#aad? ,,congress  #b;d ,session  ,h4 ,r4
 #cihi  ,,an ,,act  ,to am5d title #ch1 
,unit$ ,/ates ,code1 to improve !       
process = det]m9+ ! eligibility (       
c>egiv]s ( vet]ans to c]ta9 b5efits     
adm9i/]$ by ! ,secret>y ( ,vet]ans      
,affairs1 & = o!r purposes4  #a4 ,%ort  
title ,?is ,act may be cit$ z ! ,support
 ,our ,milit>y ,c>egiv]s ,act4  #b4     
,ext]nal cl9ical review ( d5i$          
applications by c>egiv]s ( vet]ans  7a7 
,9 g5]al ,section #agbj;,g ( title #ch1 
,unit$ ,/ates ,code1 is am5d$--  7#a7 by
 r$esignat+ subsections 7d7 & 7e7 z     
subsections 7e7 & 7f71 respectively2 &  
7#b7 by ins]t+ aft] subsection 7c7 !    
foll[+ new subsection 7d73  7d7 ,ext]nal
 cl9ical review ( applications  7#a7    
,us+ am\nts o!rwise appropriat$ to c>ry 
out ?is section1 an individual may elect
 to h an indep5d5t contractor describ$ 9
 p>agraph 7#b7 p]=m an ext]nal cl9ical  
review ( any ( ! foll[+3 7,a7 ,! d5ial  
by ! ,secret>y ( an application by an   
individual to be a c>egiv] or family    

c>egiv] eligible = ! program (          
compreh5sive assi/ance adm9i/]$ by !    
,secret>y pursuant to ?is section4  7,b7
 ,) respect to su* an application t !   
,secret>y has grant$1 a det]m9ation by !
 ,secret>y ( ! level or am\nt ( p]sonal 
c>e s]vices t a vet]an requires4  7,c7  
,a reque/ by a c>egiv] or family c>egiv]
 = a reconsid]ation ( ! level or am\nt (
 p]sonal c>e s]vices t a vet]an requires
 bas$ on *anges to ! heal? or abilities 
( ! vet]an occurr+ s9ce ! ,secret>y     
grant$ su* an application4  7,d7 ,!     
revocation by ! ,secret>y ( assi/ance   
adm9i/]$ by ! ,secret>y pursuant to ?is 
section4  7#b7 ,an indep5d5t contractor 
describ$ 9 ?is p>agraph is an indep5d5t 
contractor t--  7,a7 is aw>d$ a contract
 by ! ,secret>y to c>ry out ?is section 
pursuant to full & op5 competition "u ! 
,f$]al ,acquisition ,regulation2  7,b7  
has no direct or indirect f9ancial      
relation%ip ) any non-,dep>tm5t provid] 
( s]vices to c>egiv]s & family c>egiv]s 
pursuant to ?is title2  7,c7 has n      

o!rwise conduct$ an ext]nal cl9ical     
review ( b5efits adm9i/]$ by ! ,secret>y
 pursuant to ?is title o!r ?an ?is      
section2  7,d7 has suffici5t tra9+ &    
exp]tise 9 m$ical sci5ce & o!r          
appropriate heal?1 educational1 &       
vocational tra9+ & legal matt]s to p]=m 
! reviews describ$ 9 p>agraph 7#a72 &   
7,e7 employs a panel ( physicians or o!r
 appropriate heal? c>e pr(essionals :o d
 n provide heal? c>e to ! individual :o 
makes an election "u p>agraph 7#a74     
7#c7 ,ea* ext]nal cl9ical review        
conduct$ pursuant to p>agraph 7#a7      
%all--  7,a7 be bas$ on applicable      
in=mation includ$ 9 ! application =     
assi/ance describ$ 9 su* p>agraph1      
includ+ cl9ical exp]tise1 m$ical1       
te*nical1 & sci5tific evid5ce2  7,b7    
include an opportunity = bo? !          
individual :o elects = su* review &1 to 
! ext5t possible1 ! vet]an = :om c>e is 
be+ provid$ to (f] op9ions & support+   
data z to ! level ( c>e requir$2 &  7,c7
 include a review ( ! initial cl9ical   

review ( su* vet]an & any o!r review    
made by ! ,secret>y4  7#d7 ,9 c>ry+ out 
! ext]nal cl9ical reviews pursuant to   
p>agraph 7#a71 ! indep5d5t contractor   
%all1 z det]m9$ appropriate by !        
,secret>y--  7,a7 collect & ma9ta9      
in=mation requir$2 &  7,b7 %>e su*      
in=mation ) ! ,secret>y4  7#e7 ,!       
,secret>y %all take into acc\nt1 b is n 
b\nd by1 any det]m9ation made by !      
indep5d5t contractor pursuant to        
p>agraph 7#a7 9 det]m9+ ! f9al decision 
) respect to ! application = assi/ance4 
,! ,secret>y may make a f9al decision t 
is contr>y to su* a det]m9ation if !    
,secret>y includes cl9ically support$   
docum5tation ) ! decision4  7#f7 ,!     
,secret>y %all ensure t ea* ext]nal     
cl9ical review conduct$ by ! indep5d5t  
contractor pursuant to p>agraph 7#a7 is 
complet$ & ! ,dep>tm5t is notifi$ 9     
writ+ ( ! results ( ! review by n lat]  
?an #abj days aft] ! date on :i* !      
individual makes ! election "u su*      
p>agraph4 ,n lat] ?an #cj days aft] !   

deliv]y ( ! det]m9ation recomm5d$ by !  
indep5d5t contractors1 ! ,secret>y %all 
ensure t ! vet]an & ! individual mak+ ! 
election "u su* p>agraph is notifi$ 9   
writ+ ( ! f9al decision ( ! ,secret>y4  
,9 accordance ) p>agraph 7#e71 su*      
notification %all include an explanation
 ( ! recomm5d$ decision1 a discussion ( 
! facts & applicable regulations1 & an  
explanation ( ! cl9ical rationale = !   
f9al decision4  7#g7 ,! ,secret>y %all  
notify individuals :o submit an         
application to be a c>egiv] or family   
c>egiv] eligible = ! program (          
compreh5sive assi/ance adm9i/]$ by !    
,secret>y pursuant to ?is section ( !   
ability ( ! individual to make an       
election "u p>agraph 7#a74  7#h7 ,no?+ 9
 ?is subsection may be con/ru$ to affect
 claims made by vet]ans = disability    
comp5sation "u *apt] #aa ( ?is title4  4
  7b7 ,application ,! am5dm5ts made by  
subsection 7a7 %all apply ) respect to  
elections "u subsection 7d7 ( section   
#agbj;,g ( title #ch1 ,unit$ ,/ates     

,code1 z add$ by subsection 7a77#b71 t  
are = applications or revocations =     
assi/ance = c>egiv]s & family c>egiv]s  
pursuant to su* section = :i* !         
,secret>y ( ,vet]ans ,affairs has n made
 a f9al decision z ( ! date ( ! enactm5t
 ( ?is ,act4  #c4 ,process to det]m9e   
eligibility = c>egiv]s ( vet]ans  7a7   
,directives ,! ,secret>y ( ,vet]ans     
,affairs %all issue directives reg>d+ ! 
policies1 proc$ures1 & op]ational       
requirem5ts = ! ,family ,c>egiv]        
,program1 includ+ ) respect to det]m9+ !
 eligibility ( an individual to         
p>ticipate 9 ! ,family ,c>egiv]         
,program4  7b7 ,,gao ,report ,!         
,comptroll] ,g5]al ( ! ,unit$ ,/ates    
%all submit to ! ,committees on         
,vet]ans' ,affairs ( ! ,h\se (          
,repres5tatives & ! ,s5ate a report on !
 processes ( ! ,secret>y ( ,vet]ans     
,affairs ) respect to-- 7#a7 det]m9+ !  
eligibility ( an individual to          
p>ticipate 9 ! ,family ,c>egiv]         
,program2  7#b7 adjudicat+ appeals to   

su* det]m9ations2 &  7#c7 ! p]iodic     
eligibility reevaluation ( an individual
 p>ticipat+ 9 su* program & !           
communication ( any *anges z a result ( 
su* reevaluations to ! vet]an & c>egiv]4
  7c7 ,family ,c>egiv] ,program def9$ ,9
 ?is section1 ! t]m ,family ,c>egiv]    
,program ei!r ! program ( compreh5sive  
assi/ance = family c>egiv]s or ! program
 ( g5]al c>egiv] support s]vices        
e/abli%$ by section #agbj;,g ( title    
#ch1 ,unit$ ,/ates ,code4  #d4          
,modification to limitation on aw>ds &  
bonuses ,section #gje ( ! ,vet]ans      
,access1 ,*oice1 & ,acc\ntability ,act (
 #bjad 7,public ,law #aac-adf2 #ch      
,u4,s4,c4 #gjc note7 is am5d$ to read z 
foll[s3  #gje4 ,limitation on aw>ds &   
bonuses paid to employees ( ,dep>tm5t ( 
,vet]ans ,affairs ,! ,secret>y (        
,vet]ans ,affairs %all ensure t !       
aggregate am\nt ( aw>ds & bonuses paid  
by ! ,secret>y 9 a fiscal ye> "u *apt]  
#de or #ec ( title #e1 ,unit$ ,/ates    
,code1 or any o!r aw>ds or bonuses      

au?oriz$ "u su* title or title #ch1     
,unit$ ,/ates ,code1 does n exce$ !     
foll[+ am\nts3 7#a7 ,) respect to ea* ( 
fiscal ye>s #bjag ?r\gh #bjba1          
#bcj1jjj1jjj4  7#b7 ,) respect to ea* ( 
fiscal ye>s #bjbb ?r\gh #bjbd1          
#cfj1jjj1jjj4  4  ,pass$ ! ,h\se (      
,repres5tatives ,may #bc1 #bjaf4;,cl]k4