,,ii ,calendar ,no4 #ade #aagth         
,,congress  #ast ,session  ,s4 #cjjc    
,,in ,,the ,,senate ,,of ,,the ,,united 
,,states  ,october #ai1 #bjba,mr4       
,tester1 from the ,committee on         
,veterans' ,affairs1 reported the       
following original bill2 which was read 
twice and placed on the calendar  ,a    
,,bill  ,to improve health care and     
benefits for veterans exposed to toxic  
substances1 and for other purposes4  #a4
 ,short title2 table of contents  7a7   
,short title ,this ,act may be cited as 
the ,comprehensive and ,overdue ,support
 for ,troops of ,war ,act of #bjba or   
the ,,cost of ,war ,act of #bjba4  7b7  
,table of contents ,the table of        
contents for this ,act is as follows3   
,sec4 #a4 ,short title2 table of        
contents4,,title ,i--,expansion of      
health care for toxic exposure          
veterans,sec4 #aja4 ,health care for    
certain toxic exposure veterans4,sec4   
#ajb4 ,expansion of health care         
eligibility for certain veterans exposed

 to open burn pits4,sec4 #ajc4          
,expansion of health care eligibility   
for veterans awarded certain            
medals4,sec4 #ajd4 ,study on feasibility
 and advisability of furnishing hospital
 care and medical services to dependents
 of veterans who participated in toxic  
exposure risk activities4,,title        
,,ii--,reforms to the toxic exposure    
presumption process,sec4 #bja4          
,improvements to ability of ,department 
of ,veterans ,affairs to establish      
presumptions of service connection based
 on toxic exposure4,sec4 #bjb4          
,technical corrections4,,title          
,,iii--,reforms to the service          
connection process for toxic exposure   
veterans,sec4 #cja4 ,presumptions of    
toxic exposure4,sec4 #cjb4 ,presumption 
of exposure to airborne hazards and     
substances from burn pits4,sec4 #cjc4   
,medical nexus examinations for toxic   
exposures4,,title ,,iv--,expansion of   
presumptions of service connection for  
forgotten veterans,sec4 #dja4 ,mark     

,takai ,atomic ,veterans ,healthcare    
,parity ,act of #bjba4,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 the ,republic of 
,vietnam4,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--,strengthening       

,federal research on toxic              
exposures,sec4 #eja4 ,coordination by   
,department of ,veterans ,affairs of    
toxic exposure research4,sec4 #ejb4     
,collection1 analysis1 and report on    
treatment of veterans for medical       
conditions related to toxic             
exposure4,sec4 #ejc4 ,studies relating  
to veterans who served in ,southwest    
,asia4,sec4 #ejd4 ,study on health      
trends of post #i_/aa veterans4,sec4    
#eje4 ,study on cancer rates among      
veterans4,,title ,,vi--,improving       
support to toxic exposure veterans,sec4 
#fja4 ,definitions4,sec4 #fjb4          
,publication of list of resources of    
,department of ,veterans ,affairs for   
toxic exposure 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

 exposure veterans4,sec4 #fje4 ,,sfc    
,heath ,robinson ,burn ,pit             
,transparency ,act4,,title              
,,vii--,strengthening record-keeping of 
toxic exposures by ,department of       
,defense,sec4 #gja4 ,definitions4,sec4  
#gjb4 ,independent study on ,individual 
,longitudinal ,exposure ,record4,sec4   
#gjc4 ,biannual report on ,individual   
,longitudinal ,exposure ,record4,sec4   
#gjd4 ,correction of toxic exposure     
records4  ,i ,expansion of health care  
for toxic exposure veterans  #aja4      
,health care for certain toxic exposure 
veterans  7a7 ,in general ,section      
#agaj7;e7 of title #ch1 ,united ,states 
,code1 is amended-- 7#a7 paragraph 7#a71
 by adding at the end the following new 
subparagraph3  7,g7 ,subject to         
paragraph 7#b71 any 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 illness1 notwithstanding that there 
is insufficient medical evidence to     
conclude that such illness is           
attributable to such toxic exposure risk
 activity4  2 and  7#b7 in paragraph    
7#b77;,b7-- 7,a7 by striking or 7,f7 and
 inserting 7,f71 or 7,g72 and  7,b7 by  
striking service or testing and         
inserting service1 testing1 or activity4
  7b7 ,definitions ,section #aja of such
 title 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  
activity4  7,b7 ,an exposure to a toxic 
or hazardous substance that is subject  
to regulation by the ,occupational      
,safety and ,health ,administration4    
7#ch7 ,the term toxic exposure veteran  
means any veteran who-- 7,a7 carried out
 a toxic exposure risk activity2 or     
7,b7 received or receives hospital care1
 medical services1 or nursing home care 
pursuant to section #agaj7;e77#a7 of    

this title4  7#ci7 ,the term toxic      
exposure risk activity means any        
activity-- 7,a7 that requires a         
corresponding entry in the ,individual  
,longitudinal ,exposure ,record of the  
veteran who carried out the activity2 or
  7,b7 that the ,secretary determines   
qualifies for purposes of section       
#agaj7;e77#a7 of this title when taking 
into account what is reasonably prudent 
to protect the health of veterans4      
7#dj7 ,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  4  #ajb4 ,expansion of health 
care eligibility for certain veterans   
exposed to open burn pits  7a7 ,in      
general ,section #agaj7;e7 of title #ch1
 ,united ,states ,code1 as amended by   
section #aja7;a77#b77;,a71 is further   

amended-- 7#a7 in paragraph 7#a71 by    
adding at the end the following new     
subparagraph3  7,h7 7i7 ,subject to     
paragraph 7#b71 a covered veteran is    
eligible for hospital care1 medical     
services1 and nursing home care under   
subsection 7a77#b77;,f7 for any illness4
  7ii7 ,for purposes of this            
subparagraph1 a covered veteran is a    
veteran who-- 7,i7 is eligible for      
inclusion in the ,airborne ,hazards and 
,open ,burn ,pit ,registry2 or  7,,ii7  
has been identified by the ,secretary of
 ,defense to have been possibly exposed1
 inside or outside the ,united ,states1 
during active duty1 active duty for     
training1 or inactive duty training1 to 
an open burn pit4  7iii7 ,in this       
subparagraph3 7,i7 ,the term ,airborne  
,hazards and ,open ,burn ,pit ,registry 
means the registry established by the   
,secretary under section #bja of the    
,dignified ,burial and ,other ,veterans'
 ,benefits ,improvement ,act of #bjab   
7,public ,law #aab-bfj2 #ch ,u4,s4,c4   

#ebg note74  7,,ii7 ,the term open burn 
pit has the meaning given that term in  
section #bja7;c7 of the ,dignified      
,burial and ,other ,veterans' ,benefits 
,improvement ,act of #bjab 7,public ,law
 #aab-bfj2 #ch ,u4,s4,c4 #ebg note74  2 
and  7#b7 in paragraph 7#b77;,b71 as    
amended by section #aja7;a77#b77;,a71 by
 striking or 7,g7 and inserting 7,g71 or
 7,h74  7b7 ,effective date ,the        
amendments made by subsection 7a7 shall 
take effect on the date that is #ij days
 after the date of the enactment of this
 ,act4  #ajc4 ,expansion of health care 
eligibility for veterans awarded certain
 medals  7a7 ,in general ,section       
#agaj7;e7 of title #ch1 ,united ,states 
,code1 as amended by section            
#ajb7;a77#a71 is further amended-- 7#a7 
in paragraph 7#a71 by adding at the end 
the following new subparagraph3  7,i7   
,subject to paragraph 7#b71 a veteran is
 eligible for hospital care1 medical    
services1 and nursing home care under   
subsection 7a77#b77;,f7 for any illness 

if the veteran was awarded any of the   
following3 7i7 ,the ,afghanistan        
,campaign ,medal4  7ii7 ,the ,armed     
,forces ,expeditionary ,medal4  7iii7   
,the ,global ,war on ,terrorism         
,expeditionary ,medal4  7iv7 ,the       
,inherent ,resolve ,campaign ,medal4    
7v7 ,the ,iraqi ,campaign ,medal4  7vi7 
,the ,southwest ,asia ,service ,medal4  
2 and  7#b7 in paragraph 7#b77;,b71 as  
amended by section #ajb7;a77#b71 by     
striking or 7,h7 and inserting 7,h71 or 
7,i74  7b7 ,effective date ,the         
amendments made by subsection 7a7 shall 
take effect on the date that is #ij days
 after the date of the enactment of this
 ,act4  #ajd4 ,study on feasibility and 
advisability of furnishing hospital care
 and medical services to dependents of  
veterans who participated in toxic      
exposure risk activities  7a7 ,in       
general ,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     
#aja7;a77#a71 for any illness or        
condition 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 or condition 
is attributable to such activity4  7b7  
,elements of study ,the study required  
under subsection 7a7 shall-- 7#a7 assess
 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 assess the  
potential cost of furnishing hospital   
care and medical services to qualifying 
dependents as described in such         

subsection2  7#c7 estimate the resources
 required to furnish such care and      
services2  7#d7 assess any stress or    
other impact furnishing such care and   
services would have on the claims and   
appeals system of the ,department2  7#e7
 estimate the number of qualifying      
dependents who would be eligible for    
such care and services2 and  7#f7 assess
 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     
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 installations
 of the ,department of ,defense in the  
,united ,states2  7#b7 explore the      
liability of the ,department of ,defense
 in each such case2 and  7#c7 assess    
whether the ,department 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 ,hospital care and   
medical services ,the terms hospital    
care and medical services have the      
meanings given those terms in section   
#agja of title #ch1 ,united ,states     
,code4  7#b7 ,qualifying dependent ,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 #aja7;a77#b7 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 or condition that is    
connected to the toxic exposure risk    
activity of the veteran1 as determined  
by the ,secretary4  7#c7 ,,tricare      
program ,the term ,,tricare program has 
the meaning given that term in section  
#ajgb7g7 of title #aj1 ,united ,states  
,code4  ,,ii ,reforms to the toxic      
exposure presumption process  #bja4     
,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 of title    

#ch1 ,united ,states ,code1 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 to modify1 or to remove      
presumptions of service connection based
 on toxic exposure pursuant to this     
subchapter1 whereby-- 7#a7 the ,toxic   
,exposure ,review ,commission advises   
the ,secretary and makes recommendations
 pursuant to section #aagb of this      
title2  7#b7 the ,national ,academies of
 ,sciences1 ,engineering1 and ,medicine1
 reviews and evaluates the available    
scientific evidence pursuant to an      
agreement under section #aagc of this   
title2  7#c7 the working group          
established under section #aagd of this 
title evaluates the conclusions of the  

,national ,academies of ,sciences1      
,engineering1 and ,medicine pursuant to 
the agreement described in paragraph    
7#b7 and makes recommendations to the   
,secretary under such section2 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  
,,faca ,the ,federal ,advisory          
,committee ,act 7#e ,u4,s4,c4 ,app47    
shall not apply to an entity established
 under this subchapter4  #aagb4 ,toxic  
,exposure ,review ,commission  7a7      
,establishment ,the ,secretary shall    
establish an independent commission to  
be known as the ,toxic ,exposure ,review
 ,commission 7in this section referred  
to as the ,commission74  7b7 ,purpose   
,the ,commission shall-- 7#a7 advise the
 ,secretary on questions relating to    
toxic exposures that require scientific 
research2 and  7#b7 assist in the       

consideration of possible presumptions  
of service connection relating to toxic 
exposure4  7c7 ,duties  7#a7 ,the       
,commission shall carry out the         
following duties3 7,a7 ,collect any     
relevant information from the           
,department of ,defense and other       
sources to identify possible toxic      
exposures relating to service during    
active duty1 active duty for training1  
or inactive duty training in order to   
determine the need for a comprehensive  
review under an agreement with the      
,national ,academies of ,sciences1      
,engineering1 and ,medicine under       
section #aagc of this title4  7,b7      
,recommend to the ,secretary1 by        
majority vote1 whether a review should  
be conducted under an agreement with the
 ,national ,academies of ,sciences1     
,engineering1 and ,medicine under       
section #aagc of this title4  7,c7      
,recommend to the ,secretary1 by        
majority vote1 whether new1 independent 
studies regarding the health outcomes of

 toxic exposures1 or any other new1     
independent studies that the ,commission
 deems necessary and appropriate1 should
 be conducted4  7,d7 ,annually report to
 ,congress on progress regarding the    
duties set forth in subparagraphs 7,a7  
through 7,c71 any recommendations made  
to the ,secretary1 and any responses of 
the ,secretary to such recommendations4 
7#b7 7,a7 ,relevant information may be  
collected under paragraph 7#a77;,a7 from
 the following3 7i7 ,any ,federal agency
 as the ,commission considers necessary 
to carry out this section4  7ii7 ,public
 meetings or hearings1 which may be held
 to take such testimony and receive such
 evidence as the ,commission considers  
advisable to carry out the duties of the
 ,commission4  7,b7 ,upon request of the
 chairperson of the ,commission1 the    
head of a ,federal agency shall furnish 
information collected under subparagraph
 7,a77i7 to the ,commission unless such 
information is classified4  7d7         
,membership  7#a7 7,a7 ,the ,commission 

shall be composed of nine members1      
appointed as follows3 7i7 ,two members  
appointed by the majority leader of the 
,senate4  7ii7 ,two members appointed by
 the minority leader of the ,senate4    
7iii7 ,two members appointed by the     
,speaker of the ,house of               
,representatives4  7iv7 ,two members    
appointed by the minority leader of the 
,house of ,representatives4  7v7 ,one   
member appointed by the ,secretary4     
7,b7 ,the initial members of the        
,commission shall be appointed under    
subparagraph 7,a7 not later than #ahj   
days after the date of the enactment of 
the ,comprehensive and ,overdue ,support
 for ,troops of ,war ,act of #bjba4     
7#b7 ,in appointing individuals under   
paragraph 7#a77;,a71 the majority leader
 of the ,senate1 the minority leader of 
the ,senate1 the ,speaker of the ,house 
of ,representatives1 the minority leader
 of the ,house of ,representatives1 and 
the ,secretary shall jointly ensure that
 at least five members of the           

,commission are scientists or health    
care professionals-- 7,a7 of whom-- 7i7 
one has a background in the field of    
respiratory medicine2  7ii7 one has a   
background in the field of endocrinology
 and metabolic medicine2  7iii7 one has 
a background in hematology2  7iv7 one   
has a background in oncology2 and  7v7  
one has a background in occupational and
 environmental health2 and  7,b7 who are
 not officials or employees of the      
,federal ,government4  7#c7 ,in         
appointing individuals under paragraph  
7#a77;,a71 the majority leader of the   
,senate1 the minority leader of the     
,senate1 the ,speaker of the ,house of  
,representatives1 the minority leader of
 the ,house of ,representatives1 and the
 ,secretary shall jointly ensure that at
 least two members of the ,commission   
represent an organization recognized by 
the ,secretary for the representation of
 veterans under section #eijb of this   
title4  7#d7 ,in appointing individuals 
under paragraph 7#a77;,a71 the majority 

leader of the ,senate1 the minority     
leader of the ,senate1 the ,speaker of  
the ,house of ,representatives1 the     
minority leader of the ,house of        
,representatives1 and the ,secretary    
shall jointly give consideration to     
including in the ,commission at least   
one member who works with survivors of  
illnesses relating to toxic exposures   
and has a background in the field of    
study of toxic exposures4  7e7 ,meetings
  7#a7 ,the ,commission shall meet not  
less frequently than twice each year4   
7#b7 7,a7 ,each meeting of the          
,commission shall be open to the public4
  7,b7 ,all the proceedings1            
information1 and deliberations of the   
,commission shall be available for      
review by the public4  7,c7 ,meetings of
 the ,commission may be carried out     
through the use of telephonic or other  
appropriate telecommunication technology
 if the ,commission determines that such
 technology will allow the members to   
communicate simultaneously4  7f7        

,chairperson and vice chair ,at the     
initial meeting of the ,commission under
 subsection 7e71 the ,commission shall  
select a chairperson and vice           
chairperson from among the members of   
the ,commission by a majority vote of   
the members of the ,commission4  7g7    
,period of appointment2 vacancies  7#a7 
,a member of the ,commission shall be   
appointed for a term that may not exceed
 four years4  7#b7 ,the ,secretary shall
 ensure that terms of members of the    
,commission are staggered so that no    
such terms end on the same date4  7#c7  
,a vacancy in the ,commission shall be  
filled in the same manner as the        
original appointment1 but the individual
 appointed to fill the vacancy shall    
serve only for the unexpired portion of 
the term for which the individual's     
predecessor was appointed4  7#d7 ,in    
appointing the initial members of the   
,commission1 each official who is       
authorized to appoint two members of the
 ,commission shall appoint-- 7,a7 one   

member whose term expires after two     
years2 and  7,b7 one member whose term  
expires after four years4  7h7 ,pay     
7#a7 ,members of the ,commission shall  
serve without pay4  7#b7 ,each member of
 the ,commission who is an officer or   
employee of the ,united ,states shall   
serve without compensation in addition  
to that received for service as an      
officer or employee of the ,united      
,states4  7#c7 ,members shall receive   
travel expenses1 including per diem in  
lieu of subsistence1 in accordance with 
sections #egjb and #egjc of title #e4   
7i7 ,director of staff  7#a7 ,the       
,commission shall appoint a ,director   
who-- 7,a7 has not served as an employee
 of the ,department during the one-year 
period preceding the date of such       
appointment2 and  7,b7 is not otherwise 
barred or prohibited from serving as    
,director under ,federal ethics laws and
 regulations1 by reason of              
post-employment conflict of interest4   
7#b7 ,the ,director shall be paid at the

 rate of basic pay payable for level    
,,iv of the ,executive ,schedule under  
section #ecae of title #e4  7j7 ,staff  
7#a7 ,subject to paragraphs 7#b7 and    
7#c71 the ,director1 with the approval  
of the ,commission1 may appoint and fix 
the pay of additional personnel4  7#b7  
,the ,director may make such            
appointments without regard to the      
provisions of title #e governing        
appointments in the competitive service1
 and any personnel so appointed may be  
paid without regard to the provisions of
 chapter #ea and subchapter ,,iii of    
chapter #ec of that title relating to   
classification and ,general ,schedule   
pay rates1 except that an individual so 
appointed may not receive pay in excess 
of the annual rate of basic pay payable 
for ,,gs-#ae of the ,general ,schedule4 
7#c7 7,a7 ,not more than two-thirds of  
the personnel employed by or detailed to
 the ,commission may be on detail from  
the ,department4  7,b7 ,not more than   
half of the professional analysts of the

 ,commission staff may be persons       
detailed from the ,department to the    
,commission4  7#d7 ,subject to paragraph
 7#c71 the head of any ,federal agency1 
upon the request of the ,director1 may  
detail any of the personnel of that     
agency to the ,commission to assist the 
,commission in carrying out its duties  
under this section4  7#e7 ,the          
,commission may secure directly from any
 ,federal agency such information as the
 ,commission considers necessary to     
carry out this section4 ,upon request of
 the chairperson of the ,commission1 the
 head of such agency shall furnish such 
information to the ,commission1 unless  
such information is classified4  7k7    
,other authority  7#a7 ,the ,commission 
may procure by contract1 to the extent  
funds are available1 the temporary or   
intermittent services of experts or     
consultants pursuant to section #caji of
 title #e4  7#b7 ,to the extent funds   
are available1 the ,commission may lease
 real property and acquire personal     

property either of its own accord or in 
consultation with the ,general ,services
 ,administration4  7l7 ,communications  
7#a7 7,a7 ,except as provided in        
subparagraph 7,b71 no person may        
restrict an employee of the ,department 
in communicating with the ,commission4  
7,b7 ,subparagraph 7,a7 does not apply  
to a communication that is unlawful4    
7#b7 ,all ex parte communications with  
the ,commission shall be made part of   
the public record4  7m7 ,responses by   
,secretary ,in response to each report  
submitted to the ,secretary by the      
,commission under subsection 7c77#a71   
the ,secretary shall submit to the      
,committee on ,veterans' ,affairs of the
 ,senate and the ,committee on          
,veterans' ,affairs of the ,house of    
,representatives and make available to  
the public a report on-- 7#a7 the       
findings and opinions of the ,secretary 
with respect to the report most recently
 submitted under subsection 7c77#a72    
7#b7 whether the ,secretary intends to  

nominate for review under an agreement  
with the ,national ,academies of        
,sciences1 ,engineering1 and ,medicine  
under section #aagc of this title the   
review recommended by the ,committee in 
the report1 and if not1 an explanation  
of why1 including citations and sources2
 and  7#c7 whether the ,secretary       
intends to follow any other             
recommendation made by the ,commission4 
#aagc4 ,science review agreement  7a7   
,purpose ,the purpose of this section is
 to provide for the ,national ,academies
 of ,sciences1 ,engineering1 and        
,medicine 7in this section referred to  
as the ,academies71 an independent      
nonprofit scientific organization with  
appropriate expertise that is not part  
of the ,federal ,government1 to review  
and evaluate the available scientific   
evidence regarding associations between 
illnesses and toxic exposures4  7b7     
,agreement  7#a7 ,the ,secretary shall  
seek to enter into a #aj-year agreement 
with the ,academies to perform the      

services covered by this section4  7#b7 
,the ,secretary shall seek to enter into
 an agreement described in paragraph    
7#a7 not later than #fj days after the  
date of the enactment of the            
,comprehensive and ,overdue ,support for
 ,troops of ,war ,act of #bjba4  7#c7   
,an agreement under this section may be 
extended in five-year or #aj-year       
increments4  7c7 ,review of scientific  
evidence ,under an agreement between the
 ,secretary and the ,academies under    
this section1 the ,academies shall      
review and summarize the scientific     
evidence1 and assess the strength       
thereof1 concerning the association     
between toxic exposures during active   
military1 naval1 or air service and each
 illness suspected to be associated with
 such exposure in the human population4 
7d7 ,scientific determinations          
concerning illnesses ,for each illness  
reviewed under subsection 7c71 the      
,academies shall determine1 to the      
extent that available scientific data   

permit meaningful determinations-- 7#a7 
whether an association exists between a 
toxic exposure and the occurrence of the
 illness1 taking into account the       
strength of the scientific evidence and 
the appropriateness of the statistical  
and epidemiological methods used to     
detect the association2  7#b7 the       
increased risk of the illness among     
those subject to toxic exposures during 
active military1 naval1 or air service2 
and  7#c7 whether there exists a        
plausible biological mechanism or other 
evidence of a causal relationship       
between the toxic exposure and the      
occurrence of the illness4  7e7         
,cooperation of ,federal agencies ,the  
head of each relevant ,federal agency1  
including the ,secretary of ,defense1   
shall cooperate fully with the          
,academies in performing the services   
covered by this section4  7f7           
,recommendations for additional         
scientific studies  7#a7 ,under an      
agreement between the ,secretary and the

 ,academies under this section1 the     
,academies shall make any               
recommendations for additional          
scientific studies to resolve areas of  
continuing scientific uncertainty       
relating to toxic exposures4  7#b7 ,in  
making recommendations under paragraph  
7#a71 the ,academies shall consider--   
7,a7 the scientific information that is 
available at the time of the            
recommendation2  7,b7 the value and     
relevance of the information that could 
result from additional studies2 and     
7,c7 the cost and feasibility of        
carrying out such additional studies4   
7g7 ,reports  7#a7 ,under an agreement  
between the ,secretary and the          
,academies under this section1 for each 
review conducted under subsection 7c71  
the ,academies shall submit to the      
,secretary1 the ,committee on ,veterans'
 ,affairs of the ,senate1 and the       
,committee on ,veterans' ,affairs of the
 ,house of ,representatives an initial  
report on the activities of the         

,academies under the agreement4  7#b7   
,the report submitted under paragraph   
7#a7 shall include the following3 7,a7  
,the determinations described in        
subsection 7d74  7,b7 ,a full           
explanation of the scientific evidence  
and reasoning that led to such          
determinations4  7,c7 ,any              
recommendations of the ,academies under 
subsection 7f74  7h7 ,alternative       
contract scientific organization  7#a7  
,if the ,secretary is unable to enter   
into an agreement with the ,academies   
for the purposes of this section on     
terms acceptable to the ,secretary1 the 
,secretary shall seek to enter into an  
agreement for the purposes of this      
section with another appropriate        
scientific organization that-- 7,a7 is  
not part of the ,federal ,government2   
7,b7 operates as a not-for-profit       
entity2 and  7,c7 has expertise and     
objectivity comparable to that of the   
,academies4  7#b7 ,if the ,secretary    
enters into an agreement with another   

organization as described in paragraph  
7#a71 any reference in this subchapter  
to the ,national ,academies of          
,sciences1 ,engineering1 and ,medicine  
shall be treated as a reference to the  
other organization4  #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-- 7#a7 to evaluate 
the conclusions of the ,national        
,academies of ,sciences1 ,engineering1  
and ,medicine contained in each report  
submitted under section #aagc7;g7 of    
this title2 and  7#b7 to develop and    
submit to the ,secretary a              
recommendation within #fj days of the   
,secretary's receipt of a report under  
section #aagc7;g7 of this title with    
respect to whether-- 7,a7 to establish a
 presumption of service connection      
between each toxic exposure and illness 
covered by a report described in        
paragraph 7#a72 or  7,b7 to modify an   

existing presumption of service         
connection covered by a report described
 in paragraph 7#a74  7b7                
,recommendations  7#a7 ,in making a     
recommendation under subsection 7a77#b71
 the ,working ,group shall1 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        
additional research1 studies1 or        
reports4  7#b7 ,in making a             
recommendation under subsection 7a77#b71
 the ,working ,group shall consider only
 the positive association between a     
toxic exposure and an illness4  7#c7    
,concurrent with the submittal of a     
recommendation to the ,secretary under  
subsection 7a77#b71 the ,working ,group 
shall submit to the ,committee on       
,veterans' ,affairs of the ,senate and  
the ,committee on ,veterans' ,affairs of

 the ,house of ,representatives a       
description of such recommendation4     
#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 determination1 and all  
materials the ,secretary relied upon for
 the determination4  7b7 ,final         

regulation ,not later than #ij 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 or 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 
adding at the end 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 ,toxic ,exposure    
,review ,commission4 #aagc4 ,science    
review agreement4 #aagd4 ,working group 
on presumptions of service connection4  
#aage4 ,regulations regarding           
presumptions of service connection based
 on toxic exposure4  4  7b7             
,establishment of working group ,not    
later than #abj days after the date of  

the enactment of this ,act1 the         
,secretary of ,veterans ,affairs shall  
establish the working group required by 
section #aagd7;a7 of title #ch1 ,united 
,states ,code1 as added by subsection   
7a74  7c7 ,conforming amendments        
,chapter #aa of title #ch1 ,united      
,states ,code1 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 ,comprehensive  
and ,overdue ,support for ,troops of    
,war ,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 7c74  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 ,comprehensive and ,overdue      
,support for ,troops of ,war ,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    
#bjb4 ,technical corrections  7a7 ,in   
general ,subchapter ,,vi of chapter #aa 
of title #ch1 ,united ,states ,code1 is 
amended-- 7#a7 by redesignating section 
#aafe as section #aaff2 and  7#b7 by    
redesignating the section #aafd that was

 added by section #eeja7;a77#a7 of the  
,johnny ,isakson and ,david ,p4 ,roe1   
,m4,d4 ,veterans ,health ,care and      
,benefits ,improvement ,act of #bjbj    
7,public ,law #aaf-cae7 as section      
#aafe4  7b7 ,conforming clerical        
amendments ,the table of sections at the
 beginning of such chapter is amended by
 striking the items relating to the     
section #aafd that was added by section 
#eeja7;a77#a7 of the ,johnny ,isakson   
and ,david ,p4 ,roe1 ,m4,d4 ,veterans   
,health ,care and ,benefits ,improvement
 ,act of #bjbj 7,public ,law #aaf-cae7  
and section #aafe and inserting the     
following new items3  #aafe4            
,specialized teams to evaluate claims   
involving military sexual trauma4#aaff4 
,choice of sex of medical examiner for  
certain disabilities4  4  ,,iii ,reforms
 to the service connection process for  
toxic exposure veterans  #cja4          
,presumptions of toxic exposure  7a7 ,in
 general ,subchapter ,,ii of chapter #aa
 of title #ch1 ,united ,states ,code1 is

 amended by adding at the end the       
following new section3  #aaai4          
,presumptions of toxic exposure  7a7    
,presumption of toxic exposure ,except  
as provided in section #aabj of this    
title1 if a veteran submits to the      
,secretary a claim for compensation for 
a service-connected disability under    
section #aaaj of this title with        
indication of a toxic exposure that     
occurred during active military1 naval1 
or air service1 the ,secretary shall    
presume that the veteran was subject to 
such toxic exposure-- 7#a7 if the       
,individual ,longitudinal ,exposure     
,record of the veteran includes evidence
 of the toxic exposure2 or  7#b7 in a   
case in which the ,individual           
,longitudinal ,exposure ,record of the  
veteran does not indicate that the      
veteran was subject to the claimed toxic
 exposure during active military1 naval1
 or air service1 if credible evidence of
 the facts1 places1 and circumstances of
 the service of the veteran in the      

active military1 naval1 or air service1 
including evidence of the veteran's unit
 assignments1 military specialty1 or    
date and location of service1 shows the 
veteran was subject to the claimed toxic
 exposure during such service4  7b7     
,role of lay statements ,in a case      
described in subsection 7a77#b71 the    
,secretary shall accept as credible     
evidence under such subsection a lay    
statement by the veteran or another that
 is consistent with the other credible  
evidence of the facts1 places1 and      
circumstances of the veteran's service  
in the active military1 naval1 or air   
service4  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 #aaah the following new item3   
#aaai4 ,presumptions of toxic exposure4 
4  7c7 ,conforming amendment ,section   
#aaac of such title is amended by       
striking or #aaah each place it appears 
and inserting #aaah1 or #aaai4  #cjb4   

,presumption of exposure to airborne    
hazards and substances from burn pits   
7a7 ,in general ,subchapter ,,ii of     
chapter #aa of title #ch1 ,united       
,states ,code1 as amended by section    
#cja7;a71 is further amended by adding  
at the end the following new section3   
#aabj4 ,presumption of exposure to      
certain airborne hazards and substances 
from participation in contingency       
operations  7a7 ,in general ,for        
purposes of section #aaaj and chapter   
#ag of this title1 any veteran described
 in subsection 7b7 shall be presumed to 
have been exposed to the substances1    
chemicals1 and hazards listed in        
subsection 7c71 unless there is         
affirmative evidence to establish that  
the veteran was not exposed to any such 
substances1 chemicals1 or hazards during
 that service4  7b7 ,veterans described 
7#a7 ,a veteran described in this       
paragraph is any veteran who-- 7,a7     
during active military1 naval1 or air   
service1 was deployed in support of a   

contingency operation while so serving  
and as part of such deployment served in
 a covered location during a            
corresponding period set forth under    
paragraph 7#b72 or  7,b7 on or after    
,august #b1 #aiij1 was awarded any of   
the following3 7i7 ,the ,afghanistan    
,campaign ,medal4  7ii7 ,the ,armed     
,forces ,expeditionary ,medal4  7iii7   
,the ,global ,war ,on ,terrorism        
,expeditionary ,medal4  7iv7 ,the       
,inherent ,resolve ,campaign ,medal4    
7v7 ,the ,iraqi ,campaign ,medal4  7vi7 
,the ,southwest ,asia ,service ,medal4  
7#b7 7,a7 ,the covered locations and    
corresponding periods set forth under   
this subsection are as follows3 7i7     
,iraq and the following periods3 7,i7   
,the period beginning on ,august #b1    
#aiij1 and ending on ,february #bh1     
#aiia4  7,,ii7 ,the period beginning on 
,march #ai1 #bjjc1 and ending on such   
date as the ,secretary determines burn  
pits are no longer used in ,iraq4  7ii7 
,the ,southwest ,asia ,theater of       

operations1 other than ,iraq1 and the   
period beginning on ,august #b1 #aiij1  
and ending on such date as the          
,secretary determines burn pits are no  
longer used in such location1 including 
the following3 7,i7 ,kuwait4  7,,ii7    
,saudi ,arabia4  7,,iii7 ,oman4  7,,iv7 
,qatar4  7iii7 ,afghanistan and the     
period beginning on ,september #aa1     
#bjja1 and ending on such date as the   
,secretary determines burn pits are no  
longer used in ,afghanistan4  7iv7      
,djibouti and the period beginning on   
,september #aa1 #bjja1 and ending on    
such date as the ,secretary determines  
burn pits are no longer used in         
,djibouti4  7v7 ,syria and the period   
beginning on ,september #aa1 #bjja1 and 
ending on such date as the ,secretary   
determines burn pits are no longer used 
in ,syria4  7vi7 ,jordan and the period 
beginning on ,september #aa1 #bjja1 and 
ending on such date as the ,secretary   
determines burn pits are no longer used 
in ,jordan4  7vii7 ,egypt and the period

 beginning on ,september #aa1 #bjja1 and
 ending on such date as the ,secretary  
determines burn pits are no longer used 
in ,egypt4  7viii7 ,lebanon and the     
period beginning on ,september #aa1     
#bjja1 and ending on such date as the   
,secretary determines burn pits are no  
longer used in ,lebanon4  7ix7 ,yemen   
and the period beginning on ,september  
#aa1 #bjja1 and ending on such date as  
the ,secretary determines burn pits are 
no longer used in ,yemen4  7x7 ,such    
other locations as are set forth by the 
,airborne ,hazards and ,open ,burn ,pit 
,registry established under section #bja
 of the ,dignified ,burial and ,other   
,veterans' ,benefits ,improvement ,act  
of #bjab 7,public ,law #aab-bfj2 #ch    
,u4,s4,c4 #ebg note7 and corresponding  
periods set forth in such registry4     
7xi7 ,such other locations and          
corresponding periods as the ,secretary1
 in collaboration with the ,secretary of
 ,defense1 may determine appropriate in 
a report the ,secretary of ,veterans    

,affairs shall submit to ,congress not  
later than two years after the date of  
the enactment of the ,veterans ,burn    
,pits ,exposure ,recognition ,act of    
#bjba and not less frequently than once 
every two years thereafter4  7,b7 ,a    
location set forth under this paragraph 
shall not include any body of water     
around or any airspace above such       
location4  7c7 ,substances1 chemicals1  
and airborne hazards  7#a7 ,subject to  
paragraph 7#b71 the substances1         
chemicals1 and airborne hazards listed  
in this subsection are as follows3 7,a7 
,particulate matter1 including the      
following3 7i7 ,,pm-#aj4  7ii7          
,,pm-#b4e4  7,b7 ,polycyclic aromatic   
hydrocarbons 7,p,a,hs71 including the   
following3 7i7 ,acenaphthene4  7ii7     
,acenaphthylene4  7iii7 ,anthracene4    
7iv7 ,benzo7a7anthracene4  7v7          
,benzo7a7pyrene4  7vi7                  
,benzo7b7fluoroanthene4  7vii7          
,benzo7g1h1i7perylene4  7viii7          
,benzo7k7fluoroanthene4  7ix7 ,chrysene4

  7x7 ,dibenz7a1h7anthracene4  7xi7     
,fluoranthene4  7xii7 ,fluorene4  7xiii7
 ,indeno7#a1b1c-;cd7pyrene4  7xiv7      
,naphthalene4  7xv7 ,phenanthrene4      
7xvi7 ,pyrene4  7,c7 ,volatile organic  
compounds 7,v,o,cs71 including the      
following3 7i7 ,acetone4  7ii7          
,acrolein4  7iii7 ,benzene4  7iv7       
,carbon ,disulfide4  7v7                
,chlorodifluoromethane4  7vi7           
,chloromethane4  7vii7 ,ethylbenzene4   
7viii7 ,hexane4  7ix7                   
,hexachlorobutadiene4  7x7 m_/p-,xylene4
  7xi7 ,methylene ,chloride4  7xii7     
,pentane4  7xiii7 ,propylene4  7xiv7    
,styrene4  7xv7 ,toluene4  7,d7 ,toxic  
organic halogenated dioxins and furans  
7dioxins71 including the following3 7i7 
#a1b1c1d1f1g1h ,,hpcdd4  7ii7           
#a1b1c1d1f1g1h ,,hpcdf4  7iii7          
#a1b1c1d1g1h1i ,,hpcdf4  7iv7           
#a1b1c1d1g1h ,,hxcdd4  7v7 #a1b1c1d1g1h 
,,hxcdf4  7vi7 #a1b1c1f1g1h ,,hxcdd4    
7vii7 #a1b1c1f1g1h ,,hxcdf4  7viii7     
#a1b1c1g1h1i ,,hxcdd4  7ix7 #a1b1c1g1h1i

 ,,hxcdf4  7x7 #a1b1c1g1h ,,pecdd4  7xi7
 #a1b1c1g1h ,,pecdf4  7xii7 #b1c1d1f1g1h
 ,,hxcdf4  7xiii7 #b1c1d1g1h ,,pecdf4   
7xiv7 #b1c1g1h ,,tcdd4  7xv7 #b1c1g1h   
,,tcdf4  7xvi7 octachlorodibenzodioxin4 
7xvii7 octachlorodibenzofuran4  7,e7    
,such other substances1 chemicals1 and  
airborne hazards as the ,secretary1 in  
collaboration with the ,secretary of    
,defense1 may add under paragraph 7#b74 
7#b7 ,the ,secretary may add to or      
remove from the list under paragraph    
7#a7 as the ,secretary determines       
appropriate in a report the ,secretary  
shall submit to ,congress not later than
 two years after the date of the        
enactment of the ,comprehensive and     
,overdue ,support for ,troops of ,war   
,act of #bjba1 and not less frequently  
than once every two years thereafter4  4
  7b7 ,clerical amendment ,the table of 
sections at the beginning of chapter #aa
 of such title1 as amended by section   
#cja7;b71 is further amended by         
inserting after the item relating to    

section #aaai the following new item3   
#aabj4 ,presumption of exposure to      
certain airborne hazards and substances 
from participation in contingency       
operations4  4  7c7 ,conforming         
amendment ,section #aaac of such title1 
as amended by section #cja1 is amended  
by striking or #aaai each place it      
appears and inserting #aaai1 or #aabj4  
#cjc4 ,medical nexus examinations for   
toxic exposures  7a7 ,in general        
,subchapter ,,vi of chapter #aa of title
 #ch1 ,united ,states ,code1 as amended 
by title ,,ii of this ,act1 is further  
amended by adding at the end the        
following new section3  #aafh4 ,medical 
nexus examinations for toxic exposures  
7a7 ,in general ,except as provided in  
subsection 7c71 if a covered veteran    
submits to the ,secretary a claim for   
compensation for a service-connected    
disability under section #aaaj of this  
title relating to a toxic exposure or   
exposure to a substance1 chemical1 or   
hazard listed in section #aabj7;c7 of   

this title 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 of   
the claimed disability relating to such 
exposure2  7#b7 provide the veteran the 
option to have the examination provided 
under paragraph 7#a7 conducted by a     
specialist in the field of medicine     
which covers the specifically claimed   
disability2 and  7#c7 request a medical 
opinion1 as part of the medical         
examination provided under paragraph    
7#a71 as to whether it is at least as   
likely as not that there is a nexus     
between the claimed disability and the  
exposure4  7b7 ,covered veterans ,for   
purposes of this section1 a covered     
veteran is-- 7#a7 a veteran presumed    
under section #aaai7;a7 of this title to
 have been subject to a toxic exposure2 
or  7#b7 a veteran presumed under       
subsection 7a7 of section #aabj of this 

title to have been exposed to a         
substance1 chemical1 or hazard listed in
 subsection 7c7 of such section4  7c7   
,exception ,subsection 7a7 shall not    
apply in a case in which a covered      
veteran claims a disability that is     
clearly unrelated to the claimed        
exposure4  7d7 ,considerations in       
provision of medical opinions ,when     
providing the ,secretary with a medical 
opinion requested under subsection      
7a77#c71 the examiner shall consider the
 total potential exposure through all   
applicable military deployments1 and the
 synergistic1 combined effect of all    
applicable toxic exposure risk          
activities4  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 exposures4  4  ,,iv ,expansion of 

presumptions of service connection for  
forgotten veterans  #dja4 ,mark ,takai  
,atomic ,veterans ,healthcare ,parity   
,act of #bjba ,section                  
#aaab7;c77#c77;,b7 of title #ch1 ,united
 ,states ,code1 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 ,section #aaab7;c77#c77;,b7 of
 title #ch1 ,united ,states ,code1 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 ,in general ,section     
#aaaf of title #ch1 ,united ,states     
,code1 as amended by section #bja1 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 ,kompon ,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  7b7
 ,eligibility for hospital care and     
medical services ,section #agaj7;e77#d7 
is amended by amending subparagraph 7,a7
 to read as follows3  7,a7 ,the term    
,vietnam-era herbicide-exposed veteran  
means a veteran who-- 7i7 performed     
covered service1 as defined in section  
#aaaf7;c7 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  7c7 ,clerical   
amendments  7#a7 ,section heading ,the  
heading for section #aaaf is amended by 
striking and the ,republic of ,vietnam  
and inserting certain locations4  7#b7  
,table of sections ,the table of        
sections at the beginning of chapter #aa

 of such title 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 the ,republic of 
,vietnam ,section #aaaf7;a77#b7 of title
 #ch1 ,united ,states ,code1 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 of title #ch1  
,united ,states ,code1 is amended by    
striking became manifest-- and all that 
follows through the period at the end   
and inserting became manifest to a      
degree of #aj percent or more at any    
time44  7b7 ,permanent extension of     
period of eligibility  7#a7 ,in general 
,such section is amended by striking    
subsection 7b74  7#b7 ,conforming       
amendments ,such section1 as amended by 
paragraph 7#a71 is further amended--    
7,a7 by redesignating subsections 7c7   
and 7d7 as subsections 7b7 and 7c71     
respectively2 and  7,b7 in subsection   
7a77#b77;,c71 by striking under         
subsection 7d7 and inserting under      
subsection 7c74  7c7 ,establishing      
singular disability based questionnaire 
,such section1 as amended by subsection 
7b71 is further amended by inserting    
after subsection 7c7 the following new  
subsection 7d73  7d7 ,the ,secretary    

shall develop a ,disability ,benefits   
,questionnaire 7,,dbq71 or successor    
questionnaire1 such that if a ,persian  
,gulf veteran presents with any one     
symptom associated with ,gulf ,war      
,illness1 use of such questionnaire is  
mandatory for health care personnel of  
the ,department for the identification  
of ,gulf ,war ,illness4  4  7d7         
,training ,such section is 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 ,in general       

,subchapter ,,ii of chapter #aa of title
 #ch1 ,united ,states ,code1 as amended 
by section #cjb7;a71 is further amended 
by inserting after section #aabj the    
following new section3  #aabj;,a4       
,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 7c7 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 
,covered veterans ,for purposes of this 
section1 a covered veteran is a veteran 
presumed under subsection 7a7 of section
 #aabj of this title to have been       
exposed to a substance1 chemical1 or    
hazard listed in subsection 7c7 of such 

section4  7c7 ,diseases specified ,the  
diseases specified in this subsection   
are the following3 7#a7 ,asthma that was
 diagnosed after-- 7,a7 a deployment    
described in subparagraph 7,a7 of       
section #aabj7;b77#a7 of this title2 or 
7,b7 a period of service for which a    
medal set forth under subparagraph 7,b7 
of such section was awarded4  7#b7      
,chronic obstructive pulmonary disease4 
7#c7 ,chronic bronchitis4  7#d7         
,constrictive bronchiolitis or          
obliterative bronchiolitis4  7#e7       
,emphysema4  7#f7 ,pleuritis4  7#g7     
,pulmonary fibrosis4  7#h7 ,interstitial
 lung disease4  7#i7 ,sarcoidosis4      
7#aj7 ,respiratory cancer of any type4  
7#aa7 ,glioblastoma4  7#ab7 ,rhinitis4  
7#ac7 ,sinusitis4  4  7b7 ,clerical     
amendment ,the table of sections at the 
beginning of chapter #aa of title #ch1  
,united ,states ,code1 as amended by    
section #cjb7;b71 is further amended by 
inserting after the item relating to    
section #aabj the following new item3   

#aabj;,a4 ,presumption of service       
connection for certain diseases         
associated with exposure to burn pits   
and other toxins4  4  7c7 ,conforming   
amendment ,section #aaac of such title1 
as amended by section #cjb1 is further  
amended by striking or #aabj each place 
it appears and inserting #aabj1 or      
#aabj;,a4  ,v ,strengthening ,federal   
research on toxic exposures  #eja4      
,coordination by ,department of         
,veterans ,affairs of toxic exposure    
research  7a7 ,in general ,subchapter   
,,ii of chapter #gc of title #ch1       
,united ,states ,code1 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 undertaken 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    
described in such subsection are        
collaborative1 transparent1 and highly  
coordinated4  7c7 ,report ,not later    
than one year after the date of the     
enactment of the ,comprehensive and     
,overdue ,support for ,troops of ,war   
,act of #bjba1 and annually thereafter1 
the ,secretary shall submit to the      
,committee on ,veterans' ,affairs of the
 ,senate and the ,committee on          
,veterans' ,affairs of the ,house of    
,representatives a report on all        
research activities described in        
subsection 7a7 undertaken 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 ,collection1        
analysis1 and report on treatment of    
veterans for medical conditions 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 ,department of ,veterans
 ,affairs in connection with hospital   
care1 medical services1 and nursing home
 care furnished under section           
#agaj7;a77#b77;,f7 of title #ch1 ,united
 ,states ,code2 and  7#b7 is likely to  
be scientifically useful in determining 
the association1 if any1 between the    
medical condition of a veteran and a    
toxic exposure4  7b7 ,consent of        
patients ,compilation and analysis by   
the ,secretary of clinical data of a    
veteran under subsection 7a7 shall be   
conducted1 and such data shall be used1 
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 ,senate and  
the ,committee on ,veterans' ,affairs of
 the ,house of ,representatives a report
 containing-- 7#a7 the data compiled    
under subsection 7a72  7#b7 an analysis 
of such data2  7#c7 a description of the
 types and incidences of medical        
conditions identified by the ,department
 under such subsection2  7#d7 the       
explanation of the ,secretary for the   
incidence of such medical conditions and
 other explanations for the incidence of
 such conditions as the ,secretary      
considers reasonable2 and  7#e7 the     
views of the ,secretary on the          
scientific validity of drawing          
conclusions from the incidence of such  
medical conditions1 as evidenced by the 
data compiled under subsection 7a71     
regarding any association between such  
conditions and a toxic exposure4  7d7   

,toxic exposure defined ,in this        
section1 the term toxic exposure has the
 meaning given that term in section     
#aja7cg7 of title #ch1 ,united ,states  
,code4  #ejc4 ,studies relating to      
veterans who served in ,southwest ,asia 
7a7 ,analysis  7#a7 ,in general ,not    
later than #ahj days after the date of  
the enactment of this ,act1 the         
,secretary of ,veterans ,affairs1 in    
coordination with the ,secretary of     
,defense1 shall conduct an updated      
analysis of total and respiratory       
disease mortality in covered veterans4  
7#b7 ,elements ,the analysis required by
 paragraph 7#a7 shall include1 to the   
extent practicable1 the following3 7,a7 
,metrics of airborne exposures4  7,b7   
,the location and timing of deployments4
  7,c7 ,the military occupational       
specialty4  7,d7 ,the ,armed ,force in  
which the veteran served4  7,e7         
,pre-existing health status1 including  
with respect to asthma4  7,f7 ,relevant 
personal information1 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 uses the following3 7#a7  
,improved spatio-temporal estimates of  
ambient air pollution exposures using   
advances in retrospective exposure      
assessment4  7#b7 ,detailed information 
on the study subjects obtained through  
medical records1 administrative data1   
and other existing sources1 that        
include-- 7,a7 personal characteristics1
 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 ,in general ,not
 later than #ahj days after the date of 
the enactment of this ,act1 the         
,secretary shall conduct a toxicology   
study to include variability to         
replicate exposures of healthy1 young   
members of the ,armed ,forces1 as well  
as potentially susceptible members1 with
 preexisting health conditions4  7#b7   
,elements ,the study required under     
paragraph 7#a7 shall-- 7,a7 analyze the 
study results for mechanistic markers   
and clinically relevant outcomes2 and   
7,b7 validate serum1 tissue1 and other  
biomarkers of exposure1 susceptibility1 
or effect4  7d7 ,covered veteran defined
 ,in this section1 the term covered     
veteran means any veteran who-- 7#a7 on 
or after ,august #b1 #aiij1 served on   
active duty in-- 7,a7 ,bahrain2  7,b7   
,iraq2  7,c7 ,kuwait2  7,d7 ,oman2  7,e7
 ,qatar2  7,f7 ,saudi ,arabia2  7,g7    
,somalia2 or  7,h7 the ,united ,arab    
,emirates2 or  7#b7 on or after         
,september #aa1 #bjja1 served on active 

duty in-- 7,a7 ,afghanistan2  7,b7      
,djibouti2  7,c7 ,egypt2  7,d7 ,jordan2 
7,e7 ,lebanon2  7,f7 ,syria2 or  7,g7   
,yemen4  #ejd4 ,study on health trends  
of post #i_/aa veterans ,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  #eje4 ,study on cancer rates    
among veterans  7a7 ,in general ,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  
required by 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    
,the military occupational speciality or
 specialties of the veteran4  7#d7 ,the 
gender of the veteran4  7#e7 ,the type  

or types of cancer that the veteran has4
  ,,vi ,improving support to toxic      
exposure veterans  #fja4 ,definitions   
,in this title1 the terms active        
military1 naval1 or air service1 toxic  
exposure1 and toxic exposure 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 exposure   
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     
exposure veterans2  7,b7 families and   
caregivers of toxic exposure veterans2  
and  7,c7 survivors of toxic exposure   
veterans 7or who would be toxic exposure

 veterans were the veterans alive7 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
 exposure 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 exposure 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 ,in       
general ,the ,secretary shall establish 
a training program 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 exposure4  7#b7 ,annual training  
,training provided to processors under  
paragraph 7#a7 shall be provided not    
less frequently than annually4  #fje4   
,,sfc ,heath ,robinson ,burn ,pit       
,transparency ,act  7a7 ,short title    
,this section may be cited as the ,,sfc 
,heath ,robinson ,burn ,pit             
,transparency ,act4  7b7 ,quarterly     
notifications  7#a7 ,in general ,on a   
quarterly basis1 the ,secretary of      
,veterans ,affairs shall submit to the  
appropriate congressional committees a  
report on each reported case of burn pit
 exposure by a covered veteran reported 
during the previous quarter4  7#b7      
,elements ,each report submitted under  
paragraph 7#a7 shall include1 with      
respect to each reported case of burn   
pit exposure of a covered veteran       
included in the report1 the following3  
7,a7 ,notice of the case1 including the 
medical facility at which the case was  

reported4  7,b7 ,notice of1 as          
available-- 7i7 the enrollment status of
 the covered veteran with respect to the
 patient enrollment system of the       
,department of ,veterans ,affairs under 
section #agje7;a7 of title #ch1 ,united 
,states ,code2  7ii7 a summary of all   
health care visits by the covered       
veteran at the medical facility at which
 the case was reported that are related 
to the case2  7iii7 the demographics of 
the covered veteran1 including age1 sex1
 and race2  7iv7 any non-,department of 
,veterans ,affairs health care benefits 
that the covered veteran receives2  7v7 
the ,armed ,force in which the covered  
veteran served and the rank of the      
covered veteran2  7vi7 the period in    
which the covered veteran served2  7vii7
 each location that the covered veteran 
reported as being a location at which   
the veteran was exposed to toxic        
airborne chemicals and fumes from an    
open burn pit2  7viii7 the medical      
diagnoses of the covered veteran and the

 treatment provided to the veteran2 and 
7ix7 whether the covered veteran is     
registered in the ,airborne ,hazards and
 ,open ,burn ,pit ,registry4  7#c7      
,protection of information ,the         
,secretary shall ensure that the reports
 submitted under paragraph 7#a7 do not  
include the identity of covered veterans
 or contain other personally            
identifiable data4  7c7 ,annual report  
on cases  7#a7 ,in general ,not later   
than #ahj days after the date of the    
enactment of this ,act1 and annually    
thereafter1 the ,secretary of ,veterans 
,affairs1 in collaboration with the     
,secretary of ,defense1 shall submit to 
the appropriate congressional committees
 a report detailing the following3 7,a7 
,the total number of covered veterans4  
7,b7 ,the total number of claims for    
disability compensation under chapter   
#aa of title #ch1 ,united ,states ,code1
 approved and the total number denied by
 the ,secretary of ,veterans ,affairs   
with respect to a covered veteran1 and  

for each such denial1 the rationale of  
the denial4  7,c7 ,a comprehensive list 
of-- 7i7 the conditions for which       
covered veterans seek treatment2 and    
7ii7 the locations that the covered     
veterans reported as being locations at 
which the veterans were exposed to toxic
 airborne chemicals and fumes from open 
burn pits4  7,d7 ,identification of any 
illnesses relating to exposure to open  
burn pits that formed the basis for the 
,secretary to award benefits1 including 
entitlement to service connection or an 
increase in disability rating4  7,e7    
,the total number of covered veterans   
who died after seeking care for an      
illness relating to exposure to an open 
burn pit4  7,f7 ,any updates or trends  
with respect to the information         
described in subparagraphs 7,a71 7,b71  
7,c71 7,d71 and 7,e7 that the ,secretary
 determines appropriate4  7#b7 ,matters 
included in first report ,the ,secretary
 shall include in the first report under
 paragraph 7#a7 information specified in

 subsection 7b77#b7 with respect to     
reported cases of burn pit exposure made
 during the period beginning ,january   
#a1 #aiij1 and ending on the day before 
the date of the enactment of this ,act4 
7d7 ,comptroller ,general report ,not   
later than #ahj days after the date of  
the enactment of this ,act1 the         
,comptroller ,general of the ,united    
,states shall submit to the appropriate 
congressional committees a report       
containing an assessment of the         
effectiveness of any memorandum of      
understanding or memorandum of agreement
 entered into by the ,secretary of      
,veterans ,affairs with respect to--    
7#a7 the processing of reported cases of
 burn pit exposure2 and  7#b7 the       
coordination of care and provision of   
health care relating to such cases at   
medical facilities of the ,department of
 ,veterans ,affairs and at              
non-,department facilities4  7e7        
,definitions ,in this section3 7#a7 ,the
 term ,airborne ,hazards and ,open ,burn

 ,pit ,registry means the registry      
established by the ,secretary of        
,veterans ,affairs under section #bja of
 the ,dignified ,burial and ,other      
,veterans' ,benefits ,improvement ,act  
of #bjab 7,public ,law #aab-bfj2 #ch    
,u4,s4,c4 #ebg note74  7#b7 ,the term   
appropriate congressional committees    
means-- 7,a7 the ,committee on          
,veterans' ,affairs and the ,committee  
on ,armed ,services of the ,senate2 and 
7,b7 ,the ,committee on ,veterans'      
,affairs and the ,committee on ,armed   
,services of the ,house of              
,representatives4  7#c7 ,the term       
covered veteran means a veteran who     
presents at a medical facility of the   
,department of ,veterans ,affairs 7or in
 a non-,department facility pursuant to 
section #agjc or #agjc;,a of title #ch1 
,united ,states ,code7 for treatment    
that the veteran describes as being     
related to1 or ancillary to1 the        
exposure of the veteran to toxic        
airborne chemicals and fumes caused by  

open burn pits at any time while serving
 in the ,armed ,forces4  7#d7 ,the term 
open burn pit has the meaning given that
 term in section #bja7;c7 of the        
,dignified ,burial and ,other ,veterans'
 ,benefits ,improvement ,act of #bjab   
7,public ,law #aab-bfj2 #ch ,u4,s4,c4   
#ebg note74  7#e7 ,the term reported    
case of burn pit exposure means each    
instance in which a veteran presents at 
a medical facility of the ,department of
 ,veterans ,affairs 7or in a            
non-,department facility pursuant to    
section #agjc or #agjc;,a of title #ch1 
,united ,states ,code7 for treatment    
that the veteran describes as being     
related to1 or ancillary to1 the        
exposure of the veteran to toxic        
airborne chemicals and fumes caused by  
open burn pits at any time while serving
 in the ,armed ,forces4  ,,vii          
,strengthening record-keeping of toxic  
exposures by ,department of ,defense    
#gja4 ,definitions ,in this title3 7#a7 
,individual longitudinal exposure record

 ,the term ,individual ,longitudinal    
,exposure ,record has the meaning given 
that term in section #aja7dj7 of title  
#ch1 ,united ,states ,code1 as added by 
section #aja7;b74  7#b7 ,toxic exposure 
,the term toxic exposure has the meaning
 given that term in section #aja7cg7 of 
such title1 as so added4  #gjb4         
,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      
evaluate-- 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 experienced by the member      

during service in the ,armed ,forces    
will be accurately reflected in the     
,individual ,longitudinal ,exposure     
,record of the member4  7b7 ,independent
 research entity described ,an          
independent research entity described in
 this subsection is a federally funded  
research and development center with    
appropriate expertise and analytical    
capability to carry out the study       
required under subsection 7a74  #gjc4   
,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 of ,defense  
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 exposures that  
may not be fully captured by the current
 systems of the ,department of ,defense 
for environmental and occupational      
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   

data4  7c7 ,appropriate committees of   
,congress defined ,in this section1 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  #gjd4 ,correction of 
toxic exposure records  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 
,in general ,to update a record under   
subsection 7a71 a member of the ,armed  
,forces or veteran1 as the case may be1 
must provide such evidence as the       
,secretary of ,defense and the          
,secretary of ,veterans ,affairs jointly

 consider sufficient4  7#b7 ,regulations
 ,the ,secretary of ,veterans ,affairs  
shall prescribe by regulation the       
evidence considered sufficient under    
paragraph 7#a74  ,october #ai1          
#bjba,read twice and placed on the      
calendar