,i  #aad? ,,congress  #a/ ,session  ,h4 
,r4 #cihi  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,novemb] #e1 #bjae    
,ms4 ,/efanik introduc$ ! foll[+ bill2  
:i* 0 ref]r$ to ! ,committee on         
,vet]ans' ,affairs  ,a ,,bill  ,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 ,affairs4  #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 = b5efits 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 (     
b5efits 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 = b5efits describ$ 9 su*    
p>agraph1 includ+ cl9ical exp]tise1     
m$ical1 te*nical1 & sci5tific evid5ce2  
7,b7 include an opportunity = !         
individual :o elects = su* review to    
provide ! op9ions ( ! individual & !    

vet]an = :om c>e is provid$2 &  7,c7    
include a review ( ! initial cl9ical    
review ( su* vet]an & any o!r review    
made by ! ,secret>y4  7#d7 ,9 c>ry+ out 
! ext]nal cl9ical reviews pursuant to   
p>agraph 7#a71 ! indep5d5t contractor   
%all1 z det]m9$ appropriate by !        
,secret>y--  7,a7 collect & ma9ta9      
in=mation requir$2 &  7,b7 %>e su*      
in=mation ) ! ,secret>y4  7#e7 ,!       
det]m9ation made by ! indep5d5t         
contractor pursuant to p>agraph 7#a7    
%all be f9al4  7#f7 ,! ,secret>y %all   
ensure t ea* ext]nal cl9ical review     
conduct$ by ! indep5d5t contractor      
pursuant to p>agraph 7#a7 is complet$ & 
! individual is notifi$ 9 writ+ ( !     
results ( ! review by n lat] ?an #abj   
days aft] ! date on :i* ! individual    
makes ! election "u su* p>agraph4 ,su*  
notification %all include an explanation
 ( ! decision1 a discussion ( ! facts & 
applicable regulations1 & an explanation
 ( ! cl9ical rationale = ! decision4    
7#g7 ,! ,secret>y %all notify           

individuals :o submit an application to 
be a c>egiv] or family c>egiv] eligible 
= b5efits 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  7#a7 ,9 g5]al       
,except z provid$ by p>agraph 7#b71 !   
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 = b5efits by
 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  7#b7  
,special rule ,a c>egiv] or family      
c>egiv] may make an election = an       
ext]nal cl9ical review "u subsection    
7d77#a77;,c7 ( section #agbj;,g ( title 

#ch1 ,unit$ ,/ates ,code1 z add$ by     
subsection 7a77#b71 reg>dless ( :e!r !  
,secret>y ( ,vet]ans ,affairs made !    
f9al decision ) respect to ! application
 = b5efits by ! c>egiv] or family       
c>egiv] be=e ! date ( ! enactm5t ( ?is  
,act4