[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 952 Introduced in Senate (IS)]
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117th CONGRESS
1st Session
S. 952
To amend title 38, United States Code, to provide for a presumption of
service connection for certain diseases associated with exposure to
toxins, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
March 24, 2021
Mrs. Gillibrand (for herself and Mr. Rubio) introduced the following
bill; which was read twice and referred to the Committee on Veterans'
Affairs
_______________________________________________________________________
A BILL
To amend title 38, United States Code, to provide for a presumption of
service connection for certain diseases associated with exposure to
toxins, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Presumptive Benefits for War
Fighters Exposed to Burn Pits and Other Toxins Act of 2021''.
SEC. 2. PRESUMPTION OF SERVICE CONNECTION FOR CERTAIN DISEASES
ASSOCIATED WITH EXPOSURE TO BURN PITS AND OTHER TOXINS.
(a) In General.--Subchapter II of chapter 11 of title 38, United
States Code, is amended by adding at the end the following new section:
``Sec. 1119. Presumption of service connection for certain diseases
associated with exposure to burn pits and other toxins
``(a) Presumption of Service Connection.--(1) For the purposes of
section 1110 of this title, and subject to section 1113 of this title,
a disease specified in paragraph (2) becoming manifest in a veteran
described in paragraph (3) shall be considered to have been incurred in
or aggravated during active military, naval, or air service,
notwithstanding that there is no record of evidence of such disease
during the period of such service.
``(2) The diseases specified in this paragraph are the following:
``(A) Asthma that was diagnosed after service in a country
or territory for which a medal described in paragraph (3) was
awarded.
``(B)(i) Head cancer of any type.
``(ii) Neck cancer of any type.
``(iii) Respiratory cancer of any type.
``(iv) Gastrointestinal cancer of any type.
``(v) Reproductive cancer of any type.
``(vi) Lymphoma cancer of any type.
``(vii) Lymphomatic cancer of any type.
``(viii) Kidney cancer.
``(ix) Brain cancer.
``(x) Melanoma.
``(C) Chronic bronchitis.
``(D) Chronic obstructive pulmonary disease.
``(E) Constrictive bronchiolitis or obliterative
bronchiolitis.
``(F) Emphysema.
``(G) Granulomatous disease.
``(H) Interstitial lung disease.
``(I) Pleuritis.
``(J) Pulmonary fibrosis.
``(K) Sarcoidosis.
``(L) Any other disease listed under subsection (a)(2) of
section 1116 of this title or for which a presumption of
service connection is warranted pursuant to regulations
prescribed under section subsection (b)(1) of such section.
``(M) Any other disease with respect to which final
regulations have been prescribed under subsection (c)(3).
``(3) A veteran described in this paragraph is any veteran who on
or after August 2, 1990, was awarded any of the following:
``(A) The Afghanistan Campaign Medal.
``(B) The Armed Forces Expeditionary Medal.
``(C) The Armed Forces Reserve Medal with M-device.
``(D) The Armed Forces Service Medal.
``(E) The Global War On Terrorism Expeditionary Medal.
``(F) The Inherent Resolve Campaign Medal.
``(G) The Iraqi Campaign Medal.
``(H) The Southwest Asia Service Medal.
``(b) Process to Add Diseases Through Written Petition.--(1) In the
case that the Secretary receives a written petition from an interested
party to add a disease to the list of diseases specified in subsection
(a)(2), not later than 90 days after the date of receipt of such
petition, the Secretary shall request a determination by the National
Academies of Sciences, Engineering, and Medicine (referred to in this
section as the `National Academies') with respect to whether there is a
positive association between--
``(A) the exposure of humans to one or more covered toxins;
and
``(B) the occurrence of the disease in humans.
``(2) For purposes of this subsection, the term `interested party'
includes a representative of--
``(A) a congressionally chartered veterans service
organization;
``(B) an organization that--
``(i) is described in section 501(c)(3) of the
Internal Revenue Code of 1986 and exempt from taxation
under section 501(a) of such Code;
``(ii) serves veterans or members of the Armed
Forces; and
``(iii) has continuously operated for a period of
five years or more preceding the date of the submittal
of the written petition under paragraph (1);
``(C) a collective bargaining agent for civilian employees
of the United States Government;
``(D) a nationally recognized medical association;
``(E) the National Academies; or
``(F) a State or political subdivision of a State.
``(c) Determinations by National Academies.--(1) If the Secretary
receives a determination described in paragraph (2), not later than 180
days after receipt of such determination, the Secretary shall--
``(A) publish in the Federal Register proposed regulations
to add the disease covered by the determination to the list of
diseases specified in subsection (a)(2);
``(B) publish in the Federal Register, and submit to the
Committee on Veterans' Affairs of the Senate and the Committee
on Veterans' Affairs of the House of Representatives--
``(i) the decision of the Secretary not to publish
such proposed regulations; and
``(ii) the basis for such decision, including
specific medical science refuting the determination; or
``(C) publish in the Federal Register a decision that
insufficient evidence exists to take action under subparagraph
(A) or (B).
``(2) A determination described in this paragraph--
``(A) is a determination by the National Academies that
there is a positive association between--
``(i) the exposure of humans to one or more covered
toxins; and
``(ii) the occurrence of the disease in humans; and
``(B) may be made pursuant to--
``(i) a request from the Secretary under subsection
(b); or
``(ii) an agreement between the Secretary and the
National Academies under section 3 of the Presumptive
Benefits for War Fighters Exposed to Burn Pits and
Other Toxins Act of 2021.
``(3)(A) Not later than 180 days after the date on which the
Secretary publishes any proposed regulations under paragraph (1)(A) for
a disease, the Secretary shall prescribe final regulations for that
disease.
``(B) Such regulations shall be effective on the date of issuance.
``(d) Reference to National Academies.--In the case that the
Secretary enters into an agreement with another organization as
described in section 3(h)(1) of the Presumptive Benefits for War
Fighters Exposed to Burn Pits and Other Toxins Act of 2021, any
reference in this section to the National Academies shall be treated as
a reference to the other organization.
``(e) Definitions.--In this section:
``(1) The term `covered toxin' includes the following:
``(A) Any toxic chemical or toxic fume.
``(B) Hazardous waste, mixed waste, solid waste, or
used oil (as those terms are defined in section 1004 of
the Solid Waste Disposal Act (42 U.S.C. 6903)).
``(C) Radiological waste.
``(D) Any other carcinogen.
``(2) The term `veterans service organization' means an
organization recognized by the Secretary for the representation
of veterans under section 5902 of this title.''.
(b) Effective Date.--
(1) In general.--The amendment made by subsection (a) shall
take effect on the date that is 180 days after the date of the
enactment of this Act.
(2) Written petitions.--With respect to a written petition
described in section 1119(b)(1) of title 38, United States
Code, as added by subsection (a), that was received by the
Secretary of Veterans Affairs before the effective date
described in paragraph (1), the Secretary shall make a request
of the National Academies of Sciences, Engineering, and
Medicine under such section, as so added, not later than 90
days after such effective date.
(c) Clerical Amendment.--The table of sections at the beginning of
chapter 11 of title 38, United States Code, is amended by inserting
after the item relating to section 1118 the following new item:
``1119. Presumption of service connection for certain diseases
associated with exposure to burn pits and
other toxins.''.
(d) Conforming Amendment.--Section 1113 of such title is amended by
striking ``or 1118'' each place it appears and inserting ``1118, or
1119''.
SEC. 3. AGREEMENT WITH THE NATIONAL ACADEMIES OF SCIENCES, ENGINEERING,
AND MEDICINE CONCERNING THE EXPOSURE OF HUMANS TO BURN
PITS AND OTHER TOXINS.
(a) Agreement.--
(1) In general.--The Secretary of Veterans Affairs shall
seek to enter into an agreement with the National Academies of
Sciences, Engineering, and Medicine (referred to in this
section as the ``National Academies'') to perform the services
covered by this section.
(2) Timing.--The Secretary shall seek to enter into the
agreement described in paragraph (1) not later than 60 days
after the date of the enactment of this Act.
(b) Reviews of Scientific Evidence.--
(1) In general.--Under an agreement between the Secretary
and the National Academies, the National Academies shall review
and summarize the scientific evidence, and assess the strength
thereof, concerning the association between the exposure of
humans to covered toxins and each disease suspected to be
associated with such exposure.
(2) Reviews upon request.--Under an agreement between the
Secretary and the National Academies under this section, the
National Academies shall conduct a review described in
paragraph (1) in response to each request made by the Secretary
under section 1119(b)(1) of title 38, United States Code, as
added by section 2(a).
(c) Scientific Determinations Concerning Diseases.--
(1) In general.--For each disease reviewed under subsection
(b), the National Academies shall determine (to the extent that
available scientific data permit meaningful determinations)
whether there is a positive association between the exposure of
humans to one or more covered toxins and the occurrence of the
disease in humans, taking into account the strength of the
scientific evidence and the appropriateness of the statistical
and epidemiological methods used to detect the association.
(2) Submissions for reviews upon request.--Under an
agreement between the Secretary and the National Academies
under this section, not later than 270 days after the date on
which the Secretary transmits a request to the National
Academies with respect to a disease under section 1119(b)(1) of
title 38, United States Code, as added by section 2(a), the
National Academies shall submit to the Secretary the
determination made with respect to that disease under paragraph
(1).
(d) Recommendations for Additional Scientific Studies.--
(1) In general.--Under an agreement between the Secretary
and the National Academies under this section, the National
Academies shall make any recommendations it has for additional
scientific studies to resolve areas of continuing scientific
uncertainty relating to the exposure of humans to covered
toxins.
(2) Considerations.--In making recommendations for
additional scientific studies, the National Academies shall
consider--
(A) the scientific information that is available at
the time of the recommendation;
(B) the value and relevance of the information that
could result from additional studies; and
(C) the feasibility of carrying out such additional
studies.
(e) Subsequent Reviews.--Under an agreement between the Secretary
and the National Academies under this section, the National Academies
shall--
(1) conduct as comprehensive a review as is practicable of
the evidence referred to in subsection (b)(1) that became
available since the last review of such evidence under this
section; and
(2) make determinations and estimates on the basis of the
results of such review and all other reviews conducted for the
purposes of this section.
(f) Reports.--
(1) Initial report.--
(A) In general.--Under an agreement between the
Secretary and the National Academies under this
section, not later than 540 days after the date of the
enactment of this Act, the National Academies shall
submit to the Secretary and the Committee on Veterans'
Affairs of the Senate and the Committee on Veterans'
Affairs of the House of Representatives a report on the
activities of the National Academies under the
agreement.
(B) Elements.--The report submitted under
subparagraph (A) shall include the following:
(i) The determinations described in
subsection (c)(1).
(ii) An explanation of the scientific
evidence and reasoning that led to such
determinations.
(iii) Any recommendations of the National
Academies under subsection (d).
(2) Periodic updates.--Under an agreement between the
Secretary and the National Academies under this section, not
less frequently than once every two years, the National
Academies shall submit to the Secretary and the Committee on
Veterans' Affairs of the Senate and the Committee on Veterans'
Affairs of the House of Representatives an updated report on
the activities of the National Academies under the agreement.
(g) Limitation on Authority.--The authority to enter into
agreements under this section shall be effective for a fiscal year to
the extent that appropriations are available.
(h) Alternative Contract Scientific Organization.--
(1) In general.--If the Secretary is unable within the
period prescribed in subsection (a)(2) to enter into an
agreement with the National Academies on terms acceptable to
the Secretary, the Secretary shall seek to enter into such an
agreement with another appropriate scientific organization
that--
(A) is not part of the Government;
(B) operates as a not-for-profit entity; and
(C) has expertise and objectivity comparable to
that of the National Academies.
(2) Treatment.--If the Secretary enters into an agreement
with another organization as described in paragraph (1), any
reference in this section, section 4, and section 1119 of title
38, United States Code, as added by section 2(a), to the
National Academies shall be treated as a reference to the other
organization.
(i) Covered Toxin Defined.--In this section, the term ``covered
toxin'' has the meaning given that term in section 1119(e) of title 38,
United States Code, as added by section 2(a).
(j) Authorization of Appropriations.--There are authorized to be
appropriated to the Department of Veterans Affairs such sums as may be
necessary to carry out this section.
SEC. 4. ACCESS OF THE NATIONAL ACADEMIES OF SCIENCES, ENGINEERING, AND
MEDICINE TO INFORMATION FROM FEDERAL AGENCIES.
(a) In General.--Upon request by the National Academies of
Sciences, Engineering, and Medicine (referred to in this section as the
``National Academies''), the head of any Federal agency with relevant
information shall provide to the National Academies information in the
possession of the agency that the National Academies determines useful
in conducting a review under section 3(b).
(b) Federal Agency Defined.--In this section, the term ``Federal
agency'' means any agency as that term is defined in section 551 of
title 5, United States Code.
SEC. 5. PRESUMPTION RELATING TO PERSONAL INJURY OF CERTAIN FEDERAL
EMPLOYEES.
(a) In General.--Section 8102 of title 5, United States Code, is
amended by adding at the end the following:
``(c)(1) In this subsection, the term `covered employee' means an
employee of the Department of State, the Department of Defense, or an
element of the intelligence community (as defined in section 3 of the
National Security Act of 1947 (50 U.S.C. 3003)) who, on or after August
2, 1990, carried out the job responsibilities of the employee for not
fewer than 30 total days in a country or territory while the United
States was conducting a contingency operation (as defined in section
101 of title 10) in that country or territory.
``(2) Disability or death from a disease described in paragraph (2)
of such section suffered by a covered employee is deemed to have
resulted from personal injury sustained while in the performance of the
duty of the covered employee, whether or not the covered employee was
engaged in the course of employment when the disability or disability
resulting in death occurred.''.
(b) Effective Date.--The amendment made by subsection (a) shall
take effect on the date that is 180 days after the date of enactment of
this Act.
(c) Rule of Construction.--Subsection (c) of section 8102 of such
title, as added by subsection (a), shall not be construed to apply to a
contractor of a Federal department or agency.
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