What is TERA?
A Toxic Exposure Risk Activity (TERA) refers to certain activities during military service that involved potential exposure to toxic substances, such as burn pit emissions, chemicals, radiation, or contaminated water. VA considers a veteran’s participation in a TERA when evaluating disability claims involving certain medical conditions linked to chemical exposures.
TERA designations are part of the PACT Act’s implementation and are used to help determine eligibility for toxic exposure-related benefits.
Examples of Toxic Exposures
Military service can involve exposure to a wide range of environmental and occupational hazards.
Examples include:
- Air Pollutants: Burn pits, smoke, dust, particulate matter, oil well fires, sulfur fires
- Chemicals: Pesticides, herbicides, contaminated water
- Occupational Hazards: Asbestos, industrial solvents, lead, paints, firefighting foams
- Radiation: Exposure to radioactive materials, depleted uranium, nuclear weapons testing, or occupational sources of ionizing radiation.
- Warfare Agents: Chemical weapons, biological weapons, nerve agents
TERA and the PACT Act
Since being signed into law in 2022, the PACT Act has significantly expanded VA benefits and health care for veterans exposed to toxic substances during military service.
The law expanded presumptive service connection for certain conditions associated with specific toxic exposures and established additional requirements for VA to consider certain non-presumptive conditions associated with TERA.
The PACT Act also expanded VA healthcare eligibility for many veterans exposed to toxins and hazards during military service. VA states that qualifying TERA participation can include exposures that occurred during active duty, active duty for training, or inactive duty training.
How Does TERA Affect a VA Disability Claim?
A veteran’s participation in a TERA can be important when determining whether a current disability is connected to military service.
The PACT Act created a path for certain veterans with non-presumptive conditions to establish service connection based on toxic exposure. This means that a condition does not necessarily have to appear on VA’s list of presumptive conditions to potentially be connected to toxic exposure. However, participation in a TERA by itself does not automatically establish service connection. The evidence must support a connection between the veteran’s disability and the exposure.
When the applicable requirements are met, VA generally must provide a medical examination and obtain an opinion addressing whether the veteran’s disability is related to their participation in a TERA. In providing that opinion, the examiner must consider the veteran’s total potential toxic exposure through applicable military deployments, as well as the combined effects of their toxic exposure risk activities. Certain exceptions apply to the examination requirement.
What If VA Requests a TERA Exam?
If VA determines that a TERA examination is necessary, the veteran will generally be notified of the scheduled examination during the development of their disability claim. The examination helps VA determine whether the claimed disability may be related to the veteran’s participation in a TERA.
During the examination, a veteran may be asked about their military service, potential exposures, and the history of the claimed condition. The examiner may provide a medical opinion addressing whether the claimed condition is related to the veteran’s TERA, including consideration of the veteran’s total potential toxic exposure and the combined effects of multiple exposures.
A TERA exam does not guarantee service connection, but it can provide important evidence for the claim.
