Glioblastoma VA Claim: PACT Act Presumptive, 100% Rating & DIC (2026)

SFC Heath Robinson and the PACT Act

The Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act — universally known as the PACT Act — is named for an Ohio Army National Guard soldier who embodied the fight for veterans' burn pit benefits. Sergeant First Class Heath Robinson deployed to Kosovo and Iraq, where he was routinely exposed to burn pit smoke and other toxic airborne hazards at forward operating bases.

After returning home, SFC Robinson was diagnosed with a rare blood cancer. His condition deteriorated over years as he fought — simultaneously — for his health and for the hundreds of thousands of veterans suffering from toxic exposure-related illnesses who were being denied VA benefits. He testified before Congress. He marched in Washington. He advocated with the same sense of mission he brought to his deployments.

SFC Heath Robinson died on May 26, 2020, at age 39, before the law bearing his name was signed. The PACT Act was signed into law by President Biden on August 10, 2022. For veterans with glioblastoma and other cancers linked to toxic military exposure, it is the most significant legislative achievement in decades — and a direct consequence of SFC Robinson's sacrifice.

PACT Act Coverage for Glioblastoma

Glioblastoma multiforme (WHO Grade IV glioma) is a malignant brain tumor arising from astrocytes — the supportive glial cells of the brain. Under the PACT Act's framework, all malignant neoplasms — including glioblastoma — are covered for veterans with qualifying toxic exposure in covered service locations.

The PACT Act amended title 38 of the United States Code to create a presumption of service connection for cancer in veterans with toxic exposure during covered service. For glioblastoma, this means:

• A veteran who served in a covered location during a covered period and who has a GBM diagnosis is entitled to service connection without a nexus letter
• VA cannot deny service connection solely because GBM has a known non-service-related incidence in the general population
• The presumptive applies regardless of the veteran's GBM risk factors (family history, prior radiation exposure) — service in a covered area with a qualifying diagnosis is sufficient

For veterans whose GBM is not covered by the PACT Act presumptive (e.g., those who served exclusively before Gulf War era in non-qualifying locations), direct service connection via documented occupational exposure to chemicals — solvents, radiation, petrochemicals — is a viable alternative pathway under 38 CFR § 3.303. A nexus letter from a neuro-oncologist would be required for that pathway.

Qualifying Service Locations for PACT Act Coverage

A veteran needs to have served in any of these locations for any length of time — even temporary duty — to qualify for the presumptive. The DD-214, deployment orders, campaign medals, and unit records all serve as documentation of qualifying service.

DC 8002: How VA Rates Glioblastoma

VA rates glioblastoma under Diagnostic Code 8002 — Malignant neoplasms, brain — in 38 CFR Part 4. The rating is straightforward in its structure:

In practice, glioblastoma is nearly always fatal and treatment is continuous. The Stupp protocol — the standard of care for newly diagnosed GBM — involves surgical resection followed by concurrent radiotherapy (60 Gy over 6 weeks) and temozolomide chemotherapy, followed by 6-12 cycles of adjuvant temozolomide. After initial treatment, tumor recurrence is essentially universal, and subsequent treatment lines (bevacizumab, re-irradiation, tumor treating fields [TTFields], clinical trials) continue until death.

This means the 100% rating under DC 8002 typically remains in effect for the remainder of the veteran's life, because treatment never truly ends with GBM. The six-month post-treatment review period that applies to other cancers rarely becomes relevant for GBM patients, because there is rarely a period where all active treatment has ceased.

GBM-Related Neurological Residuals

Glioblastoma and its treatment commonly cause secondary neurological disabilities that are separately ratable:

• Epilepsy from tumor or surgical site — rated under DC 8910-8914 based on seizure frequency and severity; major seizures can rate 10%-100%
• Hemiplegia or hemiparesis — depending on tumor location, GBM can cause paralysis or weakness of one side of the body; rated under DC 8103 (hemiplegia due to brain disease) at 10%-100%
• Cognitive impairment and dementia — tumor invasion and treatment can cause significant cognitive decline; rated under DC 9301-9305 (organic mental disorders)
• Aphasia — language dysfunction from tumor in speech areas; rated under DC 8108 or neurological equivalents
• Visual field defects — GBM affecting occipital or parietal regions can cause homonymous hemianopia or other visual field loss; rated under visual field DCs

Special Monthly Compensation (SMC) for Glioblastoma

Beyond the 100% disability rating, veterans with glioblastoma often qualify for Special Monthly Compensation (SMC) — additional tax-free monthly payments above the standard 100% rate. SMC is available when specific conditions are met, and GBM frequently satisfies multiple SMC criteria:

SMC-L: Aid and Attendance

SMC at the "L" rate (aid and attendance) is awarded when a veteran requires the regular aid and attendance of another person due to disability. The criteria include needing assistance with activities of daily living — bathing, dressing, feeding, ambulation. As glioblastoma progresses, patients typically require substantial assistance with daily activities. SMC-L is appropriate when these needs are documented by a physician or VA examiner.

In 2026, SMC-L pays approximately $3,800-$4,000 per month above the 100% rate, representing a substantial increase in total compensation.

SMC-S: Housebound Status

SMC at the "S" rate applies when a veteran is substantially confined to their home due to service-connected disability. If GBM has progressed to the point where the veteran cannot leave the home without substantial assistance, SMC-S applies. SMC-S adds approximately $390/month above the 100% rate.

SMC for Loss of Use of Specific Body Parts

If GBM causes loss of use of one or both hands (affecting the dominant hand is rated at a higher level), loss of use of both feet, or loss of use of other major body parts, additional SMC levels apply. These are rated under 38 U.S.C. § 1114(k)-(r) and can significantly increase the monthly compensation amount.

Total Disability Based on Individual Unemployability (TDIU)

At 100% disability rating for GBM, a veteran already receives the maximum schedular rating and corresponding compensation. However, TDIU is still relevant in one critical scenario: if GBM is not yet rated at 100% (for example, if the veteran's claim is pending and they're still at a lower rating), TDIU can pay at the 100% rate if the veteran cannot work due to GBM.

More practically, TDIU matters for veterans who have GBM as a service-connected condition at 100% but have other non-service-connected conditions that might be evaluated differently. The overall impact is that TDIU ensures veterans who cannot work receive the maximum rate without waiting for the rating schedule to catch up.

For GBM patients, the practical reality is that the disease itself makes continued employment impossible almost immediately after diagnosis. TDIU criteria — substantially gainful employment is not possible due to service-connected disabilities — are clearly met. VA should grant TDIU (or the equivalent 100% schedular rating) promptly.

Dependency and Indemnity Compensation (DIC) for Surviving Families

For many families of veterans with glioblastoma, the most important aspect of VA benefits is what happens after the veteran dies. Dependency and Indemnity Compensation (DIC) is a tax-free monthly benefit paid to surviving spouses, dependent children, and in some cases parents of veterans who die from service-connected conditions.

Surviving Spouse DIC

A surviving spouse is eligible for DIC if:

• The veteran died from a service-connected condition (glioblastoma rated as service-connected under PACT Act or other basis)
• OR the veteran had been rated at 100% (or TDIU) for at least 10 continuous years before death, or at least 5 years from the date of discharge from service
• The surviving spouse was legally married to the veteran at the time of death and has not remarried (or remarried after age 57)

Given that GBM is fatal and is service-connected under the PACT Act, the death from GBM automatically makes the surviving spouse eligible for DIC. In 2026, the base DIC rate for surviving spouses is $1,562.74 per month. Additional amounts are paid for dependent children, and an 8-year transitional benefit adds $318.33/month if the veteran was rated at 100% for at least 8 continuous years before death.

DIC Add-Ons for Surviving Spouses

Accrued Benefits Claim

If a veteran filed a VA claim for GBM but died before VA processed the claim or awarded compensation, the surviving spouse (or other eligible beneficiary) can file an accrued benefits claim under 38 CFR § 3.1000. Accrued benefits allow the surviving spouse to "step into the shoes" of the veteran and claim the compensation owed to the veteran during their lifetime that was not paid due to the pending claim. This can represent months or years of retroactive 100% compensation — a significant amount.

Documentation Required for GBM VA Claims

For the Veteran's Claim

• MRI with and without contrast showing the tumor mass (standard diagnostic imaging for GBM)
• Pathology/surgical pathology report from tumor resection or biopsy confirming GBM (WHO Grade IV glioma)
• Neuro-oncology treatment records documenting the Stupp protocol or other treatment course
• DD-214 and deployment orders confirming service in qualifying location during qualifying period
• Enrollment in VA Airborne Hazards and Open Burn Pit Registry (helpful but not required)
• Documentation of neurological deficits and functional impairment for SMC consideration

For DIC (Surviving Spouse)

• Death certificate with cause of death (must list GBM or related complication)
• Marriage certificate
• Evidence of veteran's service-connected rating for GBM (if established before death) OR independent evidence of PACT Act qualifying service and GBM diagnosis (to establish service connection posthumously)
• Veteran's DD-214
• Social Security numbers for surviving spouse and dependent children
• Birth certificates for dependent children

Urgent Filing Strategy for Veterans with GBM

The timeline with glioblastoma is compressed. Most patients have 12-18 months from diagnosis to death. VA claims can take months to process. Every week matters. The filing strategy for GBM veterans must reflect this urgency:

Step 1: File Immediately — Day of Diagnosis if Possible

File VA Form 21-526EZ as soon as you have the pathology report. You can file online at va.gov, by mail, or in person at a VA regional office. If you're too ill to manage the paperwork, a family member with power of attorney can file on your behalf. A VSO (Veterans Service Organization) can assist with expedited filing.

Step 2: Request Expedited Processing — Terminal Illness

VA has a compassionate allowance / rapidly progressing terminal illness program. Glioblastoma qualifies as a terminal illness for expedited processing. Write "TERMINAL ILLNESS — EXPEDITE" on your claim form and cover letter. VA is required to prioritize terminal illness claims. In some cases, VA can process these claims in days rather than months.

Step 3: Claim All Residuals and SMC Simultaneously

At the time of initial filing, list every disability related to the GBM: the cancer itself, seizures, hemiparesis, cognitive impairment, aphasia — and specifically request SMC evaluation. Doing this on the initial claim prevents you from having to file multiple supplemental claims later.

Step 4: Prepare Family for DIC Filing

While the veteran is still alive, help prepare the DIC paperwork so the surviving spouse can file within days of the veteran's death. Gather the documents listed above. Know the DIC filing process. The sooner DIC is filed after death, the sooner monthly payments begin.

For additional context on the PACT Act's scope, see our guide on PACT Act presumptive conditions and our resource on burn pit exposure VA claims. Veterans who have lost a family member to cancer from toxic exposure should also review our related guides on lung cancer VA claims for additional DIC strategies.