# PACT Act & Toxic Exposure Record Review > PACT Act and toxic exposure record review: qualifying service dates and locations, the presumptive condition, and the symptom history in one cited timeline. Canonical page: https://medrecords.ai/solutions/pact-act-toxic-exposure-record-review/ --- New — **Missing Records Detection:** flags every visit, provider, and date missing from the file. [See how →](https://medrecords.ai/product/missing-records-identification/) [Home](https://medrecords.ai/) ›[Solutions](https://medrecords.ai/solutions/) › — PACT Act & Toxic Exposure Record Review PACT ACT AND TOXIC EXPOSURE RECORD REVIEW ## The presumption settles causation. The file still has to show the service. PACT Act and toxic exposure record review services build the exposure-to-condition timeline the rating depends on: the qualifying service dates and locations in the file, every documented symptom and diagnosis after them, and the presumptive condition matched to the regulation that names it. The nexus opinion stays with the clinician. [Test a file ](https://medrecords.ai/test-a-file/?src=pact-act-toxic-exposure-record-review) [Book a demo](https://medrecords.ai/demo/) Click any row → the source page it cites Exposure timeline · Case #IME-4812 documented Adams, Timothy · C-file 342 pp / 2 packets received logged 11 duplicate pages removed free p.140 — wrong patient quarantined Pages 342 Documents 27 Cited 100% ### Congress wrote the exposure list. The rater applies it to your file. We do not build for a case type until we can name the standard that defines a correct output and the person who grades the file against it. In toxic exposure claims the presumption is statutory, so the argument moves off causation and onto what the record documents. The standard and the referee The rulebook - 38 U.S.C. §1119 and §1120, added by the Honoring our PACT Act of 2022, which set the covered locations and the periods of service that establish presumptive toxic exposure - 38 CFR §3.320, the particulate matter presumptives promulgated in August 2021 for service in the Southwest Asia theater and in Afghanistan, Syria, Djibouti and Uzbekistan - 38 CFR §3.307 and §3.309, the general presumptive service connection rules, which govern Agent Orange, radiation and the chronic disease presumptions alongside the newer lists - The VA Adjudication Procedures Manual M21-1 and the toxic exposure risk activity screening it directs, which decide when a claim is developed as presumptive and when it is not The referee - The rating veterans service representative, who matches the diagnosis in the record against the presumptive list and the service dates against the covered locations - The Board of Veterans’ Appeals, which remands when the file does not establish qualifying service or when the diagnosis is not the one the presumption names - The Court of Appeals for Veterans Claims, whose case law on the duty to assist governs how far VA has to go before deciding on an incomplete record A presumptive claim denied on a diagnosis the file never named exactly From 10¢ to as low as 5¢/page here, duplicates free Exposure timeline · Case #IME-4812 cited 100% Packet — 342 pp / 2 packets · 11 deduplicated — logged Qualifying service — Dates and locations as the file documents them — cited Diagnosis against the list — Matched to the regulation that names it — cited Evidence against the claim — Including a diagnosis outside the presumptive list — flagged Timeline delivered · cited 100% · no medical opinion How it works ### 3 steps between the C-file and the timeline. 01 #### Send the C-file Service treatment records, the DD-214 and personnel file, VA and private treatment records, the exposure registry examination if there is one, and prior rating decisions, in any format. 02 #### We return the timeline, page-cited The qualifying service dates and locations the file supports, every documented symptom and diagnosis after separation, and the presumptive condition beside the regulation that lists it. 03 #### You or the clinician file Whether a non-presumptive condition is related to service is a medical opinion. The presumptive path needs the record, not the opinion, and this is the record. The boundary, in writing ### A timeline of the file, not a decision on the presumption. We assemble and cite what the service and treatment records document. We do not decide that a veteran qualifies for a presumption, rate a disability, state that a condition is related to an exposure, or sign anything. Those are the rater’s and the clinician’s. In the demo case, page 140 turned out to belong to a different patient. In a C-file that error puts another veteran’s diagnosis behind a presumptive claim, so it is quarantined rather than folded quietly into the history. Audit trail · Case #IME-4812 exportable 08:12 — Packet received · 342 pp / 2 packets — system 08:31 — 11 pages deduplicated — system 08:44 — p.140 flagged — wrong patient — system 08:54 — Exposure timeline complete · timeline delivered · cited 100% — system 09:20 — Exposure timeline reviewed · citations verified — reviewer 09:26 — Exposure timeline exported · claim filed by the veteran or representative — reviewer Every access logged · file deleted 30 days after delivery Why Medrecords AI ### The rules the platform never breaks. EVERY LINE CITED CASE #IME-4812 · ADAMS, T. 342 pp 2/14 — ER visit, right knee p.4 4/18 — arthroscopic surgery p.61 p.140 — wrong patient quarantined Medrecords AI Read every page · cite every line #### HIPAA, under a signed BAA Every file is handled under our Business Associate Agreement, from the first byte. #### Never trains a model Your records are never used to train any AI model — ours or anyone else's. #### Every line cited If we can't cite it, we don't say it. Every sentence links to its source page. #### Deleted after delivery Files are deleted 30 days after delivery, with a full audit log of every access. Powered by the platform ### 7 capabilities behind every exposure timeline. The exposure timeline is one deliverable of the same platform that reads, sorts, and cites the whole record. [ #### Medical Records OCR Every page read in full, including the personnel records that establish where and when the veteran served. IN ACTION · 342 pp / 2 packets → 27 documents, read in full ](https://medrecords.ai/product/ocr/) [ #### Medical Chronology Service and civilian care assemble from their own dates, so onset reads against separation on one line. IN ACTION · service dates → current diagnosis, one continuous timeline ](https://medrecords.ai/product/chronology/) [ #### Verifiable AI Citations Every entry links back to its page, including the ones that put the diagnosis outside the list. IN ACTION · timeline → cited 100% ](https://medrecords.ai/product/citations/) [ #### Medical Summary Reports It exports into the claim submission or the clinician’s opinion letter in their format. IN ACTION · timeline → claim package ](https://medrecords.ai/product/summaries/) [ #### Medical Record Deduplication Forty charts pulled from multiple practices and EHR migrations carry their share of duplicate visit notes. Each is matched and collapsed to one canonical record, so the prescribing pattern is read once per real encounter. IN ACTION · 40 charts → duplicate visit notes collapsed to 1 record each ](https://medrecords.ai/product/medical-record-deduplication/) [ #### Missing Records Identification A prescribing pattern read across 40 charts is only as sound as the file behind it. When a chart references a visit, refill, or referral that never made it into the production, the gap is flagged before the pattern goes to the board. IN ACTION · prescribing pattern cross-checked → gaps flagged before submission ](https://medrecords.ai/product/missing-records-identification/) [ #### Cross-Exam Simulator (beta) A board investigator or defense counsel builds a case from the chart abstraction. This beta tool maps the questioning a physician facing that hearing is likely to face on the gaps and pattern in their own record. A rehearsal tool, not legal advice. IN ACTION · prescribing pattern → likely hearing questions mapped (beta) ](https://medrecords.ai/product/cross-exam-simulator/) FAQ ### PACT Act and toxic exposure record review, answered. Because the presumption covers causation, not the two facts around it. The rater still has to see qualifying service in the covered locations and dates, and a diagnosis that matches the listed condition. Claims fail on those two, not on causation. No. We place the service dates and locations beside the diagnosis and the regulation that lists it, each cited. Whether the presumption applies is the rating decision, made by VA on the record you file. It goes on the timeline the same way, flagged as outside the presumptive lists. Direct service connection is still available under 38 CFR §3.303(d), and that route needs a nexus opinion from a clinician, built on this timeline. No. Medrecords AI does not retrieve records from providers or facilities. You bring the records you already have — review starts in minutes from upload. Retrieval vendors take days; you can keep yours and still cut the review to minutes. ### Send one file. We'll tell you what we can read. No obligation. If the case type is buildable we'll scope it; if it isn't, we'll say so. [Test a file ](https://medrecords.ai/test-a-file/?src=pact-act-toxic-exposure-record-review) [Book a demo](https://medrecords.ai/demo/) [See every case type we process →](https://medrecords.ai/solutions/case-types/) ### More solutions - [**The rating is decided on the rationale, not on the conclusion.** — Nexus letter record review: a cited service-connection timeline from the C-file, so the opinion writer builds a…](https://medrecords.ai/solutions/nexus-letter-record-review/) - [**The registrar is the bottleneck, and the backlog never clears.** — NTDB and TQIP abstraction support — data-standard elements, injury coding evidence and outcome fields located…](https://medrecords.ai/solutions/trauma-registry-abstraction/) - [**The routine certifications are fine. It's the escalated ones that cost.** — Medical certification review for escalated FMLA and ADA cases — second and third opinions, intermittent-leave…](https://medrecords.ai/solutions/fmla-ada-certification-review/) - [**The same injury story turns up in 40 unrelated files. Reading one at a time, no one connects them.** — SIU fraud review, No Surprises Act IDR, and Medicare audit response — clinical documentation read and cited…](https://medrecords.ai/solutions/claims-integrity/) - [**The same narrative, in 40 unrelated patients' charts.** — Cross-claim medical record analysis for SIU units — cloned notes, protocol uniformity, billed-vs-documented…](https://medrecords.ai/solutions/provider-fraud-record-review/) - [**The SOAF a referee opinion can actually stand on.** — SOAF preparation for federal injury compensation programs. Accepted conditions, dates of injury and job factors…](https://medrecords.ai/solutions/statement-of-accepted-facts/)