,i #aaf? ,,congress #b;d ,session ,h4 ,r4 #hbfa ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,septemb] #ae1 #bjbj,mr4 ,ruiz introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,vet]ans' ,affairs1 & 9 addition to ! ,committees on ,arm$ ,s]vices1 & ,education & ,labor1 = a p]iod to be subsequ5tly det]m9$ by ! ,speak]1 9 ea* case = consid]ation ( su* provisions z fall )9 ! jurisdiction ( ! committee conc]n$ ,a ,,bill ,to am5d title #ch1 ,unit$ ,/ates ,code1 to provide = a presumption ( s]vice connection = c]ta9 diseases associat$ ) exposure to tox9s1 includ+ emissions f op5 burn pits1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,presumptive ,b5efits = ,w> ,fight]s ,expos$ to ,burn ,pits & ,o!r ,tox9s ,act ( #bjbj4 #b4 ,presumption ( s]vice connection = c]ta9 diseases associat$ ) exposure to op5 burn pits & o!r tox9s 7a7 ,9 g5]al ,sub*apt] ,,ii ( *apt] #aa ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new section3 #aaai4 ,presumption ( s]vice connection = c]ta9 diseases associat$ ) exposure to op5 burn pits & o!r tox9s 7a7 ,presumption ( s]vice connection 7#a7 ,= ! purposes ( section #aaaj ( ?is title1 & subject to section #aaac ( ?is title1 a disease specifi$ 9 p>agraph 7#b7 becom+ manife/ 9 a vet]an describ$ 9 p>agraph 7#c7 %all be consid]$ to h be5 incurr$ 9 or aggravat$ dur+ active milit>y1 naval1 or air s]vice1 not)/&+ t !re is no record ( evid5ce ( su* disease dur+ ! p]iod ( su* s]vice4 7#b7 ,! diseases specifi$ 9 ?is p>agraph are ! foll[+3 7,a7 ,a/hma t 0 diagnos$ aft] s]vice 9 a c\ntry or t]ritory li/$ "u p>agraph 7#d77;,b74 7,b7 ,canc] ( any type4 7,c7 ,*ronic bron*itis4 7,d7 ,*ronic ob/ructive pulmon>y disease4 7,e7 ,con/rictive bron*iolitis or oblit]ative bron*iolitis4 7,f7 ,emphysema4 7,g7 ,granulomat\s disease4 7,h7 ,int]/itial lung disease4 7,i7 ,lymphoma4 7,j7 ,pleuritis4 7,k7 ,pulmon>y fibrosis4 7,l7 ,s>coidosis4 7,m7 ,any o!r disease ) respect to :i* f9al regulations h be5 prescrib$ "u subsection 7c77#c74 7#c7 ,a vet]an describ$ 9 ?is p>agraph is any vet]an :o-- 7,a7 on or aft] ,janu>y #a1 #aiij-- 7i7 s]v$ z a memb] ( ! ,arm$ ,=ces 9 support ( a milit>y op]ation describ$ 9 p>agraph 7#d72 & 7ii7 0 pres5t = #ae or m cumulative days 9 a c\ntry or t]ritory li/$ "u subp>agraph 7,b7 ( t p>agraph2 or 7,b7 0 aw>d$ a campaign m$al 9 recognition ( s]vice 9 any ( ! foll[+-- 7i7 ,op]ation ,endur+ ,fre$om2 7ii7 ,op]ation ,iraqi ,fre$om2 7iii7 ,op]ation ,nomad ,%ad[2 7iv7 ,op]ation ,new ,dawn2 7v7 ,op]ation ,inh]5t ,resolve2 7vi7 ,op]ation ,fre$om's ,s5t9el2 7vii7 ,op]ation ,odyssey ,lightn+2 or 7viii7 ,op]ation ,pacific ,eagle4 7#d7 ,a milit>y op]ation describ$ 9 ?is p>agraph is any ( ! foll[+3 7,a7 ,a cont+5cy op]ation 7z def9$ 9 section #aja7;a77#ac7 ( title #aj74 7,b7 ,a milit>y op]ation 9 any ( ! foll[+ c\ntries or t]ritories3 7i7 ,afghani/an4 7ii7 ,bahra94 7iii7 ,burk9a ,faso4 7iv7 ,cam]oon4 7v7 ,*ad4 7vi7 ,diego ,g>cia4 7vii7 ,djib\ti4 7viii7 ,egypt4 7ix7 ,e?iopia4 7x7 ,gabon4 7xi7 ,ghana4 7xii7 ,iraq4 7xiii7 ,jordan4 7xiv7 ,k5ya4 7xv7 ,kuwait4 7xvi7 ,kyrgyz/an4 7xvii7 ,libya4 7xviii7 ,mali4 7xix7 ,nig]4 7xx7 ,nig]ia4 7xxi7 ,oman4 7xxii7 ,paki/an4 7xxiii7 ,philipp9es4 7xxiv7 ,saudi ,arabia4 7xxv7 ,somalia4 7xxvi7 ,s\? ,sudan4 7xxvii7 ,sudan4 7xxviii7 ,syria4 7xxix7 ,tajiki/an4 7xxx7 ,tunisia4 7xxxi7 ,unit$ ,arab ,emirates4 7xxxii7 ,uzbeki/an4 7xxxiii7 ,yem54 7b7 ,process ,to add diseases ?r\gh writt5 petition 7#a7 ,9 ! case t ! ,secret>y receives a writt5 petition f an int]e/$ p>ty to add a disease to ! li/ ( diseases specifi$ 9 subsection 7a77#b71 n lat] ?an #ij days aft] ! date ( receipt ( su* petition1 ! ,secret>y %all reque/ a det]m9ation by ! ,national ,academies ( ,sci5ces1 ,eng9e]+1 & ,m$ic9e 7ref]r$ to 9 ?is section z ! ,national ,academies7 ) respect to :e!r !re is a positive association betwe5-- 7,a7 ! exposure ( humans to "o or m cov]$ tox9s1 includ+ emissions f op5 burn pits2 & 7,b7 ! occurr5ce ( ! disease 9 humans4 7#b7 ,= purposes ( ?is subsection1 ! t]m int]e/$ p>ty includes a repres5tative (-- 7,a7 a congressionally *>t]$ vet]ans s]vice organization2 7,b7 an organization t-- 7i7 is describ$ 9 section #eja7;c77#c7 ( ! ,int]nal ,rev5ue ,code ( #aihf & exempt f taxation "u section #eja7;a7 ( su* ,code2 7ii7 s]ves vet]ans or memb]s ( ! ,arm$ ,=ces2 & 7iii7 has cont9u\sly op]at$ = a p]iod ( five ye>s or m prec$+ ! date ( ! submittal ( ! writt5 petition "u p>agraph 7#a72 7,c7 a collective b>ga9+ ag5t = civilian employees ( ! ,unit$ ,/ates ,gov]nm5t2 7,d7 a nationally recogniz$ m$ical association2 7,e7 ! ,national ,academies2 or 7,f7 a ,/ate or political subdivision ( a ,/ate4 7c7 ,det]m9ations by ,national ,academies 7#a7 ,if ! ,secret>y receives a det]m9ation describ$ 9 p>agraph 7#b71 n lat] ?an #ahj days aft] receipt ( su* det]m9ation1 ! ,secret>y %all-- 7,a7 publi% 9 ! ,f$]al ,regi/] propos$ regulations to add ! disease cov]$ by ! det]m9ation to ! li/ ( diseases specifi$ 9 subsection 7a77#b72 7,b7 publi% 9 ! ,f$]al ,regi/]1 & submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives-- 7i7 ! decision ( ! ,secret>y n to publi% su* propos$ regulations2 & 7ii7 ! basis = su* decision1 includ+ specific m$ical sci5ce refut+ ! det]m9ation2 or 7,c7 publi% 9 ! ,f$]al ,regi/] a decision t insuffici5t evid5ce exi/s to take action "u subp>agraph 7,a7 or 7,b74 7#b7 ,a det]m9ation describ$ 9 ?is p>agraph-- 7,a7 is a det]m9ation by ! ,national ,academies t !re is a positive association betwe5-- 7i7 ! exposure humans to "o or m cov]$ tox9s1 includ+ emissions f op5 burn pits2 & 7ii7 ! occurr5ce ( ! disease 9 humans2 & 7,b7 may be made pursuant to-- 7i7 a reque/ f ! ,secret>y "u subsection 7b72 or 7ii7 an agreem5t betwe5 ! ,secret>y & ! ,national ,academies "u section #c ( ! ,presumptive ,b5efits = ,w> ,fight]s ,expos$ to ,burn ,pits & ,o!r ,tox9s ,act ( #bjbj4 7#c7 7,a7 ,n lat] ?an #ahj days aft] ! date on :i* ! ,secret>y publi%es any propos$ regulations "u p>agraph 7#a77;,a7 = a disease1 ! ,secret>y %all prescribe f9al regulations = t disease4 7,b7 ,su* regulations %all be effective on ! date ( issuance4 7d7 ,ref]5ce to ,national ,academies ,9 ! case t ! ,secret>y ent]s into an agreem5t ) ano!r organization z describ$ 9 section #c7;h77#a7 ( ! ,presumptive ,b5efits = ,w> ,fight]s ,expos$ to ,burn ,pits & ,o!r ,tox9s ,act ( #bjbj1 any ref]5ce 9 ?is section to ! ,national ,academies %all be treat$ z a ref]5ce to ! o!r organization4 7e7 ,def9itions ,9 ?is section3 7#a7 ,! t]m cov]$ tox9 means any toxic *emical1 includ+-- 7,a7 haz>d\s wa/e1 mix$ wa/e1 solid wa/e1 or us$ oil 7z ^? t]ms are def9$ 9 section #ajjd ( ! ,solid ,wa/e ,disposal ,act 7#db ,u4,s4,c4 #fijc772 7,b7 radiological wa/e2 & 7,c7 any o!r c>c9og54 7#b7 ,! t]m vet]ans s]vice organization means an organization recogniz$ by ! ,secret>y = ! repres5tation ( vet]ans "u section #eijb ( ?is title4 7#c7 ,! t]m op5 burn pit means an area ( l& locat$ t-- 7,a7 is designat$ by ! ,secret>y ( ,def5se to be us$ = dispos+ solid wa/e by burn+ 9 ! outdoor air2 & 7,b7 does n conta9 a comm]cially manufactur$ inc9]ator or o!r equipm5t specifically design$ & manufactur$ = ! burn+ ( solid wa/e4 4 7b7 ,effective date 7#a7 ,9 g5]al ,! am5dm5t made by subsection 7a7 %all take effect on ! date t is #ahj days aft] ! date ( ! enactm5t ( ?is ,act4 7#b7 ,writt5 petitions ,) respect to a writt5 petition describ$ 9 section #aaai7;b77#a7 ( title #ch1 ,unit$ ,/ates ,code1 z add$ by subsection 7a71 t 0 receiv$ by ! ,secret>y ( ,vet]ans ,affairs be=e ! effective date describ$ 9 p>agraph 7#a71 ! ,secret>y %all make a reque/ ( ! ,national ,academies ( ,sci5ces1 ,eng9e]+1 & ,m$ic9e "u su* section1 z s add$1 n lat] ?an #ij days aft] su* effective date4 7c7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( *apt] #aa ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by ins]t+ aft] ! item relat+ to section #aaah ! foll[+ new item3 #aaai4 ,presumption ( s]vice connection = c]ta9 diseases associat$ ) exposure to op5 burn pits & o!r tox9s4 4 7d7 ,con=m+ am5dm5t ,section #aaac ( su* title is am5d$ by /rik+ or #aaah ea* place x appe>s & ins]t+ #aaah1 or #aaai4 #c4 ,agreem5t ) ! ,national ,academies ( ,sci5ces1 ,eng9e]+1 & ,m$ic9e conc]n+ ! exposure ( humans to op5 burn pits & o!r tox9s 7a7 ,agreem5t 7#a7 ,9 g5]al ,! ,secret>y ( ,vet]ans ,affairs %all seek to ent] into an agreem5t ) ! ,national ,academies ( ,sci5ces1 ,eng9e]+1 & ,m$ic9e 7ref]r$ to 9 ?is section z ! ,national ,academies7 to p]=m ! s]vices cov]$ by ?is section4 7#b7 ,tim+ ,! ,secret>y %all seek to ent] into ! agreem5t describ$ 9 p>agraph 7#a7 n lat] ?an #fj days aft] ! date ( ! enactm5t ( ?is ,act4 7b7 ,reviews ( sci5tific evid5ce 7#a7 ,9 g5]al ,"u an agreem5t betwe5 ! ,secret>y & ! ,national ,academies1 ! ,national ,academies %all review & summ>ize ! sci5tific evid5ce1 & assess ! /r5g? !re(1 conc]n+ ! association betwe5 ! exposure ( humans to "o or m cov]$ tox9s1 includ+ emissions f op5 burn pits1 & ea* disease suspect$ to be associat$ ) su* exposure4 7#b7 ,reviews ^u reque/ ,"u an agreem5t betwe5 ! ,secret>y & ! ,national ,academies "u ?is section1 ! ,national ,academies %all conduct a review describ$ 9 p>agraph 7#a7 9 response to ea* reque/ made by ! ,secret>y "u section #aaai7;b77#a7 ( title #ch1 ,unit$ ,/ates ,code1 z add$ by section #b7;a74 7c7 ,sci5tific det]m9ations conc]n+ diseases 7#a7 ,9 g5]al ,= ea* disease review$ "u subsection 7b71 ! ,national ,academies %all det]m9e 7to ! ext5t t available sci5tific data p]mit mean+ful det]m9ations7 :e!r !re is a positive association betwe5 ! exposure ( humans to "o or m cov]$ tox9s1 includ+ emissions f op5 burn pits1 & ! occurr5ce ( ! disease 9 humans1 tak+ into acc\nt ! /r5g? ( ! sci5tific evid5ce & ! appropriat5ess ( ! /ati/ical & epidemiological me?ods us$ to detect ! association4 7#b7 ,submissions = reviews ^u reque/ ,"u an agreem5t betwe5 ! ,secret>y & ! ,national ,academies "u ?is section1 n lat] ?an #bgj days aft] ! date on :i* ! ,secret>y transmits a reque/ to ! ,national ,academies ) respect to a disease "u section #aaai7;b77#a7 ( title #ch1 ,unit$ ,/ates ,code1 z add$ by section #b7;a71 ! ,national ,academies %all submit to ! ,secret>y ! det]m9ation made ) respect to t disease "u p>agraph 7#a74 7d7 ,recomm5dations = additional sci5tific /udies 7#a7 ,9 g5]al ,"u an agreem5t betwe5 ! ,secret>y & ! ,national ,academies "u ?is section1 ! ,national ,academies %all make any recomm5dations x has = additional sci5tific /udies to resolve areas ( cont9u+ sci5tific unc]ta9ty relat+ to ! exposure ( humans to "o or m cov]$ tox9s1 includ+ emissions f op5 burn pits4 7#b7 ,consid]ations ,9 mak+ recomm5dations = additional sci5tific /udies1 ! ,national ,academies %all consid]-- 7,a7 ! sci5tific in=mation t is available at ! "t ( ! recomm5dation2 7,b7 ! value & relevance ( ! in=mation t c\ld result f additional /udies2 & 7,c7 ! feasibility ( c>ry+ out su* additional /udies4 7e7 ,subsequ5t reviews ,"u an agreem5t betwe5 ! ,secret>y & ! ,national ,academies "u ?is section1 ! ,national ,academies %all-- 7#a7 conduct z compreh5sive a review z is practicable ( ! evid5ce ref]r$ to 9 subsection 7b77#a7 t became available s9ce ! la/ review ( su* evid5ce "u ?is section2 & 7#b7 make det]m9ations & e/imates on ! basis ( ! results ( su* review & all o!r reviews conduct$ = ! purposes ( ?is section4 7f7 ,reports 7#a7 ,initial report 7,a7 ,9 g5]al ,"u an agreem5t betwe5 ! ,secret>y & ! ,national ,academies "u ?is section1 n lat] ?an #edj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,national ,academies %all submit to ! ,secret>y & ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! activities ( ! ,national ,academies "u ! agreem5t4 7,b7 ,elem5ts ,! report submitt$ "u subp>agraph 7,a7 %all include ! foll[+3 7i7 ,! det]m9ations describ$ 9 subsection 7c77#a74 7ii7 ,an explanation ( ! sci5tific evid5ce & reason+ t l$ to su* det]m9ations4 7iii7 ,any recomm5dations ( ! ,national ,academies "u subsection 7d74 7#b7 ,p]iodic updates ,"u an agreem5t betwe5 ! ,secret>y & ! ,national ,academies "u ?is section1 n less frequ5tly ?an once e two ye>s1 ! ,national ,academies %all submit to ! ,secret>y & ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives an updat$ report on ! activities ( ! ,national ,academies "u ! agreem5t4 7g7 ,limitation on au?ority ,! au?ority to ent] into agreem5ts "u ?is section %all be effective = a fiscal ye> to ! ext5t t appropriations are available4 7h7 ,alt]native contract sci5tific organization 7#a7 ,9 g5]al ,if ! ,secret>y is unable )9 ! p]iod prescrib$ 9 subsection 7a77#b7 to ent] into an agreem5t ) ! ,national ,academies on t]ms acceptable to ! ,secret>y1 ! ,secret>y %all seek to ent] into su* an agreem5t ) ano!r appropriate sci5tific organization t-- 7,a7 is n "p ( ! ,gov]nm5t2 7,b7 op]ates z a n-=-pr(it entity2 & 7,c7 has exp]tise & objectivity comp>able to t ( ! ,national ,academies4 7#b7 ,treatm5t ,if ! ,secret>y ent]s into an agreem5t ) ano!r organization z describ$ 9 p>agraph 7#a71 any ref]5ce 9 ?is section1 section #d1 & section #aaai ( title #ch1 ,unit$ ,/ates ,code1 z add$ by section #b7;a71 to ! ,national ,academies %all be treat$ z a ref]5ce to ! o!r organization4 7i7 ,def9itions ,9 ?is section1 ! t]ms cov]$ tox9 & op5 burn pit h ! mean+s giv5 su* t]ms 9 section #aaai7;e7 ( title #ch1 ,unit$ ,/ates ,code1 z add$ by section #b7;a74 7j7 ,au?orization ( appropriations ,!re are au?oriz$ to be appropriat$ to ! ,dep>tm5t ( ,vet]ans ,affairs su* sums z may be necess>y to c>ry out ?is section4 #d4 ,access ( ! ,national ,academies ( ,sci5ces1 ,eng9e]+1 & ,m$ic9e to in=mation f ! ,dep>tm5t ( ,def5se 7a7 ,9 g5]al ,^u reque/ by ! ,national ,academies ( ,sci5ces1 ,eng9e]+1 & ,m$ic9e 7ref]r$ to 9 ?is section z ! ,national ,academies71 ! ,secret>y ( ,def5se %all provide to ! ,national ,academies in=mation 9 ! possession ( ! ,dep>tm5t ( ,def5se t ! ,national ,academies det]m9es useful 9 conduct+ a review "u section #c7;b74 7b7 ,inclusions ,! in=mation describ$ 9 subsection 7a7 %all include1 at a m9imum-- 7#a7 all environm5tal sampl+ data relative to any location includ$ 9 ! review2 & 7#b7 a li/ ( all =w>d deploy$ positions at :i* memb]s ( ! ,arm$ ,=ces 7 deploy$ or /ation$4 #e4 ,presumption relat+ to p]sonal injury ( c]ta9 ,f$]al employees 7a7 ,9 g5]al ,section #hajb ( title #e1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+3 7c7 7#a7 ,9 ?is subsection1 ! t]m cov]$ employee means an employee :o1 on or aft] ,janu>y #a1 #aiij1 c>ri$ out ! job responsibilities ( ! employee = n few] ?an #ae total days 9 a c\ntry or t]ritory li/$ "u subp>agraph 7,b7 ( p>agraph 7#d7 ( section #aaai7;a7 ( title #ch1 9 support ( a milit>y op]ation describ$ 9 t p>agraph4 7#b7 ,disability or dea? f a disease describ$ 9 p>agraph 7#b7 ( su* section suff]$ by a cov]$ employee is deem$ to h result$ f p]sonal injury su/a9$ :ile 9 ! p]=mance ( ! duty ( ! cov]$ employee1 :e!r or n ! cov]$ employee 0 engag$ 9 ! c\rse ( employm5t :5 ! disability or disability result+ 9 dea? occurr$4 4 7b7 ,effective date ,! am5dm5t made by subsection 7a7 %all take effect on ! date t is #ahj days aft] ! date ( enactm5t ( ?is ,act4