,i #aag? ,,congress #a/ ,session ,h4 ,r4 #bcfh ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,april #e1 #bjba ,mrs4 ,luria introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,vet]ans' ,affairs ,a ,,bill ,to am5d title #ch1 ,unit$ ,/ates ,code1 to e/abli% a presumption ( s]vice connection = illnesses associat$ ) exposure to c]ta9 airborne haz>ds1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,conc$+ ,our ,vet]ans' ,exposures ,n[ ,& ,necessitat+ ,tra9+ ,act ( #bjba or ! ,,cov5ant ,act ( #bjba4 #b4 ,presumptions ( s]vice connection = illnesses associat$ ) exposure to c]ta9 airborne haz>ds 7a7 ,s5se ( ,congress ,x is ! s5se ( ,congress t-- 7#a7 z 9 pa/ !at]s ( op]ation1 ,s\?we/ ,asia & its support+ !at]s ( op]ation pose num]\s natural & manmade haz>ds t negatively affect ! heal? outcomes ( individuals s]v+ 9 ^! =eign environm5ts2 7#b7 toxic exposures f burn pits1 oil well fires1 & o!r regional airborne haz>ds increase ! pot5tial = imm$iate & long-t]m illnesses to em]ge among memb]s ( ! ,arm$ ,=ces2 & 7#c7 legislation is necess>y-- 7,a7 to confront ! sci5tific *all5ge ( produc+ cle> associations betwe5 9-!at] toxic exposures & ! illnesses confront+ vet]ans :o s]v$ 9 ,s\?we/ ,asia & beyond2 7,b7 to address ! insuffici5t data h9d]+ ! ,secret>y ( ,vet]ans ,affairs1 ! ,secret>y ( ,def5se1 & relevant p>tn]s f rea*+ proactive det]m9ations reg>d+ su* associations2 & 7,c7 to improve evaluations associat$ ) claims = disability comp5sation t relate to toxic exposure4 7b7 ,presumptions ( s]vice connection 7#a7 ,9 g5]al ,sub*apt] ,,ii ( *apt] #aa ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new section3 #aaai4 ,presumptions ( s]vice connection = illnesses associat$ ) exposure to c]ta9 airborne haz>ds 7a7 ,presumptions 7#a7 ,= ! purposes ( section #aaaj ( ?is title1 & subject to section #aaac ( ?is title1 an illness specifi$ 9 subsection 7d7 becom+ manife/ 9 a cov]$ vet]an to a degree ( #aj p]c5t or m %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* illness dur+ a p]iod ( su* s]vice4 7#b7 ,a cov]$ vet]an %all be presum$ to h be5 expos$ to an airborne haz>d specifi$ 9 subsection 7e7 dur+ s]vice ( ! cov]$ vet]an specifi$ 9 subsection 7f77#a7 unless !re is affirmative evid5ce to e/abli% t ! cov]$ vet]an 0 n expos$ to any su* airborne haz>d dur+ su* s]vice4 7b7 ,m$ical exam9ations & op9ions 7#a7 ,if a cov]$ vet]an submits to ! ,secret>y a claim = disability comp5sation = a diagnos$ illness n specifi$ 9 subsection 7d7 t includes an ass]tion t ! illness is relat$ to airborne haz>d exposure 7reg>dless ( :e!r su* ass]tion id5tifies a p>ticul> airborne haz>d specifi$ 9 subsection 7e77 or op5 burn pit exposure1 & ! evid5ce ( record is insuffici5t to e/abli% s]vice connection = ! illness1 ! ,secret>y %all provide to ! cov]$ vet]an a m$ical exam9ation & obta9 a m$ical op9ion "u section #eajc;,a ( ?is title to det]m9e :e!r ! illness is at lea/ z likely z n caus$ by an airborne haz>d specifi$ 9 subsection 7e74 7#b7 ,9 c>ry+ out p>agraph 7#a71 if ! diagnos$ illness = :i* a claim is submitt$ involves a sign or symptom specifi$ 9 section #aaag7;g7 ( ?is title1 ! ,secret>y %all ensure t-- 7,a7 ! m$ical exam9ation provid$ pursuant to su* p>agraph includes an evaluation ( ea* correspond+ body "p or sy/em t relates to ! sign or symptom2 & 7,b7 ! sign or symptom is consid]$ 9 mak+ ! det]m9ation "u su* p>agraph4 7#c7 ,9 provid+ ! ,secret>y ) a m$ical op9ion pursuant to p>agraph 7#a71 a m$ical provid] %all consid]-- 7,a7 ! total pot5tial exposure to airborne haz>ds ?r\gh any s]vice ( ! cov]$ vet]an specifi$ 9 subsection 7f77#a7 & ! syn]gi/ic effect ( comb9$ airborne haz>ds1 includ+ airborne haz>ds t involve exposure ?r\gh inhalation1 d]mal exposure1 or +e/ion2 & 7,b7 ! m$ical evid5ce & sci5tific report+ available at ! "t ( ! det]m9ation "u p>agraph 7#a74 7c7 ,relation%ip to presumptions = illnesses associat$ ) s]vice 9 ,p]sian ,gulf ,a det]m9ation t a presumption ( s]vice connection is n w>rant$ pursuant to ?is section %all n preclude ! ,secret>y f-- 7#a7 det]m9+ t a presumption ( s]vice connection is w>rant$ pursuant to section #aaah ( ?is title2 or 7#b7 pay+ comp5sation to ! vet]an 7or dep5d5cy & indemnity comp5sation to a survivor ( ! vet]an7 pursuant to section #aaag ( ?is title4 7d7 ,illnesses ,! illnesses specifi$ 9 ?is subsection are ! foll[+3 7#a7 ,a/hma t 0 diagnos$ aft] a p]iod ( s]vice specifi$ 9 subsection 7f77#a74 7#b7 7,a7 ,head canc] ( any type4 7,b7 ,neck canc] ( any type4 7,c7 ,respiratory canc] ( any type4 7,d7 ,ga/ro9te/9al canc] ( any type4 7,e7 ,reproductive canc] ( any type4 7,f7 ,lymphoma canc] ( any type4 7,g7 ,lymphomatic canc] ( any type4 7,h7 ,kidney canc]4 7,i7 ,bra9 canc]4 7,j7 ,melanoma4 7#c7 ,*ronic ob/ructive pulmon>y disease4 7#d7 ,*ronic bron*itis4 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 ,pleuritis4 7#aj7 ,pulmon>y fibrosis4 7#aa7 ,s>coidosis4 7#ab7 ,rh9itis4 7#ac7 ,s9usitis4 7e7 ,airborne ,haz>ds ,! airborne haz>ds specifi$ 9 ?is subsection are ! foll[+3 7#a7 ,p>ticulate matt]1 includ+ ! foll[+3 7,a7 ,,pm-#aj4 7,b7 ,,pm-#b4e4 7#b7 ,polycyclic aromatic hydroc>bons 7,p,a,hs71 includ+ ! foll[+3 7,a7 ,ac5aph!ne4 7,b7 ,ac5aph?yl5e4 7,c7 ,an?rac5e4 7,d7 ,b5zo7a7an?rac5e4 7,e7 ,b5zo7a7pyr5e4 7,f7 ,b5zo7b7fluoroan!ne4 7,g7 ,b5zo7g1h1i7p]yl5e4 7,h7 ,b5zo7k7fluoroan!ne4 7,i7 ,*rys5e4 7,j7 ,dib5ze7a1h7an?rac5e4 7,k7 ,fluoran!ne4 7,l7 ,fluor5e4 7,m7 ,ind5o7#a1b1c-;cd7pyr5e4 7,n7 ,naph?al5e4 7,o7 ,ph5an?r5e4 7,p7 ,pyr5e4 7#c7 ,volatile organic comp\nds1 includ+ ! foll[+3 7,a7 ,acetone4 7,b7 ,acrole94 7,c7 ,b5z5e4 7,d7 ,c>bon disulfide4 7,e7 ,*lor(luorome?ane4 7,f7 ,*lorome?ane4 7,g7 ,e?ylb5z5e4 7,h7 ,hexane4 7,i7 ,hexa*lorobutadi5e4 7,j7 ,m_/p-,xyl5e4 7,k7 ,me?yl5e *loride4 7,l7 ,p5tane4 7,m7 ,propyl5e4 7,n7 ,/yr5e4 7,o7 ,tolu5e4 7#d7 ,toxic organic halog5at$ diox9s & furans 7diox9s71 includ+ ! foll[+3 7,a7 #a1b1c1d1f1g1h-;,,hpcdd4 7,b7 #a1b1c1d1f1g1h-;,,hpcdf4 7,c7 #a1b1c1d1g1h1i-;,,hpcdf4 7,d7 #a1b1c1d1g1h-;,,hxcdd4 7,e7 #a1b1c1d1g1h-;,,hxcdf4 7,f7 #a1b1c1f1g1h-;,,hxcdd4 7,g7 #a1b1c1f1g1h-;,,hxcdf4 7,h7 #a1b1c1g1h1i-;,,hxcdd4 7,i7 #a1b1c1g1h1i-;,,hxcdf4 7,j7 #a1b1c1g1h-,,pecdd4 7,k7 #a1b1c1g1h-,,pecdf4 7,l7 #b1c1d1f1g1h-;,,hxcdf4 7,m7 #b1c1d1g1h-,,pecdf4 7,n7 #b1c1g1h-,,tcdd4 7,o7 #b1c1g1h-,,tcdf4 7,p7 ,octa*lorodib5zodiox94 7,q7 ,octa*lorodib5z(uran4 7#e7 ,any o!r airborne haz>d det]m9$ relevant by ! ,secret>y4 7f7 ,def9itions ,9 ?is section3 7#a7 ,! t]m cov]$ vet]an means any vet]an :o-- 7,a7 on or aft] ,augu/ #b1 #aiij1 p]=m$ active milit>y1 naval1 or air s]vice :ile assign$ to a duty /ation 9-- 7i7 ,bahra92 7ii7 ,iraq2 7iii7 ,kuwait2 7iv7 ,oman2 7v7 ,qat>2 7vi7 ,saudi ,arabia2 7vii7 ,somalia2 or 7viii7 ,unit$ ,arab ,emirates2 or 7,b7 on or aft] ,septemb] #aa1 #bjja1 p]=m$ active milit>y1 naval1 or air s]vice :ile assign$ to a duty /ation 9-- 7i7 ,afghani/an2 7ii7 ,djib\ti2 7iii7 ,egypt2 7iv7 ,jordan2 7v7 ,lebanon2 7vi7 ,syria2 7vii7 ,yem52 7viii7 ,uzbeki/an2 7ix7 ! ,philipp9es2 or 7x7 any o!r c\ntry det]m9$ relevant by ! ,secret>y4 7#b7 ,! t]m illness means a disease or o!r condition t affects ! heal? ( an individual on a basis o!r ?an an acute or transi5t basis4 7#c7 ,! t]m op5 burn pit has ! mean+ giv5 su* t]m 9 section #bja7;c7 ( ! ,dignifi$ ,burial & ,o!r ,vet]ans' ,b5efits ,improvem5t ,act ( #bjab 7,public ,law #aab-bfj2 #ch ,u4,s4,c4 #ebg note71 except t ! area ( l& may be locat$ 9 any c\ntry specifi$ 9 p>agraph 7#a7 or det]m9$ relevant by ! ,secret>y pursuant to su* p>agraph4 7g7 ,effective date ( aw>d ,! effective date ( an aw>d "u ?is section %all be det]m9$ 9 accordance ) section #eaaj ( ?is title1 except t su* date may n be e>li] ?an ! date ( ! enactm5t ( ?is ,act4 4 7#b7 ,cl]ical am5dm5t ,! table ( cont5ts at ! beg9n+ ( *apt] #aa ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by ins]t+ aft] ! item relat+ to section #aaah ! foll[+ new item3 #aaai4 ,presumptions ( s]vice connection = illnesses associat$ ) exposure to c]ta9 airborne haz>ds4 4 7#c7 ,implem5tation deadl9e ,! ,secret>y ( ,vet]ans ,affairs %all implem5t ! am5dm5ts made by ?is subsection by n lat] ?an #ah mon?s aft] ! date ( ! enactm5t ( ?is ,act4 7c7 ,relation%ip to presumptions = illnesses associat$ ) s]vice 9 ! ,p]sian ,gulf ,sub*apt] ,,ii ( *apt] #aa ( title #ch1 ,unit$ ,/ates ,code1 is fur!r am5d$-- 7#a7 9 section #aaag1 by add+ at ! end ! foll[+ new subsection3 7i7 ,a d5ial or t]m9ation ( comp5sation paid to a vet]an pursuant to ?is section %all n preclude ! ,secret>y f det]m9+ t a presumption ( s]vice connection is w>rant$ pursuant to section #aaai ( ?is title4 2 & 7#b7 9 section #aaah1 by add+ at ! end ! foll[+ new subsection3 7f7 ,a det]m9ation t a presumption ( s]vice connection is n w>rant$ pursuant to ?is section %all n preclude ! ,secret>y f det]m9+ t a presumption ( s]vice connection is w>rant$ pursuant to section #aaai ( ?is title4 4 7d7 ,p5d+ cases 7#a7 ,au?ority to /ay ,! ,secret>y may /ay a claim describ$ 9 p>agraph 7#b7 until ! date on :i* ! ,secret>y comm5ces ! implem5tation ( section #aaai ( title #ch1 ,unit$ ,/ates ,code 7z add$ by subsection 7b774 7#b7 ,claims describ$ ,a claim describ$ 9 ?is subp>agraph is a claim = disability comp5sation t is p5d+ at ! ,vet]ans ,b5efits ,adm9i/ration1 ! ,bo>d ( ,vet]ans' ,appeals1 ! ,c\rt ( ,appeals = ,vet]ans ,claims1 or ! ,c\rt ( ,appeals = ! ,f$]al ,circuit1 on or aft] ! date ( ! enactm5t ( ?is ,act & be=e ! date on :i* ! ,secret>y comm5ces ! implem5tation ( su* section #aaai & t relates to-- 7,a7 ! s]vice & illnesses cov]$ by su* section #aaai2 or 7,b7 ! s]vice cov]$ by su* section #aaai & a diagnos$ illness ass]t$ 9 ! claim to be relat$ to airborne haz>d exposure1 reg>dless ( :e!r su* ass]tion id5tifies a p>ticul> airborne haz>d1 or op5 burn pit exposure4 7e7 ,/&>d m$ical tra9+ curriculum 7#a7 ,curriculum ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all e/abli% a /&>d m$ical tra9+ curriculum = all m$ical provid]s conduct+ exam9ations & provid+ op9ions "u section #aaai7;b7 ( title #ch1 ,unit$ ,/ates ,code 7z add$ by subsection 7b771 t provides a /&>diz$ approa* to conduct+ & provid+ exam9ations & op9ions 9 accordance ) su* section4 7#b7 ,elem5ts ,! ,secret>y %all include 9 ! curriculum "u p>agraph 7#a7 an in/ruction = ea* m$ical provid] conduct+ an exam9ation or provid+ an op9ion to consid] ! foll[+3 7,a7 ,relevant m$ical & sci5tific lit]ature4 7,b7 ,available in=mation on ! proximity1 int5sity1 & frequ5cy ( exposure ( ! individual to airborne haz>ds4 7,c7 ,m$ically unexpla9$ *ronic multisymptom illnesses4 7,d7 ,all compet5t & cr$ible evid5ce ( record4 7#c7 ,submission to ,congress ,prior to implem5tation ( ! curriculum "u p>agraph 7#a71 ! ,secret>y %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate su* curriculum4 7f7 ,def9itions ,9 ?is section3 7#a7 ,! t]ms illness & op5 burn pit h ! mean+ giv5 su* t]ms 9 section #aaai ( title #ch1 ,unit$ ,/ates ,code 7z add$ by subsection 7b774 7#b7 ,! t]m m$ically unexpla9$ *ronic multisymptom illness has ! mean+ giv5 su* t]m 9 section #aaag7;a77#b77;,b7 ( title #ch1 ,unit$ ,/ates ,code4 #c4 ,eligibility = c>e & s]vices bas$ on pot5tial exposure to c]ta9 airborne haz>ds 7a7 ,eligibility = c>e & s]vices ,section #agaj7;e7 ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7#a7 9 p>agraph 7#a71 by add+ at ! end ! foll[+ new subp>agraph3 7,g7 7i7 ,subject to p>agraph 7#b71 a cov]$ vet]an is eligible = hospital c>e1 m$ical s]vices1 & nurs+ home c>e "u subsection 7a77#b77;,f7 = any diagnos$ illness1 not)/&+ t !re is insuffici5t m$ical evid5ce to conclude t su* illness is attributable to ! s]vice specifi$ 9 section #aaai7;f77#a7 ( ?is title4 7ii7 ,9 ?is subp>agraph1 ! t]m cov]$ vet]an has ! mean+ giv5 su* t]m 9 section #aaai ( ?is title4 2 & 7#b7 9 p>agraph 7#b77;,b71 by /rik+ or 7,f7 & ins]t+ 7,f71 or 7,g74 7b7 ,res\rce assessm5t & report 7#a7 ,initial assessm5t & report ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all-- 7,a7 complete an assessm5t to det]m9e-- 7i7 ! p]sonnel & mat]ial res\rces necess>y to implem5t ! am5dm5ts made by subsection 7a72 & 7ii7 ! total numb] ( cov]$ vet]ans1 z su* t]m is def9$ 9 section #aaai ( title #ch1 ,unit$ ,/ates ,code 7z add$ by section #b7;b771 :o receive hospital c>e or m$ical s]vices furni%$ by ! ,secret>y "u *apt] #ag ( su* title1 disaggregat$ by priority gr\p specifi$ 9 section #agje7;a7 ( su* title2 & 7,b7 submit to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate an initial report conta9+ ! f9d+s ( ! assessm5t complet$ "u subp>agraph 7,a71 includ+ a specific det]m9ation z to :e!r ! ,dep>tm5t has ! p]sonnel & mat]ial res\rces necess>y to implem5t ! am5dm5ts made by subsection 7a74 7#b7 ,subsequ5t reports ,if ! initial report submitt$ "u p>agraph 7#a77;,b7 conta9s a det]m9ation t ! ,dep>tm5t does n h ! p]sonnel or mat]ial res\rces necess>y to implem5t ! am5dm5ts made by subsection 7a71 beg9n+ n lat] ?an #ij days aft] ! submission ( su* initial report & e #ij days !reaft] until ! effective date specifi$ 9 subsection 7c71 ! ,secret>y %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate a subsequ5t report conta9+ an update to su* det]m9ation4 7c7 ,effective date ,! am5dm5ts made by subsection 7a7 %all take effect on ! date t is ! e>li] ( ! foll[+3 7#a7 ,! date on :i* ! ,secret>y submits a report "u subsection 7b7 conta9+ a det]m9ation t ! ,dep>tm5t has ! p]sonnel & mat]ial res\rces necess>y to implem5t su* am5dm5ts4 7#b7 ,! date t is #ah mon?s aft] ! date ( ! enactm5t ( ?is ,act4