The Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act was signed into law on August 10, 2022, and represented the largest expansion of VA presumptive conditions in decades. The Act added over 20 cancers to VA's presumptive list for veterans who served in covered locations with toxic exposures — including testicular cancer.
The legal basis for testicular cancer service connection under the PACT Act is found in the Act's toxic exposure provisions, which create a presumption of service connection for covered cancers in veterans with qualifying service. This means VA must service-connect the cancer without requiring the veteran to prove individual causation.
For PACT Act presumptive claims, veterans do not need a nexus letter, a private medical opinion, or any scientific evidence linking their specific cancer to their specific service. The law presumes the connection. Your deployment records and cancer diagnosis are the evidence. That's it.
Prior to the PACT Act, veterans with testicular cancer had to prove service connection through a nexus letter — a private medical opinion from a doctor stating the cancer was "at least as likely as not" caused by military service. This was difficult and expensive. The PACT Act eliminated that barrier entirely for veterans with qualifying service.
To qualify for the PACT Act presumptive for testicular cancer, you must meet two core requirements:
The PACT Act covers veterans who served on active duty, active duty for training, or inactive duty training at any of the following covered locations:
Veterans at the above locations are presumed to have had exposure to one or more of the following covered toxic substances:
Veterans must have a discharge under conditions other than dishonorable. General under honorable conditions, honorable, and most medical discharges qualify. If your discharge status is Other Than Honorable (OTH), consult with a VA-accredited attorney — there are character of discharge review processes that may help.
VA rates testicular cancer and testicular conditions under Diagnostic Code 7524 in 38 CFR Part 4, Schedule for Rating Disabilities. The rating structure follows VA's general malignant neoplasm framework:
| Phase | Rating | Notes |
|---|---|---|
| Active malignancy (any stage, under treatment) | 100% | Applies during surgery, chemo, radiation, surveillance |
| Six-month post-treatment evaluation period | 100% | Minimum continuation per VA regulation |
| Orchiectomy (testis removed) — one testis | 0% | Anatomical loss alone = 0%; claim separately under DC 7524 |
| Orchiectomy (both testes) | 30% | Bilateral orchiectomy; rated separately |
| Residual conditions (hormonal, neurological, sexual) | 10–60% | Varies by residual severity |
An important nuance: the 0% rating for unilateral orchiectomy (one testis removed) does not mean you receive no compensation. Rather, that residual is rated at the lowest compensable level independently, but the 0% for anatomical loss can still be combined with other conditions. More importantly, the associated hormonal and functional deficiencies from orchiectomy — testosterone deficiency, infertility effects — are rated separately at higher levels.
Active testicular cancer is rated at 100% during treatment regardless of stage. For testicular cancer, "active treatment" includes:
For Stage I testicular cancer where orchiectomy was performed but active surveillance (rather than adjuvant chemo or radiation) is chosen, VA considers the cancer to be in an "active" phase during the surveillance period. This means the 100% rating can continue during surveillance. However, this is sometimes disputed by C&P examiners — document your surveillance schedule carefully and have your oncologist note it is part of your active cancer management plan.
After the six-month post-treatment evaluation period ends, VA rates residual conditions separately from the cancer itself. For testicular cancer veterans, the most significant residuals are:
Bilateral orchiectomy eliminates the body's primary source of testosterone. Even unilateral orchiectomy, combined with chemotherapy effects, often results in hypogonadism — inadequate testosterone production. This causes fatigue, decreased libido, mood disturbances, decreased muscle mass, and bone density loss. Hypogonadism requiring hormone replacement therapy (HRT) is rated based on its effects on overall functioning.
Erectile dysfunction (ED) following orchiectomy, retroperitoneal surgery, chemotherapy, or radiation is rated under DC 7522. The base rating for erectile dysfunction is 0% (for the condition itself), but it entitles the veteran to a Special Monthly Compensation addition for loss of use of a creative organ — worth an additional $121/month in 2026. Veterans must claim this separately and specifically.
Cisplatin — a cornerstone of BEP chemotherapy for testicular cancer — causes dose-dependent peripheral neuropathy. Symptoms include numbness, tingling, and pain in the hands and feet that may be permanent. Neuropathy is rated under peripheral nerve codes (DC 8100 series) based on severity: mild (10%), moderate (20%), moderately severe (40%), severe (60%).
Bleomycin, the "B" in BEP chemotherapy, can cause pulmonary fibrosis — lung scarring that impairs breathing. Veterans who received bleomycin and have reduced pulmonary function should file a secondary claim for pulmonary fibrosis (DC 6833 or appropriate pulmonary code) with pulmonary function testing documentation.
Loss of fertility from bilateral orchiectomy or chemotherapy effects on sperm production is acknowledged by VA but the rating mechanics are nuanced. Infertility itself is not typically rated as a separate disability (there's no DC code for infertility), but its component causes — hormonal deficiency, testicular loss, erectile dysfunction — are each ratable. Veterans experiencing infertility should consult with a VA-accredited attorney about optimizing their claim structure.
The Airborne Hazards and Open Burn Pit Registry (AHOBPR) is a VA database that tracks veterans who were exposed to airborne hazards including burn pits, oil well fires, and sulfur fire smoke. Registering does not guarantee benefits, but it creates an official record of your exposure history that supports your PACT Act claim.
Registration is done online at va.gov and involves completing a health questionnaire about your exposures and current health status. Registration is voluntary and free — and while not required for a PACT Act claim, it is good practice for any veteran who served at a covered location.
Importantly, not registering does not prevent a PACT Act claim. Your deployment orders, DA Form 214, and any service records placing you at a covered location are sufficient documentation for the presumptive. The burn pit registry is supplemental documentation, not a prerequisite.
Filing is straightforward for PACT Act presumptive claims. Here's the process:
List your condition as "Testicular cancer — PACT Act presumptive due to toxic exposure during service in [location] [dates]." If you are also claiming residuals, list them separately: "Erectile dysfunction — secondary to service-connected testicular cancer/orchiectomy" and "Peripheral neuropathy — secondary to cisplatin chemotherapy for service-connected testicular cancer."
Submit online at va.gov/disability/file-disability-claim-form-21-526ez, by mail, or through a VSO or VA-accredited attorney.
Many younger veterans who served in Iraq and Afghanistan between 2001 and 2021 are now in their 30s and 40s — exactly the age range where testicular cancer risk peaks. The PACT Act was specifically designed with this generation in mind.
If you're a younger veteran who:
...you should file or reopen your claim immediately. The PACT Act applies retroactively to veterans who were previously denied — meaning if you were denied before August 2022, you can file a supplemental claim citing the new regulatory basis.
For more information about all PACT Act genitourinary cancer presumptives (bladder, testicular, kidney, ureter), see our comprehensive guide: PACT Act Genitourinary Cancer Claims. Also see: Burn Pit Exposure VA Claims Guide and PACT Act Presumptive Conditions Hub.
Check Your Testicular Cancer Claim
If you served in Iraq, Afghanistan, or another covered location and have been diagnosed with testicular cancer, you likely qualify for 100% VA disability during treatment. Take the free qualification quiz to understand your options.
Check My PACT Act Eligibility →Editorial Standards: Written by Marcus J. Webb, veterans benefits researcher. Verified against DC 7524 and PACT Act provisions. Last reviewed: July 2026. Not legal advice — for representation, connect with a VA-accredited attorney.
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