What the PACT Act Delivers for Burn Pit Relief, and How To Get Signed Up

Fire, Hail and Rain sweep over Combat Outpost Tangi

The flames of a burn pit pick up with the winds as a storm approaches Combat Outpost Tangi in the Tangi Valley, Afghanistan, on Aug. 31, 2009. US Army photo by Sgt. Teddy Wade.

Sgt. Teddy Wade/55th Signal Company (Combat Ca

In 2015, Matt Catsimanes’ nose was, well, a mess.

“I had a polyp so big I actually sneezed the end of it out of my nose,” he told Coffee or Die Magazine. “So I went under the knife. They basically roto-rootered my maxillary sinuses and my ethmoid sinuses.”

The former Marine underwent endoscopic nasal surgery, which helped, but he had to return to his doctor in 2018 when the polyps and cysts had grown back.

Another surgery.

'When I Have Your Wounded'

A burn pit in Afghanistan displays the words “Dustoff When I Have Your Wounded,” owned by C Company, 3-10 Aviation Regiment, Task Force Phoenix in 2013. US Army photo by Capt. Peter Smedberg/10th Combat Aviation Brigade, courtesy of CW2 Chad C. Carvalho.

Photo by Capt. Peter Smedberg/10th Combat Aviation Brigade, courtesy of CW2 Chad C. Carvalho.

Just recently, he was told it had all grown back again. He will need a third excavation.

“When I got out of the military, I was running three miles in 20 minutes,” said Catsimanes. “But I could feel myself slowing down even then. I was like, I can’t breathe. Why can I not fucking breathe?”

During his first deployment in 2007 to Camp Fallujah, Catsimanes was stationed at a guard tower near the south gate. “If the wind was right, the burn pit shit would flow into that tower pretty much the entire eight hours that we were in it,” he said. “We would have makeshift bandannas on. It felt like it was going on 24-fucking-7. They were burning old ammo, they were burning fuel, they were burning human waste.”

He started having breathing problems after his first deployment. “But it wasn’t severe enough to make me not complete a physical fitness test or really impact my day-to-day,” he said.

Burn baby, burn

Smoke billows in from all sides as Sgt. Richard Ganske, 84th Combat Engineer Battalion, pushes the bulldozer deep into the flames of the burn pit to keep burnable items constantly ablaze. US Army photo by Pvt. First Class Abel Trevino.

US Army photo by Pvt. First Class Abel Trevino.

However, it worsened after his second deployment to Forward Operating Base Anah and COP Rawah, where burn pits continued to smolder, blowing across the posts on the winds of frequent dust storms.

Catsimanes is one of many thousands —perhaps even millions — of veterans who were exposed to the fumes of burn pits while deployed in the last two decades. Burn pits, used widely in Afghanistan and Iraq, were enormous piles of detritus collected at military installations and disposed of in flames. The aftereffects of the exposure are now understood to range from chronic rhinitis to rare cancers.

But after a contentious earlier vote in the Senate, a long-awaited bill that expands eligibility for VA benefits to include Burn Pit issues — The Honoring Our Promise To Address Comprehensive Toxics (PACT) Act — became law this week.

The PACT Act creates a new list of conditions that are automatically considered “presumptive” — that is, veterans will no longer need to specifically prove that their illness is linked to their service if they served in certain areas during certain times.

The law goes into effect immediately. Veterans can begin by applying for benefits and submitting claims.

Burn Pit

Sgt. Robert B. Brown from Fayetteville, North Carolina, with Regimental Combat Team 6, Combat Camera Unit, watches over the civilian firefighters at the burn pit on May 25, 2007, at Camp Fallujah, Iraq. US Marine Corps photo by Cpl. Samuel D. Corum.

Cpl. Samuel D. Corum/Regimental Combat Team 6

For many, burn pits were a daily fact of life while deployed. Marine veteran Jason Lutcavage told Coffee or Die Magazine, “In practically every COP, there’s a burn pit. Buddy got blown up? All that gear of his gets burned. Rabid mutant bear dog gets in the wire? Shoot it and make a boot take it to the burn pit. Burn it all, every slice of Americana. Nothing quite like the smell of protein-addled feces and dead animals burning to really drive home the sense of impending victory.”

Thomas Porter, executive vice president of government affairs for Iraq and Afghanistan Veterans of America (IAVA), told Coffee or Die that his organization is “excited, ecstatic, relieved — kind of all of the above. It was a rocky ride. Politics got a little bit more involved in the process than you would normally see in a veterans bill.”

Porter noted that the law was a top priority for VA Secretary Denis McDonough. “He is going to put muscle behind the implementation of this,” Porter said. “They’ve already been hiring new claims staff to help, and they’re going to hire more.

Weapons Cache Search Mission

Capt. Edward M. Biel, commanding officer, Kilo Company, 3rd Battalion, 2nd Marine Regiment, Regimental Combat Team 5, near Anah, Iraq. US Marine Corps photo by Cpl. Seth Maggard.

Cpl. Seth Maggard/U.S. Department of Defense

The following cancers are now presumptive:

  • Brain cancer
  • Gastrointestinal cancer of any type
  • Glioblastoma
  • Head cancer of any type
  • Kidney cancer
  • Lymphatic cancer of any type
  • Lymphoma of any type
  • Melanoma
  • Neck cancer
  • Pancreatic cancer
  • Reproductive cancer of any type
  • Respiratory (breathing-related) cancer of any type

In addition, these illnesses are now presumptive:

  • Asthma that was diagnosed after service
  • Chronic bronchitis
  • Chronic obstructive pulmonary disease
  • Chronic rhinitis
  • Chronic sinusitis
  • Constrictive bronchiolitis or obliterative bronchiolitis
  • Emphysema
  • Granulomatous disease
  • Interstitial lung disease
  • Pleuritis
  • Pulmonary fibrosis
  • Sarcoidosis

Officials estimate that upwards of 3.5 million veterans have been exposed to burn pits. “When I testified before the Senate Armed Services Committee a few months ago,” Porter said, “the DOD witness was asked by subcommittee chairman [Kirsten] Gillibrand what percentage of those deployed to Iraq and Afghanistan were toxic exposed. He just said, ‘All of them.’ Everybody saw a burn pit.”
An expansive list of burn pit locations made the rounds on Twitter just before the PACT Act was signed.

Many vets protested that they had been exposed somewhere that hadn’t made the list.

In fact, the list was incomplete.

The PACT Act covers veterans of both the Gulf War and the later Global War on Terror arenas. Veterans are covered if they were deployed on or after Sept. 11, 2001, in any of these locations:

  • Afghanistan
  • Djibouti
  • Egypt
  • Jordan
  • Lebanon
  • Syria
  • Uzbekistan
  • Yemen
  • The airspace above any of these locations

The coverage extends back further in other places. The PACT act applies to any veteran who served on or after Aug. 2, 1990, in any of these locations:

  • Bahrain
  • Iraq
  • Kuwait
  • Oman
  • Qatar
  • Saudi Arabia
  • Somalia
  • United Arab Emirates

Serving in the airspace above any of these locations will also qualify veteran illnesses as being from presumptive exposures to toxins.

Burn baby, burn

Sgt. Richard Ganske, 84th Combat Engineer Battalion, uses a bulldozer to maneuver refuse into the burn pit, sorting and burning it to manage Logistics Support Activity Anaconda’s sanitation requirements. US Army photo by Pvt. First Class Abel Trevino.

US Army photo by Pvt. First Class Abel Trevino.

“If we see something that’s not getting its due attention by Congress or the VA, it’s up to us to to make noise about it,” Porter said about the role of the IAVA and other veterans service organizations in the implementation of the VA’s new coverage. “It’s not going to be easy.”

Despite his health challenges, Catsimanes recognizes that he is much luckier than many others he served next to. And he thinks the PACT Act only addresses part of the problem. “I think the thing that frustrates me,” he said, “is they knew this shit was damaging. No one ever stopped and said, ‘Maybe we shouldn’t do this.’ Where does the buck stop? No one will ever hold these people responsible for what they did.”

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Maggie BenZvi is a contributing editor for Coffee or Die. She holds a bachelor’s degree in political science from the University of Chicago, a master’s degree in human rights from Columbia University, and has worked for the ACLU as well as the International Rescue Commitee. She has also completed a summer journalism program at Northwestern University’s Medill School of Journalism. In addition to her work at Coffee or Die, she’s a stay at home mom and, notably, does not drink coffee. Got a tip? Get in touch!
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