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Toxic Exposure Risk Activity (TERA)

TL;DR — Quick Summary

  • What TERA does: Presumes you were exposed to toxins based on when, where, and what you did in service
  • What TERA does NOT do: Automatically grant service-connection for any condition
  • What you get: A C&P exam with a TERA medical opinion if you have a diagnosis or claim symptoms
  • You MUST claim: The condition you believe was caused by exposure — NOT the exposure itself
  • NG/Reserve: Exposures during unconverted NG/Reserve service are NOT eligible

What is TERA?

Depending on when, where, and what you did in service, the VA will presume you were exposed to certain toxins.

Critical: TERA Does NOT Equal Service-Connection

This presumption of exposure under 38 U.S. Code § 1119 does NOT in and of itself grant service-connection!

What it DOES do is entitle you to a C&P examination with a TERA medical opinion, so long as you have a diagnosis or claim a symptom.

Important Notes

  • This entitlement does NOT automatically apply to diagnosable physical or mental conditions. You NEED medical evidence to support your belief.
  • Hearing loss and Tinnitus are NOT considered physical conditions for this purpose.
  • Do NOT claim your exposure(s)! An exposure is NOT a disability! You MUST claim what you think your exposure caused.
  • The claimed condition(s) need NOT have started in service!
  • Exposures during (unconverted) National Guard or Reserve service CANNOT be considered under TERA. See NG/Reserve eligibility for more info.
Agent Orange Exclusions

Agent Orange Negative Associations

The Secretary of the VA has determined that the following conditions have NO association with Agent Orange. If the only TERA exposure is AO, the VA CANNOT get a TERA medical opinion for these conditions:

Cancers with NO Agent Orange Association
  • Bone and connective tissues
  • Brain
  • Digestive (anus, colorectal, esophageal, small intestines, stomach)
  • Endocrine (including thyroid and thymus)
  • Eye
  • Hepatobiliary (bile ducts, gallbladder, liver)
  • Leukemia (other than chronic B-cell leukemias, hairy-cell leukemia, CLL)
  • Melanoma
  • Mouth (including lips and tongue)
  • Nervous system
  • Nonmelanoma (basal cell and squamous cell)
  • Pancreatic
  • Pleura, mediastinum, other unspecified respiratory/intrathoracic sites
  • Pharynx
  • Reproductive (breast, cervix, ovary, penis, testes, uterus) — excluding prostate
Non-Cancers with NO Agent Orange Association
  • Asthma
  • Chronic obstructive pulmonary disease
  • Circulatory conditions (other than hypertension, ischemic heart disease, and stroke)
  • Endometriosis
  • Eye diseases
  • Farmer's lung
  • Gastrointestinal, metabolic, and digestive disorders
  • Hearing loss
  • Immune system disorders (immune suppression, allergy, autoimmunity)
  • Neurobehavioral disorders (cognitive and neuropsychiatric)
  • Neurodegenerative diseases (excluding Parkinson's disease and Parkinsonism)
  • Osteoporosis
  • Peripheral nervous system disorders (besides early-onset peripheral neuropathy)
Documenting Exposures

How to Document Your Exposures

When you file your claim, identify (to the best of your ability):

  • What toxins you were exposed to (JP8, industrial solvents, etc.)
  • How you were exposed (MOS duties, deployment, etc.)
  • How you interacted with the toxin(s) (touched, drank, inhaled)
  • How often you were exposed (daily, monthly, etc.)
  • Duration of exposures
  • Protective equipment used (or not used)

Personal Statement Example

"As an aircraft mechanic in the Navy I was exposed daily for 5 years to jet fuel, engine exhaust, oil, and solvents. When I worked, I was not provided any protective equipment. It was not unusual for me to spend hours covered from head to toe in these toxins and for my hands to develop cuts which were of course also covered in these toxins. I believe that rashes that cover my body are due to my toxic exposures."

VA Cannot Assume Exposures

VA CANNOT assume MOS/duty exposures (besides Navy asbestos)! If your MOS was a fuel handler or mechanic, the VA CANNOT assume you were exposed to anything.

You MUST state what you were exposed to. If the exposure wouldn't be obvious to someone unfamiliar with your job, explain how it happened. Support non-standard exposures with personnel records, medical records, or buddy statements.

Location-Based Exposures

Presumed Exposure Locations

If you served in these locations during these times, you are considered to have been exposed to toxins:

On or After August 2, 1990

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

On or After September 11, 2001

  • Afghanistan
  • Djibouti
  • Egypt
  • Jordan
  • Lebanon
  • Syria
  • Yemen
  • Uzbekistan
MOS-Based Exposures

Military Occupation Specialty (MOS) Exposures

There are currently NO exposures that have been officially linked to certain MOSs (besides Navy and asbestos).

HOWEVER, if your MOS involved handling fuels, solvents, asbestos (construction, demolition, shipyards), or PFAS (firefighting), you can indicate on your claim what you were exposed to and how that exposure occurred.

Asbestos Exposure

Asbestos exposure can lead to serious health risks if inhaled. Symptoms of asbestos-related diseases, such as shortness of breath, coughing, and chest pain, often do not appear until 20 to 50 years after exposure.

Routes of exposure:

  • Veterans who served in Iraq and other countries could have been exposed when older buildings were damaged and asbestos released into the air.
  • Work in: carpentry, construction, demolition, insulation installation, shipyards, and servicing friction products (clutch facings, brake linings)

Navy MOS Asbestos Exposure Probability

The VA has compiled a list of Navy MOSs with their likelihood of asbestos exposure:

MOS Code Job Title Probability
AAAirman ApprenticeMinimal
ABEAviation Boatswain's Mate (Launch & Rec Equip)Probable
ABFAviation Boatswain's MateProbable
ABHAviation Boatswain's Mate (Aircraft Handler)Probable
ACAir Traffic ControllerMinimal
ACMAviation Chief MetalsmithProbable
ADJAviation Machinist's Mate (Jet Engine Mechanic)Probable
ADRAviation Machinist's MateProbable
AEAviation Electrician's MateProbable
AFCMAircraft Maintenanceman (Master Chief)Minimal
AGAerographer's MateMinimal
AKAviation StorekeeperMinimal
AMAviation Structural MechanicProbable
AMEAviation Structural Mechanic (Safety Equipment)Probable
AMHAviation Structural Mechanic (Hydraulics)Probable
AMSAviation Structural Mechanic (Structural)Probable
ANAirmanMinimal
AOAviation OrdnancemanMinimal
AQAviation Fire Control TechnicianHighly Probable
ARAirman RecruitMinimal
ARMAviation RadiomanProbable
ASAviation Support Equipment TechnicianProbable
ATAviation Electronic TechnicianProbable
AWAviation Antisubmarine Warfare OperatorProbable
AXAviation Antisub Warfare TechnicianProbable
AZAviation Maintenance AdministrationmanMinimal
BBoilermaker (WWII)Highly Probable
BMBoatswain's MateMinimal
BRBoilermakerHighly Probable
BTBoiler TechnicianHighly Probable
BUBuilderProbable
CDConstruction DriverProbable
CEConstruction ElectricianProbable
CMConstruction MechanicMinimal
CNConstructionmanProbable
COXCoxswainMinimal
CSCommissarymanMinimal
CTCommunication TechnicianMinimal
CTRCryptologic Technician (Collections)Minimal
DCDamage ControlmanMinimal
DKDisbursing ClerkMinimal
DPData Processing TechnicianMinimal
DSData System TechnicianMinimal
DTDental TechnicianMinimal
EMElectrician's MateProbable
ENEnginemanProbable
EOEquipment OperatorMinimal
ETElectronics TechnicianProbable
FCFire ControlmanHighly Probable
FNFiremanHighly Probable
FPPipefitterHighly Probable
FTFire Control TechnicianHighly Probable
FTGFire Control Technician (Guns)Highly Probable
GMGunner's MateMinimal
GSMGas Turbine System Technician (Mechanical)Probable
HCHospital CorpsmanMinimal
HNHospitalmanMinimal
HTHull Maintenance TechnicianHighly Probable
ICInterior Communication TechnicianProbable
IMInstrumentmanHighly Probable
LILithographerMinimal
MAMaster-At-ArmsMinimal
MLCMolderProbable
MMMachinist MateProbable
MMEMetalsmithMinimal
MNMinemanMinimal
MOMMMotor Machinist MateProbable
MRMachinery RepairmanMinimal
MSMess Management SpecialistMinimal
MTMissile TechnicianProbable
MUMusicianMinimal
NCNavy CounselorMinimal
OMOpticalmanMinimal
OSPCOperations SpecialistMinimal
PCPostal ClerkMinimal
PHPhotographer's MateMinimal
PHMPharmacistMinimal
PNPersonnelmanMinimal
PRTRPrinterMinimal
PTPhotographic IntelligencemanMinimal
PTRPainterProbable
QMQuartermasterMinimal
RDRadarmanMinimal
RMRadiomanMinimal
RNRadarmanMinimal
SASeaman ApprenticeMinimal
SCShip's CookMinimal
SDStewartMinimal
SFShipfitterMinimal
SFMShipfitter (Metal Smith)Minimal
SFPShipfitter (Pipefitter)Minimal
SHShip's ServicemanMinimal
SKStorekeeperMinimal
SMSignalmanMinimal
SNSeamanMinimal
SOSonarmanHighly Probable
SOMSoundmanHighly Probable
STSonar TechnicianHighly Probable
STG/SOGSonar Technician (Surface)Highly Probable
STSSonar Technician (Submarine)Highly Probable
STMSteward's MateMinimal
SWSteelworkerProbable
TAStewart ApprenticeMinimal
TDTrademanMinimal
TETeletypeMinimal
TMTorpedoman's MateProbable
TNStewardsmanMinimal
UTUtilitiesmanHighly Probable
WTWater TenderHighly Probable
YYeomanMinimal
ILER & Effective Dates

Individual Longitudinal Exposure Record (ILER)

ILER is a report that contains exposures that DoD has identified you as being exposed to.

The VA will use this report along with your Service Treatment and Personnel Records to create a TERA Memo. This memo will be used by the examiner to help determine if your condition(s) are related to your exposures during service.

Earlier Effective Dates (Liberalizing Law)

If a condition is granted based on TERA exposures, the VA can grant an earlier effective date if ALL of the following criteria are met:

  • Exposure(s) happened on or before August 10, 2022; AND
  • Condition was diagnosed on or before August 10, 2022

If both conditions are met, the VA can assign an effective date up to ONE YEAR before the claim was initiated (but no sooner than August 10, 2022).

For more information on effective dates, see our Effective Dates guide.

Additional Exposure Resources

Here are some resources to help identify toxic exposures you may have been exposed to:

Cite Your Sources

If you use any external resource as a reference for any exposure, be sure to cite it and explain your exposure! The person working your claim likely won't be checking these resources.

Frequently Asked Questions

I have a diagnosis but my only exposure is Agent Orange. Can I use TERA?

It depends on your condition. If your condition is on the AO negative association list (see above), the VA CANNOT get a TERA medical opinion. You would need to pursue service-connection through the Agent Orange presumptives or direct service-connection with a private nexus opinion.

I was National Guard. Can I use TERA?

Only if your exposure occurred during a converted period of service (Title 10 federal active duty). Exposures during regular NG/Reserve drill weekends or state activations (Title 32) are NOT covered under TERA. The exception is Camp Lejeune exposure, but even then only for those specific presumptives.

My MOS isn't listed for asbestos. Can I still claim exposure?

Yes! The table only lists Navy MOSs. If you served in another branch and were exposed to asbestos (construction, demolition, shipyards, damaged buildings overseas), you can still claim it. You'll need to document your exposure in your personal statement and provide supporting evidence.

What's the difference between TERA and a presumptive condition?

Presumptive conditions are automatically service-connected if you meet the eligibility criteria — you don't need to prove a nexus.

TERA only establishes that you were exposed to toxins. You still need a medical opinion linking your current condition to that exposure. TERA gets you a C&P exam with a medical opinion, but doesn't guarantee service-connection.

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