,,ib ,union ,calendar ,no4 #agi #aagth ,,congress #b;d ,session ,h4 ,r4 #cifg ,report ,no4 #aag-bdi1 ,part ,i ,,in ,,the ,,house ,,of ,,representatives ,june #ag1 #bjba,mr4 ,takano 7for himself1 ,mrs4 ,luria1 ,mr4 ,ruiz1 ,ms4 ,slotkin1 ,mr4 ,trone1 ,ms4 ,brownley1 ,mr4 ,levin of ,california1 ,mr4 ,pappas1 ,mr4 ,lamb1 ,mr4 ,brown of ,maryland1 ,mr4 ,gallego1 ,ms4 ,underwood1 ,mr4 ,sablan1 ,mr4 ,mrvan1 ,mr4 ,allred1 ,ms4 ,kaptur1 ,ms4 ,lois ,frankel of ,florida1 ,mr4 ,ryan1 ,mr4 ,mc,govern1 ,mr4 ,harder of ,california1 ,mr4 ,fitzpatrick1 ,mr4 ,kilmer1 ,mr4 ,soto1 ,ms4 ,meng1 ,ms4 ,strickland1 and ,ms4 ,spanberger7 introduced the following bill2 which was referred to the ,committee on ,veterans' ,affairs1 and in addition to the ,committee on ,armed ,services1 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 ,february #bb1 #bjbb;,additional sponsors3 ,mrs4 ,kirkpatrick1 ,ms4 ,norton1 ,mr4 ,malinowski1 ,ms4 ,newman1 ,ms4 ,sherrill1 ,mr4 ,khanna1 ,mr4 ,rush1 ,mr4 ,aguilar1 ,mrs4 ,hayes1 ,mrs4 ,trahan1 ,ms4 ,omar1 ,mr4 ,levin of ,michigan1 ,mr4 ,o',halleran1 ,mr4 ,kind1 ,mr4 ,carson1 ,mr4 ,san ,nicolas1 ,mr4 ,perlmutter1 ,mr4 ,neguse1 ,ms4 ,lofgren1 ,mrs4 ,dingell1 ,ms4 ,davids of ,kansas1 ,mr4 ,cohen1 ,mrs4 ,axne1 ,mr4 ,grijalva1 ,mr4 ,grothman1 ,mr4 ,cooper1 ,mr4 ,moulton1 ,mr4 ,pocan1 ,mr4 ,swalwell1 ,mr4 ,tonko1 ,ms4 ,blunt ,rochester1 ,ms4 ,bonamici1 ,ms4 ,porter1 ,mr4 ,krishnamoorthi1 ,mr4 ,blumenauer1 ,mrs4 ,bustos1 ,ms4 ,de,gette1 ,mr4 ,jones1 ,mr4 ,courtney1 ,ms4 ,pingree1 ,ms4 ,bourdeaux1 ,ms4 ,manning1 ,mr4 ,welch1 ,ms4 ,leger ,fernandez1 ,mr4 ,langevin1 ,mr4 ,keating1 ,mr4 ,bishop of ,georgia1 ,mr4 ,lieu1 ,mr4 ,cline1 ,mr4 ,larsen of ,washington1 ,ms4 ,kelly of ,illinois1 ,mr4 ,lynch1 ,mrs4 ,torres of ,california1 ,ms4 ,williams of ,georgia1 ,ms4 ,houlahan1 ,ms4 ,sewell1 ,mr4 ,casten1 ,mr4 ,cicilline1 ,mr4 ,schiff1 ,mr4 ,cartwright1 ,mr4 ,espaillat1 ,mr4 ,horsford1 ,mr4 ,de,fazio1 ,mr4 ,schrader1 ,mr4 ,carbajal1 ,ms4 ,castor of ,florida1 ,ms4 ,jacobs of ,california1 ,mr4 ,castro of ,texas1 ,mr4 ,raskin1 ,mrs4 ,cherfilus-,mc,cormick1 ,ms4 ,scanlon1 ,mr4 ,stanton1 ,mr4 ,costa1 ,mr4 ,gottheimer1 and ,ms4 ,bass ,february #bb1 #bjbb,reported from the ,committee on ,veterans' ,affairs ,february #bb1 #bjbb;,committee on ,armed ,services discharged2 committed to the ,committee of the ,whole ,house on the ,state of the ,union and ordered to be printed ,a ,,bill ,to improve health care and benefits for veterans exposed to toxic substances1 and for other purposes4 #a4 ,short title2 references to title #ch1 ,united ,states ,code2 table of contents 7a7 ,short title ,this ,act may be cited as the ,honoring our ,promise to ,address ,comprehensive ,toxics ,act of #bjba or the ,honoring our ,,pact ,act of #bjba4 7b7 ,references to title #ch1 ,united ,states ,code ,except as otherwise expressly provided1 whenever in this title an amendment or repeal is expressed in terms of an amendment to1 or repeal of1 a section or other provision1 the reference shall be considered to be made to a section or other provision of title #ch1 ,united ,states ,code4 7c7 ,table of contents ,the table of contents for this ,act is as follows3 ,sec4 #a4 ,short title2 references to title #ch1 ,united ,states ,code2 table of contents4,title ,i--,expansion of health care eligibility for toxic exposed veterans,sec4 #aja4 ,short title4,sec4 #ajb4 ,definitions relating to toxic exposed veterans4,sec4 #ajc4 ,expansion of health care for specific categories of toxic exposed veterans4,title ,,ii--,toxic exposure presumption process,sec4 #bja4 ,short title4,sec4 #bjb4 ,improvements to ability of ,department of ,veterans ,affairs to establish presumptions of service connection based on toxic exposure4,sec4 #bjc4 ,reevaluation of claims for compensation involving presumptions of service connection4,title ,,iii--,improving the establishment of service connection process for toxic exposed veterans,sec4 #cja4 ,short title4,sec4 #cjb4 ,presumptions of toxic exposure4,sec4 #cjc4 ,medical nexus examinations for toxic exposure risk activities4,title ,,iv--,presumptions of service connection,sec4 #dja4 ,treatment of veterans who participated in cleanup of ,enewetak ,atoll as radiation-exposed veterans for purposes of presumption of service connection of certain disabilities by ,department of ,veterans ,affairs4,sec4 #djb4 ,treatment of veterans who participated in nuclear response near ,palomares1 ,spain1 as radiation-exposed veterans for purposes of presumption of service connection of certain disabilities by ,department of ,veterans ,affairs4,sec4 #djc4 ,presumptions of service connection for diseases associated with exposures to certain herbicide agents for veterans who served in certain locations4,sec4 #djd4 ,addition of additional diseases associated with exposure to certain herbicide agents for which there is a presumption of service connection for veterans who served in certain locations4,sec4 #dje4 ,improving compensation for disabilities occurring in ,persian ,gulf ,war veterans4,sec4 #djf4 ,presumption of service connection for certain diseases associated with exposure to burn pits and other toxins4,title ,v--,research matters,sec4 #eja4 ,coordination by ,department of ,veterans ,affairs of toxic exposure research4,sec4 #ejb4 ,data collection1 analysis1 and report on treatment of veterans for illnesses related to toxic exposure4,sec4 #ejc4 ,studies related to veterans who served in ,southwest ,asia and certain other locations4,sec4 #ejd4 ,study on health trends of post #i_/aa veterans4,sec4 #eje4 ,study on cancer rates among veterans4,sec4 #ejf4 ,study on feasibility and advisability of furnishing hospital care and medical services to dependents of veterans who participated in toxic exposure risk activities4,title ,,vi--,improvement of resources and training regarding toxic exposed veterans,sec4 #fja4 ,short title2 definitions4,sec4 #fjb4 ,publication of list of resources of ,department of ,veterans ,affairs for toxic exposed veterans and outreach program for such veterans and caregivers and survivors of such veterans4,sec4 #fjc4 ,incorporation of toxic exposure questionnaire during primary care appointments4,sec4 #fjd4 ,training for personnel of the ,department of ,veterans ,affairs with respect to toxic exposed veterans4,title ,,vii--,registries1 records1 and other matters,sec4 #gja4 ,registry of individuals exposed to per- and polyfluoroalkyl substances on military installations4,sec4 #gjb4 ,fort ,mc,clellan ,health ,registry4,sec4 #gjc4 ,independent study on ,individual ,longitudinal ,exposure ,record4,sec4 #gjd4 ,biannual report on ,individual ,longitudinal ,exposure ,record4,sec4 #gje4 ,correction of exposure records by members of the ,armed ,forces and veterans4 ,i ,expansion of health care eligibility for toxic exposed veterans #aja4 ,short title ,this title may be cited as the ,conceding ,our ,veterans' ,exposures ,now ,and ,necessitating ,training ,act or the ,,covenant ,act4 #ajb4 ,definitions relating to toxic exposed veterans 7a7 ,in general ,section #agaj7;a77#b77;,f7 is amended by striking who was exposed to a toxic substance1 radiation1 or other conditions1 as provided in subsection 7e7 and inserting in accordance with subsection 7e71 who is a toxic exposed veteran4 7b7 ,definitions of toxic exposure and toxic exposed veteran ,section #aja is amended by adding at the end the following new paragraphs3 7#cg7 ,the term toxic exposure includes the following3 7,a7 ,a toxic exposure risk activity1 as defined in section #agaj7;e77#d7 of this title4 7,b7 ,an exposure to a substance1 chemical1 or airborne hazard specified in section #aaai7;b77#b74 7#ch7 ,the term toxic exposed veteran means a veteran described in section #agaj7;e77#a7 of this title4 4 7c7 ,definition of toxic exposure risk activity ,section #agaj7;e77#d7 is amended by adding at the end the following new subparagraph3 7,c7 ,the term toxic exposure risk activity means any activity-- 7i7 that requires a corresponding entry in the ,individual ,longitudinal ,exposure ,record of the ,department for the veteran who carried out the activity2 or 7ii7 that the ,secretary determines qualifies for purposes of this subsection when taking into account what is reasonably prudent to protect the health of veterans4 4 #ajc4 ,expansion of health care for specific categories of toxic exposed veterans 7a7 ,in general ,section #agaj7;e71 as amended by section #ajb7;c71 is further amended-- 7#a7 in paragraph 7#a71 by adding at the end the following new subparagraphs3 7,g7 ,subject to paragraph 7#b71 a veteran who participated in a toxic exposure risk activity while serving on active duty1 active duty for training1 or inactive duty training is eligible for hospital care1 medical services1 and nursing home care under subsection 7a77#b77;,f7 for any illness4 7,h7 ,subject to paragraph 7#b71 a covered veteran 7as defined in section #aaai7;c7 of this title7 is eligible for hospital care1 medical services1 and nursing home care under subsection 7a77#b77;,f7 for any illness4 2 and 7#b7 in paragraph 7#b77;,b7-- 7,a7 by striking or 7,f7 and inserting 7,f71 7,g71 or 7,h72 and 7,b7 by striking service or testing and inserting service1 testing1 or activity4 7b7 ,resource assessment and report 7#a7 ,initial assessment and report ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall-- 7,a7 complete an assessment to determine-- 7i7 the personnel and material resources necessary to implement the amendments made by subsection 7a72 and 7ii7 the total number of covered veterans1 as such term is defined in section #aaai7;c7 of title #ch1 ,united ,states ,code 7as added by section #cja71 who receive hospital care or medical services furnished by the ,secretary under chapter #ag of such title1 disaggregated by priority group specified in section #agje7;a7 of such title2 and 7,b7 submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate an initial report containing the findings of the assessment completed under subparagraph 7,a71 including a specific determination as to whether the ,department has the personnel and material resources necessary to implement the amendments made by subsection 7a74 7#b7 ,subsequent reports ,if the initial report submitted under paragraph 7#a77;,b7 contains a determination that the ,department does not have the personnel or material resources necessary to implement the amendments made by subsection 7a71 beginning not later than #ij days after the submission of such initial report and every #ij days thereafter until the effective date specified in subsection 7c71 the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate a subsequent report containing an update to such determination4 7c7 ,effective date ,the amendments made by subsection 7a7 shall take effect on the date that is the earlier of the following3 7#a7 ,the date on which the ,secretary submits a report under subsection 7b7 containing a determination that the ,department has the personnel and material resources necessary to implement such amendments1 and notifies the ,law ,revision ,counsel of the ,house of ,representatives of the submission of the report so the ,law ,revision ,counsel may execute the amendments4 7#b7 ,the date that is #ah months after the date of the enactment of this ,act4 ,,ii ,toxic exposure presumption process #bja4 ,short title ,this title may be cited as the ,fairly ,assessing ,service-related ,toxic ,exposure ,residuals ,presumptions ,act or the ,,faster ,presumptions ,act4 #bjb4 ,improvements to ability of ,department of ,veterans ,affairs to establish presumptions of service connection based on toxic exposure 7a7 ,advisory committees1 panels1 and boards 7#a7 ,establishment ,chapter #aa is amended by adding at the end the following new subchapter3 ,,vii ,research and determinations relating to presumptions of service connection based on toxic exposure #aaga4 ,procedures to determine presumptions of service connection based on toxic exposure2 definitions 7a7 ,procedures ,the ,secretary shall determine whether to establish1 or to remove1 presumptions of service connection based on toxic exposure pursuant to this subchapter1 whereby-- 7#a7 the ,formal ,advisory ,committee on ,toxic ,exposure under section #aagb of this title-- 7,a7 provides advice to the ,secretary on toxic exposed veterans and cases in which veterans who1 during active military1 naval1 or air service1 may have experienced a toxic exposure or their dependents may have experienced a toxic exposure while the veterans were serving in the active military1 naval1 or air service2 7,b7 provides to the ,secretary recommendations on corrections needed in the ,individual ,longitudinal ,exposure ,record to better reflect veterans and dependents described in subparagraph 7,a72 and 7,c7 provides to the ,secretary recommendations regarding which cases of possible toxic exposure described in subparagraph 7,a7 the ,science ,review ,board should review2 7#b7 the ,science ,review ,board under section #aagc of this title-- 7,a7 reviews cases of possible toxic exposure nominated by the ,secretary2 7,b7 reviews research nominated by the ,secretary2 7,c7 develops recommendations for new research2 and 7,d7 determines the strength of evidence supporting positive association between toxic exposure and an illness2 7#c7 the ,working ,group under section #aagd of this title evaluates the conclusions of the ,science ,review ,board and recommends to the ,secretary whether to establish or modify a presumption of service connection2 and 7#d7 the ,secretary prescribes regulations under section #aage of this title4 7b7 ,illness defined ,in this subchapter1 the term illness includes a disease or other condition affecting the health of an individual4 7c7 ,nonapplication of sunset requirements ,section #ad of the ,federal ,advisory ,committee ,act 7#e ,u4,s4,c4 ,app47 shall not apply to an entity established under this subchapter4 #aagb4 ,formal ,advisory ,committee on ,toxic ,exposure 7a7 ,establishment 7#a7 ,there is in the ,veterans ,health ,administration of the ,department the ,formal ,advisory ,committee on ,toxic ,exposure 7in this section referred to as the ,committee74 7#b7 7,a7 ,the ,committee shall be composed of nine members appointed as follows3 7i7 ,five members shall be appointed by the ,secretary4 7ii7 ,one member shall be appointed by the ,speaker of the ,house of ,representatives4 7iii7 ,one member shall be appointed by the minority leader of the ,house of ,representatives4 7iv7 ,one member shall be appointed by the majority leader of the ,senate4 7v7 ,one member shall be appointed by the minority leader of the ,senate4 7,b7 ,the members appointed under subparagraph 7,a7 shall meet the following criteria3 7i7 ,not more than three members shall be appointed from among individuals who are officials or employees of the ,veterans ,benefits ,administration or the ,veterans ,health ,administration4 7ii7 ,at least one member shall be appointed from among individuals who are officials or employees of other departments or agencies of the ,federal ,government1 including the ,department of ,defense and the ,agency of ,toxic ,substances and ,disease ,registry of the ,centers for ,disease ,control and ,prevention4 7iii7 ,at least one member shall be appointed from among individuals who are representatives of disabled veterans4 7iv7 ,at least one member shall be appointed from among individuals in the private sector1 ,state or local government1 or academia1 who are experts in toxicology and epidemiology4 7#c7 ,the ,secretary shall determine the pay and allowances of the members of the ,committee1 including with respect to any additional pay and allowances for members who are officials or employees of the ,federal ,government4 7#d7 ,each member of the ,committee shall be appointed for a two-year term1 and may serve not more than three successive terms4 7#e7 ,a vacancy in the ,committee shall be filled in the manner in which the original appointment was made4 7b7 ,consultation ,the ,secretary may consult with1 and seek the advice of1 the ,committee with respect to cases in which veterans who1 during active military1 naval1 or air service1 are suspected of having experienced a toxic exposure or dependents of veterans who may have experienced a toxic exposure during such service4 7c7 ,assessments 7#a7 ,the ,committee shall assess cases of the toxic exposure of veterans and their dependents that occurred during active military1 naval1 or air service4 7#b7 ,the assessments under paragraph 7#a7 shall cover suspected and known toxic exposures occurring during active military1 naval1 or air service1 including by identifying and evaluating new and emerging toxic exposures that are not recognized under existing presumptions of service connection4 7#c7 ,the ,committee may conduct an assessment under paragraph 7#a7 in response to a person described in subsection 7e77#b71 by a majority vote of the members of the ,committee4 7#d7 ,the ,committee shall on a periodic basis assess the ,individual ,longitudinal ,exposure ,record to ensure the accuracy of data collected4 7d7 ,research recommendations 7#a7 ,following an assessment of a case of the toxic exposure of veterans or their dependents that occurred during active military1 naval1 or air service under subsection 7c71 the ,committee may develop a recommendation for the ,secretary regarding whether there should be a review of the health effects related to the case of exposure conducted by the ,science ,review ,board established under section #aagc of this title4 7#b7 ,upon receipt of evidence suggesting that previous findings regarding the periods and locations of exposure covered by an existing presumption of service connection are no longer supported1 the ,committee may nominate such evidence for evaluation by the ,working ,group to modify the periods and locations4 7e7 ,input 7#a7 ,not less than quarterly1 the ,committee shall provide an opportunity for persons described in paragraph 7#b7 to present written or oral comments to the ,committee4 7#b7 ,the persons described in this paragraph are persons who may be affected by the actions of the ,committee1 including-- 7,a7 veterans1 the families of veterans1 veterans service organizations and representatives1 researchers1 and other members of the general public2 and 7,b7 departments and agencies of the ,federal ,government4 7f7 ,reports by the ,committee ,not less frequently than once each year1 the ,committee shall submit to the ,secretary and the ,committees on ,veterans' ,affairs of the ,senate and the ,house of ,representatives1 and make publicly available1 a report on-- 7#a7 recommendations for research under subsection 7d71 if any2 and 7#b7 recommendations for such legislative or administrative action as the ,committee considers necessary for the ,committee to be more effective in carrying out the requirements of this section4 7g7 ,responses by ,secretary ,in response to each report submitted under subsection 7f71 the ,secretary shall submit to the ,secretary and the ,committees on ,veterans' ,affairs of the ,senate and the ,house of ,representatives1 and make publicly available1 a report on-- 7#a7 the findings and opinions of the ,secretary with respect to the report most recently submitted under subsection 7f72 and 7#b7 whether the ,secretary intends to nominate to the ,science ,review ,board the review recommended by the ,committee in the report1 and if not1 an explanation of why1 including citations and sources4 #aagc4 ,science ,review ,board 7a7 ,establishment 7#a7 ,there is in the ,veterans ,health ,administration of the ,department the ,science ,review ,board 7in this section referred to as the ,board74 7#b7 7,a7 ,the members of the ,board shall be appointed by the ,secretary1 in consultation with the ,national ,academies of ,sciences1 ,engineering1 and ,medicine1 from the general public from among individuals who are distinguished in the fields of medicine1 biological sciences1 or health administration4 7,b7 ,an individual may not concurrently serve on the ,board and the ,formal ,advisory ,committee on ,toxic ,exposure under section #aagb of this title4 7,c7 ,the ,secretary shall determine the number1 terms of service1 and pay and allowances of members of the ,board appointed by the ,secretary4 7b7 ,duties 7#a7 ,upon receiving a nomination for the evaluation of research on the health effects of toxic exposures of members of the active military1 naval1 or air service or dependents of such members made by the ,secretary1 the ,board shall-- 7,a7 evaluate the likelihood that a positive association exists between an illness and a toxic exposure while serving in the active military1 naval1 or air service2 and 7,b7 assess the toxic exposures and illnesses identified by the ,secretary and determine whether the evidence supports a finding of a positive association between the toxic exposure and the illness4 7#b7 ,in carrying out paragraph 7#a77;,b71 the ,board shall review all relevant data to determine the strength of evidence for a positive association based on the following four categories3 7,a7 ,the sufficient category1 where the evidence is sufficient to conclude that a positive association exists4 7,b7 ,the equipoise and above category1 where the evidence is sufficient to conclude that a positive association is at least as likely as not1 but not sufficient to conclude that a positive association exists4 7,c7 ,the below equipoise category1 where the evidence is not sufficient to conclude that a positive association is at least as likely as not1 or is not sufficient to make a scientifically informed judgment4 7,d7 ,the against category1 where the evidence suggests the lack of a positive association4 7#c7 7,a7 ,with respect to an evaluation conducted under this subsection1 if the ,board determines that the evidence for a positive association is categorized as either the sufficient or equipoise and above categories1 the ,board shall estimate the size of the positive association effect among those exposed by calculating the relative risk and exposure prevalence4 7,b7 7i7 ,the ,board shall use the relative risk and exposure prevalence calculated under subparagraph 7,a7 to estimate the service-attributable fraction of illness in a military setting to determine the probability of positive association for an individual4 7ii7 ,in calculating the service-attributable fraction of illness1 the ,board shall consider the dose-response relationships4 7#d7 7,a7 ,with respect to an evaluation conducted under this subsection1 if the ,board determines that the evidence for a positive association is categorized as the below equipoise category1 the ,board shall develop a recommendation as to whether additional data gathering and research are necessary4 7,b7 ,if the ,board recommends additional data gathering and research pursuant to subparagraph 7,a71 the ,secretary shall seek to enter into an agreement with the ,national ,academies of ,sciences1 ,engineering1 and ,medicine1 or another nonprofit1 nongovernmental entity that the ,secretary determines has similar expertise and objectivity as the ,national ,academies1 to conduct such data gathering and research4 7c7 ,reports 7#a7 ,for each evaluation conducted under subsection 7b7 where the ,board determines that the evidence for positive association is categorized as either the sufficient or equipoise and above categories1 the ,board shall submit to the ,secretary a report identifying the evidence found to reach such positive association determinations4 7#b7 ,in addition to submitting reports under paragraph 7#a71 the ,board shall submit to the ,secretary reports1 at such times and at such frequencies as the ,board considers appropriate1 containing such recommendations as the ,board may have for additional or new research on matters relating to toxic exposures described in subsection 7b77#a74 7d7 ,responses from the ,secretary 7#a7 ,in response to each report received by the ,secretary under subsection 7c77#a71 the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,senate and the ,house of ,representatives1 and make publicly available1 a report on the findings and opinions of the ,secretary with respect to the report received under such subsection4 7#b7 ,each report submitted under paragraph 7#a7 of this subsection shall include1 with respect to a report received under subsection 7c77#a71 the following3 7,a7 ,the findings and opinions of the ,secretary with respect to the report received under subsection 7c77#a74 7,b7 ,whether the ,secretary intends to nominate to the ,working ,group1 established under section #aagd7;a7 of this title1 the work of the ,science ,review ,board covered by the report received under subsection 7c77#a7 for further action1 and if not1 an explanation of why1 including citations and sources4 #aagd4 ,working group on presumptions of service connection 7a7 ,establishment ,the ,secretary shall establish a working group 7in this section referred to as the ,working ,group7 to-- 7#a7 evaluate-- 7,a7 the conclusions of the ,science ,review ,board contained in each report submitted under section #aagc7;c77#a7 of this title2 and 7,b7 evidence nominated by the ,formal ,advisory ,committee on ,toxic ,exposure under section #aagb7;d77#b7 regarding the periods and locations of exposure covered by an existing presumption of service connection2 and 7#b7 develop and submit to the ,secretary a recommendation with respect to whether-- 7,a7 to establish a presumption of service connection for the toxic exposure and illness covered by the report described in subparagraph 7,a7 of paragraph 7#a72 or 7,b7 to modify an existing presumption of service connection described in subparagraph 7,b7 of such paragraph4 7b7 ,recommendations 7#a7 ,in making a recommendation under subsection 7a77#b71 the ,working ,group shall-- 7,a7 in cases where the evidence for a positive association is categorized as either the sufficient or equipoise and above categories1 as described in subparagraph 7,a7 or 7,b7 of section #aagc7;b77#b7 of this title1 weigh such evidence heavily in favor of establishing a presumption of service connection2 7,b7 take into consideration such factors as may be determined appropriate by the ,secretary2 and 7,c7 if the ,working ,group determines that additional research1 studies1 or reports are appropriate before making a final recommendation with respect to establishing or modifying a presumption of service connection1 submit to the ,secretary a description of such appropriate additional research1 studies1 or reports4 7#b7 ,at the same time as when the ,working ,group submits to the ,secretary a recommendation under paragraph 7#b7 of subsection 7a7 with respect to an evaluation under paragraph 7#a7 of such subsection1 the ,working ,group shall submit to the ,committees on ,veterans' ,affairs of the ,senate and the ,house of ,representatives a description of such recommendation4 7c7 ,report ,the ,secretary shall periodically publish on the internet website of the ,department a report identifying any factors for the ,working ,group to consider under subsection 7b77#a77;,b71 as determined appropriate by the ,secretary4 #aage4 ,regulations regarding presumptions of service connection based on toxic exposure 7a7 ,action upon ,working ,group recommendation ,not later than #fj days after the date on which the ,secretary receives a recommendation to establish or modify a presumption of service connection under section #aagd7;a77#b7 of this title-- 7#a7 if the ,secretary determines that the presumption1 or modification1 is warranted1 the ,secretary shall issue proposed regulations setting forth the presumption or revise regulations to carry out such modification2 or 7#b7 if the ,secretary determines that the presumption1 or modification1 is not warranted1 the ,secretary shall publish in the ,federal ,register a notice of the determination1 including the reasons supporting the determination4 7b7 ,final regulation ,not later than #ahj days after the date on which the ,secretary issues any proposed regulations under subsection 7a77#a71 the ,secretary shall issue final regulations4 ,such regulations shall be effective on the date of issuance4 7c7 ,removal of presumption 7#a7 ,the ,secretary may issue regulations to remove an illness from a presumption of service connection previously established pursuant to a regulation issued under subsection 7b74 7#b7 ,whenever an illness is removed from regulations pursuant to paragraph 7#a71 or the periods and locations of exposure covered by a presumption of service connection are modified under subsection 7a7-- 7,a7 a veteran who was awarded compensation for such illness on the basis of the presumption provided under such regulations before the effective date of the removal or modification shall continue to be entitled to receive compensation on that basis2 and 7,b7 a survivor of a veteran who was awarded dependency and indemnity compensation for the death of a veteran resulting from such illness on the basis of such presumption shall continue to be entitled to receive dependency and indemnity compensation on such basis4 4 7#b7 ,clerical amendment ,the table of sections at the beginning of such chapter is amended by inserting after the item relating to section #aafe the following new items3 ,subchapter ,,vii--,research and determinations relating to presumptions of service connection based on toxic exposure #aaga4 ,procedures to determine presumptions of service connection based on toxic exposure2 definitions4 #aagb4 ,formal ,advisory ,committee on ,toxic ,exposure4 #aagc4 ,science ,review ,board4 #aagd4 ,working group on presumptions of service connection4 #aage4 ,regulations regarding presumptions of service connection based on toxic exposure4 4 7b7 ,conforming amendments ,chapter #aa is amended-- 7#a7 in section #aaaf-- 7,a7 by striking subsections 7b71 7c71 7d71 and 7e72 7,b7 by inserting after subsection 7a7 the following new subsection 7b73 7b7 ,the ,secretary shall ensure that any determination made on or after the date of the enactment of the ,honoring our ,promise to ,address ,comprehensive ,toxics ,act of #bjba regarding a presumption of service connection based on exposure to an herbicide agent under this section is made pursuant to subchapter ,,vii of this chapter1 including with respect to assessing reports received by the ,secretary from the ,national ,academy of ,sciences under section #c of the ,agent ,orange ,act of #aiia 7,public ,law #ajb-d74 2 and 7,c7 by redesignating subsection 7f7 as subsection 7c72 7#b7 in section #aaaf;,b7b77#b77;,a71 by inserting pursuant to subchapter ,,vii of this chapter1 before the ,secretary determines2 and 7#c7 in section #aaah-- 7,a7 by striking subsections 7b7 through 7e72 and 7,b7 by inserting after subsection 7a7 the following new subsection 7b73 7b7 ,the ,secretary shall ensure that any determination made on or after the date of the enactment of the ,honoring our ,promise to ,address ,comprehensive ,toxics ,act of #bjba regarding a presumption of service connection based on a toxic exposure under this section is made pursuant to subchapter ,,vii of this chapter4 4 #bjc4 ,reevaluation of claims for compensation involving presumptions of service connection 7a7 ,in general ,subchapter ,,vi of chapter #aa is amended by adding at the end the following new section3 #aafg4 ,reevaluation of compensation determinations pursuant to changes in presumptions of service connection 7a7 ,reevaluation ,except as provided in subsection 7b71 whenever a law1 including through a regulation or ,federal court decision1 establishes or modifies a presumption of service connection1 the ,secretary shall-- 7#a7 identify all claims for compensation under this chapter that-- 7,a7 were submitted to the ,secretary2 7,b7 were evaluated and denied by the ,secretary before the date on which such provision of law went into effect2 and 7,c7 might have been evaluated differently had the establishment or modification been applicable to the claim2 7#b7 allow for the reevaluation of such claims at the election of the veteran2 and 7#c7 with respect to claims approved pursuant to such reevaluation1 provide compensation under this chapter effective as if the establishment or modification of the presumption of service connection had been in effect on the date of the submission of the original claim described in paragraph 7#a74 7b7 ,outreach ,with respect to each claim identified under subsection 7a71 the ,secretary shall conduct outreach to inform relevant veterans that they may elect to have a claim be reevaluated in light of the establishment or modification of a presumption of service connection described in such subsection4 ,such outreach shall include the following3 7#a7 ,the ,secretary shall publish on the internet website of the ,department a notice that such veterans may elect to have a claim so reevaluated4 7#b7 ,the ,secretary shall notify1 in writing or by electronic means1 veterans service organizations of the ability of such veterans to elect to have a claim so reevaluated4 7c7 ,relation to other laws ,the ,secretary shall carry out subsection 7a7 to the degree that doing so does not conflict with any other provision of law4 4 7b7 ,clerical amendment ,the table of sections at the beginning of chapter #aa of such title is amended by inserting after the item relating to section #aafe the following new item3 #aafg4 ,reevaluation of compensation determinations pursuant to changes in presumptions of service connection4 4 7c7 ,application ,section #aafg of title #ch1 ,united ,states ,code1 as added by subsection 7a71 shall apply with respect to presumptions of service connection established or modified on or after the date of the enactment of this ,act1 including pursuant to amendments made by this ,act4 ,,iii ,improving the establishment of service connection process for toxic exposed veterans #cja4 ,short title ,this title may be cited as the ,veterans ,burn ,pits ,exposure ,recognition ,act4 #cjb4 ,presumptions of toxic exposure 7a7 ,in general ,subchapter ,,ii of chapter #aa is amended by adding at the end the following new section3 #aaai4 ,presumptions of toxic exposure 7a7 ,consideration of ,individual ,longitudinal ,exposure ,record required ,if a veteran submits to the ,secretary a claim for compensation for a service-connected disability under section #aaaj of this title with evidence of a disability and a toxic exposure that occurred during active military1 naval1 or air service1 the ,secretary shall1 in adjudicating such claim1 consider-- 7#a7 the ,individual ,longitudinal ,exposure ,record of the veteran2 and 7#b7 if the ,individual ,longitudinal ,exposure ,record of the veteran does not indicate that the veteran was subject to a toxic exposure during active military1 naval1 or air service1 the totality of the circumstances of the service of the veteran4 7b7 ,presumption of specific toxic exposure for members who served in certain locations 7#a7 ,the ,secretary shall1 for purposes of section #aaaj and chapter #ag of this title1 presume that any covered veteran was exposed to the substances1 chemicals1 and hazards listed in paragraph 7#b7 during the service of the covered veteran specified in subsection 7c77#a71 unless there is affirmative evidence to establish that the covered veteran was not exposed to any such substances1 chemicals1 or hazards in connection with such service4 7#b7 7,a7 ,subject to subparagraph 7,b71 the substances1 chemicals1 and airborne hazards listed in this paragraph are as follows3 7i7 ,particulate matter1 including the following3 7,i7 ,,pm-#aj4 7,,ii7 ,,pm-#b4e4 7ii7 ,polycyclic aromatic hydrocarbons 7,p,a,hs71 including the following3 7,i7 ,acenaphthene4 7,,ii7 ,acenaphthylene4 7,,iii7 ,anthracene4 7,,iv7 ,benzo7a7anthracene4 7,v7 ,benzo7a7pyrene4 7,,vi7 ,benzo7b7fluoranthene4 7,,vii7 ,benzo7g1h1i7perylene4 7,,viii7 ,benzo7k7fluoranthene4 7,,ix7 ,chrysene4 7,x7 ,dibenz7a1h7anthracene4 7,,xi7 ,fluoranthene4 7,,xii7 ,fluorene4 7,,xiii7 ,indeno7#a1b1c-;cd7pyrene4 7,,xiv7 ,naphthalene4 7,,xv7 ,phenanthrene4 7,,xvi7 ,pyrene4 7iii7 ,volatile organic compounds 7,v,o,cs71 including the following3 7,i7 ,acetone4 7,,ii7 ,acrolein4 7,,iii7 ,benzene4 7,,iv7 ,carbon ,disulfide4 7,v7 ,chlorodifluoromethane4 7,,vi7 ,chloromethane4 7,,vii7 ,ethylbenzene4 7,,viii7 ,hexachlorobutadiene4 7,,ix7 ,hexane4 7,x7 m_/p-,xylene4 7,,xi7 ,methylene ,chloride4 7,,xii7 ,pentane4 7,,xiii7 ,propylene4 7,,xiv7 ,styrene4 7,,xv7 ,toluene4 7iv7 ,toxic organic halogenated dioxins and furans 7dioxins71 including the following3 7,i7 #a1b1c1d1f1g1h ,,hpcdd4 7,,ii7 #a1b1c1d1f1g1h ,,hpcdf4 7,,iii7 #a1b1c1d1g1h1i ,,hpcdf4 7,,iv7 #a1b1c1d1g1h ,,hxcdd4 7,v7 #a1b1c1f1g1h ,,hxcdd4 7,,vi7 #a1b1c1g1h1i ,,hxcdd4 7,,vii7 #a1b1c1d1g1h ,,hxcdf4 7,,viii7 #a1b1c1f1g1h ,,hxcdf4 7,,ix7 #a1b1c1g1h1i ,,hxcdf4 7,x7 #a1b1c1g1h ,,pecdd4 7,,xi7 #a1b1c1g1h ,,pecdf4 7,,xii7 #b1c1d1f1g1h ,,hxcdf4 7,,xiii7 #b1c1d1g1h ,,pecdf4 7,,xiv7 #b1c1g1h ,,tcdd4 7,,xv7 #b1c1g1h ,,tcdf4 7,,xvi7 ,octachlorodibenzodioxin4 7,,xvii7 ,octachlorodibenzofuran4 7v7 ,such other substances1 chemicals1 and airborne hazards as the ,secretary1 in collaboration with the ,secretary of ,defense1 may determine appropriate4 7,b7 7i7 ,the ,secretary may add to or remove from the list under subparagraph 7,a7 as the ,secretary1 in collaboration with the ,secretary of ,defense1 determines appropriate4 7ii7 ,beginning not later than two years after the date of the enactment of the ,honoring our ,promise to ,address ,comprehensive ,toxics ,act of #bjba1 and not less frequently than once every two years thereafter1 the ,secretary shall submit to ,congress a report identifying any additions or removals made pursuant to subparagraph 7,a7 during the period covered by the report4 7c7 ,definitions ,in this section3 7#a7 ,the term covered veteran means any veteran who-- 7,a7 on or after ,august #b1 #aiij1 performed active military1 naval1 or air service while assigned to a duty station in-- 7i7 ,bahrain2 7ii7 ,iraq2 7iii7 ,kuwait2 7iv7 ,oman2 7v7 ,qatar2 7vi7 ,saudi ,arabia2 7vii7 ,somalia2 or 7viii7 ,united ,arab ,emirates2 or 7,b7 on or after ,september #aa1 #bjja1 performed active military1 naval1 or air service while assigned to a duty station in-- 7i7 ,afghanistan2 7ii7 ,djibouti2 7iii7 ,egypt2 7iv7 ,jordan2 7v7 ,lebanon2 7vi7 ,syria2 7vii7 ,yemen2 7viii7 ,uzbekistan2 7ix7 the ,philippines2 or 7x7 any other country determined relevant by the ,secretary4 7#b7 ,the term ,individual ,longitudinal ,exposure ,record includes any pilot program or other program used by the ,department of ,veterans ,affairs or the ,department of ,defense to track how members of the ,armed ,forces or veterans have been exposed to various occupational or environmental hazards4 7#c7 ,the term toxic exposure risk activity has the meaning given such term in section #agaj7;e77#d7 of this title4 4 7b7 ,clerical amendment ,the table of sections at the beginning of chapter #aa is amended by inserting after the item relating to section #aaah the following new item3 #aaai4 ,presumptions of toxic exposure4 4 #cjc4 ,medical nexus examinations for toxic exposure risk activities 7a7 ,in general ,subchapter ,,vi of chapter #aa1 as amended by section #bjc of this ,act1 is further amended by adding at the end the following new section3 #aafh4 ,medical nexus examinations for toxic exposure risk activities 7a7 ,medical examinations and medical opinions 7#a7 ,except as provided in subsection 7b71 if a veteran submits to the ,secretary a claim for compensation for a service-connected disability under section #aaaj of this title with evidence of a disability and evidence of participation in a toxic exposure risk activity during active military1 naval1 or air service1 and such evidence is not sufficient to establish a service connection for the disability1 the ,secretary shall-- 7,a7 provide the veteran with a medical examination under section #eajc;,a7d7 of this title2 and 7,b7 request a medical opinion as to whether it is at least as likely as not that there is a nexus between the disability and the toxic exposure risk activity4 7#b7 ,when providing the ,secretary with a medical opinion requested under paragraph 7#a71 the health care provider shall consider the total potential exposure through all applicable military deployments1 and the synergistic1 combined effect of all applicable toxic exposure risk activities4 7b7 ,exception ,subsection 7a7 shall not apply if the ,secretary determines there is no indication of an association between the disability claimed by the veteran and the toxic exposure risk activity for which the veteran submitted evidence4 7c7 ,toxic exposure risk activity defined ,in this section1 the term toxic exposure risk activity has the meaning given such term in section #agaj7;e77#d7 of this title4 4 7b7 ,clerical amendment ,the table of sections at the beginning of chapter #aa of such title1 as amended by title ,,ii of this ,act1 is further amended by inserting after the item relating to section #aafg1 as added by such title1 the following new item3 #aafh4 ,medical nexus examinations for toxic exposure risk activities4 4 ,,iv ,presumptions of service connection #dja4 ,treatment of veterans who participated in cleanup of ,enewetak ,atoll as radiation-exposed veterans for purposes of presumption of service connection of certain disabilities by ,department of ,veterans ,affairs 7a7 ,short title ,this section may be cited as the ,mark ,takai ,atomic ,veterans ,healthcare ,parity ,act4 7b7 ,enewetak ,atoll ,section #aaab7;c77#c77;,b7 is amended by adding at the end the following new clause3 7v7 ,cleanup of ,enewetak ,atoll during the period beginning on ,january #a1 #aigg1 and ending on ,december #ca1 #aihj4 4 #djb4 ,treatment of veterans who participated in nuclear response near ,palomares1 ,spain1 as radiation-exposed veterans for purposes of presumption of service connection of certain disabilities by ,department of ,veterans ,affairs 7a7 ,short title ,this section may be cited as the ,palomares ,veterans ,act4 7b7 ,palomares ,section #aaab7;c77#c77;,b71 as amended by section #dja1 is further amended by adding at the end the following new clause3 7vi7 ,onsite participation in the response effort following the collision of a ,united ,states ,air ,force ,b-#eb bomber and refueling plane that caused the release of four thermonuclear weapons in the vicinity of ,palomares1 ,spain1 during the period beginning ,january #ag1 #aiff1 and ending ,march #ca1 #aifg4 4 #djc4 ,presumptions of service connection for diseases associated with exposures to certain herbicide agents for veterans who served in certain locations 7a7 ,short title ,this section may be cited as the ,veterans ,agent ,orange ,exposure ,equity ,act4 7b7 ,in general ,section #aaaf1 as amended by section #bjb1 is further amended-- 7#a7 by striking 1 during active military1 naval1 or air service1 served in the ,republic of ,vietnam during the period beginning on ,january #i1 #aifb1 and ending on ,may #g1 #aige each place it appears and inserting performed covered service2 7#b7 by striking performed active military1 naval1 or air service in the ,republic of ,vietnam during the period beginning on ,january #i1 #aifb1 and ending on ,may #g1 #aige each place it appears and inserting performed covered service2 and 7#c7 by adding at the end the following new subsection3 7d7 ,in this section1 the term covered service means active military1 naval1 or air service-- 7#a7 performed in the ,republic of ,vietnam during the period beginning on ,january #i1 #aifb1 and ending on ,may #g1 #aige2 7#b7 performed in ,thailand at any ,united ,states or ,royal ,thai base during the period beginning on ,january #i1 #aifb1 and ending on ,june #cj1 #aigf1 without regard to where on the base the veteran was located or what military job specialty the veteran performed2 7#c7 performed in ,laos during the period beginning on ,december #a1 #aife1 and ending on ,september #cj1 #aifi2 7#d7 performed in ,cambodia at ,mimot or ,krek1 ,kampong ,cham ,province during the period beginning on ,april #af1 #aifi1 and ending on ,april #cj1 #aifi2 or 7#e7 performed on ,guam or ,american ,samoa1 or in the territorial waters thereof1 during the period beginning on ,january #i1 #aifb1 and ending on ,july #ca1 #aihj1 or served on ,johnston ,atoll or on a ship that called at ,johnston ,atoll during the period beginning on ,january #a1 #aigb1 and ending on ,september #cj1 #aigg4 4 7c7 ,eligibility for hospital care and medical services ,section #agaj7;e77#d71 as amended by section #ajc1 is further amended by striking subparagraph 7,a7 and inserting the following new subparagraph3 7,a7 ,the term ,vietnam-era herbicide-exposed veteran means a veteran who-- 7i7 performed covered service1 as defined in section #aaaf7;d7 of this title2 or 7ii7 the ,secretary finds may have been exposed during such service to dioxin or was exposed during such service to a toxic substance found in a herbicide or defoliant used for military purposes during such period4 4 7d7 ,clerical amendments 7#a7 ,section heading ,the heading for section #aaaf is amended by striking the ,republic of ,vietnam and inserting certain locations4 7#b7 ,table of sections ,the table of sections at the beginning of chapter #aa is amended by striking the item relating to section #aaaf and inserting the following new item3 #aaaf4 ,presumptions of service connection for diseases associated with exposure to certain herbicide agents2 presumption of exposure for veterans who served in certain locations4 4 #djd4 ,addition of additional diseases associated with exposure to certain herbicide agents for which there is a presumption of service connection for veterans who served in certain locations 7a7 ,short title ,this section may be cited as the ,fair ,care for ,vietnam ,veterans ,act4 7b7 ,additional diseases ,section #aaaf7;a77#b71 as amended by section #iaji of the ,william ,m4 7,mac7 ,thornberry ,national ,defense ,authorization ,act for ,fiscal ,year #bjba 7,public ,law #aaf-bhc71 is further amended by adding at the end the following new subparagraphs3 7,l7 ,hypertension4 7,m7 ,monoclonal gammopathy of undetermined significance4 4 #dje4 ,improving compensation for disabilities occurring in ,persian ,gulf ,war veterans 7a7 ,reduction in threshold of eligibility ,subsection 7a77#a7 of section #aaag is amended by striking became manifest-- and all that follows through the period at the end and inserting became manifest to any degree at any time44 7b7 ,permanent extension of period of eligibility ,such section is further amended-- 7#a7 by striking subsection 7b72 7#b7 by redesignating subsections 7c7 and 7d7 as subsections 7b7 and 7c71 respectively2 and 7#c7 in subsection 7a77#b77;,c71 by striking under subsection 7d7 and inserting under subsection 7c74 7c7 ,establishing singular disability-,based questionnaire ,such section is further amended by inserting after subsection 7c7 7as redesignated by subsection 7b77 the following new subsection 7d73 7d7 ,if a ,persian ,gulf veteran at a medical facility of the ,department presents with any one symptom associated with ,gulf ,war ,illness1 the ,secretary shall ensure that health care personnel of the ,department use a disability benefits questionnaire1 or successor questionnaire1 to identify ,gulf ,war ,illness4 4 7d7 ,expansion of definition of ,persian ,gulf veteran ,subsection 7f7 of such section is amended by inserting 1 ,afghanistan1 ,israel1 ,egypt1 ,turkey1 ,syria1 or ,jordan1 after operations4 7e7 ,training ,such section is further amended by adding at the end the following new subsection3 7i7 7#a7 ,the ,secretary shall take such actions as may be necessary to ensure that health care personnel of the ,department are appropriately trained to effectively carry out this section4 7#b7 ,not less frequently than once each year1 the ,secretary shall submit to ,congress a report on the actions taken by the ,secretary to carry out paragraph 7#a74 4 #djf4 ,presumption of service connection for certain diseases associated with exposure to burn pits and other toxins 7a7 ,short title ,this section may be cited as the ,presumptive ,benefits for ,war ,fighters ,exposed to ,burn ,pits and ,other ,toxins ,act4 7b7 ,in general ,subchapter ,,ii of chapter #aa1 as amended by section #cjc7;a71 is further amended by inserting after section #aaai the following new section3 #aabj4 ,presumption of service connection for certain diseases associated with exposure to burn pits and other toxins 7a7 ,presumption of service connection ,for the purposes of section #aaaj of this title1 and subject to section #aaac of this title1 a disease specified in subsection 7b7 becoming manifest in a covered veteran 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 7b7 ,diseases specified ,the diseases specified in this subsection are the following3 7#a7 ,asthma that was diagnosed after service of the covered veteran as specified in subsection 7c74 7#b7 ,the following types of cancer3 7,a7 ,head cancer of any type4 7,b7 ,neck cancer of any type4 7,c7 ,respiratory cancer of any type4 7,d7 ,gastrointestinal cancer of any type4 7,e7 ,reproductive cancer of any type4 7,f7 ,lymphoma cancer of any type4 7,g7 ,lymphomatic cancer of any type4 7,h7 ,kidney cancer4 7,i7 ,brain cancer4 7,j7 ,melanoma4 7,k7 ,pancreatic cancer4 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 ,pleuritis4 7#aj7 ,pulmonary fibrosis4 7#aa7 ,sarcoidosis4 7#ab7 ,chronic sinusitis4 7#ac7 ,chronic rhinitis4 7#ad7 ,glioblastoma4 7#ae7 ,any other disease for which the ,secretary determines1 pursuant to regulations prescribed under subchapter ,,vii that a presumption of service connection is warranted based on a positive association with a substance1 chemical1 or airborne hazard specified in section #aaai7;b77#b7 of this title4 7c7 ,covered veteran defined ,in this section1 the term covered veteran has the meaning given that term in section #aaai7;c7 of this title4 4 7c7 ,clerical amendment ,the table of sections at the beginning of chapter #aa1 as amended by section #cjb7;b71 is further amended by inserting after the item relating to section #aaai the following new item3 #aabj4 ,presumption of service connection for certain diseases associated with exposure to burn pits and other toxins4 4 7d7 ,conforming amendment ,section #aaac is amended by striking or #aaah each place it appears and inserting #aaah1 or #aabj4 ,v ,research matters #eja4 ,coordination by ,department of ,veterans ,affairs of toxic exposure research 7a7 ,in general ,subchapter ,,ii of chapter #gc is amended by adding at the end the following new section3 #gccj;,d4 ,coordination of toxic exposure research 7a7 ,in general ,the ,secretary shall coordinate all research activities carried out or funded by the executive branch of the ,federal ,government on the health consequences of toxic exposures experienced during service in the ,armed ,forces4 7b7 ,strategic plan ,in carrying out subsection 7a71 the ,secretary shall establish a strategic plan1 to be known as the ,toxic ,exposure ,research ,strategic ,plan1 to ensure that the research activities specified in such subsection are collaborative1 transparent1 and highly coordinated4 7c7 ,report ,not later than one year after the date of the enactment of the ,honoring our ,promise to ,address ,comprehensive ,toxics ,act of #bjba1 and annually thereafter1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,house of ,representatives and the ,senate a report on any research activities specified in subsection 7a7 carried out during the year covered by the report4 4 7b7 ,clerical amendment ,the table of sections at the beginning of such subchapter is amended by inserting after the item relating to section #gccj;,c the following new item3 #gccj;,d4 ,coordination of toxic exposure research4 4 #ejb4 ,data collection1 analysis1 and report on treatment of veterans for illnesses related to toxic exposure 7a7 ,in general ,the ,secretary of ,veterans ,affairs shall compile and analyze1 on a continuous basis1 all clinical data that-- 7#a7 is obtained by the ,secretary in connection with hospital care1 medical services1 or nursing home care furnished to a veteran for an illness under section #agaj7;a77#b77;,f7 of title #ch1 ,united ,states ,code1 as amended by section #ajb2 and 7#b7 is likely to be scientifically useful1 as determined by the ,secretary1 in determining whether a positive association exists between the illness of the veteran and a toxic exposure4 7b7 ,consent of patients ,the ,secretary shall ensure that the compilation and analysis of the clinical data of a veteran under subsection 7a7 shall be conducted1 and such data shall be used1 in a manner that is consistent with the informed consent of the veteran and in compliance with all applicable ,federal law4 7c7 ,annual report ,not later than one year after the date of the enactment of this ,act1 and annually thereafter1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,house of ,representatives and the ,senate a report containing-- 7#a7 any data compiled under subsection 7a72 7#b7 an analysis of any such data2 7#c7 a description of the types and incidences of illnesses identified by the ,secretary pursuant to such subsection2 7#d7 an explanation by the ,secretary for the incidence of such illnesses and such alternate explanations for the incidence of such illnesses as the ,secretary may consider reasonable2 and 7#e7 a description of the views of the ,secretary regarding the scientific validity of drawing conclusions from the incidence of such illnesses1 as evidenced by the data compiled under subsection 7a71 regarding the existence of a positive association between such illness and a toxic exposure4 7d7 ,definitions ,in this section3 7#a7 ,the term toxic exposure has the meaning given that term in section #aja of title #ch1 ,united ,states ,code4 7#b7 ,the term illness has the meaning given that term in section #aaga of such title1 as added by section #bjb4 #ejc4 ,studies related to veterans who served in ,southwest ,asia and certain other locations 7a7 ,analysis on mortality in covered veterans 7#a7 ,analysis ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall conduct an updated analysis of total and respiratory disease mortality in covered veterans4 7#b7 ,elements ,the analysis under paragraph 7#a7 shall include1 to the extent practicable1 the following3 7,a7 ,metrics of airborne exposures4 7,b7 ,the location and timing of any deployments of the veteran4 7,c7 ,the military occupational specialty of the veteran4 7,d7 ,the ,armed ,force in which the veteran served4 7,e7 ,the preexisting health status of the veteran1 including with respect to asthma4 7,f7 ,such personal information of the veteran as the ,secretary may consider relevant1 including cigarette and e-cigarette smoking history1 diet1 sex1 gender1 age1 race1 and ethnicity4 7b7 ,epidemiological study ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary shall conduct an epidemiological study of covered veterans that involves-- 7#a7 the use of improved spatio-temporal estimates of ambient air pollution exposures that leverage advances in retrospective exposure assessment2 and 7#b7 the collection of detailed information on the covered veterans studied through medical records1 administrative data1 and other existing sources1 including1 with respect to the covered veterans-- 7,a7 personal information1 including cigarette and e-cigarette smoking history1 diet1 sex1 gender1 age1 race1 and ethnicity2 7,b7 deployment history1 including locations1 periods1 and number of deployments2 7,c7 biospecimen data2 and 7,d7 supplementary health status and outcomes data1 including imaging and physiological parameters4 7c7 ,toxicology study 7#a7 ,study ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary shall conduct a toxicology study1 to include variability1 to replicate toxic exposures of healthy1 young members of the ,armed ,forces1 as well as potentially susceptible members1 with preexisting health conditions4 7#b7 ,elements ,the study under paragraph 7#a7 shall include-- 7,a7 an analysis of results for mechanistic markers and clinically relevant outcomes2 and 7,b7 a validation of any serum1 tissue1 or other biomarkers of toxic exposure1 susceptibility1 or effect with respect to the subjects of the study4 7d7 ,covered veteran defined ,in this section1 the term covered veteran has the meaning given that term in section #aaai7;c7 of title #ch1 ,united ,states ,code1 as added by section #cjb4 #ejd4 ,study on health trends of post #i_/aa veterans 7a7 ,study ,the ,secretary of ,veterans ,affairs shall conduct an epidemiological study on the health trends of veterans who served in the ,armed ,forces after ,september #aa1 #bjja4 7b7 ,report ,not later than two years after the date of the enactment of this ,act1 the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate a report on the study under subsection 7a74 #eje4 ,study on cancer rates among veterans 7a7 ,study ,the ,secretary of ,veterans ,affairs shall conduct a study on the incidence of cancer in veterans to determine trends in the rates of the incidence of cancer in veterans4 7b7 ,elements ,the study under subsection 7a7 shall assess1 with respect to each veteran included in the study1 the following3 7#a7 ,the age of the veteran4 7#b7 ,the period of service and length of service of the veteran in the ,armed ,forces4 7#c7 ,any military occupational speciality of the veteran4 7#d7 ,the gender of the veteran4 7#e7 ,any type of cancer that the veteran has4 7c7 ,report ,not later than two years after the date of the enactment of this ,act1 the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate a report on the study under subsection 7a74 #ejf4 ,study on feasibility and advisability of furnishing hospital care and medical services to dependents of veterans who participated in toxic exposure risk activities 7a7 ,study ,the ,secretary of ,veterans ,affairs shall conduct a study on the feasibility and advisability of furnishing hospital care and medical services to qualifying dependents of veterans described in section #agaj7;e77#a77;,g7 of title #ch1 ,united ,states ,code1 as added by section #ajc7;a77#a71 for any illness determined by the ,secretary to be connected to a toxic exposure risk activity carried out by the veteran1 as determined by the ,secretary1 notwithstanding that there is insufficient medical evidence to conclude that such illness is attributable to such activity4 7b7 ,elements ,the study under subsection 7a7 shall include-- 7#a7 an assessment of the impact of furnishing hospital care and medical services to qualifying dependents as described in such subsection on the ability of the ,department of ,veterans ,affairs to furnish hospital care and medical services to veterans2 7#b7 an assessment of the potential cost of furnishing hospital care and medical services to qualifying dependents as described in such subsection2 7#c7 an estimate of the resources required to furnish such care and services2 7#d7 an assessment of any stress or other effect furnishing such care and services would have on the claims and appeals system of the ,department2 7#e7 an estimate of the number of qualifying dependents who would be eligible for such care and services2 and 7#f7 an assessment of the feasibility of adjudicating claims for such care and services4 7c7 ,phased-,in application ,in conducting the study under subsection 7a71 the ,secretary shall assess the feasibility and advisability of phasing in the furnishing of hospital care and medical services to qualifying dependents described in such subsection by the decade in which such toxic exposure risk activity occurred1 starting with the most recent decade4 7d7 ,review of toxic exposure cases regarding liability of ,department of ,defense ,in conducting the study under subsection 7a71 the ,secretary shall-- 7#a7 review known cases of toxic exposure on military installations of the ,department of ,defense located in the ,united ,states2 7#b7 analyze the liability of the ,department of ,defense in each such case2 and 7#c7 assess whether the ,secretary of ,defense should provide care and services relating to such toxic exposures under the ,,tricare program4 7e7 ,report ,not later than two years after the date of the enactment of this ,act1 the ,secretary shall submit to ,congress a report on the study conducted under subsection 7a74 7f7 ,definitions ,in this section3 7#a7 ,the terms hospital care and medical services have the meanings given those terms in section #agja of title #ch1 ,united ,states ,code4 7#b7 ,the term illness has the meaning given that term in section #aaga of such title1 as added by section #bjb4 7#c7 ,the term qualifying dependent means-- 7,a7 a dependent of a veteran described in section #agaj7;e77#a77;,g7 of title #ch1 ,united ,states ,code1 as added by section #ajc7;a77#a71 who resided with the veteran during the period in which1 and on the installation at which1 the veteran participated in a toxic exposure risk activity2 7,b7 an individual who was in utero of such a veteran or other qualifying dependent when the veteran participated in a toxic exposure risk activity2 or 7,c7 a dependent of such a veteran who is not described in subparagraph 7,a7 or 7,b7 but who may have an illness that is connected to the toxic exposure risk activity of the veteran1 as determined by the ,secretary4 7#d7 ,the term toxic exposure has the meaning given that term in section #aja of such title1 as added by section #ajb7;b74 7#e7 ,the term toxic exposure risk activity has the meaning given that term in section #agaj7;e77#d7 of such title1 as added by section #ajc7;a77#c74 7#f7 ,the term ,,tricare program has the meaning given that term in section #ajgb of such title4 ,,vi ,improvement of resources and training regarding toxic exposed veterans #fja4 ,short title2 definitions 7a7 ,short title ,this title may be cited as the ,toxic ,exposure in the ,american ,military ,act or the ,,team ,act4 7b7 ,definitions ,in this title1 the terms active military1 naval1 or air service1 toxic exposure1 and toxic exposed veteran have the meanings given those terms in section #aja of title #ch1 ,united ,states ,code4 #fjb4 ,publication of list of resources of ,department of ,veterans ,affairs for toxic exposed veterans and outreach program for such veterans and caregivers and survivors of such veterans 7a7 ,publication of list of resources 7#a7 ,in general ,not later than one year after the date of the enactment of this ,act1 and annually thereafter1 the ,secretary of ,veterans ,affairs shall publish a list of resources of the ,department of ,veterans ,affairs for-- 7,a7 toxic exposed veterans1 including with respect to-- 7i7 disability compensation under chapter #aa of title #ch1 ,united ,states ,code2 and 7ii7 hospital care1 medical services1 and nursing home care under section #agaj7;a77#b77;,f7 of such title2 7,b7 caregivers of toxic exposed veterans who are participating in the program of comprehensive assistance for family caregivers under section #agbj;,g7a7 of such title2 and 7,c7 survivors of toxic exposed veterans who are receiving death benefits under the laws administered by the ,secretary4 7#b7 ,update ,the ,secretary shall periodically update the list published under paragraph 7#a74 7b7 ,outreach ,the ,secretary shall develop1 with input from the community1 an informative outreach program for veterans on illnesses that may be related to toxic exposure1 including outreach with respect to benefits and support programs4 #fjc4 ,incorporation of toxic exposure questionnaire during primary care appointments 7a7 ,in general ,the ,secretary of ,veterans ,affairs shall incorporate a clinical questionnaire to help determine potential toxic exposures during active military1 naval1 or air service as part of the initial screening conducted for an appointment of a veteran with a primary care provider of the ,department of ,veterans ,affairs to improve understanding by the ,department of toxic exposures of veterans while serving in the ,armed ,forces4 7b7 ,determination of questions ,the questions included in the questionnaire required under subsection 7a7 shall be determined by the ,secretary with input from medical professionals4 #fjd4 ,training for personnel of the ,department of ,veterans ,affairs with respect to toxic exposed veterans 7a7 ,health care personnel ,the ,secretary of ,veterans ,affairs shall provide to health care personnel of the ,department of ,veterans ,affairs education and training to identify1 treat1 and assess the impact on toxic exposed veterans of illnesses related to toxic exposure and inform such personnel of how to ask for additional information from veterans regarding different toxic exposures4 7b7 ,benefits personnel 7#a7 ,standard claims processor training curriculum 7,a7 ,curriculum ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary shall establish a standard training curriculum for processors of claims under the laws administered by the ,secretary who review claims for disability benefits relating to service-connected disabilities based on toxic exposure1 including employees who adjudicate such claims4 7,b7 ,matters included ,the ,secretary shall ensure that the training under subparagraph 7,a7 includes the following explanations with respect to claims relating to toxic exposure3 7i7 ,a lack of a presumption of service connection is not by itself sufficient to determine that service connection does not exist4 7ii7 ,the claims adjudicator shall always consider whether direct service connection is applicable and request1 as needed1 an advisory medical opinion pursuant to section #aafh of title #ch1 ,united ,states ,code1 as added by section #cjc4 7iii7 ,the claims adjudicator shall always review and consider the ,individual ,longitudinal ,exposure ,record program of the ,department of ,veterans ,affairs pursuant to section #aaai of such title1 as added by section #cjb1 but a lack of such information is not by itself sufficient to determine that such exposure did not occur or sufficient to deny the claim4 7,c7 ,provision of training ,the ,secretary shall-- 7i7 provide training under subparagraph 7,a7 to each employee described in such subparagraph not less frequently than annually2 and 7ii7 using the ,systematic ,technical ,accuracy ,review program1 or such successor program1 conduct a nationwide1 quarterly1 randomized review of the quality of adjudication of claims relating to toxic exposure4 7#b7 ,standard medical examiner training curriculum 7,a7 ,curriculum ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary shall establish a standard medical training curriculum for medical providers who conduct examinations and provide opinions pursuant to section #aafh of title #ch1 ,united ,states ,code1 as added by section #cjc1 regardless of whether the provider is an employee of the ,department or a contractor4 7,b7 ,standardized approach ,the ,secretary shall ensure that the curriculum established under subparagraph 7,a7-- 7i7 provides a standardized approach to conducting and providing examinations and opinions in accordance with such section #aafh2 and 7ii7 instructs medical providers to consider1 when conducting an examination or providing an opinion-- 7,i7 relevant medical and scientific literature2 7,,ii7 the proximity1 intensity1 and frequency of exposure of the individual to the identified toxic exposure2 7,,iii7 medically unexplained chronic multisymptom illnesses2 and 7,,iv7 all competent and credible evidence of record4 ,,vii ,registries1 records1 and other matters #gja4 ,registry of individuals exposed to per- and polyfluoroalkyl substances on military installations 7a7 ,establishment of registry 7#a7 ,in general ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall-- 7,a7 establish and maintain a registry for eligible individuals who may have been exposed to per- and polyfluoroalkyl substances 7in this section referred to as ,,pfas7 due to the environmental release of aqueous film-forming foam 7in this section referred to as ,,afff7 on military installations to meet the requirements of military specification ,,mil-,f-#bdche;,f2 7,b7 include any information in such registry that the ,secretary determines necessary to ascertain and monitor the health effects of the exposure of members of the ,armed ,forces to ,,pfas associated with ,,afff2 7,c7 develop a public information campaign to inform eligible individuals about the registry1 including how to register and the benefits of registering2 and 7,d7 periodically notify eligible individuals of significant developments in the study and treatment of conditions associated with exposure to ,,pfas4 7#b7 ,coordination ,the ,secretary of ,veterans ,affairs shall coordinate with the ,secretary of ,defense in carrying out paragraph 7#a74 7b7 ,reports 7#a7 ,initial report ,not later than two years after the date on which the registry under subsection 7a7 is established1 the ,secretary of ,veterans ,affairs shall submit to ,congress an initial report containing the following3 7,a7 ,an assessment of the effectiveness of actions taken by the ,secretary of ,veterans ,affairs and the ,secretary of ,defense to collect and maintain information on the health effects of exposure to ,,pfas4 7,b7 ,recommendations to improve the collection and maintenance of such information4 7,c7 ,using established and previously published epidemiological studies1 recommendations regarding the most effective and prudent means of addressing the medical needs of eligible individuals with respect to exposure to ,,pfas4 7#b7 ,followup report ,not later than five years after submitting the initial report under paragraph 7#a71 the ,secretary of ,veterans ,affairs shall submit to ,congress a followup report containing the following3 7,a7 ,an update to the initial report submitted under paragraph 7#a74 7,b7 ,an assessment of whether and to what degree the content of the registry established under subsection 7a7 is current and scientifically up to date4 7#c7 ,independent scientific organization ,the ,secretary of ,veterans ,affairs shall enter into an agreement with an independent scientific organization to prepare the reports under paragraphs 7#a7 and 7#b74 7c7 ,recommendations for additional exposures ,to be included ,not later than five years after the date of the enactment of this ,act1 and every five years thereafter1 the ,secretary of ,veterans ,affairs1 in consultation with the ,secretary of ,defense and the ,administrator of the ,environmental ,protection ,agency1 shall submit to ,congress recommendations for additional chemicals with respect to which individuals exposed to such chemicals should be included in the registry established under subsection 7a74 7d7 ,eligible individual defined ,in this section1 the term eligible individual means any individual who1 on or after a date specified by the ,secretary of ,veterans ,affairs through regulations1 served or is serving in the ,armed ,forces at a military installation where ,,afff was used or at another location of the ,department of ,defense where ,,afff was used4 #gjb4 ,fort ,mc,clellan ,health ,registry 7a7 ,establishment ,the ,secretary of ,veterans ,affairs shall establish and maintain a special record to be known as the ,fort ,mc,clellan ,health ,registry 7in this section referred to as the ,registry74 7b7 ,contents ,except as provided in subsection 7c71 the ,registry shall include the following information3 7#a7 ,a list containing the name of each individual who1 while serving as a member of the ,armed ,forces1 was stationed at ,fort ,mc,clellan1 ,alabama1 at any time during the period beginning ,january #a1 #aice1 and ending on ,may #bj1 #aiii1 and who-- 7,a7 applies for care or services from the ,department of ,veterans ,affairs under chapter #ag of title #ch1 ,united ,states ,code2 7,b7 files a claim for compensation under chapter #aa of such title on the basis of any disability which may be associated with such service2 7,c7 dies and is survived by a spouse1 child1 or parent who files a claim for dependency and indemnity compensation under chapter #ac of such title on the basis of such service2 7,d7 requests from the ,secretary a health examination under subsection 7d72 or 7,e7 receives from the ,secretary a health examination similar to the health examination referred to in subparagraph 7,d7 and requests inclusion in the ,registry4 7#b7 ,relevant medical data relating to the health status of1 and other information that the ,secretary considers relevant and appropriate with respect to1 each individual described in paragraph 7#a7 who-- 7,a7 grants to the ,secretary permission to include such information in the ,registry2 or 7,b7 at the time the individual is listed in the ,registry1 is deceased4 7c7 ,individuals submitting claims or making requests before date of enactment ,if in the case of an individual described in subsection 7b77#a7 the application1 claim1 or request referred to in such subsection was submitted1 filed1 or made before the date of the enactment of this ,act1 the ,secretary shall1 to the extent feasible1 include in the ,registry such individual's name and the data and information1 if any1 described in subsection 7b77#b7 relating to the individual4 7d7 ,examinations ,upon the request of a veteran who was stationed at ,fort ,mc,clellan1 ,alabama1 at any time during the period beginning ,january #a1 #aice1 and ending on ,may #bj1 #aiii1 the ,secretary shall provide the veteran with a health examination 7including any appropriate diagnostic tests7 and consultation and counseling with respect to the results of the examination and the tests4 7e7 ,outreach 7#a7 ,ongoing outreach to individuals listed in ,registry ,the ,secretary shall1 from time to time1 notify individuals listed in the ,registry of significant developments in research on the health consequences of potential exposure to a toxic substance or environmental hazard related to service at ,fort ,mc,clellan4 7#b7 ,examination outreach ,the ,secretary shall carry out appropriate outreach activities with respect to the provision of any health examinations 7including any diagnostic tests7 and consultation and counseling services under subsection 7d74 7f7 ,consultation ,the ,secretary of ,veterans ,affairs shall consult with the ,secretary of ,defense to acquire information maintained by the ,secretary of ,defense that the ,secretary of ,veterans ,affairs considers necessary to establish and maintain the ,registry4 #gjc4 ,independent study on ,individual ,longitudinal ,exposure ,record 7a7 ,in general ,not later than #fj days after the date of the enactment of this ,act1 the ,secretary of ,defense shall enter into a contract with an independent research entity described in subsection 7b7 to carry out a comprehensive study of the development of the ,individual ,longitudinal ,exposure ,record to determine-- 7#a7 the quality of the location data1 occupational and environmental exposure data1 and health surveillance data2 and 7#b7 whether a member of the ,armed ,forces can be reasonably assured that any toxic exposure they experience during service in the ,armed ,forces will be accurately reflected in the ,individual ,longitudinal ,exposure ,record of the member4 7b7 ,independent research entity ,the entity described in this subsection is an independent research entity that is a not-for-profit entity or a federally funded research and development center with appropriate expertise and analytical capability to carry out the study required under subsection 7a74 7c7 ,toxic exposure defined ,in this section1 the term toxic exposure has the meaning given that term in section #aja7cg7 of title #ch1 ,united ,states ,code1 as added by section #ajb7;b74 #gjd4 ,biannual report on ,individual ,longitudinal ,exposure ,record 7a7 ,in general ,not later than one year after the date on which the ,individual ,longitudinal ,exposure ,record achieves full operation capability1 as determined by the ,secretary of ,defense1 and every #ahj days thereafter1 the ,secretary shall1 in consultation with the ,secretary of ,veterans ,affairs1 submit to the appropriate committees of ,congress a report on the data quality of the databases of the ,department of ,defense that provide the information presented in the ,individual ,longitudinal ,exposure ,record and the usefulness of the ,individual ,longitudinal ,exposure ,record in supporting members of the ,armed ,forces and veterans in receiving health care and benefits from the ,department of ,defense and the ,department of ,veterans ,affairs4 7b7 ,elements ,each report required by subsection 7a7 shall include1 for the period covered by the report1 the following3 7#a7 ,an identification of toxic exposure events that may not be fully captured by the current systems of the ,department of ,defense for environmental1 occupational1 and health monitoring1 and recommendations for how to improve those systems4 7#b7 ,an analysis of the quality of the location data used by the ,department of ,defense in determining toxic exposures of members of the ,armed ,forces and veterans1 and recommendations for how to improve the quality of that location data if necessary4 7c7 ,definitions ,in this section3 7#a7 ,appropriate committees of ,congress ,the term appropriate committees of ,congress means-- 7,a7 the ,committee on ,armed ,services and the ,committee on ,veterans' ,affairs of the ,senate2 and 7,b7 the ,committee on ,armed ,services and the ,committee on ,veterans' ,affairs of the ,house of ,representatives4 7#b7 ,toxic exposure ,the term toxic exposure has the meaning given that term in section #aja7cg7 of title #ch1 ,united ,states ,code1 as added by section #ajb7;b74 #gje4 ,correction of exposure records by members of the ,armed ,forces and veterans 7a7 ,in general ,the ,secretary of ,defense and the ,secretary of ,veterans ,affairs shall provide a means for members of the ,armed ,forces and veterans to update their records as necessary to reflect a toxic exposure by such member or veteran in the ,individual ,longitudinal ,exposure ,record4 7b7 ,evidence 7#a7 ,provision of evidence ,to update a record under subsection 7a71 a member of the ,armed ,forces or veteran1 as the case may be1 shall provide such evidence as the ,secretary of ,defense and the ,secretary of ,veterans ,affairs jointly consider necessary4 7#b7 ,benefit of the doubt ,in reviewing evidence provided under paragraph 7#a71 the ,secretary of ,defense and the ,secretary of ,veterans ,affairs shall give the benefit of the doubt to the member of the ,armed ,forces or veteran who provided the evidence1 as the case may be1 in a manner that is equivalent to the benefit of the doubt required under section #eajg7;b7 of title #ch1 ,united ,states ,code4 7#c7 ,regulations ,the ,secretary of ,veterans ,affairs1 in consultation with the ,secretary of ,defense1 shall prescribe by regulation the evidence considered necessary under paragraph 7#a74 7c7 ,toxic exposure defined ,in this section1 the term toxic exposure has the meaning given that term in section #aja7cg7 of title #ch1 ,united ,states ,code1 as added by section #ajb7;b74 ,february #bb1 #bjbb,reported from the ,committee on ,veterans' ,affairs,february #bb1 #bjbb;,committee on ,armed ,services discharged2 committed to the ,committee of the ,whole ,house on the ,state of the ,union and ordered to be printed