Revealing Secrets: An Ex-VA Rater's Perspective

Understanding Toxic Exposure Claims and the Importance of TERAs: An Insider’s Perspective

By Chris – Veteran, Former VSO, and Current VA Claims Rater

When the PACT Act passed on August 10, 2022, many veterans, especially those who served in wartime theaters, celebrated the new presumptives. In simple terms, a “presumptive” condition means the VA is acknowledging a nexus—a medical link—between your service and certain medical conditions. If you can prove you served in a qualifying location and you have a related condition, the VA assumes it’s connected to your service. That means you don’t need a medical opinion to support your claim—it’s basically a rubber stamp process.

What many veterans didn’t realize is that the PACT Act also opened the door for claims from those who didn’t serve in combat zones. If you’re one of these veterans, you can still file for conditions potentially related to toxic exposure. The process is a bit more complex, but here’s how it works from an insider’s point of view—mine.

The Power of the TERA Memorandum

If you’re filing a claim and believe your duties exposed you to hazardous substances—such as asbestos, jet fuels, solvents, or cleaning agents—be explicit. Go to the VA’s Military Exposure website and research what exposures are listed for your MOS or job role. Then, when you file your claim using VA Form 21-526EZ or appeal with a VA Form 20-0995, include a lay statement that outlines:

Your specific MOS or job duties
The substances you were exposed to (e.g., lead, jet fuel, PAHs, etc.)
How your tasks exposed you to those substances

Previously, VA raters were restricted from forming internal memos based on MOS alone. But now, if your duties relate to known exposures, we are encouraged to issue what’s called a “TERA” (Toxic Exposure Risk Activity) memorandum. This internal document guides contract examiners to explore potential medical connections to your claimed conditions.

Be Detailed and Specific

General statements like “I was in the Air Force and exposed to fuel” won’t cut it. You need to get specific. Spell out the tasks and the environment. Use supporting documents from VA resources. That gives raters like me what we need to evaluate your claim thoroughly.

Claims without enough detail may be denied—or worse, older claims might have their TERA status overturned if they were too vaguely based on MOS. But now, the system allows veterans to strengthen claims with specifics, especially if the exposure was well-documented through your service duties.

Understanding the Burden of Proof

The legal standard for VA benefits is “at least as likely as not.” That means the evidence for and against must be balanced. Some contract examiners push borderline studies as rationale, but that’s not always enough. For example, if you have coronary artery disease and were exposed to asbestos in the Navy, a high-probability M21 table listing helps—but other risk factors (smoking, family history, obesity) could still outweigh your service exposure in the examiner’s eyes.

Some VA contractors err on the side of the veteran. Others are stricter. That’s why you must build the best possible case: list exposures, explain your duties, and back it up with studies or statements. Don’t rely on just one weak link—connect the dots thoroughly.

Conditions That Don’t Qualify for TERAs

There’s also a TERA Exception Job Aid that outlines conditions which are excluded from TERA-based consideration. These include mental health and most musculoskeletal disorders. So, if your claim involves PTSD or back pain, you likely won’t receive a TERA memo—even if you were exposed to toxins. That said, respiratory, cardiac, organ-related issues, strokes, hypertension, and cancers may qualify.

Secondary Conditions and Smart Filing

Secondary claims are gaining more ground. For example, if you have a service-connected condition like PTSD and also suffer from sleep apnea, there’s growing support for linking the two. While some examiners reject this connection, others accept it, especially when studies suggest a link between trauma, stress, and obstructive sleep apnea. The same applies for asthma and other conditions.

Sleep apnea tied to another condition like PTSD or asthma can bring a 50% rating with CPAP usage. That’s a significant rating. Be strategic. Know how your conditions interrelate, and gather the documentation and research to support your case.

Final Thoughts

If you served between Vietnam and the Gulf War, especially in the 80s, and were exposed to environmental hazards—even without being in a wartime theater—do your research. File your claims with intention and detail. Use the VA’s own resources to bolster your case. And if you need to appeal based on a TERA or denial without one, consider doing so armed with all the right information.

TERA memorandums are more important now than ever. This is one of the most important “secret sauces” I can share. Use it. File strong claims. And good luck to you, brother or sister in arms.

Disclaimer: The content of this article is opinion-based and reflects the personal experiences and insights of the author, who is a veteran and former VA claims rater. It does not represent official policy or guidance from the U.S. Department of Veterans Affairs (VA).

Subjectivity in Claims Decisions from a VA Claims Rater’s Insights.

Author: Chris, VA Claims Rater & Veteran Advocate

Introduction

Hey there, fellow veterans and patriots—Chris here. I’m a proud veteran with a current VA disability rating, a former Veteran Service Officer (VSO), and today, I serve as a VA Claims Rater. I’m not speaking on behalf of the VA, but I want to give you a real, unfiltered look into how things work from the inside—straight from someone who lives, breathes, and respects this process deeply.

As I sit here enjoying a peaceful afternoon near my home—just back from the gym and enjoying a good cigar—I feel compelled to talk to you about something I know many of you wrestle with: the subjectivity of the VA claims process.

Is the VA Claims Process Subjective? Yes… and No.

Let me start by saying: the law that governs the claims process is not subjective. Neither is the M21-1, the procedural manual we raters use to interpret that law. However, when it comes to applying the law to real people and real claims, subjectivity does enter the picture—because humans are involved.

From medical examiners making judgments about the likelihood of service connection, to VA raters (like me) evaluating the rationale behind those medical opinions, the process requires thoughtful analysis and weighing of evidence. And like anything involving human beings, it’s not always black and white.

When It’s Easy: Presumptive Claims

Many claims are straightforward. Vietnam veterans with Agent Orange exposure, Gulf War veterans with respiratory or digestive issues, or claims involving clearly documented medical conditions and service records—those are often quickly granted.

These are what we call presumptive claims—where the law presumes service connection based on where and when you served and what condition you’re dealing with. If your documentation and diagnosis line up, the system is designed to work for you, not against you.

When It’s Not So Easy: The Gray Areas

But let’s be real: not every claim fits neatly into a box.

Say you twisted your ankle once during a run in 1985 and never mentioned it again for decades—until now, in 2025, you’re claiming chronic ankle pain. There’s no continuous documentation, no follow-ups, and no treatment for 40 years. Now a private doctor says, “Yeah, it’s likely related.” Well… I have to question that.

My job is to weigh the quality of evidence, not just accept it at face value. Did your condition begin in service and continue afterward? Is your doctor’s rationale sound—or just a boilerplate statement without specifics?

I’ve seen both ends of the spectrum: lazy raters approving whatever is put in front of them, and overly skeptical ones denying legitimate claims. But I try to walk a line of integrity and fairness. I ask for clarification when a rationale doesn’t make sense. I challenge vague opinions. I push for better justification. Because veterans deserve the truth—even when it’s hard to hear.

What Veterans Should Know

Here’s what I need you to understand as a fellow veteran:

This system is not a lottery. It’s not about gaming the VA or grabbing every dollar you can just because you wore the uniform. It’s about getting the benefits you’ve actually earned.
Private DBQs and Nexus Letters aren’t automatic golden tickets. Many are poorly written or based on generalizations. Some are outright scams. Be careful and seek trustworthy, experienced help.
Yes, you can appeal. If you believe in your claim, fight for it—but fight with facts, with good documentation, and with patience.
Don’t expect perfection. I’ve been on both sides—helping veterans as a VSO, and now deciding claims as a rater. Sometimes we make mistakes. Sometimes you, the veteran, do too. And sometimes, even doctors are off the mark.

From My Heart to Yours

Look, I’m not here to sugarcoat things. I’m a Christian. I answer to God, not man. That means I make decisions based on what I truly believe is right, not what’s easiest or what gets the claim off my desk faster. I’ve denied claims that didn’t meet the burden of proof, and I’ve pushed back on medical opinions that didn’t make sense—even if they were favorable.

But I’ve also fought for clarification when I thought a veteran was being shortchanged. I’ve stood up when I saw solid evidence being ignored. And if the rationale makes sense, I gladly grant the claim.

I’ve been frustrated too—both as a claimant and now as a rater. And I know many of you are out there paying good money for private doctors and lawyers because you feel the VA didn’t give you a fair shake. I get it. Just be careful who you trust—because not everyone in this game is honest.

Final Thoughts and Real Talk

You deserve respect. You deserve justice. But you also deserve the truth. And the truth is, not every claim is valid, and not every denial is a conspiracy.

If you’re filing with integrity, and your medical evidence backs you up, then push forward. Appeal. Ask questions. Get second opinions. But don’t fall for the “100% through shortcuts” trap that some folks on YouTube or social media might be selling.

You didn’t serve your country to become a part of fraud, waste, and abuse—and neither did I.

📢 Disclaimer (From Chris, VA Rater and Veteran)

The views expressed in this article are strictly my own and do not reflect the official policy or position of the Department of Veterans Affairs. I speak to you as a veteran, a former VSO, and someone who currently serves as a VA claims rater with a heart for helping other veterans.

This isn’t legal advice or medical guidance—this is one man’s honest opinion after walking in your shoes and sitting in the seat that helps decide your fate. I believe in integrity, I believe in fairness, and I believe in giving you the tools to succeed without feeding you false hope.

Stay strong, stay honest—and don’t ever stop fighting for what’s rightfully yours.

— Chris

Veteran | VA Claims Rater | Advocate for Truth

Revealing Secrets: A Current VA Rater’s Perspective