Home > 105th Congressional Bills > S. 2358 (is) To provide for the establishment of a service-connection for illnesses associated with service in the Persian Gulf War, to extend and enhance certain health care authorities relating to such service, and for other purposes. ...S. 2358 (is) To provide for the establishment of a service-connection for illnesses associated with service in the Persian Gulf War, to extend and enhance certain health care authorities relating to such service, and for other purposes. ...
105th CONGRESS
2d Session
S. 2358
_______________________________________________________________________
AN ACT
To provide for the establishment of a presumption of service-connection
for illnesses associated with service in the Persian Gulf War, to
extend and enhance certain health care authorities relating to such
service, 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; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Persian Gulf War
Veterans Act of 1998''.
(b) Table of Contents.--The table of contents of this Act is as
follows:
Sec. 1. Short title; table of contents.
TITLE I--SERVICE CONNECTION FOR PERSIAN GULF WAR ILLNESSES
Sec. 101. Presumption of service connection for illnesses associated
with service in the Persian Gulf during the
Persian Gulf War.
Sec. 102. Agreement with National Academy of Sciences.
Sec. 103. Monitoring of health status and health care of Persian Gulf
War veterans.
Sec. 104. Reports on recommendations for additional scientific
research.
Sec. 105. Outreach.
Sec. 106. Definitions.
TITLE II--EXTENSION AND ENHANCEMENT OF PERSIAN GULF WAR HEALTH CARE
AUTHORITIES
Sec. 201. Extension of authority to provide health care for Persian
Gulf War veterans.
Sec. 202. Extension and improvement of evaluation of health status of
spouses and children of Persian Gulf War
veterans.
TITLE III--MISCELLANEOUS
Sec. 301. Assessment of establishment of independent entity to evaluate
post-conflict illnesses among members of
the Armed Forces and health care provided
by DoD and VA before and after deployment
of such members.
TITLE I--SERVICE CONNECTION FOR PERSIAN GULF WAR ILLNESSES
SEC. 101. PRESUMPTION OF SERVICE CONNECTION FOR ILLNESSES ASSOCIATED
WITH SERVICE IN THE PERSIAN GULF DURING THE PERSIAN GULF
WAR.
(a) In General.--(1) Subchapter II of chapter 11 of title 38,
United States Code, is amended by adding at the end the following:
``Sec. 1118. Presumptions of service connection for illnesses
associated with service in the Persian Gulf during the
Persian Gulf War
``(a)(1) For purposes of section 1110 of this title, and subject to
section 1113 of this title, each illness, if any, described in
paragraph (2) shall be considered to have been incurred in or
aggravated by service referred to in that paragraph, notwithstanding
that there is no record of evidence of such illness during the period
of such service.
``(2) An illness referred to in paragraph (1) is any diagnosed or
undiagnosed illness that--
``(A) the Secretary determines in regulations prescribed
under this section to warrant a presumption of service
connection by reason of having a positive association with
exposure to a biological, chemical, or other toxic agent,
environmental or wartime hazard, or preventive medicine or
vaccine known or presumed to be associated with service in the
Armed Forces in the Southwest Asia theater of operations during
the Persian Gulf War; and
``(B) becomes manifest within the period, if any,
prescribed in such regulations in a veteran who served on
active duty in that theater of operations during that war and
by reason of such service was exposed to such agent, hazard, or
medicine or vaccine.
``(3) For purposes of this subsection, a veteran who served on
active duty in the Southwest Asia theater of operations during the
Persian Gulf War and has an illness described in paragraph (2) shall be
presumed to have been exposed by reason of such service to the agent,
hazard, or medicine or vaccine associated with the illness in the
regulations prescribed under this section unless there is conclusive
evidence to establish that the veteran was not exposed to the agent,
hazard, or medicine or vaccine by reason of such service.
``(b)(1)(A) Whenever the Secretary makes a determination described
in subparagraph (B), the Secretary shall prescribe regulations
providing that a presumption of service connection is warranted for the
illness covered by that determination for purposes of this section.
``(B) A determination referred to in subparagraph (A) is a
determination based on sound medical and scientific evidence that a
positive association exists between--
``(i) the exposure of humans or animals to a biological,
chemical, or other toxic agent, environmental or wartime
hazard, or preventive medicine or vaccine known or presumed to
be associated with service in the Southwest Asia theater of
operations during the Persian Gulf War; and
``(ii) the occurrence of a diagnosed or undiagnosed illness
in humans or animals.
``(2)(A) In making determinations for purposes of paragraph (1),
the Secretary shall take into account--
``(i) the reports submitted to the Secretary by the
National Academy of Sciences under section 102 of the Persian
Gulf War Veterans Act of 1998; and
``(ii) all other sound medical and scientific information
and analyses available to the Secretary.
``(B) In evaluating any report, information, or analysis for
purposes of making such determinations, the Secretary shall take into
consideration whether the results are statistically significant, are
capable of replication, and withstand peer review.
``(3) An association between the occurrence of an illness in humans
or animals and exposure to an agent, hazard, or medicine or vaccine
shall be considered to be positive for purposes of this subsection if
the credible evidence for the association is equal to or outweighs the
credible evidence against the association.
``(c)(1) Not later than 60 days after the date on which the
Secretary receives a report from the National Academy of Sciences under
section 102 of the Persian Gulf War Veterans Act of 1998, the Secretary
shall determine whether or not a presumption of service connection is
warranted for each illness, if any, covered by the report.
``(2) If the Secretary determines under this subsection that a
presumption of service connection is warranted, the Secretary shall,
not later than 60 days after making the determination, issue proposed
regulations setting forth the Secretary's determination.
``(3)(A) If the Secretary determines under this subsection that a
presumption of service connection is not warranted, the Secretary
shall, not later than 60 days after making the determination, publish
in the Federal Register a notice of the determination. The notice shall
include an explanation of the scientific basis for the determination.
``(B) If an illness already presumed to be service connected under
this section is subject to a determination under subparagraph (A), the
Secretary shall, not later than 60 days after publication of the notice
under that subparagraph, issue proposed regulations removing the
presumption of service connection for the illness.
``(4) Not later than 90 days after the date on which the Secretary
issues any proposed regulations under this subsection, the Secretary
shall issue final regulations. Such regulations shall be effective on
the date of issuance.
``(d) Whenever the presumption of service connection for an illness
under this section is removed under subsection (c)--
``(1) a veteran who was awarded compensation for the
illness on the basis of the presumption before the effective
date of the removal of the presumption shall continue to be
entitled to receive compensation on that basis; and
``(2) a survivor of a veteran who was awarded dependency
and indemnity compensation for the death of a veteran resulting
from the illness on the basis of the presumption before that
date shall continue to be entitled to receive dependency and
indemnity compensation on that basis.
``(e) Subsections (b) through (d) shall cease to be effective 10
years after the first day of the fiscal year in which the National
Academy of Sciences submits to the Secretary the first report under
section 102 of the Persian Gulf War Veterans Act of 1998.''.
(2) The table of sections at the beginning of such chapter is
amended by inserting after the item relating to section 1117 the
following new item:
``1118. Presumptions of service connection for illnesses associated
with service in the Persian Gulf during the
Persian Gulf War.''.
(b) Conforming Amendments.--Section 1113 of title 38, United States
Code, is amended--
(1) by striking out ``or 1117'' each place it appears and
inserting in lieu thereof ``1117, or 1118''; and
(2) in subsection (a), by striking out ``or 1116'' and
inserting in lieu thereof ``, 1116, or 1118''.
(c) Compensation for Undiagnosed Gulf War Illnesses.--Section 1117
of title 38, United States Code, is amended--
(1) by redesignating subsections (c), (d), and (e) as
subsections (d), (e), and (f), respectively; and
(2) by inserting after subsection (b) the following new
subsection (c):
``(c)(1) Whenever the Secretary determines under section 1118(c) of
this title that a presumption of service connection for an undiagnosed
illness (or combination of undiagnosed illnesses) previously
established under this section is no longer warranted--
``(A) a veteran who was awarded compensation under this
section for such illness (or combination of illnesses) on the
basis of the presumption shall continue to be entitled to
receive compensation under this section on that basis; and
``(B) a survivor of a veteran who was awarded dependency
and indemnity compensation for the death of a veteran resulting
from the disease on the basis of the presumption before that
date shall continue to be entitled to receive dependency and
indemnity compensation on that basis.
``(2) This subsection shall cease to be effective 10 years after
the first day of the fiscal year in which the National Academy of
Sciences submits to the Secretary the first report under section 102 of
the Persian Gulf War Veterans Act of 1998.''.
SEC. 102. AGREEMENT WITH NATIONAL ACADEMY OF SCIENCES.
(a) Purpose.--The purpose of this section is to provide for the
National Academy of Sciences, an independent nonprofit scientific
organization with appropriate expertise, to review and evaluate the
available scientific evidence regarding associations between illnesses
and exposure to toxic agents, environmental or wartime hazards, or
preventive medicines or vaccines associated with Gulf War service.
(b) Agreement.--The Secretary of Veterans Affairs shall seek to
enter into an agreement with the National Academy of Sciences for the
Academy to perform the activities covered by this section and section
103(a)(6). The Secretary shall seek to enter into the agreement not
later than two months after the date of enactment of this Act.
(c) Identification of Agents and Illnesses.--(1) Under the
agreement under subsection (b), the National Academy of Sciences
shall--
(A) identify the biological, chemical, or other toxic
agents, environmental or wartime hazards, or preventive
medicines or vaccines to which members of the Armed Forces who
served in the Southwest Asia theater of operations during the
Persian Gulf War may have been exposed by reason of such
service; and
(B) identify the illnesses (including diagnosed illnesses
and undiagnosed illnesses) that are manifest in such members.
(2) In identifying illnesses under paragraph (1)(B), the Academy
shall review and summarize the relevant scientific evidence regarding
chronic illnesses among the members described in paragraph (1)(A) and
among other appropriate populations of individuals, including
mortality, symptoms, and adverse reproductive health outcomes among
such members and individuals.
(d) Initial Consideration of Specific Agents.--(1) In identifying
under subsection (c) the agents, hazards, or preventive medicines or
vaccines to which members of the Armed Forces may have been exposed for
purposes of the first report under subsection (i), the National Academy
of Sciences shall consider, within the first six months after the date
of enactment of this Act, the following:
(A) The following organophosphorous pesticides:
(i) Chlorpyrifos.
(ii) Diazinon.
(iii) Dichlorvos.
(iv) Malathion.
(B) The following carbamate pesticides:
(i) Proxpur.
(ii) Carbaryl.
(iii) Methomyl.
(C) The carbamate pyridostigmine bromide used as nerve
agent prophylaxis.
(D) The following chlorinated dydrocarbon and other
pesticides and repellents:
(i) Lindane.
(ii) Pyrethrins.
(iii) Permethrins.
(iv) Rodenticides (bait).
(v) Repellent (DEET).
(E) The following low-level nerve agents and precursor
compounds at exposure levels below those which produce
immediately apparent incapacitating symptoms:
(i) Sarin.
(ii) Tabun.
(F) The following synthetic chemical compounds:
(i) Mustard agents at levels below those which
cause immediate blistering.
(ii) Volatile organic compounds.
(iii) Hydrazine.
(iv) Red fuming nitric acid.
(v) Solvents.
(G) The following sources of radiation:
(i) Depleted uranium.
(ii) Microwave radiation.
(iii) Radio frequency radiation.
(H) The following environmental particulates and
pollutants:
(i) Hydrogen sulfide.
(ii) Oil fire byproducts.
(iii) Diesel heater fumes.
(iv) Sand micro-particles.
(I) Diseases endemic to the region (including the
following):
(i) Leishmaniasis.
(ii) Sandfly fever.
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