TERA VA Claims: What That Means and How It Affects Your Benefits

Many veterans see “TERA” in a claim file, VA decision, remand or C&P exam request and assume VA has already granted exposure-based benefits. Instead, TERA is the exposure finding that can help connect your disability to service and, when the legal requirements are met, require VA to get a medical examination and nexus opinion.

• A TERA VA claim is not a claim for exposure alone. Veterans should file for a diagnosed condition, such as asthma, COPD, migraines, neuropathy, cancer or a skin condition. VA then considers whether a toxic exposure risk activity connects that condition to service.
• TERA is different from a presumptive condition. A presumptive condition may qualify once the veteran meets the service and exposure rules. A TERA usually triggers development and a medical opinion, but it does not create an automatic grant for non-presumptive conditions.
• VA uses exposure records and service records to make a TERA determination. This may include the Individual Longitudinal Exposure Record, service treatment records, personnel records, MOS evidence and a TERA memorandum.
• TERA carries no rating percentage. VA rates the resulting disability, not the exposure activity.
• Many TERA appeals are remanded for missing development. A complete claim needs a current diagnosis, strong exposure evidence and a medical opinion that addresses the veteran’s full toxic-exposure history.

What Is a TERA VA Claim?

A TERA claim is a disability claim in which the VA considers whether a current condition is linked to a toxic exposure risk activity in service. TERA stands for toxic exposure risk activity. It refers to military duties, locations or activities that may have exposed a service member to toxins or environmental hazards.

For example, a veteran does not receive compensation for burn pit exposure by itself. The veteran files for a diagnosed condition, such as asthma, chronic bronchitis, COPD, sinusitis, rhinitis, cancer or another disability. VA then decides whether a toxic exposure risk activity helps connect that diagnosis to service.

If the record shows a current disability and evidence that the veteran participated in a toxic exposure risk activity, VA may need to order a medical exam and obtain a nexus opinion. The examiner must consider the veteran’s total potential exposure and the combined effect of the veteran’s toxic exposure risk activities.

PACT Act and TERA

The PACT Act expanded how VA handles toxic-exposure claims. It added some presumptive conditions, expanded certain presumptive locations, required toxic-exposure screenings for enrolled veterans and created a stronger duty for VA to develop claims involving toxic exposure.

The TERA framework appears almost entirely after the PACT Act implementation period, with major growth in 2024 to 2025.

Can I File a Claim for a TERA?

Veterans do not file a claim for TERA by itself, they must file a claim for a current diagnosed condition. TERA becomes part of the evidence VA considers when deciding whether that condition is connected to service.

For example, a veteran might file for asthma due to burn-pit exposure, COPD due to fumes or airborne hazards, peripheral neuropathy due to solvent exposure, skin disease due to chemical exposure, kidney disease due to contaminated water, cancer due to occupational hazards, or migraines due to fuel or solvent exposure. In each example, the disability is the claim, while the TERA is the exposure activity VA must consider.

What Counts as a Toxic Exposure Risk Activity?

• Air pollutants: burn pits, sand, dust, particulates, oil-well fires and sulfur fires
• Chemicals: pesticides, herbicides, depleted uranium, contaminated water and other chemical hazards
• Occupational hazards: asbestos, industrial solvents, lead, chemical-resistant paint and firefighting foam
• Radiation: nuclear weapons work, radioactive materials, X-rays and military occupational radiation exposure
• Warfare agents: nerve agents, chemical weapons and biological weapons

How Does VA Decide If Veterans Have a TERA?

VA decides whether a veteran had a TERA by reviewing the exposure history, service records and any records that identify known or likely hazards tied to duty locations or military jobs.

VA should not make the decision from a personal statement alone unless the statement is detailed and consistent with the rest of the evidence. The strongest claims combine the veteran’s statement with service records, MOS evidence, deployment history, personnel records, unit records or other documentation.

VA may consider:

• Service location
• Timeframe
• MOS or rate
• Daily duties
• Deployment locations
• Known hazards at those locations
• Known hazards tied to the occupation
• Exposure records in VA or Department of Defense systems
• Service treatment and personnel records
• Lay or buddy statements

The goal is to answer two questions: What were you exposed to, and why does your service record support that exposure?

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What Is the Individual Longitudinal Exposure Record?

The Individual Longitudinal Exposure Record, or ILER, is a system used to track known or potential military exposures. ILER may include information tied to:

• Deployment locations
• Military installations
• Occupational hazards
• Environmental monitoring
• Exposure incidents
• Service records
• Department of Defense exposure data

ILER can help VA identify whether a veteran had a documented or likely exposure. It may show exposures tied to a deployment, installation or military occupation.

However, ILER is not perfect. A missing ILER entry does not always mean the exposure did not happen.

Some older exposures may not appear clearly. Some occupational exposures may require more detail from personnel records or unit records. Some veterans may need to submit lay statements, buddy statements, performance reports or other evidence to fill the gap.

What Is a TERA Memorandum?

A TERA memorandum is VA’s written summary of the toxic exposure risk activity it found, conceded or considered in the claim. The memo helps tell the VA examiner what exposure history to address. That makes it an important document.

A TERA memorandum may identify the claimed exposure, the service location tied to that exposure, the MOS or duty assignment involved, the records VA reviewed, whether VA conceded the TERA, and the exposure information the examiner should consider.

VA’s TERA claims-processing procedures are documented in the VA M21-1 manual, including guidance on environmental, military occupational and other hazardous exposure claims.

If the TERA memo is incomplete, the exam may also be incomplete. For example, a veteran may claim exposure to burn pits, fuel fumes and solvents. If the TERA memo only discusses burn pits, the examiner may fail to consider the full exposure picture. That can lead to a weak opinion, a denial or a Board remand.

Does VA Presume Toxic Exposure Based on Certain Locations?

Under the PACT Act, VA recognizes certain locations and service periods for burn pits and other toxic exposures. These location rules can help establish exposure.

If the condition is presumptive, the location and diagnosis may be enough. If the condition is not presumptive, VA may still need a medical opinion explaining whether the toxic exposure caused the condition.

What If You Never Deployed?

You may still have a TERA even if you didn’t deploy, because TERA is not limited to combat deployments. VA recognizes that some veterans had toxic exposure during training, garrison duties, maintenance work, shipboard service, aviation work, firefighting, construction, weapons handling, water treatment or other military occupations.

Examples of TERA outside of deployment

• A mechanic exposed to solvents, fuels, brake dust or asbestos
• A firefighter exposed to firefighting foam, smoke or chemicals
• A shipyard or Navy veteran exposed to asbestos or lead paint
• A water-treatment specialist exposed to chemicals
• An aircraft maintainer exposed to fuel, exhaust or hydraulic fluid
• A construction worker exposed to dust, solvents, coatings or pesticides
• A service member exposed to radiation through occupational duties

For non-deployment TERA claims, the MOS and duty description can become especially important.

TERA and VA Presumptive Conditions

A TERA is not the same as a VA presumptive condition. A presumptive condition is a condition VA automatically connects to service when the veteran meets the required service and exposure criteria. In those cases, the law supplies the medical link.

A TERA case works differently. It helps establish exposure and may trigger a medical opinion, but it does not automatically prove that a non-presumptive condition is connected to service.

This distinction is where many veterans get stuck. If VA concedes you had burn pit exposure, that does not mean every later respiratory, heart, digestive, neurological or musculoskeletal condition gets granted. If the condition is not presumptive, the claim still needs a medical link.

Example: Presumptive Condition

A veteran served in Iraq after Aug. 2, 1990, and later developed asthma diagnosed after service. If the veteran meets the service requirements and has the qualifying diagnosis, VA grants the claim under the presumptive rules without requiring the veteran to prove the medical link from scratch.

Example: TERA Route for a Non-Presumptive Condition

A veteran worked around solvents and fuels during service and later developed a neurological condition that is not on a presumptive list.

VA could concede a TERA based on the occupational exposure. But the veteran still needs a medical opinion explaining why that exposure at least as likely as not caused or aggravated the neurological condition.

Most Common Types of Conditions Involving TERA Appeals

Among the 13,762 Board of Veterans’ Appeals decisions from 2022 through 2025 that expressly mentioned the TERA framework phrase “toxic exposure risk activity”, respiratory claims appeared most often.

Source: Hill & Ponton analysis of Board of Veterans’ Appeals decisions including the TERA specific phrase “toxic exposure risk activity”, 2022 through 2025.

These numbers show the types of conditions where TERA arguments could be used in appeal before the Board, which tends to include the more complex and disputed cases.

Respiratory claims are the largest category because the PACT Act expanded benefits for burn pits and airborne hazards. But TERA also appears in musculoskeletal, neurological, cardiovascular, digestive and skin claims when veterans argue that toxins, occupational hazards or environmental hazards played a role.

What Happens After VA Concedes a TERA?

When VA concedes a TERA, it has found evidence that you participated in a toxic exposure risk activity during service. That finding can trigger a VA examination and medical opinion for a non-presumptive condition.

This is often called a TERA exam or TERA medical opinion, though the exam is still tied to the diagnosed condition. The examiner is not rating the exposure but rather deciding whether the claimed disability is connected to the exposure.

When Should VA Order a TERA Exam?

VA may need to order a TERA exam when the record contains:

• Evidence of a current disability
• Evidence that the veteran participated in a TERA
• Not enough evidence to grant the claim without a medical opinion

The purpose of the exam is to answer the nexus question: Is the current disability at least as likely as not related to the toxic exposure risk activity?

If VA denies the claim without ordering an exam, the denial may be flawed if the record already showed a current disability and evidence of TERA participation.

What Should the Examiner Consider?

A proper TERA medical opinion must consider the veteran’s total potential exposure during service, including the combined effect of all toxic exposure risk activities (many veterans had more than one exposure). The examiner should review deployment locations, MOS and daily duties, known hazards tied to the veteran’s work or location, medical history, other risk factors, scientific or medical literature, the TERA memorandum, and ILER findings when available.

What Makes a TERA Medical Opinion Strong?

• Identifies the correct diagnosis
• Reviews the veteran’s service and exposure history
• Discusses the TERA memo or ILER results
• Addresses all relevant exposures, not just one
• Explains the veteran’s risk factors
• Discusses medical research where helpful
• Uses the correct VA standard
• Gives a clear conclusion with reasoning

What Makes a TERA Medical Opinion Weak?

Many TERA appeals are remanded when VA did not develop the claim correctly or relied on an inadequate opinion. A weak VA opinion might:

• Ignore the TERA memorandum
• Fail to discuss ILER
• Address only one exposure
• Ignore the veteran’s MOS
• Rely only on the absence of treatment in service
• Use the same boilerplate language from claim to claim
• Say the condition is not presumptive and stop there
• Fail to discuss the combined effect of exposures
• Ignore medical literature submitted by the veteran
• Fail to explain why other risk factors outweigh service exposure

Can VA Deny a TERA Claim After Conceding Exposure?

A conceded TERA proves or supports the exposure element. It does not always prove the medical nexus. VA may still deny if:

• There is no current diagnosis
• The claimed condition is not presumptive
• The examiner gives a negative opinion
• VA finds another cause more likely
• The evidence does not show functional impairment
• The exposure evidence is incomplete or inconsistent

What Evidence Do I Need to Prove a VA TERA Claim?

A TERA VA claim usually comes down to three things: a current diagnosed condition, proof that you participated in a toxic exposure risk activity, and a medical link between the exposure and the condition, unless the condition is presumptive.

The exposure piece is where many claims are made or lost. VA needs enough detail to understand what happened, where it happened, how often it happened, and why your service records support it.

Service Records

Service records help prove where you served, what you did, and what hazards your job or location may have involved. DD-214 may show your MOS and periods of service. The personnel file may show locations, units, deployments, and duty descriptions that connect you to a toxic exposure risk activity.

MOS and Duty Evidence

Your MOS can be one of the strongest pieces of TERA evidence, but the job title alone may not tell the full story. VA needs to understand what you actually did day to day.

For example, a vehicle mechanic may have handled brake dust, degreasers, solvents, fuels, exhaust, hydraulic fluid, and contaminated equipment. A firefighter may have encountered smoke, chemicals, and firefighting foam. A shipyard or Navy veteran may have worked around asbestos, lead paint, fuel, solvents, or other hazards.

Other high-exposure jobs include aircraft mechanics, fuel specialists, welders, construction workers, water-treatment specialists, weapons handlers, painters, electricians, pest-control specialists, nuclear weapons specialists, and radiology or X-ray technicians.

Location and Deployment Evidence

For some claims, location does much of the work. If VA recognizes the deployment location as a presumptive exposure location, records showing the dates and place of service may help establish the exposure activity.

Helpful evidence can include deployment orders, travel vouchers, hazardous duty records, unit records, evaluation reports, award citations, leave and earnings statements, medical records from the deployment period, photos or letters with dates and locations, and buddy statements confirming where you served.

If VA cannot verify the location, the claim may stall even when the exposure seems obvious to you. That is why location evidence should be as specific as possible.

ILER Evidence

ILER can strengthen a TERA claim when it supports the exposure. But you should not assume VA used ILER correctly. If the claim file includes an ILER report or TERA memo, review it carefully. Check whether VA listed the right deployment, base or installation, MOS, exposure type, date range, and all known exposures. If something is missing, point it out directly.

A missing or incomplete ILER entry does not always mean the exposure did not happen. It may mean VA needs more service records, unit records, lay evidence, or occupational evidence before making the correct TERA determination.

Personal Statement

A personal statement lets you explain the exposure in plain language. This can help VA understand details that do not appear clearly in official records.

Your statement should state where the exposure happened, when it happened, what you were exposed to, what you saw or handled, how often the exposure occurred, what protective gear you had, and how your MOS or duty assignment placed you near the hazard.

Avoid vague statements when possible. “I was exposed to chemicals” is weaker than explaining that you cleaned vehicle parts with solvents, handled fuel-contaminated equipment, and worked around diesel exhaust inside a motor pool several days a week without consistent respiratory protection. Specific details give VA and the examiner facts they can evaluate.

Buddy Statements

Buddy statements can help confirm exposures that official records do not fully describe. They are especially useful when the veteran’s MOS sounds low-risk on paper, but the daily work involved regular exposure.

A strong buddy statement should explain how the witness knows you, when and where you served together, what the witness personally observed, and how often the exposure happened.

For example, a buddy statement may confirm that an administrative worker was housed near a burn pit, a supply worker handled contaminated equipment, a cook worked near smoke or fuel, or a mechanic regularly used solvents without proper protective gear.

Medical Records Showing a Current Diagnosis

Symptoms may support the claim, but VA usually needs a diagnosed condition or functional impairment it can evaluate. For example, shortness of breath is important evidence, but the claim is stronger when medical records identify asthma, COPD, chronic bronchitis, or another respiratory diagnosis.

Useful medical evidence includes VA treatment records, private medical records, specialist reports, diagnostic testing, imaging, pulmonary function tests, lab results, biopsy or pathology reports, medication history, hospital records, and surgical records.

Medical Nexus Opinion

For a non-presumptive condition, the medical nexus opinion often becomes the most important evidence. It should identify the diagnosis, review the veteran’s service records, discuss the TERA evidence, address ILER or the TERA memo if available, and explain how the veteran’s exposure history relates to the claimed condition.

The nexus opinion should also address other risk factors and use the correct VA standard: at least as likely as not. That means the medical evidence supporting the connection is at least as persuasive as the evidence against it.

Benefit of the Doubt

VA must apply the benefit-of-the-doubt rule when the positive and negative evidence are in approximate balance. That does not mean VA grants every close claim automatically. It means the veteran does not have to prove the claim beyond all doubt: VA should resolve reasonable doubt in the veteran’s favor.

TERA VA Claim Percentages

While there are no claim percentages for all TERA VA claims, Hill & Ponton found 13,762 Board of Veterans’ Appeals decisions from 2022 through 2025 that expressly mention the TERA framework phrase “toxic exposure risk activity”.

In other words, when the Board is aware of a TERA issue, it most often finds that VA needs to do more before the claim can be decided. That “more” may include:

• Creating or correcting a TERA memo
• Reviewing ILER
• Ordering a TERA exam
• Getting a medical nexus opinion
• Replacing an inadequate opinion
• Considering all exposures together
• Reviewing service records more carefully

What Do TERA Percentages Mean for Your Claim?

These percentages do not predict your individual outcome. They do show that claims often fail or stall because VA did not fully develop the evidence. While frustrating, it can give the veteran another chance to fix the missing piece.

If the Board remands a TERA claim, the claim returns to the VA for a new exam, a better opinion, ILER review or additional records development.

How Do Initial PACT Act Claims Compare?

VA has reported a 75% grant rate for PACT Act-related claims at the initial claim stage, where many cases involving presumptive conditions resolve. TERA appeals are often harder because they may involve non-presumptive conditions, missing exposure records, inadequate exams or disputed medical opinions.

Why Are TERA Claims Denied or Remanded?

VA Says There Is No Current Diagnosis

VA does not grant disability compensation for exposure alone. If the record does not show a current disability, VA may deny the claim even if the exposure is conceded.

How to respond: Submit medical records showing a current diagnosed condition. If VA used the wrong diagnosis or overlooked a specialist’s findings, submit the records that clarify the disability.

VA Does Not Concede a TERA

VA may say the records do not show a qualifying toxic exposure risk activity. This can happen when the veteran’s MOS is unclear, the deployment is missing, ILER is incomplete or the personal statement does not give enough detail.

How to respond: Submit personnel records, MOS descriptions, deployment records, ILER evidence, unit records, buddy statements and a detailed personal statement. Ask VA to document the TERA determination and address the exposure evidence.

VA Creates an Incomplete TERA Memorandum

Sometimes VA concedes one exposure but ignores others. For example, the memo may discuss burn pits but leave out solvents, fuels, asbestos or firefighting foam.

How to respond: Identify the missing exposures and submit evidence for each one. Ask VA to correct or reconsider the TERA memo so the examiner reviews the full exposure history.

VA Does Not Order a TERA Exam

VA may deny the claim without getting a medical opinion. That can be a problem when the record shows a current disability and evidence of participation in a TERA, but the evidence is not enough to grant without a nexus opinion.

How to respond: Point to the current diagnosis, the TERA evidence and VA’s duty to obtain an exam and opinion. The right appeal lane depends on whether you have new evidence or whether VA overlooked evidence already in the file.

VA Relies on a Boilerplate Medical Opinion

A VA examiner may acknowledge the exposure but still give a weak negative opinion. Common problems include:

• The examiner says the condition is not presumptive and stops there.
• The examiner ignores the combined effect of exposures.
• The examiner fails to discuss the TERA memo.
• The examiner overlooks ILER or MOS evidence.
• The examiner relies only on the absence of treatment during service.
• The examiner does not address medical literature.
• The examiner does not explain why other risk factors matter more.

How to respond: Challenge the opinion’s adequacy. Explain what the examiner missed and consider submitting a reasoned private nexus opinion.

VA Says the Condition Is Not Presumptive

A non-presumptive condition is not automatically denied. TERA exists partly because not every toxic-exposure claim fits into a presumptive box.

How to respond: Develop the claim through direct service connection. Submit a medical opinion explaining why the toxic exposure at least as likely as not caused or aggravated the condition.

VA Overlooks Secondary Service Connection

Some conditions may be connected indirectly. For example, a service-connected respiratory condition may aggravate another condition. A toxic-exposure-related cancer may cause residuals. Medication for a service-connected condition may create additional disability.

How to respond: Consider whether the condition should be claimed as secondary to an already service-connected disability. Medical evidence should explain causation or aggravation.

VA Denies Instead of Remanding for Missing Development

In some cases, VA or the Board may deny when the record really needs more development. Appeal after identifying the missing development. This may include ILER review, service personnel records, a TERA memo, a VA exam, an addendum opinion or a corrected opinion that addresses all exposures.

What Should You Do After a TERA Denial or Remand?

Start with the decision letter. Look for the missing piece:

• Did VA concede the TERA?
• Did VA create a TERA memo?
• Did VA review ILER?
• Did VA order an exam?
• Did the examiner discuss all exposures?
• Did VA deny because the condition is not presumptive?
• Did VA say there is no current diagnosis?
• Did VA overlook your MOS or deployment records?
• Did VA apply the benefit-of-the-doubt rule?

Then respond directly. You may need to submit:

• Updated medical records
• Personnel records
• MOS evidence
• Deployment records
• ILER evidence
• A personal statement
• Buddy statements
• Medical literature
• A private nexus opinion
• Argument challenging an inadequate C&P exam

Do not simply resend the same claim without addressing the gap. TERA cases often improve when the veteran fixes the missing exposure evidence or challenges the medical opinion.

Hill & Ponton Can Help with a Denied TERA VA Claim

TERA appeals usually depend on whether VA conceded the exposure, ordered the right exam and relied on a complete medical opinion. Hill & Ponton focuses on helping veterans appeal denied VA disability claims, with no upfront costs.

If VA denied your claim after a toxic exposure risk activity, failed to order a TERA exam or relied on a weak medical opinion, you can request a free case evaluation to discuss your appeal options.

Content Reviewed by

Shannon Brewer, Senior Attorney

Shannon was born on MacDill AFB in Tampa, Florida as the daughter of a U.S. Air Force Master Sergeant and a high school English teacher. She was a member of the University of Florida Law Review and published a case note on the Florida Privacy Amendment. She practiced land use and environmental law for several years but felt called to serve our veteran population and changed her practice area to veterans disability law.