Title 38 — Veterans' BenefitsRelease 119-73

§1168 Medical nexus examinations for toxic exposure risk activities

Title 38 › Part PART II— - GENERAL BENEFITS › Chapter CHAPTER 11— - COMPENSATION FOR SERVICE-CONNECTED DISABILITY OR DEATH › Subchapter SUBCHAPTER VI— - GENERAL COMPENSATION PROVISIONS › § 1168

Last updated Apr 6, 2026|Official source

Summary

When a veteran files a claim under section 1110 with proof of a disability and proof they took part in a toxic exposure risk activity during active service, and that proof is not enough to show service connection, the Secretary must order a medical exam under section 5103A(d) and get a medical opinion on whether it is at least as likely as not that the disability is linked to the exposure. The opinion must consider total exposure across deployments and the combined effect of the veteran’s exposures, but it does not have to assess the combined effect of each substance listed in section 1119(b)(2). This requirement does not apply if the Secretary finds no indication of a link. "Toxic exposure risk activity" is defined in section 1710(e)(4).

Full Legal Text

Title 38, §1168

Veterans' Benefits — Source: USLM XML via OLRC

(a)(1)Except as provided in subsection (b), if a veteran submits to the Secretary a claim for compensation for a service-connected disability under section 1110 of this title with evidence of a disability and evidence of participation in a toxic exposure risk activity during active military, naval, air, or space service, and such evidence is not sufficient to establish a service connection for the disability, the Secretary shall—

(A)provide the veteran with a medical examination under section 5103A(d) of this title; and

(B)obtain a medical opinion (to be requested by the Secretary in connection with the medical examination under subparagraph (A)) as to whether it is at least as likely as not that there is a nexus between the disability and the toxic exposure risk activity.

(2)When providing the Secretary with a medical opinion under paragraph (1)(B) for a veteran, the health care provider shall consider—

(A)the total potential exposure through all applicable military deployments of the veteran; and

(B)the synergistic, combined effect of all toxic exposure risk activities of the veteran.

(3)The requirement under paragraph (2)(B) shall not be construed as requiring a health care provider to consider the synergistic, combined effect of each of the substances, chemicals, and airborne hazards identified in the list under section 1119(b)(2) of this title.

(b)Subsection (a) shall not apply if the Secretary determines there is no indication of an association between the disability claimed by the veteran and the toxic exposure risk activity for which the veteran submitted evidence.

(c)In this section, the term “toxic exposure risk activity” has the meaning given that term in section 1710(e)(4) of this title.

Reference

Citations & Metadata

Citation

38 U.S.C. § 1168

Title 38 — Veterans' Benefits

Last Updated

Apr 6, 2026

Release point: 119-73