denying the claim. If denied, the decision will explain why, which is crucial information for your appeal.

If your claim is denied, don’t give up. Many toxic exposure claims win on appeal rather than the first pass.

Carefully read VA’s decision letter to identify why they denied your claim. Was it because they couldn’t establish exposure? Or did they accept exposure but reject the medical nexus?

Supplemental Claim: Often the best route if you have new evidence to submit. File VA Form 20-0995 with additional evidence addressing why the prior decision was wrong.

Higher-Level Review (HLR): Request a senior rater to review your existing file if you believe VA made a clear error without needing new evidence. Use VA Form 20-0996.

Board of Veterans’ Appeals (BVA): Appeal to the BVA if your case is complex or if lower-level reviews have failed. You can request to submit new evidence or have a hearing using VA Form 10182. You can also search the BVA decision database for similar cases to help strengthen your appeal.

Focus on the gaps identified in your denial:

• A more detailed nexus letter addressing VA’s objections
• Additional lay statements clarifying any misconceptions
• New exposure evidence you discovered after filing

Veterans have successfully won PFAS-related claims through persistence and strong evidence. In one Board of Veterans’ Appeals case, a veteran firefighter with renal cancer won his appeal after submitting:

• An in-depth nexus letter from an oncologist referencing studies on PFAS and kidney cancer
• A buddy statement confirming routine AFFF handling
• Service records proving his firefighter role
• Evidence his base was later found contaminated

The Board found this evidence persuasive enough to grant service connection, noting the oncologist’s “well-reasoned rationale with references to scientific research.”

Filing a VA disability claim for PFAS/AFFF exposure is challenging but not impossible. By thoroughly documenting your exposure, establishing a strong medical nexus, and being persistent through the claims process, you can significantly improve your chances of success.

You served your country and were exposed to hazards through that service. While the VA system requires you to connect the dots, you have every right to pursue compensation for conditions caused by that service. Every piece of evidence brings you one step closer to the benefits you’ve earned.

You don’t have to take action alone. Visit our Military & Veterans page for more resources, updates on PFAS legislation, and access to experienced professionals who can help with your claim.