K2 Veterans VA Claims: PACT Act Presumptives, Cancer & How to File (2026)
Quick answer: Yes. Serving at Karshi-Khanabad (K2), Uzbekistan on or after September 11, 2001 qualifies you for the PACT Act's presumption of burn pit exposure. If you have a listed cancer or lung condition, VA presumes service connection with no nexus letter. K2 has no separate presumptive list yet, so other conditions need direct or secondary service connection.
Thousands of service members passed through K2 in the first years after 9/11, and many now have cancers or breathing problems they believe started there. The law is clearer than most veterans realize: K2 is already a covered location under the PACT Act. What is still unsettled is whether K2 gets its own, broader presumptive list. This guide separates what is confirmed from what is still being studied, so you can file the strongest claim today.
Does the PACT Act cover K2 (Karshi-Khanabad)?
Yes. The PACT Act (Public Law 117-168) added 38 U.S.C. 1119, which defines a "covered veteran." Under subsection (c)(1)(B), that includes any veteran who, on or after September 11, 2001, served on active duty while assigned to a duty station in, including the airspace above, Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Yemen or Uzbekistan.
VA confirms this on its PACT Act page, and its K2 page says K2 veterans are "fully covered under PACT Act." VA describes K2, also called Camp Stronghold Freedom, as a former Soviet air base that the U.S. Army, Air Force and Marines used from 2001 to 2005 to support missions into Afghanistan.
Covered status does two things. First, VA presumes you were exposed to burn pit smoke and other airborne hazards, unless there is affirmative evidence you were not. Second, if you later develop a disease on the statutory list, 38 U.S.C. 1120 treats it as incurred in service even with no medical record from your deployment. For the full claims process, see our PACT Act claim guide and the overview of burn pit exposure claims.
Which date applies? The PACT Act and VA's January 2025 rules use September 11, 2001 for Uzbekistan. VA's older particulate matter rule, 38 CFR 3.320, uses September 19, 2001 for asthma, rhinitis, sinusitis and certain rare respiratory cancers. Both dates come before the U.S. occupation of K2 began, so neither changes the answer for K2 veterans.
Which conditions are presumptive for K2 veterans?
What cancers are presumptive for K2 veterans (K2 Uzbekistan cancer VA)?
Congress listed ten cancer types in 38 U.S.C. 1120(b)(2): head, neck, respiratory, gastrointestinal and reproductive cancers of any type, lymphoma of any type, and kidney cancer, brain cancer, melanoma and pancreatic cancer. Glioblastoma is listed separately in 1120(b)(14). VA has since added more by regulation. VA's airborne hazards page currently lists these presumptive cancers:
- Brain cancer and glioblastoma
- Head cancer and neck cancer of any type
- Respiratory (breathing-related) cancer of any type
- Gastrointestinal cancer of any type
- Reproductive cancer of any type
- Kidney cancer and pancreatic cancer
- Lymphatic cancer of any type and lymphoma of any type
- Melanoma
- Acute leukemia, chronic leukemia, multiple myelomas, myelodysplastic syndromes and myelofibrosis
- Urinary bladder, ureter and related genitourinary cancers
- Rare respiratory cancers: squamous cell carcinoma of the larynx or trachea, adenocarcinoma of the trachea, salivary gland-type tumors of the trachea or lung, adenosquamous carcinoma of the lung, large cell carcinoma of the lung, sarcomatoid carcinoma of the lung, and typical and atypical carcinoid of the lung
The leukemia, myeloma, MDS and myelofibrosis additions came from an interim final rule effective January 10, 2025. The bladder, ureter and genitourinary cancers came from a separate interim final rule effective January 2, 2025. Both rules cover Uzbekistan on or after September 11, 2001. The rare respiratory cancers were added in a 2022 rule. Condition-specific guides: melanoma, lung cancer, head and neck cancer and genitourinary cancers.
Which lung and breathing conditions are presumptive?
Under 38 U.S.C. 1120(b), the covered respiratory conditions are asthma diagnosed after service, chronic bronchitis, COPD, constrictive or obliterative bronchiolitis, emphysema, granulomatous disease, interstitial lung disease, pleuritis, pulmonary fibrosis, sarcoidosis, chronic sinusitis and chronic rhinitis. See our complete list of PACT Act presumptive conditions for details on each.
Watch the wording: "Presumptive" means VA presumes the connection to service. You still need a current diagnosis, and the presumption can be rebutted by affirmative evidence, such as proof the disease had a different cause or came from willful misconduct (38 CFR 3.320(b)).
Not sure which presumptive applies to you?
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Get a Free Case Review →Is there a K2-specific presumptive list or law?
Not that we could confirm. K2 veterans use the general PACT Act burn pit lists above. Several K2-specific efforts exist, but none we found has become law or a final VA rule:
- Bills in Congress. The K2 Veterans Care Act of 2021 (S. 454) was introduced in the 117th Congress. In the 119th Congress, H.R. 3441, the K2 Veterans Total Coverage Act of 2025, was introduced on May 15, 2025 and referred to the House Veterans' Affairs Committee. As introduced, it would add presumptions for any cancer and for thyroid, bone, cardiovascular, skin, neurological, respiratory, endocrine, liver, kidney and other diseases in veterans who served at K2. We could not confirm it has been enacted.
- VA's K2 review. In 2024, VA announced an accelerated process to evaluate more K2 presumptives, according to a Senate Veterans' Affairs Committee release. On November 27, 2024, VA published a notice seeking public comment on K2 exposures and conditions of interest.
- VA's October 2025 response. VA's response to the 185 comments received said K2 veterans are eligible for all PACT Act conditions and that conditions not yet covered will be evaluated as evidence accrues.
- Proposed "toxic exposure risk activity" rule. A proposed rule published October 1, 2024 would treat certain K2 exposures as toxic exposure risk activity. VA said in October 2025 that the rulemaking was not final.
Because these items can change, check the VA K2 page before you file.
What have DoD and VA found about K2 exposures?
According to VA's K2 page, veterans at K2 may have encountered jet fuel from a leaking Soviet-era underground fuel system, volatile organic compounds, particulate matter and dust, depleted uranium left from destroyed Soviet missiles, asbestos in roof tiles and dirt, and lead-based paint in the in-processing center. VA also states that environmental assessments confirmed the absence of chemical warfare agents and ionizing radiation. VA's October 2025 notice adds there is no evidence that enriched uranium was present at K2.
On health outcomes, VA reports that an initial DoD study found a higher risk of malignant melanoma and of neoplasms of the lymphatic and hematopoietic tissues (excluding non-Hodgkin lymphoma and leukemia). VA cautions that those results rested on few cases and "should not be viewed as definitive evidence." DoD also published a K2 mortality study.
VA's K2 Surveillance Program began in summer 2022 and is planned to run for 10 or more years. In its October 2025 notice, VA said that, to date, there is no evidence to support an increased disease or mortality risk associated with K2 service, and that it will keep reviewing the research. That finding is not a bar to your claim. VA states it reviews K2 claims case by case, and your presumptive conditions apply regardless of the study results. Veterans also dispute these findings, which is part of why the legislation above exists.
How are K2-related conditions rated, and what do they pay in 2026?
Service connection decides whether you are paid. The rating decides how much. Cancers and lung diseases are rated under the body-system criteria in 38 CFR 4.97 and the rest of Part 4. These are the criteria for three common K2-era respiratory presumptives:
| Condition (DC) | Rating levels | Key criteria (summarized) |
|---|---|---|
| Asthma (DC 6602) | 10%, 30%, 60%, 100% | Based on FEV-1 and FEV-1/FVC results, medication (intermittent or daily bronchodilator, inhaled anti-inflammatory, systemic steroids) and frequency of physician visits |
| Chronic sinusitis (DC 6510–6514) | 0%, 10%, 30%, 50% | Number of incapacitating or non-incapacitating episodes per year; 50% requires radical surgery with chronic osteomyelitis or near-constant sinusitis after repeated surgeries |
| Allergic rhinitis (DC 6522) | 10%, 30% | 30% with polyps; 10% without polyps but with more than 50% nasal obstruction on both sides or complete obstruction on one side |
Cancers are rated by type and site, so check the guide for your condition. The table below shows 2026 monthly compensation for a veteran with no dependents, effective December 1, 2025, from VA's official rate tables. Veterans rated 30% or higher can receive more with dependents, and a new cost-of-living adjustment typically takes effect each December 1.
| Combined rating | Monthly pay (veteran alone) | Annual |
|---|---|---|
| 10% | $180.42 | $2,165 |
| 20% | $356.66 | $4,280 |
| 30% | $552.47 | $6,630 |
| 40% | $795.84 | $9,550 |
| 50% | $1,132.90 | $13,595 |
| 60% | $1,435.02 | $17,220 |
| 70% | $1,808.45 | $21,701 |
| 80% | $2,102.15 | $25,226 |
| 90% | $2,362.30 | $28,348 |
| 100% | $3,938.58 | $47,263 |
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Get Free Claim Help →How do I file a K2 veterans VA claim?
- Get a diagnosis. Presumptions only work for a diagnosed condition. Ask your doctor for the exact diagnosis, such as the cancer type and pathology, since the list names specific cancers.
- Check the presumptive list. Compare your diagnosis to the lists above. Our free PACT Act screener can help you check.
- Protect your effective date. File an intent to file (VA Form 21-0966). Under 38 CFR 3.155, you then have one year to complete the claim and keep the earlier date.
- File the claim. Use VA Form 21-526EZ online through VA's claim page. State that you served at K2, Uzbekistan, list each condition, and cite the PACT Act presumption.
- Attend your exam. If VA schedules a C&P exam, prepare using our C&P exam guide.
- Review the decision. If denied, you can seek a higher-level review, file a supplemental claim with new evidence, or appeal to the Board.
The effective date generally depends on when VA receives your claim or intent to file, under 38 CFR 3.400. Read our effective date and back pay guide to see how filing early affects back pay.
What evidence proves K2 service and a diagnosis?
For a presumptive claim, VA needs two things: proof you were assigned to a duty station in Uzbekistan on or after September 11, 2001, and a diagnosis. Because K2 was a temporary, expeditionary base, location proof is where many K2 veterans struggle. Use anything that places you there:
- DD-214 and any DD-214 equivalents (see our DD-214 guide)
- Orders, TDY or deployment orders naming Uzbekistan, K2, Karshi-Khanabad or Camp Stronghold Freedom
- Official military personnel file, pay records showing deployment pay, and award citations
- Unit histories, flight or movement manifests, and unit rosters
- Buddy statements from people who served with you at K2 (see our buddy statement guide)
- Your own written statement describing dates, duties, and exposures such as fuel odors, dust, burn areas
- Medical records: diagnosis, pathology and imaging reports, and treatment notes
- VA Airborne Hazards and Open Burn Pit Registry enrollment, if any
If you cannot find your records, request them early. Our guide to getting your DD-214 explains how.
What if my condition is not presumptive?
Many conditions K2 veterans report, such as thyroid disease or autoimmune disorders, are not on the presumptive lists. That does not end the claim. VA's October 2025 notice states that it considers all avenues of service connection: direct, secondary and presumptive.
How does direct service connection work for K2 exposure?
Under 38 CFR 3.303, you generally need a current disability, an event or exposure in service, and a medical link between them. For K2, the in-service exposure can be documented hazards that VA itself lists, including jet fuel, particulate matter, depleted uranium, asbestos and lead. Then a clinician explains, with reasons, why it is at least as likely as not that the exposure caused or worsened your condition. Our nexus letter guide explains what a strong opinion contains.
Can I claim a condition secondary to a presumptive one?
Yes. If a condition is caused or aggravated by a service-connected disability, 38 CFR 3.310 allows secondary service connection. For example, treatment effects or complications of a service-connected cancer or lung disease can support additional claims. See our secondary service connection guide.
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How do I win a K2 claim? Common mistakes to avoid
- Proving only the diagnosis. Include proof of K2 service in the first submission, not after a denial.
- Using a vague diagnosis. "Skin cancer" or "lung problems" may not match the list. Get the specific type documented.
- Skipping the intent to file. Months of back pay can depend on it.
- Leaving out secondary conditions. Claim related conditions you already have and explain the link.
- Treating a study as a verdict. VA's early findings do not change the presumptions already in law, and they do not stop a direct-service-connection claim.
- Missing the C&P exam. Tell the examiner about every symptom and exposure.
What free VA health care and testing can K2 veterans get?
Claiming compensation is separate from getting care. VA says its PACT Act expansion lets many veterans enroll in VA health care without filing for disability benefits first, and that VA must give a toxic exposure screening to every veteran enrolled in VA health care. VA also says K2 veterans can receive a no-cost depleted uranium urine test and are auto-enrolled in the redesigned Airborne Hazards and Open Burn Pit Registry. Details are on VA's K2 page.
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K2 veterans often have strong presumptive claims that still get denied for missing proof of service. An accredited attorney can help assemble the file at no upfront cost.
Connect with a Free VA Attorney →Frequently Asked Questions
Yes. Uzbekistan is a covered location in 38 U.S.C. 1119(c), and service there on or after September 11, 2001 earns a presumption of burn pit and airborne hazard exposure. VA's K2 page states that K2 veterans are fully covered under the PACT Act. You still need a current diagnosis of a listed condition.
VA's burn pit presumptive list includes brain, glioblastoma, head, neck, kidney, pancreatic, gastrointestinal, reproductive, respiratory, lymphatic and lymphoma cancers, melanoma, multiple myeloma, acute and chronic leukemia, myelodysplastic syndromes, myelofibrosis, bladder, ureter and related genitourinary cancers, plus several rare lung and airway cancers.
Not yet, as far as we could confirm. Bills such as H.R. 3441 (K2 Veterans Total Coverage Act of 2025) were introduced but we found no record that any became law. VA's K2 Surveillance Program is still studying K2 health outcomes. Until a K2 rule is final, K2 veterans use the PACT Act lists or prove service connection directly.
No. If you served at K2 on or after September 11, 2001 and have a diagnosed condition on the presumptive list, VA presumes the connection to service. You mainly need proof of service location and a diagnosis. A nexus letter helps for conditions that are not on the list.
You can still pursue service connection directly by showing a current diagnosis, an in-service exposure or event at K2, and a medical opinion linking them. You can also claim a condition as secondary to one that is already service connected. VA says it reviews K2 claims case by case.
VA says veterans who served at K2 are eligible for a urine assay to test for the isotopic signature of depleted uranium at no cost. Contact an Environmental Health Coordinator at a VA facility near you to schedule it. The test is separate from a disability claim.
The PACT Act covers service in Uzbekistan, including its airspace, on or after September 11, 2001. VA says the U.S. military occupied K2 from 2001 to 2005. The older particulate matter rule at 38 CFR 3.320 uses September 19, 2001, which still falls before K2 operations began.
Sources: 38 U.S.C. 1119, 38 U.S.C. 1120, VA Public Health: K2, VA.gov PACT Act, 90 FR 47909, VA 2026 rates.