Toxic exposure: AFFF and PFAS
AFFF Firefighting Foam (PFAS) and VA Disability Claims
Military firefighters and flight-line crews used AFFF, a firefighting foam, for decades. It is loaded with PFAS, the so-called forever chemicals that build up in the body and never fully break down.
There is no VA presumption for PFAS yet. So a PFAS claim is a direct-connection claim, won with a medical opinion that ties your condition to the exposure. That is the nexus letter we write.
Medically reviewed by the Patriot Path Medical Team
Licensed MD and PhD reviewers • Last updated: June 2026
What AFFF and PFAS are
AFFF stands for aqueous film-forming foam. It was used in fire training, crash response, and hangar systems. The PFAS in it spread into the soil and the groundwater on many bases, so exposure came from the foam itself and from drinking water.
PFAS are tied to kidney cancer, testicular cancer, and thyroid disease, among others. Because PFAS-related illness can take years to show up, the link to service is easy for the VA to miss. A nexus letter is what makes it clear.
Where this exposure can still win a claim
Many conditions are tied to the specific chemicals you were exposed to, not just to a program name. That is the opening when you are not presumptive.
The chemicals you were exposed to, and what they cause
Firefighting foam (AFFF and PFAS) carries chemicals that also show up in other exposures. Some conditions they cause are already presumptive for a different program. If you have one of these and you are not presumptive here, you are not stuck. The same science can support a direct service-connection claim, which is exactly what a nexus letter is for.
Also found in: AFFF firefighting foam used on flight lines and in fire training.
Linked conditions
- Kidney cancer
- Testicular cancer
- Thyroid disease
There is no VA presumption for pfas (forever chemicals) yet. These conditions are won by direct service connection, where a nexus letter is the deciding piece.
Source: PFAS, Perfluoroalkyl and polyfluoroalkyl substances (VA Public Health)
This shows possible pathways, not a decision on your claim. Whether a condition connects to your exposure is a medical judgment, made case by case. It is not medical or legal advice.
How a nexus letter fits
When a claim is not presumptive, you win it by direct service connection. Under 38 CFR 3.303, that needs three things: a current diagnosis, an in-service exposure, and a medical opinion tying them together.
The opinion has to clear one standard: “at least as likely as not,” a 50% or better chance the condition is tied to service. That comes from the benefit-of-the-doubt rule in 38 U.S.C. 5107(b), carried out in 38 CFR 3.102. The PACT Act goes further: for a non-presumptive condition tied to a qualifying toxic exposure, the VA must order an exam and a medical opinion. That opinion is the nexus, and it is what we write.
Proving the exposure when there is no record
The military rarely wrote down who handled or breathed what. So the in-service exposure can have no paper trail. You can still prove it, and your own account counts.
The VA treats your firsthand statement as competent evidence of what you did and were exposed to, under 38 CFR 3.159. A statement from someone who served with you helps too. You can give it real weight by signing it as an unsworn declaration under penalty of perjury, under 28 U.S.C. 1746, which carries the same force as a sworn affidavit with no notary. Be specific: your job, your base, the dates, and exactly what you were around. We help you put it together so it lines up with the medical opinion.
Related condition guides
Secondary conditions
A PFAS-related cancer can lead to other ratable conditions, including depression. We look for those secondary claims too.
Frequently asked questions
Is PFAS exposure presumptive?
Not at this time. There is no VA presumption for PFAS, so it is a direct-connection claim that needs a medical nexus opinion tying your condition to the exposure.
Who was exposed to AFFF?
Military firefighters, crash and rescue crews, flight-line and flight-deck personnel, and anyone who lived or worked where AFFF got into the water supply.
What conditions are linked to PFAS?
Kidney cancer, testicular cancer, and thyroid disease are the most established, along with effects on the immune system. The science continues to grow.
I have no records of AFFF exposure. Can I still file?
Yes. Your own account of your job and the foam or water you were around is competent evidence, and you can sign it under penalty of perjury. A nexus letter then ties it to your condition.
My PFAS claim was denied. What now?
Denials usually turn on the link between the exposure and the illness. A clear exposure statement and a strong nexus opinion are what address that.
Does Patriot Path help with AFFF and PFAS claims?
Yes. Non-presumptive exposure that needs a physician opinion is exactly our lane. The first consultation is free.
Were you exposed to firefighting foam (afff and pfas)?
Let’s figure out your path together. The first consultation is free, and we will tell you straight whether a nexus letter can help your claim.
Sources & regulatory references
- PFAS, Perfluoroalkyl and polyfluoroalkyl substances (VA Public Health) https://www.publichealth.va.gov/exposures/pfas.asp
- PFAS information (US EPA) https://www.epa.gov/pfas