,i #aafth ,,congress #b;d ,session ,h4 ,r4 #hbfa ,,in ,,the ,,house ,,of ,,representatives ,september #ae1 #bjbj,mr4 ,ruiz introduced the following bill2 which was referred to the ,committee on ,veterans' ,affairs1 and in addition to the ,committees on ,armed ,services1 and ,education and ,labor1 for a period to be subsequently determined by the ,speaker1 in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned ,a ,,bill ,to amend title #ch1 ,united ,states ,code1 to provide for a presumption of service connection for certain diseases associated with exposure to toxins1 including emissions from open burn pits1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,presumptive ,benefits for ,war ,fighters ,exposed to ,burn ,pits and ,other ,toxins ,act of #bjbj4 #b4 ,presumption of service connection for certain diseases associated with exposure to open burn pits and other toxins 7a7 ,in general ,subchapter ,,ii of chapter #aa of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new section3 #aaai4 ,presumption of service connection for certain diseases associated with exposure to open burn pits and other toxins 7a7 ,presumption of service connection 7#a7 ,for the purposes of section #aaaj of this title1 and subject to section #aaac of this title1 a disease specified in paragraph 7#b7 becoming manifest in a veteran described in paragraph 7#c7 shall be considered to have been incurred in or aggravated during active military1 naval1 or air service1 notwithstanding that there is no record of evidence of such disease during the period of such service4 7#b7 ,the diseases specified in this paragraph are the following3 7,a7 ,asthma that was diagnosed after service in a country or territory listed under paragraph 7#d77;,b74 7,b7 ,cancer of any type4 7,c7 ,chronic bronchitis4 7,d7 ,chronic obstructive pulmonary disease4 7,e7 ,constrictive bronchiolitis or obliterative bronchiolitis4 7,f7 ,emphysema4 7,g7 ,granulomatous disease4 7,h7 ,interstitial lung disease4 7,i7 ,lymphoma4 7,j7 ,pleuritis4 7,k7 ,pulmonary fibrosis4 7,l7 ,sarcoidosis4 7,m7 ,any other disease with respect to which final regulations have been prescribed under subsection 7c77#c74 7#c7 ,a veteran described in this paragraph is any veteran who-- 7,a7 on or after ,january #a1 #aiij-- 7i7 served as a member of the ,armed ,forces in support of a military operation described in paragraph 7#d72 and 7ii7 was present for #ae or more cumulative days in a country or territory listed under subparagraph 7,b7 of that paragraph2 or 7,b7 was awarded a campaign medal in recognition of service in any of the following-- 7i7 ,operation ,enduring ,freedom2 7ii7 ,operation ,iraqi ,freedom2 7iii7 ,operation ,nomad ,shadow2 7iv7 ,operation ,new ,dawn2 7v7 ,operation ,inherent ,resolve2 7vi7 ,operation ,freedom's ,sentinel2 7vii7 ,operation ,odyssey ,lightning2 or 7viii7 ,operation ,pacific ,eagle4 7#d7 ,a military operation described in this paragraph is any of the following3 7,a7 ,a contingency operation 7as defined in section #aja7;a77#ac7 of title #aj74 7,b7 ,a military operation in any of the following countries or territories3 7i7 ,afghanistan4 7ii7 ,bahrain4 7iii7 ,burkina ,faso4 7iv7 ,cameroon4 7v7 ,chad4 7vi7 ,diego ,garcia4 7vii7 ,djibouti4 7viii7 ,egypt4 7ix7 ,ethiopia4 7x7 ,gabon4 7xi7 ,ghana4 7xii7 ,iraq4 7xiii7 ,jordan4 7xiv7 ,kenya4 7xv7 ,kuwait4 7xvi7 ,kyrgyzstan4 7xvii7 ,libya4 7xviii7 ,mali4 7xix7 ,niger4 7xx7 ,nigeria4 7xxi7 ,oman4 7xxii7 ,pakistan4 7xxiii7 ,philippines4 7xxiv7 ,saudi ,arabia4 7xxv7 ,somalia4 7xxvi7 ,south ,sudan4 7xxvii7 ,sudan4 7xxviii7 ,syria4 7xxix7 ,tajikistan4 7xxx7 ,tunisia4 7xxxi7 ,united ,arab ,emirates4 7xxxii7 ,uzbekistan4 7xxxiii7 ,yemen4 7b7 ,process ,to add diseases through written petition 7#a7 ,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 7a77#b71 not later than #ij days after the date of receipt of such petition1 the ,secretary shall request a determination by the ,national ,academies of ,sciences1 ,engineering1 and ,medicine 7referred to in this section as the ,national ,academies7 with respect to whether there is a positive association between-- 7,a7 the exposure of humans to one or more covered toxins1 including emissions from open burn pits2 and 7,b7 the occurrence of the disease in humans4 7#b7 ,for purposes of this subsection1 the term interested party includes a representative of-- 7,a7 a congressionally chartered veterans service organization2 7,b7 an organization that-- 7i7 is described in section #eja7;c77#c7 of the ,internal ,revenue ,code of #aihf and exempt from taxation under section #eja7;a7 of such ,code2 7ii7 serves veterans or members of the ,armed ,forces2 and 7iii7 has continuously operated for a period of five years or more preceding the date of the submittal of the written petition under paragraph 7#a72 7,c7 a collective bargaining agent for civilian employees of the ,united ,states ,government2 7,d7 a nationally recognized medical association2 7,e7 the ,national ,academies2 or 7,f7 a ,state or political subdivision of a ,state4 7c7 ,determinations by ,national ,academies 7#a7 ,if the ,secretary receives a determination described in paragraph 7#b71 not later than #ahj days after receipt of such determination1 the ,secretary shall-- 7,a7 publish in the ,federal ,register proposed regulations to add the disease covered by the determination to the list of diseases specified in subsection 7a77#b72 7,b7 publish in the ,federal ,register1 and submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives-- 7i7 the decision of the ,secretary not to publish such proposed regulations2 and 7ii7 the basis for such decision1 including specific medical science refuting the determination2 or 7,c7 publish in the ,federal ,register a decision that insufficient evidence exists to take action under subparagraph 7,a7 or 7,b74 7#b7 ,a determination described in this paragraph-- 7,a7 is a determination by the ,national ,academies that there is a positive association between-- 7i7 the exposure humans to one or more covered toxins1 including emissions from open burn pits2 and 7ii7 the occurrence of the disease in humans2 and 7,b7 may be made pursuant to-- 7i7 a request from the ,secretary under subsection 7b72 or 7ii7 an agreement between the ,secretary and the ,national ,academies under section #c of the ,presumptive ,benefits for ,war ,fighters ,exposed to ,burn ,pits and ,other ,toxins ,act of #bjbj4 7#c7 7,a7 ,not later than #ahj days after the date on which the ,secretary publishes any proposed regulations under paragraph 7#a77;,a7 for a disease1 the ,secretary shall prescribe final regulations for that disease4 7,b7 ,such regulations shall be effective on the date of issuance4 7d7 ,reference to ,national ,academies ,in the case that the ,secretary enters into an agreement with another organization as described in section #c7;h77#a7 of the ,presumptive ,benefits for ,war ,fighters ,exposed to ,burn ,pits and ,other ,toxins ,act of #bjbj1 any reference in this section to the ,national ,academies shall be treated as a reference to the other organization4 7e7 ,definitions ,in this section3 7#a7 ,the term covered toxin means any toxic chemical1 including-- 7,a7 hazardous waste1 mixed waste1 solid waste1 or used oil 7as those terms are defined in section #ajjd of the ,solid ,waste ,disposal ,act 7#db ,u4,s4,c4 #fijc772 7,b7 radiological waste2 and 7,c7 any other carcinogen4 7#b7 ,the term veterans service organization means an organization recognized by the ,secretary for the representation of veterans under section #eijb of this title4 7#c7 ,the term open burn pit means an area of land located that-- 7,a7 is designated by the ,secretary of ,defense to be used for disposing solid waste by burning in the outdoor air2 and 7,b7 does not contain a commercially manufactured incinerator or other equipment specifically designed and manufactured for the burning of solid waste4 4 7b7 ,effective date 7#a7 ,in general ,the amendment made by subsection 7a7 shall take effect on the date that is #ahj days after the date of the enactment of this ,act4 7#b7 ,written petitions ,with respect to a written petition described in section #aaai7;b77#a7 of title #ch1 ,united ,states ,code1 as added by subsection 7a71 that was received by the ,secretary of ,veterans ,affairs before the effective date described in paragraph 7#a71 the ,secretary shall make a request of the ,national ,academies of ,sciences1 ,engineering1 and ,medicine under such section1 as so added1 not later than #ij days after such effective date4 7c7 ,clerical amendment ,the table of sections at the beginning of chapter #aa of title #ch1 ,united ,states ,code1 is amended by inserting after the item relating to section #aaah the following new item3 #aaai4 ,presumption of service connection for certain diseases associated with exposure to open burn pits and other toxins4 4 7d7 ,conforming amendment ,section #aaac of such title is amended by striking or #aaah each place it appears and inserting #aaah1 or #aaai4 #c4 ,agreement with the ,national ,academies of ,sciences1 ,engineering1 and ,medicine concerning the exposure of humans to open burn pits and other toxins 7a7 ,agreement 7#a7 ,in general ,the ,secretary of ,veterans ,affairs shall seek to enter into an agreement with the ,national ,academies of ,sciences1 ,engineering1 and ,medicine 7referred to in this section as the ,national ,academies7 to perform the services covered by this section4 7#b7 ,timing ,the ,secretary shall seek to enter into the agreement described in paragraph 7#a7 not later than #fj days after the date of the enactment of this ,act4 7b7 ,reviews of scientific evidence 7#a7 ,in general ,under an agreement between the ,secretary and the ,national ,academies1 the ,national ,academies shall review and summarize the scientific evidence1 and assess the strength thereof1 concerning the association between the exposure of humans to one or more covered toxins1 including emissions from open burn pits1 and each disease suspected to be associated with such exposure4 7#b7 ,reviews upon request ,under an agreement between the ,secretary and the ,national ,academies under this section1 the ,national ,academies shall conduct a review described in paragraph 7#a7 in response to each request made by the ,secretary under section #aaai7;b77#a7 of title #ch1 ,united ,states ,code1 as added by section #b7;a74 7c7 ,scientific determinations concerning diseases 7#a7 ,in general ,for each disease reviewed under subsection 7b71 the ,national ,academies shall determine 7to the extent that available scientific data permit meaningful determinations7 whether there is a positive association between the exposure of humans to one or more covered toxins1 including emissions from open burn pits1 and the occurrence of the disease in humans1 taking into account the strength of the scientific evidence and the appropriateness of the statistical and epidemiological methods used to detect the association4 7#b7 ,submissions for reviews upon request ,under an agreement between the ,secretary and the ,national ,academies under this section1 not later than #bgj days after the date on which the ,secretary transmits a request to the ,national ,academies with respect to a disease under section #aaai7;b77#a7 of title #ch1 ,united ,states ,code1 as added by section #b7;a71 the ,national ,academies shall submit to the ,secretary the determination made with respect to that disease under paragraph 7#a74 7d7 ,recommendations for additional scientific studies 7#a7 ,in general ,under an agreement between the ,secretary and the ,national ,academies under this section1 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 one or more covered toxins1 including emissions from open burn pits4 7#b7 ,considerations ,in making recommendations for additional scientific studies1 the ,national ,academies shall consider-- 7,a7 the scientific information that is available at the time of the recommendation2 7,b7 the value and relevance of the information that could result from additional studies2 and 7,c7 the feasibility of carrying out such additional studies4 7e7 ,subsequent reviews ,under an agreement between the ,secretary and the ,national ,academies under this section1 the ,national ,academies shall-- 7#a7 conduct as comprehensive a review as is practicable of the evidence referred to in subsection 7b77#a7 that became available since the last review of such evidence under this section2 and 7#b7 make determinations and estimates on the basis of the results of such review and all other reviews conducted for the purposes of this section4 7f7 ,reports 7#a7 ,initial report 7,a7 ,in general ,under an agreement between the ,secretary and the ,national ,academies under this section1 not later than #edj days after the date of the enactment of this ,act1 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 agreement4 7,b7 ,elements ,the report submitted under subparagraph 7,a7 shall include the following3 7i7 ,the determinations described in subsection 7c77#a74 7ii7 ,an explanation of the scientific evidence and reasoning that led to such determinations4 7iii7 ,any recommendations of the ,national ,academies under subsection 7d74 7#b7 ,periodic updates ,under an agreement between the ,secretary and the ,national ,academies under this section1 not less frequently than once every two years1 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 agreement4 7g7 ,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 available4 7h7 ,alternative contract scientific organization 7#a7 ,in general ,if the ,secretary is unable within the period prescribed in subsection 7a77#b7 to enter into an agreement with the ,national ,academies on terms acceptable to the ,secretary1 the ,secretary shall seek to enter into such an agreement with another appropriate scientific organization that-- 7,a7 is not part of the ,government2 7,b7 operates as a not-for-profit entity2 and 7,c7 has expertise and objectivity comparable to that of the ,national ,academies4 7#b7 ,treatment ,if the ,secretary enters into an agreement with another organization as described in paragraph 7#a71 any reference in this section1 section #d1 and section #aaai of title #ch1 ,united ,states ,code1 as added by section #b7;a71 to the ,national ,academies shall be treated as a reference to the other organization4 7i7 ,definitions ,in this section1 the terms covered toxin and open burn pit have the meanings given such terms in section #aaai7;e7 of title #ch1 ,united ,states ,code1 as added by section #b7;a74 7j7 ,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 section4 #d4 ,access of the ,national ,academies of ,sciences1 ,engineering1 and ,medicine to information from the ,department of ,defense 7a7 ,in general ,upon request by the ,national ,academies of ,sciences1 ,engineering1 and ,medicine 7referred to in this section as the ,national ,academies71 the ,secretary of ,defense shall provide to the ,national ,academies information in the possession of the ,department of ,defense that the ,national ,academies determines useful in conducting a review under section #c7;b74 7b7 ,inclusions ,the information described in subsection 7a7 shall include1 at a minimum-- 7#a7 all environmental sampling data relative to any location included in the review2 and 7#b7 a list of all forward deployed positions at which members of the ,armed ,forces were deployed or stationed4 #e4 ,presumption relating to personal injury of certain ,federal employees 7a7 ,in general ,section #hajb of title #e1 ,united ,states ,code1 is amended by adding at the end the following3 7c7 7#a7 ,in this subsection1 the term covered employee means an employee who1 on or after ,january #a1 #aiij1 carried out the job responsibilities of the employee for not fewer than #ae total days in a country or territory listed under subparagraph 7,b7 of paragraph 7#d7 of section #aaai7;a7 of title #ch1 in support of a military operation described in that paragraph4 7#b7 ,disability or death from a disease described in paragraph 7#b7 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 employee1 whether or not the covered employee was engaged in the course of employment when the disability or disability resulting in death occurred4 4 7b7 ,effective date ,the amendment made by subsection 7a7 shall take effect on the date that is #ahj days after the date of enactment of this ,act4