Federal officials on Monday encouraged Minnesota veterans to seek new health benefits that presumptively link deployment-related toxic exposures to a range of severe or chronic illnesses.

This year's passage of the Pact Act represents the largest expansion of veterans benefits in a generation, but veterans need to know the opportunity exists, said Dr. Shereef Elnahal, health undersecretary for the U.S. Department of Veterans Affairs.

"This is the price … of war and deployment," Elnahal told a group of veterans Monday at the Minneapolis Veterans Medical Center. "We are finally answering the call that advocates for years have been putting forward about these toxins."

The legislation classified 12 respiratory illnesses and 12 cancers as presumptively related to toxic exposures, including burn pits that were used in the Gulf War to incinerate items from plastics to metals to unused ordnance to chemicals.

The act also adds high blood pressure, a common condition, as presumptive eligibility for benefits for Vietnam War veterans who were exposed to the herbicide Agent Orange.

Minnesota Sen. Amy Klobuchar advocated for the legislation, which included bills she coauthored to increase training for medical providers so they could recognize exposure-related illnesses.

Klobuchar in an interview from Washington, D.C., said she was motivated by research at the Minneapolis VA that gave credence to the link between the illnesses and exposures, and by stories from veterans such as Amie Muller. She served near a burn pit in Iraq, was later diagnosed with pancreatic cancer, and died in 2017 at 36.

"Amie died way too young," Klobuchar said.

Benefits eligibility has been a challenge for veterans with Gulf War Illness (GWI), a mysterious syndrome that ranges from fatigue to joint pain to digestive problems to memory and mood impairment. Toxic exposures are considered a likely cause.

The federal General Accounting Office in 2017 reported the VA denied more than 80% of GWI claims — tripling the denial rate for other medical issues from that conflict.

"No longer will you have to provide that burden of proof," said Elnahal, who was among the VA leaders visiting hospitals across the nation to promote the benefits.

An estimated 40,000 existing enrollees in the Minneapolis VA region could qualify for additional benefits based on their possible toxic exposures in Vietnam, the Gulf War or post-9/11 deployments, he said. Another 30,000 veterans who haven't enrolled may qualify as well.

Minneapolis researchers have explored the immune system's role in triggering illnesses after exposure to toxins. They studied inflammation patterns in mice exposed to carbon particles that simulate burn pit materials.

Another Minneapolis VA group has searched for genetic markers that identify exposure-related injuries, which also could be related to oil fires, sand storms, exploded ordnance and other Gulf War hazards — alone or in combination. They found a relationship between a key protein and the size of the hippocampus — a portion of the brain that regulates mood and memory. It could serve as a marker for cognitive risks related to toxic exposures.

Elnahal said research will focus on additional medical conditions, potentially expanding access as studies link them to toxic exposures.

Veterans previously denied benefits related to these exposures are encouraged to reapply. Benefit decisions will be made in 2023 for most veterans but will be made immediately for those with terminal illnesses.

The expansion will add almost $280 billion to the federal budget over 10 years, according to estimates from the Congressional Budget Office. Klobuchar said she is confident that federal budgets will meet that commitment.

How to get help

For more information about benefits, go to va.gov/pact.