What is TERA？ ｜ VA PACT Act Claims

Presumptive ?

Tara .

Who is Tara ?

What is Tara ?

Let's talk about this .

If you've been applying for VA disability benefits or trying to work through the process in the last 2 or so years , you've probably heard the acronym TERA , t e r a .

And it's easy to get that confused with presumptive service connection because they're kinda related and they came out roughly the same time in the PACT Act .

And by that , I mean , presumptive has actually been around a while , but a list of presumptive conditions came out in August of 2022 related to burn pits and some related to Agent Orange .

So let me back up a minute and talk a little bit about service connection just so we're on the same page .

As you know , as I've discussed , VA disability benefits is no more than three things .

It is something happened in service , something's wrong with you now and there's a connection between the 2 of them .

What is presumptive service connection ?

Let me explain this in the context of what it isn't .

Direct service connection is , let's say , you have an injury in service and that injury is still lingering .

You had a bad parachute jump and broke your ankle and now your ankle has arthritis .

That is direct service connection or could be direct service connection .

It depends on the circumstances but that would describe direct service connection .

Secondary service connection would be something like you had a bad parachute jump , you broke your ankle , your ankle has been service connected for years but now all the limping has caused your knee to start hurting .

Whatever's wrong with your knee might be secondarily service connected .

Now again , don't get wrapped around the axle about your ankle being service connected first before your knee .

You can apply for both at the same time .

Direct just says , hey , this is actually what's causing that .

The VA will look at your service treatment records , see your broken ankle in service and then they'll see your knee pain today .

So , again , don't get worried about staggering these things .

Presumptive gets a little weird .

Presumptive says that you were exposed or did something while in service years ago potentially even or you were in some place at a certain time and you were exposed to something and now you have a current condition , well , the science says that it is as likely as it is not that your current condition is related to that thing that you were exposed to 50 years ago .

For instance , we know Agent Orange is incredibly toxic and causes all sorts of conditions .

So if you're a veteran with a disability like diabetes or Parkinson's and you were in Vietnam between 62 and 72 the VA will grant service connection without really doing much more digging because it's presumed that those diseases are actually related to your time in Vietnam because you know if you were in Vietnam during those years you were exposed to Agent Orange .

Orange .

How does something become presumptive ?

There are a couple ways that can happen .

One of the ways that can happen is after lots of studies and the VA sees a lot of literature , scientific literature , they sponsor studies and over years they determine well the science is really showing that folks who are in Vietnam have a much higher likely rate of diabetes or certain types of cancer .

Those who are in Iraq and Afghanistan during the global war on terror have a much higher rate of lung cancer or digestive cancer like stomach cancer or colon cancer .

They do these studies and over time they gather the evidence and they get together every so often and they figure out and say , okay , yeah , this is actually probably a presumptive condition and they add it to the federal register and after notice and comment period , yadayadayada , it becomes presumptive according to regulation .

Now congress can get involved if they think that the VA isn't moving fast enough .

You're probably asking yourself why don't they get involved more often ?

I digress .

If congress wants to add a presumptive condition they can do so by passing a law .

That's what they did with the PACT Act is they added a whole list presumptive conditions if you were exposed to , or rather if you were in certain parts of the world during the global war on terror or even as far back as 1990 .

So for instance , if you were in Iraq anytime after 1990 and you develop , let's say , asthma , they just assume that's because you were breathing in burn pits and oil fires and whatever other toxic crap isn't was floating around the air at that time .

Again , no further opinions after we render .

They just have to see how bad it is at that point .

Now that's the first step .

That's presumptive .

Right ?

There's also other ways of adding presumptive that was changed in the PACT Act but I'm not gonna get into that .

Now what is TARA ?

TARA stands for toxic exposure risk activity .

Now that's a new thing with the PACT Act as well because the PACT Act didn't just do presumptives .

It changed a lot of different things about how the VA benefits are done .

Now , TARA basically says to the VA , hey .

You need to look into all of the stuff the veteran did during their time in service and prepare some forms called an ILER and Tara risk assessment memo and basically figure out what the veteran was exposed to over the course of their career and then see if that current condition that they have now is related to that .

Now does that sound like presumptive to you ?

It's not .

It's really not presumptive .

Tara is different than presumptive because Tara still requires a medical opinion and evidence gathering to figure out what specifically the veteran was exposed to .

Now again , if they were exposed to burn pits in Iraq or if they were in Iraq , it was assumed they were exposed to burn pits so that can get you part of the way there .

But if it's not a presumptive condition , like say some of the other forms of cancer that aren't specifically listed in the code of federal regulations or by statute , it might still be a terror condition based on whatever the medical science says and whatever the doctor's opinion is .

And this is where maybe sometimes a nexus letter can be helpful .

Now don't go out and buy nexus letters because I said so .

It can be helpful .

Now some of these conditions might be we've seen Tara exposures done is where someone has prostate cancer not because they were in Vietnam but because they were a machinist mate working in the engine room of a ship exposed to VOCs , volatile organic compounds and other nasty chemicals and that caused their condition .

Now you're thinking , well , this doesn't sound like presumptive at all and that would be correct .

I think and I've spoken to other attorneys about this , Tara is just a variation on the duty to assist .

Stick with me here .

Right ?

The VA has always had a duty to assist the veteran in getting their claim perfected , meaning that they had to figure out ways to get the veteran's claim or get the evidence together or a proper exam .

I think TARA is just an extension of that because it's telling the VA to say , hey .

You need to figure out what this guy was exposed to , guy or gal was exposed to , and you need to figure out and do a proper medical exam to figure out whether that is their current condition is related to all that stuff they were exposed to .

Now obviously a lot can go wrong here because we are seeing nurse practitioners , family nurse practitioners do complicated evaluations on things like myeloma .

It's not that simple .

This isn't an orthopedic condition .

This is gonna require a deep dive into literature and balancing various other risk factors and so on and so forth .

So it gets a little complicated but fundamentally , in my opinion and after discussing with some other veterans , Tara is kind of an outgrowth of direct service connection by way of the duty to assist .

You were exposed to something in service , something happened in service , you have something wrong now , TARA is that connection .

Presumption says we're not even gonna think about the connection .

We just say it is connected .

TARA forces the VA to make that connection for the veteran if the science supports it .

That was pretty complicated and if it's confusing , believe me you're not alone .

The VA gets this wrong a lot too .

So don't sweat being confused about this stuff .

It is definitely not straightforward at all .

Now the way we've seen this gone wrong so far , they're ordering toxic exposure risk assessment exams for things like traumatic arthritis , right ?

So your exposure to benzene is not what caused your knee injury .

That's a different theory of service connection .

We've seen terrible exams done where they're sending these exams forward and it makes no sense .

It's incredibly frustrating .

But again , that's why we're here doing what we do .

With that said , if you've been denied service connection for something you believe the science supports should be service connected or your rating is incorrect , and it's , you know , that you have a fairly recent decision less than a year old , do reach out to us and maybe we can help fix the problem .

Until next time .

Take care .