#aag? ,,congress  #b;d ,session  ,9 !   
,h\se ( ,repres5tatives1 ,u4 ,s41  ,july
 #ac1 #bjbb  ,,am5dm5t3  ,t ! bill f !  
,s5ate 7,s4 #ccgc7 entitl$ ,an ,act to  
improve ! ,iraq & ,afghani/an ,s]vice   
,grant & ! ,*ildr5 ( ,fall5 ,h]oes      
,grant41 d pass ) ! foll[+ ,/rike out   
all aft] ! enact+ clause & ins]t3  #a4  
,%ort title2 ref]5ces to title #ch1     
,unit$ ,/ates ,code2 table ( cont5ts    
7a7 ,%ort title ,?is ,act may be cit$ z 
! ,s]geant ,fir/ ,class ,hea? ,rob9son  
,honor+ our ,promise to ,address        
,compreh5sive ,toxics ,act ( #bjbb or ! 
,honor+ our ,,pact ,act ( #bjbb4  7b7   
,matt]s relat+ to am5dm5ts to title #ch1
 ,unit$ ,/ates ,code  7#a7 ,ref]5ces    
,except z o!rwise expressly provid$1 :5 
9 ?is ,act an am5dm5t or repeal is      
express$ 9 t]ms ( an am5dm5t to1 or     
repeal (1 a section or o!r provision1 ! 
ref]5ce %all be consid]$ to be made to a
 section or o!r provision ( title #ch1  
,unit$ ,/ates ,code4  7#b7 ,am5dm5ts to 
tables ( cont5ts ,except z o!rwise      

expressly provid$1 :5 an am5dm5t made by
 ?is ,act to title #ch1 ,unit$ ,/ates   
,code1 adds a section or l>g]           
organizational unit to t title or am5ds 
! designation or head+ ( a section or   
l>g] organizational unit 9 t title1 t   
am5dm5t also %all h ! effect ( am5d+ any
 table ( sections 9 t title to alt] !   
table to con=m to ! *anges made by !    
am5dm5t4  7c7 ,table ( cont5ts ,! table 
( cont5ts = ?is ,act is z foll[s3  ,sec4
 #a4 ,%ort title2 ref]5ces to title #ch1
 ,unit$ ,/ates ,code2 table ( cont5ts4  
,,title ,i--,expansion ( heal? c>e      
eligibility ,subtitle ,a--,toxic-expos$ 
vet]ans ,sec4 #aja4 ,%ort title4 ,sec4  
#ajb4 ,def9itions relat+ to toxic-expos$
 vet]ans4 ,sec4 #ajc4 ,expansion ( heal?
 c>e = specific categories (            
toxic-expos$ vet]ans & vet]ans support+ 
c]ta9 ov]seas cont+5cy op]ations4 ,sec4 
#ajd4 ,assessm5ts ( implem5tation &     
op]ation4 ,subtitle ,b--,c]ta9 vet]ans (
 combat s]vice & o!r matt]s ,sec4 #aaa4 
,expansion ( p]iod ( eligibility = heal?

 c>e = c]ta9 vet]ans ( combat s]vice4   
,,title ,,ii--,toxic exposure           
presumption process ,sec4 #bja4 ,%ort   
title4 ,sec4 #bjb4 ,improvem5ts to      
ability ( ,dep>tm5t ( ,vet]ans ,affairs 
to e/abli% presumptions ( s]vice        
connection bas$ on toxic exposure4 ,sec4
 #bjc4 ,outrea* to claimants =          
disability comp5sation pursuant to      
*anges 9 presumptions ( s]vice          
connection4 ,sec4 #bjd4 ,reevaluation ( 
claims = dep5d5cy & indemnity           
comp5sation involv+ presumptions (      
s]vice connection4 ,,title              
,,iii--,improv+ ! e/abli%m5t ( s]vice   
connection process = toxic-expos$       
vet]ans ,sec4 #cja4 ,%ort title4 ,sec4  
#cjb4 ,presumptions ( toxic exposure4   
,sec4 #cjc4 ,m$ical nexus exam9ations = 
toxic exposure risk activities4 ,,title 
,,iv--,presumptions ( s]vice connection 
,sec4 #dja4 ,treatm5t ( vet]ans :o      
p>ticipat$ 9 cleanup ( ,enewetak ,atoll 
z radiation-expos$ vet]ans = purposes ( 
presumption ( s]vice connection ( c]ta9 

disabilities by ,dep>tm5t ( ,vet]ans    
,affairs4 ,sec4 #djb4 ,treatm5t (       
vet]ans :o p>ticipat$ 9 nucle> response 
ne> ,palom>es1 ,spa91 or ,?ule1 ,gre5l&1
 z radiation-expos$ vet]ans = purposes (
 presumption ( s]vice connection ( c]ta9
 disabilities by ,dep>tm5t ( ,vet]ans   
,affairs4 ,sec4 #djc4 ,presumptions (   
s]vice connection = diseases associat$ )
 exposures to c]ta9 h]bicide ag5ts =    
vet]ans :o s]v$ 9 c]ta9 locations4 ,sec4
 #djd4 ,addition ( additional diseases  
associat$ ) exposure to c]ta9 h]bicide  
ag5ts = :i* !re is a presumption (      
s]vice connection = vet]ans :o s]v$ 9   
c]ta9 locations4 ,sec4 #dje4 ,improv+   
comp5sation = disabilities occurr+ 9    
,p]sian ,gulf ,w> vet]ans4 ,sec4 #djf4  
,presumption ( s]vice connection = c]ta9
 diseases associat$ ) exposure to burn  
pits & o!r tox9s4 ,sec4 #djg4 ,rule (   
con/ruction4 ,,title ,v--,rese>* matt]s 
,sec4 #eja4 ,int]ag5cy work+ gr\p on    
toxic exposure rese>*4 ,sec4 #ejb4      
,analysis & report on treatm5t ( vet]ans

 = m$ical conditions relat$ to toxic    
exposure4 ,sec4 #ejc4 ,analysis relat+  
to mortality ( vet]ans :o s]v$ 9 ,s\?we/
 ,asia4 ,sec4 #ejd4 ,/udy on heal? tr5ds
 ( po/-#i_/aa vet]ans4 ,sec4 #eje4 ,/udy
 on canc] rates among vet]ans4 ,sec4    
#ejf4 ,/udy on heal? effects ( wa/e     
relat$ to ,manhattan ,project on c]ta9  
vet]ans4 ,sec4 #ejg4 ,/udy on toxic     
exposure & m5tal heal? outcomes4 ,sec4  
#ejh4 ,/udy on vet]ans 9 ,t]ritories ( !
 ,unit$ ,/ates4 ,sec4 #eji4 ,dep>tm5t ( 
,vet]ans ,affairs public website = toxic
 exposure rese>*4 ,sec4 #eaj4 ,report on
 heal? effects ( jet fuels us$ by ,arm$ 
,=ces4 ,,title ,,vi--,improvem5t (      
res\rces & tra9+ reg>d+ toxic-expos$    
vet]ans ,sec4 #fja4 ,%ort title2        
def9itions4 ,sec4 #fjb4 ,publication (  
li/ ( res\rces ( ,dep>tm5t ( ,vet]ans   
,affairs = toxic-expos$ vet]ans &       
vet]ans :o report toxic exposures &     
outrea* program = su* vet]ans & c>egiv]s
 & survivors ( su* vet]ans4 ,sec4 #fjc4 
,incorporation ( toxic exposure scre5+ =

 vet]ans4 ,sec4 #fjd4 ,tra9+ = p]sonnel 
( ! ,dep>tm5t ( ,vet]ans ,affairs )     
respect to vet]ans :o report toxic      
exposures4 ,,title ,,vii--,res\rc+ ,sec4
 #gja4 ,au?ority to use appropriations  
to enhance claims process+ capacity &   
automation4 ,sec4 #gjb4 ,au?orization ( 
major m$ical facility leases ( ,dep>tm5t
 ( ,vet]ans ,affairs = fiscal ye> #bjbc4
 ,sec4 #gjc4 ,treatm5t ( major m$ical   
facility leases ( ! ,dep>tm5t ( ,vet]ans
 ,affairs4 ,sec4 #gjd4 ,au?ority to ent]
 into agreem5ts ) academic affiliates & 
o!r entities to acquire space = !       
purpose ( provid+ heal?-c>e res\rces to 
vet]ans4 ,sec4 #gje4 ,modifications to  
enhanc$-use lease au?ority ( ,dep>tm5t (
 ,vet]ans ,affairs4 ,sec4 #gjf4         
,au?ority = jo9t leas+ actions (        
,dep>tm5t ( ,def5se & ,dep>tm5t (       
,vet]ans ,affairs4 ,sec4 #gjg4          
,appropriation ( am\nts = major m$ical  
facility leases4 ,,title                
,,viii--,records & o!r matt]s ,sec4     
#hja4 ,epidemiological /udy on ,=t      

,mc,clellan vet]ans4 ,sec4 #hjb4        
,bi5nial brief+ on ,individual          
,longitud9al ,exposure ,record4 ,sec4   
#hjc4 ,correction ( exposure records by 
memb]s ( ! ,arm$ ,=ces & vet]ans4 ,sec4 
#hjd4 ,f$]al cause ( action relat+ to   
wat] at ,camp ,lejeune1 ,nor? ,c>ol9a4  
,sec4 #hje4 ,co/ ( ,w> ,toxic ,exposures
 ,fund4 ,sec4 #hjf4 ,appropriation =    
fiscal ye> #bjbb4 ,sec4 #hjg4           
,au?orization ( electronic notice 9     
claims "u laws adm9i/]$ by ! ,secret>y (
 ,vet]ans ,affairs4 ,sec4 #hjh4 ,burn   
pit transp>5cy4 ,,title                 
,,ix--,improvem5t ( work=ce ( ,dep>tm5t 
( ,vet]ans ,affairs ,sec4 #ija4         
,national rural recruitm5t & hir+ plan =
 ,vet]ans ,heal? ,adm9i/ration4 ,sec4   
#ijb4 ,au?ority to buy out s]vice       
contracts = c]ta9 heal? c>e pr(essionals
 9 ex*ange = employm5t at rural or      
highly rural facilities ( ,dep>tm5t (   
,vet]ans ,affairs4 ,sec4 #ijc4          
,qualifications = human res\rces        
positions )9 ,dep>tm5t ( ,vet]ans       

,affairs & plan to recruit & reta9 human
 res\rces employees4 ,sec4 #ijd4        
,modification ( pay cap = c]ta9         
employees ( ,vet]ans ,heal?             
,adm9i/ration4 ,sec4 #ije4 ,expansion ( 
opportunities = h\sekeep+ aides4 ,sec4  
#ijf4 ,modification ( au?ority ( !      
,secret>y ( ,vet]ans ,affairs relat+ to 
h\rs1 conditions ( employm5t1 & pay =   
c]ta9 employees ( ,vet]ans ,heal?       
,adm9i/ration4 ,sec4 #ijg4 ,waiv] ( pay 
limitation = c]ta9 employees ( ,dep>tm5t
 ( ,vet]ans ,affairs4 ,sec4 #ijh4       
,elim9ation ( limitation on aw>ds &     
bonus = employees ( ,dep>tm5t ( ,vet]ans
 ,affairs4 ,sec4 #iji4 ,additional      
au?ority ( ! ,secret>y ( ,vet]ans       
,affairs relat+ to recruitm5t & ret5tion
 ( p]sonnel4  ,i ,expansion ( heal? c>e 
eligibility  ,a ,toxic-expos$ vet]ans   
#aja4 ,%ort title ,?is title may be cit$
 z ! ,conc$+ ,our ,vet]ans' ,exposure   
,n[ & ,necessitat+ ,tra9+ ,act ( #bjbb  
or ! ,,cov5ant ,act ( #bjbb4  #ajb4     
,def9itions relat+ to toxic-expos$      

vet]ans  7a7 ,9 g5]al ,section          
#agaj7;a77#b77;,f7 is am5d$ by /rik+ :o 
0 expos$ to a toxic sub/ance1 radiation1
 or o!r conditions1 z provid$ 9         
subsection 7e7 & ins]t+ :o is a         
toxic-expos$ vet]an1 9 accordance )     
subsection 7e74  7b7 ,def9itions ( toxic
 exposure & toxic-expos$ vet]an ,section
 #aja is am5d$ by add+ at ! end ! foll[+
 new p>agraphs3  7#cg7 ,! t]m toxic     
exposure includes ! foll[+3  7,a7 ,a    
toxic exposure risk activity1 z def9$ 9 
section #agaj7;e77#d7 ( ?is title4  7,b7
 ,an exposure to a sub/ance1 *emical1 or
 airborne haz>d id5tifi$ 9 ! li/ "u     
section #aaai7;b77#b7 ( ?is title4      
7#ch7 ,! t]m toxic-expos$ vet]an means  
any vet]an describ$ 9 section           
#agaj7;e77#a7 ( ?is title4  4  7c7      
,def9ition ( toxic exposure risk        
activity ,section #agaj7;e77#d7 is am5d$
 by add+ at ! end ! foll[+ new          
subp>agraph3  7,c7 ,! t]m toxic exposure
 risk activity means any activity-- 7i7 
t requires a correspond+ entry 9 an     

exposure track+ record sy/em 7z def9$ 9 
section #aaai7;c7 ( ?is title7 = !      
vet]an :o c>ri$ out ! activity2 or  7ii7
 t ! ,secret>y det]m9es qualifies =     
purposes ( ?is subsection :5 tak+ into  
acc\nt :at is reasonably prud5t to      
protect ! heal? ( vet]ans4  4  #ajc4    
,expansion ( heal? c>e = specific       
categories ( toxic-expos$ vet]ans &     
vet]ans support+ c]ta9 ov]seas cont+5cy 
op]ations  7a7 ,9 g5]al  7#a7 ,expansion
 ,subsection 7e7 ( section #agaj1 z     
am5d$ by section #ajb7;c71 is fur!r     
am5d$--  7,a7 9 p>agraph 7#a71 by add+  
at ! end ! foll[+ new subp>agraphs3     
7,g7 ,beg9n+ n lat] ?an ! applicable    
date specifi$ 9 p>agraph 7#f71 & subject
 to p>agraph 7#b71 a vet]an :o          
p>ticipat$ 9 a toxic exposure risk      
activity :ile s]v+ on active duty1      
active duty = tra9+1 or inactive duty   
tra9+ is eligible = hospital c>e        
7includ+ m5tal heal? s]vices & c\nsel+71
 m$ical s]vices1 & nurs+ home c>e "u    
subsection 7a77#b77;,f7 = any illness4  

7,h7 ,beg9n+ n lat] ?an ! applicable    
date specifi$ 9 p>agraph 7#f71 & subject
 to p>agraph 7#b71 a cov]$ vet]an 7z    
def9$ 9 section #aaai7;c7 ( ?is title7  
is eligible = hospital c>e 7includ+     
m5tal heal? s]vices & c\nsel+71 m$ical  
s]vices1 & nurs+ home c>e "u subsection 
7a77#b77;,f7 = any illness4  7,i7 7i7   
,beg9n+ n lat] ?an ! applicable date    
specifi$ 9 p>agraph 7#f71 & subject to  
p>agraph 7#b71 a vet]an :o deploy$ 9    
support ( a cont+5cy op]ation specifi$ 9
 clause 7ii7 is eligible = hospital c>e 
7includ+ m5tal heal? s]vices & c\nsel+71
 m$ical s]vices1 & nurs+ home c>e "u    
subsection 7a77#b77;,f7 = any illness4  
7ii7 ,a cont+5cy op]ation specifi$ 9 ?is
 clause is any ( ! foll[+3 7,i7         
,op]ation ,endur+ ,fre$om4  7,,ii7      
,op]ation ,fre$om's ,s5t9el4  7,,iii7   
,op]ation ,iraqi ,fre$om4  7,,iv7       
,op]ation ,new ,dawn4  7,v7 ,op]ation   
,inh]5t ,resolve4  7,,vi7 ,resolute     
,support ,mission4  2 &  7,b7 9 p>agraph
 7#b77;,b7--  7i7 by /rik+ or 7,f7 &    

ins]t+ 7,f71 7,g71 7,h71 or 7,i72 &     
7ii7 by /rik+ s]vice or te/+ & ins]t+   
s]vice1 te/+1 or activity4  7#b7 ,phase 
9 ,su* subsection is fur!r am5d$ by add+
 at ! end ! foll[+ new p>agraph3  7#f7  
7,a7 ,! ,secret>y %all det]m9e ! dates 9
 subp>agraphs 7,g71 7,h71 & 7,i7 (      
p>agraph 7#a7 z foll[s3  7i7 ,octob] #a1
 #bjbd1 ) respect to a vet]an describ$ 9
 su* subp>agraph 7,g7 or 7,h7 :o 0      
dis*>g$ or releas$ f ! active milit>y1  
naval1 air1 or space s]vice dur+ ! p]iod
 beg9n+ on ,augu/ #b1 #aiij1 & end+ on  
,septemb] #aa1 #bjja4  7ii7 ,octob] #a1 
#bjbf1 ) respect to a vet]an describ$ 9 
su* subp>agraph 7,g7 or 7,h7 :o 0       
dis*>g$ or releas$ f ! active milit>y1  
naval1 air1 or space s]vice dur+ ! p]iod
 beg9n+ on ,septemb] #ab1 #bjja1 & end+ 
on ,decemb] #ca1 #bjjf4  7iii7 ,octob]  
#a1 #bjbh1 ) respect to a vet]an        
describ$ 9 su* subp>agraph 7,g7 or 7,h7 
:o 0 dis*>g$ or releas$ f ! active      
milit>y1 naval1 air1 or space s]vice    
dur+ ! p]iod beg9n+ on ,janu>y #a1      

#bjjg1 & end+ on ,decemb] #ca1 #bjab4   
7iv7 ,octob] #a1 #bjcj1 ) respect to a  
vet]an describ$ 9 su* subp>agraph 7,g7  
or 7,h7 :o 0 dis*>g$ or releas$ f !     
active milit>y1 naval1 air1 or space    
s]vice dur+ ! p]iod beg9n+ on ,janu>y   
#a1 #bjac1 & end+ on ,decemb] #ca1      
#bjah4  7v7 ,octob] #a1 #bjcb1 ) respect
 to a vet]an describ$ 9 su* subp>agraph 
7,i74  7,b7 7i7 ,! ,secret>y may modify 
a date specifi$ 9 subp>agraph 7,a7 to an
 e>li] date1 z ! ,secret>y det]m9es     
appropriate bas$ on ! numb] ( vet]ans   
receiv+ hospital c>e1 m$ical s]vices1 & 
nurs+ home c>e "u subp>agraphs 7,g71    
7,h71 & 7,i7 ( p>agraph 7#a7 & !        
res\rces available to ! ,secret>y4  7ii7
 ,if ! ,secret>y det]m9es to modify a   
date "u clause 7i71 ! ,secret>y %all--  
7,i7 notify ! ,committee on ,vet]ans'   
,affairs ( ! ,s5ate & ! ,committee on   
,vet]ans' ,affairs ( ! ,h\se (          
,repres5tatives ( ! propos$             
modification2 &  7,,ii7 publi% su*      
modifi$ date 9 ! ,f$]al ,regi/]4  4  7b7

 ,outrea* plans ,) respect to ea* (     
clauses 7i7 ?r\gh 7v7 ( section         
#agaj7;e77#f77;,a7 ( title #ch1 ,unit$  
,/ates ,code 7z add$ by subsection      
7a77#b771 n lat] ?an #ahj days be=e !   
date specifi$ 9 ! clause 7includ+ a date
 modifi$ pursuant to su* section71 !    
,secret>y %all submit to ! ,committee on
 ,vet]ans' ,affairs ( ! ,s5ate & !      
,committee on ,vet]ans' ,affairs ( !    
,h\se ( ,repres5tatives a plan to       
conduct outrea* to ! vet]ans describ$ 9 
! clause to notify su* vet]ans ( _!     
eligibility = hospital c>e1 m$ical      
s]vices1 or nurs+ home c>e "u           
subp>agraph 7,g71 7,h71 or 7,i71 (      
section #agaj7;e77#a7 ( su* title1 z !  
case may be4  #ajd4 ,assessm5ts (       
implem5tation & op]ation  7a7 ,initial  
res\rce assessm5t & report ,n lat] ?an  
#ahj days aft] ! date ( ! enactm5t ( ?is
 ,act1 ! ,secret>y ( ,vet]ans ,affairs  
%all-- 7#a7 complete an assessm5t to    
det]m9e--  7,a7 ! p]sonnel & mat]ial    
res\rces necess>y to implem5t section   

#ajc 7includ+ ! am5dm5ts made by su*    
section72 &  7,b7 ! total numb] ( cov]$ 
vet]ans1 z su* t]m is def9$ 9 section   
#aaai7;c7 ( title #ch1 ,unit$ ,/ates    
,code 7z add$ by section #cjb71 :o      
receive hospital c>e or m$ical s]vices  
furni%$ by ! ,secret>y "u *apt] #ag (   
su* title1 disaggregat$ by priority gr\p
 specifi$ 9 section #agje7;a7 ( su*     
title2 &  7#b7 submit to ! ,committee on
 ,vet]ans' ,affairs ( ! ,s5ate & !      
,committee on ,vet]ans' ,affairs ( !    
,h\se ( ,repres5tatives a report conta9+
 ! f9d+s ( ! assessm5t complet$ "u      
p>agraph 7#a71 includ+ a specific       
det]m9ation z to :e!r ! ,dep>tm5t has ! 
p]sonnel & mat]ial res\rces necess>y to 
implem5t section #ajc4  7b7 ,in=mation  
sy/ems ,n lat] ?an ,octob] #a1 #bjbd1 ! 
,secret>y %all e/abli% in=mation sy/ems 
to assess ! implem5tation ( section     
#ajc1 includ+ ! am5dm5ts made by su*    
section1 & use ! results ( assessm5ts "u
 su* sy/ems to in=m ! reports "u        
subsection 7c74  7c7 ,annual reports    

7#a7 ,reports ,n lat] ?an ,octob] #a1   
#bjbe1 & on an annual basis !reaft]     
until ,octob] #a1 #bjcc1 ! ,secret>y    
%all submit to ! ,committee on ,vet]ans'
 ,affairs ( ! ,s5ate & ! ,committee on  
,vet]ans' ,affairs ( ! ,h\se (          
,repres5tatives a report on ! foll[+3   
7,a7 ,! effect ( ! implem5tation (1 & ! 
provision & managem5t ( c>e "u1 section 
#ajc 7includ+ ! am5dm5ts made by su*    
section7 on ! dem& by vet]ans describ$ 9
 subp>agraphs 7,g71 7,h71 & 7,i7 (      
section #agaj7;e77#a7 ( title #ch1      
,unit$ ,/ates ,code 7z add$ by su*      
section #ajc7 = heal? c>e s]vices       
furni%$ by ! ,secret>y4  7,b7 ,any      
diff]+ patt]ns ( dem& = heal? c>e       
s]vices by su* vet]ans1 disaggregat$ by 
factors su* z ! relative di/ance ( !    
vet]an f m$ical facilities ( ! ,dep>tm5t
 & :e!r ! vet]an _h previ\sly receiv$   
hospital c>e or m$ical s]vices furni%$  
by ! ,secret>y "u *apt] #ag ( su* title4
  7,c7 ,! ext5t to :i* ! ,secret>y has  
met su* dem&4  7,d7 ,any *anges1 dur+ ! 

ye> cov]$ by ! report1 9 ! deliv]y      
patt]ns ( heal? c>e furni%$ by !        
,secret>y "u *apt] #ag ( su* title1 & ! 
fiscal impact ( su* *anges4  7#b7       
,matt]s ,ea* report "u p>agraph 7#a7    
%all include1 ) respect to ! ye> cov]$  
by ! report1 detail$ in=mation on !     
foll[+3  7,a7 ,! total numb] ( vet]ans  
enroll$ 9 ! pati5t enrollm5t sy/em :o1  
dur+ su* ye>1 receiv$ hospital c>e or   
m$ical s]vices furni%$ by ! ,secret>y "u
 *apt] #ag ( title #ch1 ,unit$ ,/ates   
,code4  7,b7 ,( ! vet]ans specifi$ 9    
subp>agraph 7,a71 ! numb] ( su* vet]ans 
:o1 dur+ ! prec$+ ?ree fiscal ye>s1 _h n
 receiv$ su* c>e or s]vices4  7,c7 ,)   
respect to ! vet]ans specifi$ 9         
subp>agraph 7,b71 ! co/ ( provid+ heal? 
c>e to su* vet]ans dur+ ! ye> cov]$ by !
 report1 %[n 9 total & disaggregat$ by--
 7i7 ! level ( c>e2 &  7ii7 :e!r ! c>e 0
 provid$ ?r\gh ! ,vet]ans ,community    
,c>e ,program4  7,d7 ,) respect to !    
numb] ( vet]ans describ$ 9 subp>agraphs 
7,g71 7,h71 & 7,i7 ( section            

#agaj7;e77#a7 ( title #ch1 ,unit$ ,/ates
 ,code 7z add$ by section #ajc71 !      
foll[+ 7%[n 9 total & disaggregat$ by   
m$ical facility ( ! ,dep>tm5t1 z        
applicable73  7i7 ,! numb] ( su* vet]ans
 :o1 dur+ ! ye> cov]$ by ! report1      
enroll$ 9 ! pati5t enrollm5t sy/em4     
7ii7 ,! numb] ( su* vet]ans :o appli$ =1
 b 7 d5i$1 su* enrollm5t4  7iii7 ,!     
numb] ( su* vet]ans :o 7 d5i$ hospital  
c>e or a m$ical s]vice furni%$ by !     
,secret>y t 0 consid]$ to be m$ically   
necess>y b n ( an em]g5cy nature4  7,e7 
,! numb]s & *>act]i/ics (1 & ! type &   
ext5t ( heal? c>e furni%$ by ! ,secret>y
 to1 vet]ans enroll$ 9 ! pati5t         
enrollm5t sy/em 7%[n 9 total &          
disaggregat$ by m$ical facility ( !     
,dep>tm5t74  7,f7 ,! numb]s &           
*>act]i/ics (1 & ! type & ext5t ( heal? 
c>e furni%$ by ! ,secret>y to1 vet]ans n
 enroll$ 9 ! pati5t enrollm5t sy/em     
7disaggregat$ by ea* class ( eligibility
 = c>e "u section #agaj ( title #ch1    
,unit$ ,/ates ,code1 & fur!r %[n z a    

total p] class & disaggregat$ by m$ical 
facility ( ! ,dep>tm5t74  7,g7 ,!       
specific fiscal impact 7%[n 9 total &   
disaggregat$ by geographic heal? c>e    
deliv]y areas7 ( *anges 9 ! deliv]y     
patt]ns ( heal? c>e furni%$ by !        
,secret>y "u *apt] #ag ( su* title z a  
result ( ! implem5tation ( section #ajc 
7includ+ ! am5dm5ts made by su*         
section74  7d7 ,def9itions ,9 ?is       
section3 7#a7 ,pati5t enrollm5t sy/em ,!
 t]m pati5t enrollm5t sy/em means !     
pati5t enrollm5t sy/em ( ! ,dep>tm5t (  
,vet]ans ,affairs e/abli%$ & op]at$ "u  
section #agje7;a7 ( title #ch1 ,unit$   
,/ates ,code4  7#b7 ,vet]ans ,community 
,c>e ,program ,! t]m ,vet]ans ,community
 ,c>e ,program means ! program e/abli%$ 
"u section #agjc ( title #ch1 ,unit$    
,/ates ,code4  ,b ,c]ta9 vet]ans (      
combat s]vice & o!r matt]s  #aaa4       
,expansion ( p]iod ( eligibility = heal?
 c>e = c]ta9 vet]ans ( combat s]vice    
7a7 ,exp&$ p]iod ,section #agaj7;e77#c7 
is am5d$--  7#a7 9 subp>agraph 7,a7--   

7,a7 by /rik+ ,janu>y #bg1 #bjjc &      
ins]t+ ,septemb] #aa1 #bjja2 &  7,b7 by 
/rik+ five-ye> p]iod & ins]t+ #aj-ye>   
p]iod2  7#b7 by am5d+ subp>agraph 7,b7  
to read z foll[s3  7,b7 ,) respect to a 
vet]an describ$ 9 p>agraph 7#a77;,d7 :o 
0 dis*>g$ or releas$ f ! active milit>y1
 naval1 air1 or space s]vice aft]       
,septemb] #aa1 #bjja1 & be=e ,octob] #a1
 #bjac1 b did n enroll to receive su*   
hospital c>e1 m$ical s]vices1 or nurs+  
home c>e "u su* p>agraph pursuant to    
subp>agraph 7,a7 be=e ,octob] #a1 #bjbb1
 ! "o-ye> p]iod beg9n+ on ,octob] #a1   
#bjbb4  2 &  7#c7 by /rik+ subp>agraph  
7,c74  7b7 ,cl>ification ( cov]age      
,section #agaj7;e77#a77;,d7 is am5d$ by 
ins]t+ aft] ,p]sian ,gulf ,w> ! foll[+3 
7includ+ any vet]an :o1 9 connection )  
s]vice dur+ su* p]iod1 receiv$ ! ,arm$  
,=ces ,exp$ition>y ,m$al1 ,s]vice       
,specific ,exp$ition>y ,m$al1 ,combat   
,era ,specific ,exp$ition>y ,m$al1      
,campaign ,specific ,m$al1 or any o!r   
combat !at] aw>d e/abli%$ by a ,f$]al   

/atute or an ,executive ord]74  7c7     
,outrea* plan ,n lat] ?an ,decemb] #a1  
#bjbb1 ! ,secret>y ( ,vet]ans ,affairs  
%all submit to ! ,committee on ,vet]ans'
 ,affairs ( ! ,s5ate & ! ,committee on  
,vet]ans' ,affairs ( ! ,h\se (          
,repres5tatives a plan to conduct       
outrea* to vet]ans describ$ 9           
subp>agraph 7,b7 ( section #agaj7;e77#c7
 ( title #ch1 ,unit$ ,/ates ,code1 z    
am5d$ by subsection 7a77#b71 to notify  
su* vet]ans ( _! eligibility = hospital 
c>e1 m$ical s]vices1 or nurs+ home c>e  
pursuant to su* subp>agraph4  7d7       
,report on enrollm5ts ,n lat] ?an       
,janu>y #cj1 #bjbd1 ! ,secret>y %all    
submit to ! ,committee on ,vet]ans'     
,affairs ( ! ,s5ate & ! ,committee on   
,vet]ans' ,affairs ( ! ,h\se (          
,repres5tatives a report id5tify+1 )    
respect to ! "o-ye> p]iod beg9n+ on     
,octob] #a1 #bjbb1 ! numb] ( vet]ans    
describ$ 9 section #agaj7;e77#c77;,b7 ( 
title #ch1 ,unit$ ,/ates ,code1 z am5d$ 
by subsection 7a77#b71 :o1 dur+ su*     

p]iod1 enroll$ 9 ! pati5t enrollm5t     
sy/em ( ! ,dep>tm5t ( ,vet]ans ,affairs 
e/abli%$ & op]at$ "u section #agje7;a7 (
 su* title4  7e7 ,effective date ,?is   
section & ! am5dm5ts made by ?is section
 %all take effect on ,octob] #a1 #bjbb4 
,,ii ,toxic exposure presumption process
  #bja4 ,%ort title ,?is title may be   
cit$ z ! ,toxic ,exposure 9 ! ,am]ican  
,milit>y ,act ( #bjbb or ! ,,team ,act (
 #bjbb4  #bjb4 ,improvem5ts to ability (
 ,dep>tm5t ( ,vet]ans ,affairs to       
e/abli% presumptions ( s]vice connection
 bas$ on toxic exposure  7a7 ,advisory  
committees1 panels1 & bo>ds ,*apt] #aa  
is am5d$ by add+ at ! end ! foll[+ new  
sub*apt]3  ,,vii ,det]m9ations relat+ to
 presumptions ( s]vice connection bas$  
on toxic exposure  #aaga4 ,proc$ures to 
det]m9e presumptions ( s]vice connection
 bas$ on toxic exposure2 def9itions  7a7
 ,proc$ures ,! ,secret>y %all det]m9e   
:e!r to e/abli%1 or to remove1          
presumptions ( s]vice connection bas$ on
 toxic exposure pursuant to ?is         

sub*apt]1 :]eby-- 7#a7 "u section #aagb 
( ?is title--  7,a7 ! ,secret>y         
provides-- 7i7 public notice reg>d+ :at 
=mal evaluations ! ,secret>y plans to   
conduct2 &  7ii7 ! public an opportunity
 to comm5t on ! propos$ =mal            
evaluations2  7,b7 ! work+ gr\p e/abli%$
 "u subsection 7b7 ( su* section        
provides--  7i7 advice to ! ,secret>y on
 toxic-expos$ vet]ans & cases 9 :i*     
vet]ans :o1 dur+ active milit>y1 naval1 
air1 or space s]vice1 may h exp]i5c$ a  
toxic exposure or _! dep5d5ts may h     
exp]i5c$ a toxic exposure :ile ! vet]ans
 7 s]v+ 9 ! active milit>y1 naval1 air1 
or space s]vice2  7ii7 recomm5dations to
 ! ,secret>y on corrections ne$$ 9 !    
,individual ,longitud9al ,exposure      
,record to bett] reflect vet]ans &      
dep5d5ts describ$ 9 clause 7i72 &  7iii7
 recomm5dations to ! ,secret>y reg>d+   
:i* cases ( possible toxic exposure %\ld
 be review$2  7#b7 ! ,secret>y provides 
= =mal evaluations ( su* recomm5dations 
"u section #aagc ( ?is title & takes    

into acc\nt reports receiv$ by !        
,secret>y f ! ,national ,academies (    
,sci5ces1 ,eng9e]+1 & ,m$ic9e "u section
 #aagf ( ?is title2 &  7#c7 ! ,secret>y 
issues regulations "u section #aagd (   
?is title4  7b7 ,def9itions ,9 ?is      
sub*apt]3  7#a7 ,! t]m illness includes 
a disease or o!r condition affect+ !    
heal? ( an individual1 includ+ m5tal &  
physical heal?4  7#b7 ,! t]m ,individual
 ,longitud9al ,exposure ,record         
includes--  7,a7 s]vice records2  7,b7  
any database ma9ta9$ by ! ,dep>tm5t (   
,def5se & %>$ ) ! ,dep>tm5t ( ,vet]ans  
,affairs to s]ve z a c5tral portal =    
exposure-relat$ data t compiles1        
collates1 pres5ts1 & provides available 
occupational & environm5tal exposure    
in=mation to support ! ne$s ( !         
,dep>tm5t ( ,def5se & ! ,dep>tm5t (     
,vet]ans ,affairs2 or  7,c7 any         
successor sy/em to a database describ$ 9
 subp>agraph 7,b74  #aagb4 ,annual      
notice & opportunity = public comm5t    
7a7 ,notice requir$  7#a7 7,a7 ,n less  

frequ5tly ?an once ea* ye>1 ! ,secret>y 
%all publi% 9 ! ,f$]al ,regi/] notice ( 
! =mal evaluations t ! ,secret>y plans  
to conduct pursuant to section #aagc (  
?is title4  7,b7 ,ea* notice publi%$ "u 
subp>agraph 7,a7 %all include1 = ea*    
=mal evaluation ref]r$ to 9 ! notice1 an
 explanation z to :y ! milit>y          
environm5tal exposures & adv]se heal?   
outcomes t are ! subject ( ! =mal       
evaluation 7 *os5 by ! ,secret>y = =mal 
evaluation "u section #aagc ( ?is title4
  7#b7 7,a7 ,) ea* notice publi%$ "u    
p>agraph 7#a71 ! ,secret>y %all seek    
public comm5t on ! milit>y environm5tal 
exposures & adv]se heal? outcomes t are 
! subject ( ! =mal evaluations ref]r$ to
 9 ! notice4  7,b7 ,! ,secret>y %all--  
7i7 consid] all public comm5t receiv$ "u
 subp>agraph 7,a72 &  7ii7 publi% 9 !   
,f$]al ,regi/] a response to ! comm5ts  
receiv$ "u subp>agraph 7,a74  7#c7 7,a7 
,= ea* notice publi%$ "u p>agraph 7#a71 
! ,secret>y %all hold an op5 meet+ =    
memb]s ( ! public to voice _! comm5ts 9 

response to ! notice4  7,b7 ,to help    
evaluate presumptions ( s]vice          
connection1 ! ,secret>y %all1 n less    
frequ5tly ?an qu>t]ly1 collaborate )1   
p>tn] )1 & give weight to ! advice (    
vet]ans s]vice organizations & su* o!r  
/akehold]s z ! ,secret>y consid]s       
appropriate4  7#d7 ,failure to include a
 milit>y environm5tal exposure or adv]se
 heal? effect 9 a ,f$]al ,regi/] notice 
publi%$ pursuant to subsection 7a7 %all 
n preclude ! ,secret>y f initiat+ a =mal
 evaluation ( su* exposure or heal?     
effect4  7b7 ,work+ ,gr\p  7#a7 ,!      
,secret>y %all e/abli% a work+ gr\p )9 !
 ,dep>tm5t 79 ?is section ref]r$ to z ! 
,work+ ,gr\p74  7#b7 ,! ,work+ ,gr\p    
%all include p]sonnel ( ! ,vet]ans      
,heal? ,adm9i/ration & ! ,vet]ans       
,b5efits ,adm9i/ration4  7#c7 ,!        
,secret>y %all consult )1 & seek !      
advice (1 ! ,work+ ,gr\p ) respect to   
cases 9 :i*-- 7,a7 a vet]an may h1 dur+ 
active milit>y1 naval1 air1 or space    
s]vice1 exp]i5c$ a toxic exposure2 or   

7,b7 a dep5d5t ( a vet]an may h exp]i5c$
 a toxic exposure dur+ ! active milit>y1
 naval1 air1 or space s]vice ( ! vet]an4
  7c7 ,assessm5ts  7#a7 ,! ,work+ ,gr\p 
%all assess cases ( ! toxic exposure (  
vet]ans & _! dep5d5ts t occurr$ dur+    
active milit>y1 naval1 air1 or space    
s]vice1 includ+ by conduct+ ongo+       
surveillance & review+ su* exposure     
describ$ 9 sci5tific lit]ature1 m$ia    
reports1 in=mation f vet]ans1 &         
in=mation f ,congress4  7#b7 ,!         
assessm5ts "u p>agraph 7#a7 %all cov]   
suspect$ & kn[n toxic exposures occurr+ 
dur+ active milit>y1 naval1 air1 or     
space s]vice1 includ+ by id5tify+ &     
evaluat+ new & em]g+ toxic exposures t  
are n recogniz$ "u exi/+ presumptions ( 
s]vice connection4  7#c7 ,! ,work+ ,gr\p
 may conduct an assessm5t "u p>agraph   
7#a7 9 response to a comm5t receiv$ "u  
p>agraph 7#b7 or 7#c7 ( subsection 7a74 
7#d7 ,! ,work+ ,gr\p %all1 9            
consultation ) ! ,secret>y ( ,def5se1 on
 a p]iodic basis1 assess ! ,individual  

,longitud9al ,exposure ,record to ensure
 ! accuracy ( data collect$4  7d7       
,developm5t ( recomm5dations  7#a7      
,foll[+ an assessm5t ( a case ( ! toxic 
exposure ( vet]ans t occurr$ dur+ active
 milit>y1 naval1 air1 or space s]vice "u
 subsection 7c71 or _! dep5d5ts1 !      
,work+ ,gr\p may develop a recomm5dation
 = =mal evaluation "u section #aagc (   
?is title to conduct a review ( ! heal? 
effects relat$ to ! case ( exposure if !
 ,work+ ,gr\p det]m9es t ! rese>* may   
*ange ! curr5t und]/&+ ( ! relation%ip  
betwe5 an exposure to an environm5tal   
haz>d & adv]se heal? outcomes 9 humans4 
7#b7 ,^u receipt ( evid5ce sugge/+ t    
previ\s f9d+s reg>d+ ! p]iods &         
locations ( exposure cov]$ by an exi/+  
presumption ( s]vice connection are no  
long] support$1 ! ,work+ ,gr\p may      
nom9ate su* evid5ce = =mal evaluation "u
 section #aagc ( ?is title to modify !  
p]iods & locations4  7e7 ,reports by !  
,work+ ,gr\p ,n less frequ5tly ?an once 
ea* ye>1 ! ,work+ ,gr\p %all submit to !

 ,secret>y1 ! ,committee on ,vet]ans'   
,affairs ( ! ,s5ate1 & ! ,committee on  
,vet]ans' ,affairs ( ! ,h\se (          
,repres5tatives1 & make publicly        
available1 a report on--  7#a7          
recomm5dations develop$ "u subsection   
7d71 if any2 &  7#b7 recomm5dations =   
su* legislative or adm9i/rative action z
 ! ,work+ ,gr\p consid]s necess>y = !   
,work+ ,gr\p to be m effective 9 c>ry+  
out ! requirem5ts ( ?is section4  7f7   
,responses by ,secret>y ,9 response to  
ea* report submitt$ "u subsection 7e71 !
 ,secret>y %all1 n lat] ?an #cj days    
aft] receiv+ ! report1 initiate a =mal  
evaluation pursuant to section #aagc (  
?is title4  #aagc4 ,=mal evaluation (   
recomm5dations  7a7 ,=mal evaluations ,!
 ,secret>y %all e/abli% a process to    
conduct a =mal evaluation ) respect to  
ea* recomm5dation made by ! ,work+ ,gr\p
 "u section #aagb ( ?is title4  7b7     
,evid5ce1 data1 & factors ,! ,secret>y  
%all ensure t ea* =mal evaluation "u    
subsection 7a7 cov]s ! foll[+3 7#a7     

,sci5tific evid5ce1 bas$ on ! review (  
available sci5tific lit]ature1 includ+  
human1 toxicological1 animal1 &         
me?odological /udies1 & o!r factors4    
7#b7 ,claims data1 bas$ on ! review (   
claim rate1 grant rate1 & s]vice        
connection preval5ce1 & o!r factors4    
7#c7 ,o!r factors ! ,secret>y det]m9es  
appropriate1 su* z--  7,a7 ! level (    
disability & mortality caus$ by ! heal? 
effects relat$ to ! case ( toxic        
exposure be+ evaluat$2  7,b7 ! quantity 
& quality ( ! in=mation available &     
review$2  7,c7 ! feasibility ( & p]iod =
 g5]at+ relevant in=mation & evid5ce2   
7,d7 :e!r su* heal? effects are combat- 
or deploym5t-relat$2  7,e7 ! ubiquity or
 r>ity ( ! heal? effects2 &  7,f7 any "t
 frame dur+ :i* a heal? effect mu/      
become manife/4  7c7 ,conduct (         
evaluations  7#a7 ,! ,secret>y %all     
ensure t ea* =mal evaluation "u         
subsection 7a7-- 7,a7 reviews sci5tific 
evid5ce 9 a mann] t--  7i7 con=ms to    
pr9ciples ( sci5tific & data integrity2 

7ii7 is free f suppression or di/ortion 
( sci5tific or te*nological f9d+s1 data1
 in=mation1 conclusions1 or te*nical    
results2 &  7,b7  7i7 evaluates !       
likelihood t a positive association     
exi/s betwe5 an illness & a toxic       
exposure :ile s]v+ 9 ! active milit>y1  
naval1 air1 or space s]vice2 &  7ii7    
assesses ! toxic exposures & illnesses &
 det]m9es :e!r ! evid5ce supports a f9d+
 ( a positive association betwe5 ! toxic
 exposure & ! illness4  7#b7 ,9 c>ry+   
out p>agraph 7#a77;,b77ii71 a =mal      
evaluation "u subsection 7a7 %all       
include review+ all relevant data to    
det]m9e ! /r5g? ( evid5ce = a positive  
association bas$ on ! foll[+ f\r        
categories3 7,a7 ,! suffici5t category1 
:]e ! evid5ce is suffici5t to conclude t
 a positive association exi/s4  7,b7 ,! 
equipoise & above category1 :]e !       
evid5ce is suffici5t to conclude t a    
positive association is at lea/ z likely
 z n1 b n suffici5t to conclude t a     
positive association exi/s4  7,c7 ,!    

bel[ equipoise category1 :]e ! evid5ce  
is n suffici5t to conclude t a positive 
association is at lea/ z likely z n1 or 
is n suffici5t to make a sci5tifically  
in=m$ judgm5t4  7,d7 ,! aga9/ category1 
:]e ! evid5ce sugge/s ! lack ( a        
positive association4  7d7              
,recomm5dation = e/abli%+ a presumption 
( s]vice connection ,n lat] ?an #abj    
days aft] ! date on :i* a =mal          
evaluation is comm5c$1 ! elem5t ( !     
,dep>tm5t t conducts ! evaluation %all  
submit to ! ,secret>y a recomm5dation ) 
respect to e/abli%+ a presumption (     
s]vice connection = ! toxic exposure &  
illness1 or modify+ an exi/+ presumption
 ( s]vice connection1 cov]$ by !        
evaluation4  #aagd4 ,regulations reg>d+ 
presumptions ( s]vice connection bas$ on
 toxic exposure  7a7 ,action ^u         
recomm5dation ,n lat] ?an #afj days aft]
 ! date on :i* ! ,secret>y receives a   
recomm5dation to e/abli% or modify a    
presumption ( s]vice connection "u      
section #aagc ( ?is title-- 7#a7 if !   

,secret>y det]m9es1 9 ! discretion ( !  
,secret>y1 t ! presumption1 or          
modification1 is w>rant$1 ! ,secret>y   
%all--  7,a7 comm5ce issu+ regulations 9
 accordance ) ! provisions ( sub*apt]   
,,ii ( *apt] #e ( title #e 7commonly    
ref]r$ to z ! ,adm9i/rative ,proc$ures  
,act7 sett+ =? ! presumption or comm5ce 
revis+ regulations to c>ry out su*      
modification2 &  7,b7 include 9 su*     
regulations any "t frame dur+ :i* a     
heal? effect mu/ become manife/2 or     
7#b7 if ! ,secret>y det]m9es1 9 !       
discretion ( ! ,secret>y1 t !           
presumption1 or modification1 is n      
w>rant$1 ! ,secret>y %all publi% 9 !    
,f$]al ,regi/] a notice ( ! det]m9ation1
 includ+ ! reasons support+ !           
det]m9ation4  7b7 ,removal ( presumption
  7#a7 7,a7 ,! ,secret>y may--  7i7     
issue a regulation to remove an illness 
f a presumption ( s]vice connection     
previ\sly e/abli%$ pursuant to a        
regulation issu$ "u subsection 7a72 &   
7ii7 issue a regulation to remove a     

presumption ( s]vice connection e/abli%$
 pursuant to title ,,iv ( ! ,s]geant    
,fir/ ,class ,hea? ,rob9son ,honor+ our 
,promise to ,address ,compreh5sive      
,toxics ,act ( #bjbb if ! ,secret>y     
concludes t evid5ce sugge/s ! lack ( a  
positive association betwe5 ! disease & 
! toxic exposure4  7,b7 ,"u subp>agraph 
7,a77ii71 ! ,secret>y %all n consid] !  
lack ( evid5ce z suffici5t to support a 
decision = removal ( a presumption4     
7#b7 ,:5ev] an illness is remov$ f      
regulations pursuant to p>agraph 7#a71  
or ! p]iods & locations ( exposure cov]$
 by a presumption ( s]vice connection   
are modifi$ "u subsection 7a7--  7,a7 a 
vet]an :o 0 aw>d$ comp5sation "u *apt]  
#aa ( ?is title = su* illness on ! basis
 ( ! presumption provid$ "u su*         
regulations be=e ! effective date ( !   
removal or modification %all cont9ue to 
be entitl$ to receive comp5sation on t  
basis2  7,b7 a survivor ( a vet]an :o 0 
aw>d$ dep5d5cy & indemnity comp5sation  
"u *apt] #ac ( ?is title = ! dea? ( a   

vet]an result+ f su* illness on ! basis 
( su* presumption %all cont9ue to be    
entitl$ to receive dep5d5cy & indemnity 
comp5sation on su* basis2 &  7,c7 no    
vet]an or survivor cov]$ "u subp>agraph 
7,a7 or 7,b7 %all h _! comp5sation r$uc$
 solely because ( ! removal ( an illness
 pursuant to p>agraph 7#a74  #aage4     
,au?ority to modify process2            
congressional ov]sight  7a7 ,9 g5]al ,! 
,secret>y may modify ! process "u :i* ! 
work+ gr\p e/abli%$ "u subsection 7b7 ( 
section #aagb ( ?is title conducts      
assessm5ts "u su* section1 ! ,secret>y  
conducts =mal evaluations "u section    
#aagc ( ?is title1 & issues regulations 
"u section #aagd ( ?is title if--  7#a7 
su* evaluations cov] ! evid5ce1 data1 & 
factors requir$ by subsection 7b7 ( su* 
section #aagc2 &  7#b7 a p]iod ( #ahj   
days has elaps$ foll[+ ! date on :i* !  
,secret>y submits ! notice "u subsection
 7b7 reg>d+ ! modification4  7b7 ,notice
 ,if ! ,secret>y proposes to modify !   
process "u :i* ! work+ gr\p e/abli%$ "u 

subsection 7b7 ( section #aagb ( ?is    
title conducts assessm5ts "u su*        
section1 ! process "u :i* ! ,secret>y   
conducts =mal evaluations "u section    
#aagc ( ?is title1 or issues regulations
 "u section #aagd ( ?is title1 !        
,secret>y %all submit to ! ,committee on
 ,vet]ans' ,affairs ( ! ,s5ate & !      
,committee on ,vet]ans' ,affairs ( !    
,h\se ( ,repres5tatives a notice ( !    
propos$ modifications conta9+ ! foll[+3 
7#a7 ,a description ( ! propos$         
modifications4  7#b7 ,a description (   
any exceptions to ! requirem5ts ( su*   
sections t are propos$ because ( limit$ 
available sci5tific evid5ce1 & a        
description ( h[ su* evaluations w be   
conduct$4  #aagf4 ,agreem5t ) ,national 
,academies ( ,sci5ces1 ,eng9e]+1 &      
,m$ic9e conc]n+ toxic exposures  7a7    
,purpose ,! purpose ( ?is section is to 
provide = ! ,national ,academies (      
,sci5ces1 ,eng9e]+1 & ,m$ic9e 79 ?is    
section ref]r$ to z ! ,academies71 an   
indep5d5t nonpr(it sci5tific            

organization ) appropriate exp]tise t is
 n "p ( ! ,f$]al ,gov]nm5t1 to review & 
evaluate ! available sci5tific evid5ce  
reg>d+ associations betwe5 diseases &   
toxic exposures4  7b7 ,agreem5t  7#a7 ,!
 ,secret>y %all seek to ent] into a     
five-ye> agreem5t ) ! ,academies to p]=m
 ! s]vices cov]$ by ?is section4  7#b7  
,! ,secret>y %all seek to ent] into an  
agreem5t describ$ 9 p>agraph 7#a7 n lat]
 ?an #fj days aft] ! date ( ! enactm5t (
 ! ,s]geant ,fir/ ,class ,hea? ,rob9son 
,honor+ our ,promise to ,address        
,compreh5sive ,toxics ,act ( #bjbb4     
7#c7 ,an agreem5t "u ?is section may be 
ext5d$ 9 five-ye> increm5ts4  7c7       
,review ( sci5tific evid5ce ,"u an      
agreem5t betwe5 ! ,secret>y & !         
,academies "u ?is section1 ! ,academies 
%all review & summ>ize ! sci5tific      
evid5ce1 & assess ! /r5g? !re(1 conc]n+ 
! association betwe5 toxic exposures    
dur+ active milit>y1 naval1 air1 or     
space s]vice & ea* disease suspect$ to  
be associat$ ) su* exposure 9 ! human   

population4  7d7 ,sci5tific det]m9ations
 conc]n+ diseases ,= ea* disease review$
 "u subsection 7c71 ! ,academies %all   
det]m9e1 to ! ext5t t available         
sci5tific data p]mit mean+ful           
det]m9ations-- 7#a7 :e!r an association 
exi/s betwe5 toxic exposures & !        
occurr5ce ( ! disease1 tak+ into acc\nt 
! /r5g? ( ! sci5tific evid5ce & !       
appropriat5ess ( ! /ati/ical &          
epidemiological me?ods us$ to detect !  
association2  7#b7 ! increas$ risk ( !  
disease among ^? report+ toxic exposures
 dur+ active milit>y1 naval1 air1 or    
space s]vice2  7#c7 :e!r !re exi/s a    
plausible biological me*anism or o!r    
evid5ce ( a positive association betwe5 
! toxic exposure & ! occurr5ce ( !      
disease2 &  7#d7 det]m9e ! /r5g? (      
evid5ce = a positive association bas$ on
 categories furni%$ "u section #aagc (  
?is title4  7e7 ,coop]ation ( ,f$]al    
ag5cies ,! head ( ea* relevant ,f$]al   
ag5cy1 includ+ ! ,secret>y ( ,def5se1   
%all coop]ate fully ) ! ,academies 9    

p]=m+ ! s]vices cov]$ by ?is section4   
7f7 ,recomm5dations = additional        
sci5tific /udies  7#a7 ,"u an agreem5t  
betwe5 ! ,secret>y & ! ,academies "u ?is
 section1 ! ,academies %all make any    
recomm5dations = additional sci5tific   
/udies to resolve areas ( cont9u+       
sci5tific unc]ta9ty relat+ to toxic     
exposures4  7#b7 ,9 mak+ recomm5dations 
"u p>agraph 7#a71 ! ,academies %all     
consid]--  7,a7 ! sci5tific in=mation t 
is available at ! "t ( ! recomm5dation2 
7,b7 ! value & relevance ( ! in=mation t
 c\ld result f additional /udies2 &     
7,c7 ! co/ & feasibility ( c>ry+ out su*
 additional /udies4  7g7 ,reports  7#a7 
7,a7 ,"u an agreem5t betwe5 ! ,secret>y 
& ! ,academies "u ?is section1 n lat]   
?an "o ye> aft] ! date ( ! enactm5t ( ! 
,s]geant ,fir/ ,class ,hea? ,rob9son    
,honor+ our ,promise to ,address        
,compreh5sive ,toxics ,act ( #bjbb1 !   
,academies %all submit to ! ,secret>y1 !
 ,committee on ,vet]ans' ,affairs ( !   
,s5ate1 & ! ,committee on ,vet]ans'     

,affairs ( ! ,h\se ( ,repres5tatives an 
initial report on ! activities ( !      
,academies "u ! agreem5t4  7,b7 ,!      
report submitt$ "u subp>agraph 7,a7 %all
 include ! foll[+3 7i7 ,! det]m9ations  
describ$ 9 subsection 7d74  7ii7 ,a full
 explanation ( ! sci5tific evid5ce &    
reason+ t l$ to su* det]m9ations4  7iii7
 ,any recomm5dations ( ! ,academies "u  
subsection 7f74  7#b7 ,"u an agreem5t   
betwe5 ! ,secret>y & ! ,academies "u ?is
 section1 n less frequ5tly ?an once e   
two ye>s aft] ! date on :i* ! initial   
report is submitt$ "u p>agraph          
7#a77;,a71 ! ,academies %all submit to !
 ,secret>y1 ! ,committee on ,vet]ans'   
,affairs ( ! ,s5ate1 & ! ,committee on  
,vet]ans' ,affairs ( ! ,h\se (          
,repres5tatives an updat$ report on !   
activities ( ! ,academies "u ! agreem5t4
  7h7 ,alt]native contract sci5tific    
organization  7#a7 ,if ! ,secret>y is   
unable )9 ! "t p]iod prescrib$ 9        
subsection 7b77#b7 to ent] into an      
agreem5t ) ! ,academies = ! purposes (  

?is section on t]ms acceptable to !     
,secret>y1 ! ,secret>y %all seek to ent]
 into an agreem5t = ! purposes ( ?is    
section ) ano!r appropriate sci5tific   
organization t--  7,a7 is n "p ( !      
,f$]al ,gov]nm5t2  7,b7 op]ates z a     
n-=-pr(it entity2 &  7,c7 has exp]tise &
 objectivity comp>able to t ( !         
,academies4  7#b7 ,if ! ,secret>y ent]s 
into an agreem5t ) ano!r organization z 
describ$ 9 p>agraph 7#a71 any ref]5ce 9 
?is sub*apt] to ! ,academies %all be    
treat$ z a ref]5ce to ! o!r             
organization4  4  7b7 ,reports & brief+s
  7#a7 ,report  7,a7 ,9 g5]al ,n lat]   
?an two ye>s aft] ! date ( ! enactm5t ( 
?is ,act1 ! ,secret>y ( ,vet]ans        
,affairs %all submit to ! ,committee on 
,vet]ans' ,affairs ( ! ,s5ate & !       
,committee on ,vet]ans' ,affairs ( !    
,h\se ( ,repres5tatives a report on !   
implem5tation (1 & recomm5dations =1    
sub*apt] ,,vii ( *apt] #aa ( title #ch1 
,unit$ ,/ates ,code1 z add$ by          
subsection 7a74  7,b7 ,consultation ,!  

,secret>y %all develop ! report "u      
subp>agraph 7,a7 9 consultation )       
organizations recogniz$ by ! ,secret>y =
 ! repres5tation ( vet]ans "u section   
#eijb ( su* title & any o!r entity !    
,secret>y det]m9es appropriate4  7#b7   
,brief+ ,on a qu>t]ly basis dur+ !      
two-ye> p]iod beg9n+ on ! date ( !      
enactm5t ( ?is ,act1 ! ,secret>y %all   
provide to ! ,committee on ,vet]ans'    
,affairs ( ! ,s5ate & ! ,committee on   
,vet]ans' ,affairs ( ! ,h\se (          
,repres5tatives a brief+ on !           
implem5tation ( sub*apt] ,,vii ( *apt]  
#aa ( su* title1 z add$ by subsection   
7a74  7c7 ,indep5d5t assessm5t  7#a7    
,agreem5t ,! ,secret>y %all seek to ent]
 into an agreem5t ) ! ,national         
,academies ( ,sci5ce1 ,eng9e]+1 &       
,m$ic9e 79 ?is subsection ref]r$ to z ! 
,academies7 be=e ! date t is #ij days   
aft] ! date ( ! enactm5t ( ?is ,act to  
p]=m ! s]vices set =? "u p>agraph 7#b74 
7#b7 ,assessm5t  7,a7 ,9 g5]al ,"u an   
agreem5t betwe5 ! ,secret>y & !         

,academies "u p>agraph 7#a71 !          
,academies %all conduct an assessm5t ( !
 implem5tation by ! ,dep>tm5t ( ,vet]ans
 ,affairs ( ! process e/abli%$ "u       
sub*apt] ,,vii ( *apt] #aa ( title #ch1 
,unit$ ,/ates ,code1 z add$ by          
subsection 7a74  7,b7 ,elem5ts ,!       
assessm5t conduct$ "u subp>agraph 7,a7  
%all include ! foll[+3  7i7 ,an         
assessm5t ( ! ,dep>tm5t's implem5tation 
( ! process e/abli%$ "u subsection 7a7  
to det]m9e :e!r ! process is 9          
accordance ) curr5t sci5tific /&>ds =   
assess+ ! l9k betwe5 exposure to        
environm5tal haz>ds & ! developm5t (    
heal? outcomes1  7ii7 assess :e!r !     
crit]ia is fair & consi/5t1 &  7iii7    
provide recomm5dations = improvem5ts to 
! process4  7#c7 ,report ,n lat] ?an "o 
ye> aft] ! date on :i* ! ,secret>y ent]s
 into an agreem5t "u p>agraph 7#a71 !   
,secret>y %all submit to ! ,committee on
 ,vet]ans' ,affairs ( ! ,s5ate & !      
,committee on ,vet]ans' ,affairs ( !    
,h\se ( ,repres5tatives a report on !   

f9d+s ( ! ,academies pursuant to su*    
agreem5t4  7#d7 ,alt]native contract    
sci5tific organization  7,a7 ,9 g5]al   
,if ! ,secret>y is unable )9 ! "t p]iod 
prescrib$ 9 p>agraph 7#a7 to ent] into  
an agreem5t ) ! ,academies = ! purposes 
( ?is subsection on t]ms acceptable to !
 ,secret>y1 ! ,secret>y %all seek to    
ent] into an agreem5t = ! purposes ( ?is
 subsection ) ano!r appropriate         
sci5tific organization t-- 7i7 is n "p (
 ! ,f$]al ,gov]nm5t2  7ii7 op]ates z a  
n-=-pr(it entity2 &  7iii7 has exp]tise 
& objectivity comp>able to t ( !        
,academies4  7,b7 ,treatm5t ,if !       
,secret>y ent]s into an agreem5t ) ano!r
 organization z describ$ 9 subp>agraph  
7,a71 any ref]5ce 9 ?is subsection to ! 
,academies ( ,sci5ces1 ,eng9e]+1 &      
,m$ic9e %all be treat$ z a ref]5ce to ! 
o!r organization4  7d7 ,con=m+ am5dm5ts 
,*apt] #aa is am5d$--  7#a7 9 section   
#aaaf-- 7,a7 by /rik+ subsections 7b71  
7c71 7d71 & 7e72  7,b7 by ins]t+ aft]   
subsection 7a7 ! foll[+ new subsection  

7b73  7b7 ,! ,secret>y %all ensure t any
 det]m9ation made on or aft] ! date ( ! 
enactm5t ( ! ,s]geant ,fir/ ,class ,hea?
 ,rob9son ,honor+ our ,promise to       
,address ,compreh5sive ,toxics ,act (   
#bjbb reg>d+ a presumption ( s]vice     
connection bas$ on exposure to an       
h]bicide ag5t "u ?is section is made    
pursuant to sub*apt] ,,vii ( ?is *apt]1 
includ+ ) respect to assess+ reports    
receiv$ by ! ,secret>y f ! ,national    
,academy ( ,sci5ces "u section #c ( !   
,ag5t ,orange ,act ( #aiia 7,public ,law
 #ajb-d74  2 &  7,c7 by r$esignat+      
subsection 7f7 z subsection 7c72  7#b7 9
 section #aaaf;,b7b77#b77;,a71 by ins]t+
 pursuant to sub*apt] ,,vii ( ?is *apt]1
 be=e ! ,secret>y det]m9es2 &  7#c7 9   
section #aaah-- 7,a7 by /rik+           
subsections 7b7 ?r\gh 7e72 &  7,b7 by   
ins]t+ aft] subsection 7a7 ! foll[+ new 
subsection 7b73  7b7 ,! ,secret>y %all  
ensure t any det]m9ation made on or aft]
 ! date ( ! enactm5t ( ! ,s]geant ,fir/ 
,class ,hea? ,rob9son ,honor+ our       

,promise to ,address ,compreh5sive      
,toxics ,act ( #bjbb reg>d+ a           
presumption ( s]vice connection bas$ on 
a toxic exposure "u ?is section is made 
pursuant to sub*apt] ,,vii ( ?is *apt]4 
4  #bjc4 ,outrea* to claimants =        
disability comp5sation pursuant to      
*anges 9 presumptions ( s]vice          
connection  7a7 ,9 g5]al ,sub*apt] ,,vi 
( *apt] #aa is am5d$ by add+ at ! end ! 
foll[+ new section3  #aafg4 ,outrea*    
pursuant to *anges 9 presumptions (     
s]vice connection  7a7 ,9 g5]al ,:5ev] a
 law1 includ+ ?r\gh a regulation or     
,f$]al c\rt decision or settlem5t1      
e/abli%es or modifies a presumption (   
s]vice connection1 ! ,secret>y %all--   
7#a7 id5tify all claims = comp5sation "u
 ?is *apt] t-- 7,a7 7 submitt$ to !     
,secret>y2  7,b7 7 evaluat$ & d5i$ by ! 
,secret>y be=e ! date on :i* su*        
provision ( law w5t into effect2 &  7,c7
 might h be5 evaluat$ diff]5tly _h !    
e/abli%m5t or modification be5          
applicable to ! claim2 &  7#b7 pursuant 

to subsection 7b71 conduct outrea* to ! 
claimants4  7b7 ,outrea*  7#a7 ,!       
,secret>y %all conduct outrea* to in=m  
claimants id5tifi$ "u subsection 7a7 t  
!y may submit a supplem5tal claim 9     
light ( ! e/abli%m5t or modification ( a
 presumption ( s]vice connection        
describ$ 9 subsection 7a74  7#b7        
,outrea* "u p>agraph 7#a7 %all include !
 foll[+3 7,a7 ,! ,secret>y %all publi%  
on ! int]net website ( ! ,dep>tm5t a    
notice t su* vet]ans may elect to file a
 supplem5tal claim4  7,b7 ,! ,secret>y  
%all notify1 9 writ+ or by electronic   
means1 vet]ans s]vice organizations ( ! 
ability ( su* vet]ans to file a         
supplem5tal claim4  7,c7 ,! ,secret>y   
%all contact ea* claimant id5tifi$ "u   
subsection 7a7 9 ! same mann] t !       
,dep>tm5t la/ provid$ notice ( a        
decision4  4  7b7 ,application ,section 
#aafg ( title #ch1 ,unit$ ,/ates ,code1 
z add$ by subsection 7a71 %all apply )  
respect to presumptions ( s]vice        
connection e/abli%$ or modifi$ on or    

aft] ! date ( ! enactm5t ( ?is ,act1    
includ+ pursuant to am5dm5ts made by ?is
 ,act4  7c7 ,rule ( con/ruction ,no?+ 9 
?is section %all be con/ru$ z--  7#a7   
modify+ ! obligations ( ! ,dep>tm5t (   
,vet]ans ,affairs "u ,f$]al c\rt        
decisions or settlem5ts 9 effect z ( !  
date ( ! enactm5t ( ?is ,act2 or  7#b7  
requir+ a retroactively appli$ effective
 date ( a supplem5tal claim e>li] ?an ! 
date a presumption ( s]vice connection  
is e/abli%$ or modifi$4  #bjd4          
,reevaluation ( claims = dep5d5cy &     
indemnity comp5sation involv+           
presumptions ( s]vice connection  7a7 ,9
 g5]al ,sub*apt] ,i ( *apt] #ac is am5d$
 by add+ at ! end ! foll[+ new section3 
#acje4 ,reevaluation ( dep5d5cy &       
indemnity comp5sation det]m9ations      
pursuant to *anges 9 presumptions (     
s]vice connection  7a7 ,reevaluation    
,:5ev] a law1 includ+ ?r\gh a regulation
 or ,f$]al c\rt decision or settlem5t1  
e/abli%es or modifies a presumption (   
s]vice connection1 ! ,secret>y %all--   

7#a7 id5tify all claims = dep5d5cy &    
indemnity comp5sation "u ?is *apt] t--  
7,a7 7 submitt$ to ! ,secret>y2  7,b7 7 
evaluat$ & d5i$ by ! ,secret>y be=e !   
date on :i* su* provision ( law w5t into
 effect2 &  7,c7 might h be5 evaluat$   
diff]5tly _h ! e/abli%m5t or            
modification be5 applicable to ! claim2 
7#b7 all[ = ! reevaluation ( su* claims 
at ! election ( ! claimant2 &  7#c7     
not)/&+ section #eaaj ( ?is title1 )    
respect to claims approv$ pursuant to   
su* reevaluation1 provide comp5sation "u
 ?is *apt] effective z if ! e/abli%m5t  
or modification ( ! presumption ( s]vice
 connection _h be5 9 effect on ! date ( 
! submission ( ! orig9al claim describ$ 
9 p>agraph 7#a74  7b7 ,outrea*  7#a7 ,! 
,secret>y %all conduct outrea* to in=m  
relevant claimants t !y may elect to h a
 claim be reevaluat$ 9 light ( !        
e/abli%m5t or modification ( a          
presumption ( s]vice connection describ$
 9 subsection 7a74  7#b7 ,outrea* "u    
p>agraph 7#a7 %all include ! foll[+3    

7,a7 ,! ,secret>y %all publi% on !      
int]net website ( ! ,dep>tm5t a notice t
 su* claimants may elect to h a claim s 
reevaluat$4  7,b7 ,! ,secret>y %all     
notify1 9 writ+ or by electronic means1 
vet]ans s]vice organizations ( ! ability
 ( su* claimants to elect to h a claim s
 reevaluat$4  7,c7 ,! ,secret>y %all    
contact ea* claimant id5tifi$ "u        
subsection 7a7 9 ! same mann] t !       
,dep>tm5t la/ provid$ notice ( a        
decision4  4  7b7 ,application ,section 
#acje ( title #ch1 ,unit$ ,/ates ,code1 
z add$ by subsection 7a71 %all apply )  
respect to presumptions ( s]vice        
connection e/abli%$ or modifi$ on or    
aft] ! date ( ! enactm5t ( ?is ,act1    
includ+ pursuant to am5dm5ts made by ?is
 ,act4  7c7 ,rule ( con/ruction ,no?+ 9 
?is section %all be con/ru$ z modify+ ! 
obligations ( ! ,dep>tm5t ( ,vet]ans    
,affairs "u ,f$]al c\rt decisions or    
settlem5ts 9 effect z ( ! date ( !      
enactm5t ( ?is ,act4  ,,iii ,improv+ !  
e/abli%m5t ( s]vice connection process =

 toxic-expos$ vet]ans  #cja4 ,%ort title
 ,?is title may be cit$ z ! ,vet]ans    
,burn ,pits ,exposure ,recognition ,act 
( #bjbb4  #cjb4 ,presumptions ( toxic   
exposure ,sub*apt] ,,ii ( *apt] #aa is  
am5d$ by add+ at ! end ! foll[+ new     
section3  #aaai4 ,presumptions ( toxic  
exposure  7a7 ,consid]ation ( records   
,if a vet]an submits to ! ,secret>y a   
claim = comp5sation = a s]vice-connect$ 
disability "u section #aaaj ( ?is title 
) evid5ce ( a disability & a toxic      
exposure t occurr$ dur+ active milit>y1 
naval1 air1 or space s]vice1 ! ,secret>y
 may1 9 adjudicat+ su* claim1 consid]-- 
7#a7 any record ( ! vet]an 9 an exposure
 track+ record sy/em2 &  7#b7 if no     
record ( ! vet]an 9 an exposure track+  
record sy/em indicates t ! vet]an 0     
subject to a toxic exposure dur+ active 
milit>y1 naval1 air1 or space s]vice1 ! 
totality ( ! circum/ances ( ! s]vice ( !
 vet]an4  7b7 ,presumption ( specific   
toxic exposure = memb]s :o s]v$ 9 c]ta9 
locations  7#a7 ,! ,secret>y %all1 =    

purposes ( section #aaaj & *apt] #ag (  
?is title1 presume t any cov]$ vet]an 0 
expos$ to ! sub/ances1 *emicals1 &      
airborne haz>ds id5tifi$ 9 ! li/ "u     
p>agraph 7#b7 dur+ ! s]vice ( ! cov]$   
vet]an specifi$ 9 subsection 7c77#a71   
unless !re is affirmative evid5ce to    
e/abli% t ! cov]$ vet]an 0 n expos$ to  
any su* sub/ances1 *emicals1 or haz>ds 9
 connection ) su* s]vice4  7#b7 ,!      
,secret>y %all--  7,a7 e/abli% & ma9ta9 
a li/ t conta9s an id5tification ( "o or
 m su* sub/ances1 *emicals1 & airborne  
haz>ds z ! ,secret>y1 9 collaboration ) 
! ,secret>y ( ,def5se1 may det]m9e      
appropriate = purposes ( ?is section2 & 
7,b7 det]m9e1 us+ proc$ures consi/5t )  
section #aagb ( ?is title & ?r\gh !     
conduct ( a =mal evaluation "u section  
#aagc ( ?is title1 :e!r to e/abli% an   
end date = a cov]$ vet]an to qualify =  
presumptions ( exposure "u ?is section1 
if appropriate1 b 9 no case e/abli% an  
end date e>li] ?an ! la/ day ( ! p]iod  
specifi$ 9 section #aja7cc7 = ! ,p]sian 

,gulf ,w>4  7#c7 ,beg9n+ n lat] ?an two 
ye>s aft] ! date ( ! enactm5t ( !       
,s]geant ,fir/ ,class ,hea? ,rob9son    
,honor+ our ,promise to ,address        
,compreh5sive ,toxics ,act ( #bjbb1 & n 
less frequ5tly ?an once e two ye>s      
!reaft]1 ! ,secret>y %all submit to !   
,committee on ,vet]ans' ,affairs ( !    
,s5ate & ! ,committee on ,vet]ans'      
,affairs ( ! ,h\se ( ,repres5tatives a  
report id5tify+ any additions or        
removals to ! li/ "u p>agraph 7#b7 dur+ 
! p]iod cov]$ by ! report4  7c7         
,def9itions ,9 ?is section3  7#a7 ,! t]m
 cov]$ vet]an means any vet]an :o-- 7,a7
 on or aft] ,augu/ #b1 #aiij1 p]=m$     
active milit>y1 naval1 air1 or space    
s]vice :ile assign$ to a duty /ation 91 
includ+ airspace above--  7i7 ,bahra92  
7ii7 ,iraq2  7iii7 ,kuwait2  7iv7 ,oman2
  7v7 ,qat>2  7vi7 ,saudi ,arabia2      
7vii7 ,somalia2 or  7viii7 ,unit$ ,arab 
,emirates2 or  7,b7 on or aft] ,septemb]
 #aa1 #bjja1 p]=m$ active milit>y1      
naval1 air1 or space s]vice :ile assign$

 to a duty /ation 91 includ+ airspace   
above-- 7i7 ,afghani/an2  7ii7 ,djib\ti2
  7iii7 ,egypt2  7iv7 ,jordan2  7v7     
,lebanon2  7vi7 ,syria2  7vii7 ,yem52   
7viii7 ,uzbeki/an2 or  7ix7 any o!r     
c\ntry det]m9$ relevant by ! ,secret>y4 
7#b7 ,! t]m exposure track+ record      
sy/em-- 7,a7 means any sy/em1 program1  
or pilot program us$ by ! ,secret>y (   
,vet]ans ,affairs or ! ,secret>y (      
,def5se to track h[ vet]ans or memb]s ( 
! ,arm$ ,=ces h be5 expos$ to v>i\s     
occupational or environm5tal haz>ds2 &  
7,b7 includes ! ,individual ,longitud9al
 ,exposure ,record1 or successor sy/em4 
7#c7 ,! t]m toxic exposure risk activity
 has ! mean+ giv5 su* t]m 9 section     
#agaj7;e77#d7 ( ?is title4  4  #cjc4    
,m$ical nexus exam9ations = toxic       
exposure risk activities ,sub*apt] ,,vi 
( *apt] #aa1 z am5d$ by section #bjc1 is
 fur!r am5d$ by add+ at ! end ! foll[+  
new section3  #aafh4 ,m$ical nexus      
exam9ations = toxic exposure risk       
activities  7a7 ,m$ical exam9ations &   

m$ical op9ions  7#a7 ,except z provid$ 9
 subsection 7b71 if a vet]an submits to 
! ,secret>y a claim = comp5sation = a   
s]vice-connect$ disability "u section   
#aaaj ( ?is title ) evid5ce ( a         
disability & evid5ce ( p>ticipation 9 a 
toxic exposure risk activity dur+ active
 milit>y1 naval1 air1 or space s]vice1 &
 su* evid5ce is n suffici5t to e/abli% a
 s]vice connection = ! disability1 !    
,secret>y %all--  7,a7 provide ! vet]an 
) a m$ical exam9ation "u section        
#eajc;,a7d7 ( ?is title2 &  7,b7 obta9 a
 m$ical op9ion 7to be reque/$ by !      
,secret>y 9 connection ) ! m$ical       
exam9ation "u subp>agraph 7,a77 z to    
:e!r x is at lea/ z likely z n t !re is 
a nexus betwe5 ! disability & ! toxic   
exposure risk activity4  7#b7 ,:5       
provid+ ! ,secret>y ) a m$ical op9ion "u
 p>agraph 7#a77;,b7 = a vet]an1 ! heal? 
c>e provid] %all consid]-- 7,a7 ! total 
pot5tial exposure ?r\gh all applicable  
milit>y deploym5ts ( ! vet]an2 &  7,b7 !
 syn]gi/ic1 comb9$ effect ( all toxic   

exposure risk activities ( ! vet]an4    
7#c7 ,! requirem5t "u p>agraph 7#b77;,b7
 %all n be con/ru$ z requir+ a heal? c>e
 provid] to consid] ! syn]gi/ic1 comb9$ 
effect ( ea* ( ! sub/ances1 *emicals1 & 
airborne haz>ds id5tifi$ 9 ! li/ "u     
section #aaai7;b77#b7 ( ?is title4  7b7 
,exception ,subsection 7a7 %all n apply 
if ! ,secret>y det]m9es !re is no       
indication ( an association betwe5 !    
disability claim$ by ! vet]an & ! toxic 
exposure risk activity = :i* ! vet]an   
submitt$ evid5ce4  7c7 ,toxic exposure  
risk activity def9$ ,9 ?is section1 !   
t]m toxic exposure risk activity has !  
mean+ giv5 t t]m 9 section #agaj7;e77#d7
 ( ?is title4  4  ,,iv ,presumptions (  
s]vice connection  #dja4 ,treatm5t (    
vet]ans :o p>ticipat$ 9 cleanup (       
,enewetak ,atoll z radiation-expos$     
vet]ans = purposes ( presumption (      
s]vice connection ( c]ta9 disabilities  
by ,dep>tm5t ( ,vet]ans ,affairs  7a7   
,%ort title ,?is section may be cit$ z !
 ,m>k ,takai ,atomic ,vet]ans ,heal?c>e 

,p>ity ,act ( #bjbb4  7b7 ,enewetak     
,atoll ,section #aaab7;c77#c77;,b7 is   
am5d$ by add+ at ! end ! foll[+ new     
clause3  7v7 ,cleanup ( ,enewetak ,atoll
 dur+ ! p]iod beg9n+ on ,janu>y #a1     
#aigg1 & end+ on ,decemb] #ca1 #aihj4  4
  #djb4 ,treatm5t ( vet]ans :o          
p>ticipat$ 9 nucle> response ne>        
,palom>es1 ,spa91 or ,?ule1 ,gre5l&1 z  
radiation-expos$ vet]ans = purposes (   
presumption ( s]vice connection ( c]ta9 
disabilities by ,dep>tm5t ( ,vet]ans    
,affairs  7a7 ,%ort title ,?is section  
may be cit$ z ! ,palom>es or ,?ule      
,vet]ans ,act ( #bjbb4  7b7 ,palom>es or
 ,?ule ,section #aaab7;c77#c77;,b71 z   
am5d$ by section #dja1 is fur!r am5d$ by
 add+ at ! end ! foll[+ new clauses3    
7vi7 ,onsite p>ticipation 9 ! response  
ef=t foll[+ ! collision ( a ,unit$      
,/ates ,air ,=ce ,b-#eb bomb] & refuel+ 
plane t caus$ ! release ( f\r !rmonucle>
 weapons 9 ! vic9ity ( ,palom>es1 ,spa91
 dur+ ! p]iod beg9n+ ,janu>y #ag1 #aiff1
 & end+ ,m>* #ca1 #aifg4  7vii7 ,onsite 

p>ticipation 9 ! response ef=t foll[+ ! 
on-bo>d fire & cra% ( a ,unit$ ,/ates   
,air ,=ce ,b-#eb bomb] t caus$ ! release
 ( f\r !rmonucle> weapons 9 ! vic9ity ( 
,?ule ,air ,=ce ,base1 ,gre5l&1 dur+ !  
p]iod beg9n+ ,janu>y #ba1 #aifh1 & end+ 
,septemb] #be1 #aifh4  4  #djc4         
,presumptions ( s]vice connection =     
diseases associat$ ) exposures to c]ta9 
h]bicide ag5ts = vet]ans :o s]v$ 9 c]ta9
 locations  7a7 ,%ort title ,?is section
 may be cit$ z ! ,vet]ans ,ag5t ,orange 
,exposure ,equity ,act ( #bjbb4  7b7 ,9 
g5]al ,section #aaaf1 z am5d$ by section
 #bjb1 is fur!r am5d$-- 7#a7 by /rik+ 1 
dur+ active milit>y1 naval1 air1 or     
space s]vice1 s]v$ 9 ! ,republic (      
,vietnam dur+ ! p]iod beg9n+ on ,janu>y 
#i1 #aifb1 & end+ on ,may #g1 #aige ea* 
place x appe>s & ins]t+ p]=m$ cov]$     
s]vice2  7#b7 by /rik+ p]=m$ active     
milit>y1 naval1 air1 or space s]vice 9 !
 ,republic ( ,vietnam dur+ ! p]iod      
beg9n+ on ,janu>y #i1 #aifb1 & end+ on  
,may #g1 #aige ea* place x appe>s &     

ins]t+ p]=m$ cov]$ s]vice2 &  7#c7 by   
add+ at ! end ! foll[+ new subsection3  
7d7 ,9 ?is section1 ! t]m cov]$ s]vice  
means active milit>y1 naval1 air1 or    
space s]vice-- 7#a7 p]=m$ 9 ! ,republic 
( ,vietnam dur+ ! p]iod beg9n+ on       
,janu>y #i1 #aifb1 & end+ on ,may #g1   
#aige2  7#b7 p]=m$ 9 ,?ail& at any      
,unit$ ,/ates or ,royal ,?ai base dur+ !
 p]iod beg9n+ on ,janu>y #i1 #aifb1 &   
end+ on ,june #cj1 #aigf1 )\t reg>d to  
:]e on ! base ! vet]an 0 locat$ or :at  
milit>y job specialty ! vet]an p]=m$2   
7#c7 p]=m$ 9 ,laos dur+ ! p]iod beg9n+  
on ,decemb] #a1 #aife1 & end+ on        
,septemb] #cj1 #aifi2  7#d7 p]=m$ 9     
,cambodia at ,mimot or ,krek1 ,kampong  
,*am ,prov9ce dur+ ! p]iod beg9n+ on    
,april #af1 #aifi1 & end+ on ,april #cj1
 #aifi2 or  7#e7 p]=m$ on ,guam or      
,am]ican ,samoa1 or 9 ! t]ritorial wat]s
 !re(1 dur+ ! p]iod beg9n+ on ,janu>y   
#i1 #aifb1 & end+ on ,july #ca1 #aihj1  
or s]v$ on ,john/on ,atoll or on a %ip t
 call$ at ,john/on ,atoll dur+ ! p]iod  

beg9n+ on ,janu>y #a1 #aigb1 & end+ on  
,septemb] #cj1 #aigg4  4  7c7           
,eligibility = hospital c>e & m$ical    
s]vices ,section #agaj7;e77#d71 z am5d$ 
by section #ajb7;c71 is fur!r am5d$ by  
/rik+ subp>agraph 7,a7 & ins]t+ ! foll[+
 new subp>agraph3  7,a7 ,! t]m          
,vietnam-era h]bicide-expos$ vet]an     
means a vet]an :o--  7i7 p]=m$ cov]$    
s]vice1 z def9$ 9 section #aaaf7;d7 (   
?is title2 or  7ii7 ! ,secret>y f9ds may
 h be5 expos$ dur+ active milit>y1      
naval1 air1 or space s]vice to diox9    
dur+ ! ,vietnam era1 reg>dless ( !      
geographic area ( su* s]vice1 or 0      
expos$ dur+ su* s]vice to a toxic       
sub/ance f\nd 9 a h]bicide or defoliant 
us$ = milit>y purposes dur+ su* era1    
reg>dless ( ! geographic area ( su*     
s]vice4  4  7d7 ,con=m+ am5dm5t ,! head+
 = section #aaaf is am5d$ by /rik+ !    
,republic ( ,vietnam & ins]t+ c]ta9     
locations4  7e7 ,effective date &       
applicability ,! am5dm5ts made by ?is   
section %all take effect on ! date ( !  

enactm5t ( ?is ,act & %all apply z      
foll[s3  7#a7 ,on ! date ( ! enactm5t ( 
?is ,act = claimants = dep5d5cy &       
indemnity comp5sation "u *apt] #ac (    
title #ch1 ,unit$ ,/ates ,code1 & =     
vet]ans :om ! ,secret>y ( ,vet]ans      
,affairs det]m9es are-- 7,a7 t]m9ally   
ill2  7,b7 homeless2  7,c7 "u extreme   
f9ancial h>d%ip2  7,d7 m ?an #he ye>s   
old2 or  7,e7 capable ( demon/rat+ o!r  
suffici5t cause4  7#b7 ,on ,octob] #a1  
#bjbb1 = ev]yone n describ$ 9 p>agraph  
7#a74  #djd4 ,addition ( additional     
diseases associat$ ) exposure to c]ta9  
h]bicide ag5ts = :i* !re is a           
presumption ( s]vice connection =       
vet]ans :o s]v$ 9 c]ta9 locations  7a7  
,%ort title ,?is section may be cit$ z !
 ,fair ,c>e = ,vietnam ,vet]ans ,act (  
#bjbb4  7b7 ,monoclonal gammopa?y (     
undet]m9$ significance ,section         
#aaaf7;a77#b7 ( title #ch1 ,unit$ ,/ates
 ,code1 is am5d$ by add+ at ! end !     
foll[+ new subp>agraph3  7,l7           
,monoclonal gammopa?y ( undet]m9$       

significance4  4  7c7 ,hyp]t5sion ,su*  
section1 z am5d$ by subsection 7b71 is  
fur!r am5d$ by add+ at ! end ! foll[+   
new subp>agraph3  7,m7 ,hyp]t5sion4  4  
7d7 ,effective dates & applicability    
7#a7 ,monoclonal gammopa?y ( undet]m9$  
significance  7,a7 ,9 g5]al ,! am5dm5t  
made by subsection 7b7 %all take effect 
on ! date ( ! enactm5t ( ?is ,act & %all
 apply z foll[s3 7i7 ,on ! date ( !     
enactm5t ( ?is ,act = claimants =       
dep5d5cy & indemnity comp5sation "u     
*apt] #ac ( title #ch1 ,unit$ ,/ates    
,code1 & = vet]ans :om ! ,secret>y (    
,vet]ans ,affairs det]m9es are--  7,i7  
t]m9ally ill2  7,,ii7 homeless2  7,,iii7
 "u extreme f9ancial h>d%ip2  7,,iv7 m  
?an #he ye>s old2 or  7,v7 capable (    
demon/rat+ o!r suffici5t cause4  7ii7   
,on ,octob] #a1 #bjbb1 = ev]yone n      
describ$ 9 clause 7i74  7,b7            
,retroactive application ,not)/&+ any   
,f$]al c\rt decisions or settlem5ts 9   
effect on ! day be=e ! date ( ! enactm5t
 ( ?is ,act1 ! ,secret>y ( ,vet]ans     

,affairs %all aw>d retroactive claims = 
a condition "u section #aaaf7;a77#b77,l7
 ( title #ch1 ,unit$ ,/ates ,code1 z    
add$ by subsection 7b7 ( ?is section1   
only to claimants = dep5d5cy & indemnity
 comp5sation "u *apt] #ac ( su* title   
describ$ 9 subp>agraph 7,a77i7 ( ?is    
p>agraph4  7#b7 ,hyp]t5sion  7,a7 ,9    
g5]al ,! am5dm5t made by subsection 7c7 
%all take effect on ! date ( ! enactm5t 
( ?is ,act & %all apply z foll[s3  7i7  
,on ! date ( ! enactm5t ( ?is ,act =    
claimants = dep5d5cy & indemnity        
comp5sation "u *apt] #ac ( title #ch1   
,unit$ ,/ates ,code1 & = vet]ans :om !  
,secret>y ( ,vet]ans ,affairs det]m9es  
are-- 7,i7 t]m9ally ill2  7,,ii7        
homeless2  7,,iii7 "u extreme f9ancial  
h>d%ip2  7,,iv7 m ?an #he ye>s old2 or  
7,v7 capable ( demon/rat+ o!r suffici5t 
cause4  7ii7 ,on ,octob] #a1 #bjbf1 =   
ev]yone n describ$ 9 subp>agraph 7,a74  
7,b7 ,retroactive application ,not)/&+  
any ,f$]al c\rt decisions or settlem5ts 
9 effect on ! day be=e ! date ( !       

enactm5t ( ?is ,act1 ! ,secret>y (      
,vet]ans ,affairs %all aw>d retroactive 
claims = a condition "u section         
#aaaf7;a77#b77,m7 ( title #ch1 ,unit$   
,/ates ,code1 z add$ by subsection 7c7 (
 ?is section1 only to claimants =       
dep5d5cy & indemnity comp5sation "u     
*apt] #ac ( su* title describ$ 9        
subp>agraph 7,a77i7 ( ?is p>agraph4     
#dje4 ,improv+ comp5sation =            
disabilities occurr+ 9 ,p]sian ,gulf ,w>
 vet]ans  7a7 ,r$uction 9 ?re%old (     
eligibility ,subsection 7a77#a7 (       
section #aaag is am5d$ by /rik+ became  
manife/-- & all t foll[s ?r\gh ! p]iod  
at ! end & ins]t+ became manife/ to any 
degree at any "t44  7b7 ,p]man5t        
ext5sion ( p]iod ( eligibility ,su*     
section is fur!r am5d$--  7#a7 by /rik+ 
subsection 7b72  7#b7 by r$esignat+     
subsections 7c7 & 7d7 z subsections 7b7 
& 7c71 respectively2 &  7#c7 9          
subsection 7a77#b77;,c71 by /rik+ "u    
subsection 7d7 & ins]t+ "u subsection   
7c74  7c7 ,e/abli%+ s+ul>               

disability-bas$ que/ionnaire ,su*       
section is fur!r am5d$ by ins]t+ aft]   
subsection 7c7 7z r$esignat$ by         
subsection 7b77 ! foll[+ new subsection 
7d73  7d7 ,if a ,p]sian ,gulf vet]an at 
a m$ical facility ( ! ,dep>tm5t pres5ts 
) any "o symptom associat$ ) ,gulf ,w>  
,illness1 ! ,secret>y %all ensure t     
heal? c>e p]sonnel ( ! ,dep>tm5t use a  
disability b5efits que/ionnaire1 or     
successor que/ionnaire1 design$ to      
id5tify ,gulf ,w> ,illness1 9 addition  
to any o!r diagno/ic actions ! p]sonnel 
det]m9e appropriate4  4  7d7 ,expansion 
( def9ition ( ,p]sian ,gulf vet]an      
,subsection 7f7 ( su* section is am5d$  
by ins]t+ 1 ,afghani/an1 ,israel1       
,egypt1 ,turkey1 ,syria1 or ,jordan1    
aft] op]ations4  7e7 ,tra9+ ,su* section
 is fur!r am5d$ by add+ at ! end !      
foll[+ new subsection3  7i7 7#a7 ,!     
,secret>y %all take su* actions z may be
 necess>y to ensure t heal? c>e p]sonnel
 ( ! ,dep>tm5t are appropriately tra9$  
to effectively c>ry out ?is section4    

7#b7 ,n less frequ5tly ?an once ea* ye>1
 ! ,secret>y %all submit to ,congress a 
report on ! actions tak5 by ! ,secret>y 
to c>ry out p>agraph 7#a74  4  #djf4    
,presumption ( s]vice connection = c]ta9
 diseases associat$ ) exposure to burn  
pits & o!r tox9s  7a7 ,%ort title ,?is  
section may be cit$ z ! ,presumptive    
,b5efits = ,w> ,fight]s ,expos$ to ,burn
 ,pits & ,o!r ,tox9s ,act ( #bjbb4  7b7 
,9 g5]al ,sub*apt] ,,ii ( *apt] #aa1 z  
am5d$ by section #cjb1 is fur!r am5d$ by
 ins]t+ aft] section #aaai ! foll[+ new 
section3  #aabj4 ,presumption ( s]vice  
connection = c]ta9 diseases associat$ ) 
exposure to burn pits & o!r tox9s  7a7  
,presumption ( s]vice connection ,= !   
purposes ( section #aaaj ( ?is title1 & 
subject to section #aaac ( ?is title1 a 
disease specifi$ 9 subsection 7b7 becom+
 manife/ 9 a cov]$ vet]an %all be       
consid]$ to h be5 incurr$ 9 or aggravat$
 dur+ active milit>y1 naval1 air1 or    
space s]vice1 not)/&+ t !re is no record
 ( evid5ce ( su* disease dur+ ! p]iod ( 

su* s]vice4  7b7 ,diseases specifi$ ,!  
diseases specifi$ 9 ?is subsection are !
 foll[+3 7#a7 ,a/hma t 0 diagnos$ aft]  
s]vice ( ! cov]$ vet]an z specifi$ 9    
subsection 7c74  7#b7 ,! foll[+ types ( 
canc]3 7,a7 ,head canc] ( any type4     
7,b7 ,neck canc] ( any type4  7,c7      
,respiratory canc] ( any type4  7,d7    
,ga/ro9te/9al canc] ( any type4  7,e7   
,reproductive canc] ( any type4  7,f7   
,lymphoma canc] ( any type4  7,g7       
,lymphomatic canc] ( any type4  7,h7    
,kidney canc]4  7,i7 ,bra9 canc]4  7,j7 
,melanoma4  7,k7 ,pancreatic canc]4     
7#c7 ,*ronic bron*itis4  7#d7 ,*ronic   
ob/ructive pulmon>y disease4  7#e7      
,con/rictive bron*iolitis or oblit]ative
 bron*iolitis4  7#f7 ,emphysema4  7#g7  
,granulomat\s disease4  7#h7 ,int]/itial
 lung disease4  7#i7 ,pleuritis4  7#aj7 
,pulmon>y fibrosis4  7#aa7 ,s>coidosis4 
7#ab7 ,*ronic s9usitis4  7#ac7 ,*ronic  
rh9itis4  7#ad7 ,gliobla/oma4  7#ae7    
,any o!r disease = :i* ! ,secret>y      
det]m9es1 pursuant to regulations       

prescrib$ "u sub*apt] ,,vii t a         
presumption ( s]vice connection is      
w>rant$ bas$ on a positive association )
 a sub/ance1 *emical1 or airborne haz>d 
id5tifi$ 9 ! li/ "u section             
#aaai7;b77#b7 ( ?is title4  7c7 ,cov]$  
vet]an def9$ ,9 ?is section1 ! t]m cov]$
 vet]an has ! mean+ giv5 t t]m 9 section
 #aaai7;c7 ( ?is title4  4  7c7 ,con=m+ 
am5dm5t ,section #aaac is am5d$ by /rik+
 or #aaah ea* place x appe>s & ins]t+   
#aaah1 or #aabj4  7d7 ,effective date & 
applicability ,! am5dm5ts made by ?is   
section %all take effect on ! date ( !  
enactm5t ( ?is ,act & %all apply z      
foll[s3  7#a7 ,on ! date ( ! enactm5t ( 
?is ,act = claimants = dep5d5cy &       
indemnity comp5sation "u *apt] #ac (    
title #ch1 ,unit$ ,/ates ,code1 &       
vet]ans :om ! ,secret>y ( ,vet]ans      
,affairs det]m9es are-- 7,a7 t]m9ally   
ill2  7,b7 homeless2  7,c7 "u extreme   
f9ancial h>d%ip2  7,d7 m ?an #he ye>s   
old2 or  7,e7 capable ( demon/rat+ o!r  
suffici5t cause4  7#b7 ,on ! date ( !   

enactm5t ( ?is ,act = ev]yone n describ$
 9 p>agraph 7#a71 ) respect to p>agraphs
 7#a71 7#b77;,c71 7#b77;,i71 7#e71 7#f71
 7#g71 7#h71 7#i71 7#aj71 7#aa71 7#ab71 
7#ac71 & 7#ad71 ( section #aabj7;b7 (   
title #ch1 ,unit$ ,/ates ,code1 z add$  
by subsection 7b74  7#c7 ,on ,octob] #a1
 #bjbc1 = ev]yone n describ$ 9 p>agraph 
7#a71 ) respect to p>agraphs 7#c7 & 7#d7
 ( section #aabj7;b7 ( su* title1 z s   
add$4  7#d7 ,on ,octob] #a1 #bjbd1 =    
ev]yone n describ$ 9 p>agraph 7#a71 )   
respect to subp>agraphs 7,a71 7,b71     
7,d71 7,e71 7,f71 7,g71 & 7,k7 ( section
 #aabj7;b77#b7 ( su* title1 z s add$4   
7#e7 ,on ,octob] #a1 #bjbe1 = ev]yone n 
describ$ 9 p>agraph 7#a71 ) respect to  
subp>agraphs 7,h7 & 7,j7 ( section      
#aabj7;b77#b7 ( su* title1 z s add$4    
#djg4 ,rule ( con/ruction  7a7 ,g5]ally 
,no?+ 9 ?is ,act %all be con/ru$ to     
prev5t ! ,secret>y ( ,vet]ans ,affairs f
 process+ claims = b5efits "u title #ch1
 ,unit$ ,/ates ,code1 = a condition or  
disease = :i* ?is ,act e/abli%es a      

presumption ( s]vice connection1 z a    
claim = b5efits = a condition or disease
 ) direct s]vice connection4  7b7       
,effective dates & applicability ,!     
,secret>y %all n d5y a claim = b5efits  
"u title #ch1 ,unit$ ,/ates ,code1 = a  
condition or disease = :i* ?is ,act     
e/abli%es a presumption ( s]vice        
connection because ! claimant fil$ !    
claim prior to ! effective date or date 
( applicability = t p>ticul> condition  
or disease4  ,v ,rese>* matt]s  #eja4   
,int]ag5cy work+ gr\p on toxic exposure 
rese>*  7a7 ,e/abli%m5t  7#a7 ,9 g5]al  
,n lat] ?an "o ye> aft] ! date ( !      
enactm5t ( ?is ,act1 ! ,secret>y (      
,vet]ans ,affairs %all1 9 collaboration 
) ! heads ( ! entities describ$ 9       
p>agraph 7#b71 e/abli% ! ,toxic         
,exposure ,rese>* ,work+ ,gr\p 79 ?is   
section ref]r$ to z ! ,work+ ,gr\p74    
7#b7 ,composition ,! ,work+ ,gr\p %all  
consi/ ( employees1 select$ by !        
,secret>y1 ( ! foll[+3  7,a7 ,!         
,dep>tm5t ( ,vet]ans ,affairs4  7,b7 ,! 

,dep>tm5t ( ,def5se4  7,c7 ,! ,dep>tm5t 
( ,heal? & ,human ,s]vices4  7,d7 ,!    
,environm5tal ,protection ,ag5cy4  7,e7 
,o!r entities ( ! ,f$]al ,gov]nm5t      
involv$ 9 rese>* activities reg>d+ !    
heal? consequ5ces ( toxic exposures     
exp]i5c$ dur+ active milit>y1 naval1    
air1 or space s]vice4  7b7 ,functions ,!
 ,work+ ,gr\p %all p]=m ! foll[+        
functions3  7#a7 ,id5tify collaborative 
rese>* activities & res\rces available  
among entities repres5t$ by memb]s ( !  
,work+ ,gr\p to conduct su*             
collaborative rese>* activities4  7#b7  
,develop a five-ye> /rategic plan = su* 
entities to c>ry out collaborative      
rese>* activities4  7c7 ,report+ ,!     
,secret>y %all submit to ! ,committee on
 ,vet]ans' ,affairs ( ! ,s5ate & !      
,committee on ,vet]ans' ,affairs ( !    
,h\se ( ,repres5tatives ! foll[+3 7#a7  
,n lat] ?an "o ye> aft] ! date ( !      
enactm5t ( ?is ,act1 a report on !      
e/abli%m5t ( ! ,work+ ,gr\p "u          
subsection 7a74  7#b7 ,n lat] ?an two   

ye>s aft] ! date ( ! enactm5t ( ?is     
,act1 a report conta9+ ! collaborative  
rese>* activities id5tifi$1 & ! /rategic
 plan develop$1 by ! ,work+ ,gr\p "u    
subsection 7b74  7#c7 ,n less frequ5tly 
?an annually dur+ ! five-ye> p]iod cov]$
 by ! /rategic plan "u subsection 7b71 a
 progress report on implem5tation ( !   
/rategic plan4  7d7 ,t]m9ation ,! ,work+
 ,gr\p %all t]m9ate aft] submitt+ ! f9al
 report "u subsection 7c74  7e7         
,def9itions ,9 ?is section3  7#a7       
,active milit>y1 naval1 air1 or space   
s]vice ,! t]m active milit>y1 naval1    
air1 or space s]vice has ! mean+ giv5 t 
t]m 9 section #aja ( title #ch1 ,unit$  
,/ates ,code4  7#b7 ,collaborative      
rese>* activity ,! t]m collaborative    
rese>* activity means a rese>*          
activity--  7,a7 agre$ ^u by ! ,work+   
,gr\p2  7,b7 conduct$ by an entity      
repres5t$ by a memb] ( ! ,work+ ,gr\p2  
7,c7 fund$ by ! ,f$]al ,gov]nm5t2 &     
7,d7 reg>d+ ! heal? consequ5ces ( toxic 
exposures exp]i5c$ dur+ active milit>y1 

naval1 air1 or space s]vice4  7#c7      
,toxic exposure ,! t]m toxic exposure   
has ! mean+ giv5 su* t]m 9 section #aja 
( title #ch1 ,unit$ ,/ates ,code1 z     
am5d$ by section #ajb7;b74  #ejb4       
,analysis & report on treatm5t ( vet]ans
 = m$ical conditions relat$ to toxic    
exposure  7a7 ,9 g5]al ,! ,secret>y (   
,vet]ans ,affairs %all analyze1 on a    
cont9u\s basis1 all cl9ical data t--    
7#a7 is obta9$ by ! ,dep>tm5t ( ,vet]ans
 ,affairs 9 connection ) hospital c>e1  
m$ical s]vices1 & nurs+ home c>e furni%$
 "u section #agaj7;a77#b77;,f7 ( title  
#ch1 ,unit$ ,/ates ,code2 &  7#b7 is    
likely to be sci5tifically useful 9     
det]m9+ ! association1 if any1 betwe5 ! 
m$ical condition ( a vet]an & a toxic   
exposure4  7b7 ,annual report ,n lat]   
?an "o ye> aft] ! date ( ! enactm5t (   
?is ,act1 & annually !reaft]1 !         
,secret>y %all submit to ! ,committee on
 ,vet]ans' ,affairs ( ! ,s5ate & !      
,committee on ,vet]ans' ,affairs ( !    
,h\se ( ,repres5tatives a report conta9+

 ! foll[+3 7#a7 ,! aggregate data       
compil$ "u subsection 7a74  7#b7 ,an    
analysis ( su* data4  7#c7 ,a           
description ( ! types & incid5ces (     
m$ical conditions id5tifi$ by !         
,dep>tm5t "u su* subsection4  7#d7 ,!   
explanation ( ! ,secret>y = ! incid5ce (
 su* m$ical conditions & o!r            
explanations = ! incid5ce ( su*         
conditions z ! ,secret>y consid]s       
reasonable4  7#e7 ,! views ( ! ,secret>y
 on ! sci5tific validity ( draw+        
conclusions f ! incid5ce ( su* m$ical   
conditions1 z evid5c$ by ! data compil$ 
"u subsection 7a71 reg>d+ any           
association betwe5 su* conditions &     
toxic exposures4  7c7 ,toxic exposure   
def9$ ,9 ?is section1 ! t]m toxic       
exposure has ! mean+ giv5 su* t]m 9     
section #aja ( title #ch1 ,unit$ ,/ates 
,code1 z am5d$ by section #ajb7;b74     
#ejc4 ,analysis relat+ to mortality (   
vet]ans :o s]v$ 9 ,s\?we/ ,asia  7a7    
,analysis  7#a7 ,9 g5]al ,n lat] ?an    
#bgj days aft] ! date ( ! enactm5t ( ?is

 ,act1 ! ,secret>y ( ,vet]ans ,affairs1 
9 coord9ation ) ! ,secret>y ( ,def5se1  
%all conduct an updat$ analysis ( total 
& respiratory disease mortality 9 cov]$ 
vet]ans4  7#b7 ,elem5ts ,! analysis     
requir$ by p>agraph 7#a7 %all include1  
to ! ext5t practicable1 ! foll[+ )      
respect to ea* cov]$ vet]an3 7,a7       
,metrics ( airborne exposures4  7,b7 ,! 
location & tim+ ( deploym5ts ( ! vet]an4
  7,c7 ,! milit>y occupational specialty
 ( ! vet]an4  7,d7 ,! ,arm$ ,=ce 9 :i* !
 vet]an s]v$4  7,e7 ,pre-exi/+ heal?    
/atus ( ! vet]an1 includ+ ) respect to  
a/hma4  7,f7 ,relevant p]sonal in=mation
 ( ! vet]an1 includ+ cig>ette &         
e-cig>ette smok+ hi/ory1 diet1 sex1     
g5d]1 age1 race1 & e?nicity4  7b7 ,cov]$
 vet]an def9$ ,9 ?is section1 ! t]m     
cov]$ vet]an means any vet]an :o--  7#a7
 on or aft] ,augu/ #b1 #aiij1 s]v$ on   
active duty 9-- 7,a7 ,bahra92  7,b7     
,iraq2  7,c7 ,kuwait2  7,d7 ,oman2  7,e7
 ,qat>2  7,f7 ,saudi ,arabia2  7,g7     
,somalia2 or  7,h7 ! ,unit$ ,arab       

,emirates2 or  7#b7 on or aft] ,septemb]
 #aa1 #bjja1 s]v$ on active duty 9--    
7,a7 ,afghani/an2  7,b7 ,djib\ti2  7,c7 
,egypt2  7,d7 ,jordan2  7,e7 ,lebanon2  
7,f7 ,syria2 or  7,g7 ,yem54  #ejd4     
,/udy on heal? tr5ds ( po/-#i_/aa       
vet]ans ,! ,secret>y ( ,vet]ans ,affairs
 %all conduct an epidemiological /udy on
 ! heal? tr5ds ( vet]ans :o s]v$ 9 !    
,arm$ ,=ces aft] ,septemb] #aa1 #bjja4  
#eje4 ,/udy on canc] rates among vet]ans
  7a7 ,9 g5]al ,! ,secret>y ( ,vet]ans  
,affairs %all conduct a /udy on !       
incid5ce ( canc] 9 vet]ans to det]m9e   
tr5ds 9 ! rates ( ! incid5ce ( canc] 9  
vet]ans4  7b7 ,elem5ts ,! /udy requir$  
by subsection 7a7 %all assess1 ) respect
 to ea* vet]an includ$ 9 ! /udy1 !      
foll[+3  7#a7 ,! age ( ! vet]an4  7#b7  
,! p]iod ( s]vice & l5g? ( s]vice ( !   
vet]an 9 ! ,arm$ ,=ces4  7#c7 ,! milit>y
 occupational specialty or specialties (
 ! vet]an4  7#d7 ,! sex ( ! vet]an4     
7#e7 ,! type or types ( canc] t ! vet]an
 has4  #ejf4 ,/udy on heal? effects (   

wa/e relat$ to ,manhattan ,project on   
c]ta9 vet]ans  7a7 ,/udy ,n lat] ?an    
#ahj days aft] ! date ( ! enactm5t ( ?is
 ,act1 ! ,secret>y ( ,vet]ans ,affairs  
%all ent] into an agreem5t ) ! ,national
 ,academies ( ,sci5ces1 ,eng9e]+1 &     
,m$ic9e = ! conduct ( a /udy on ! heal? 
tr5ds ( vet]ans :o1 :ile s]v+ 9 ! active
 milit>y1 naval1 air1 or space s]vice-- 
7#a7 p>ticipat$ 9 activities relat+ to !
 ,manhattan ,project 7includ+ activities
 relat+ to cov]$ wa/e7 9 connection )   
su* s]vice2 or  7#b7 resid$ at or ne>1 z
 det]m9$ by ! ,secret>y1 ! locations    
describ$ 9 subsection 7b74  7b7 ,cov]$  
locations ,! locations describ$ 9 ?is   
subsection are ! foll[+ locations3 7#a7 
,9 ! c\nty ( ,/4 ,l\is1 ,miss\ri1 !     
foll[+3  7,a7 ,coldwat] ,creek1         
,miss\ri4  7,b7 ,! ,/4 ,l\is ,airport   
,site1 ,miss\ri4  7,c7 ,! ,we/ ,lake    
,l&fill4  7#b7 ,oak ,ridge1 ,t5nessee4  
7#c7 ,han=d1 ,wa%+ton4  7#d7 ,any o!r   
location t is proximate to cov]$ wa/e1 z
 det]m9$ by ! ,secret>y4  7c7 ,elem5ts  

,! /udy "u subsection 7a7 %all assess1 )
 respect to ea* vet]an includ$ 9 ! /udy1
 ! foll[+3 7#a7 ,! age1 sex1 & race ( ! 
vet]an4  7#b7 ,! p]iod & location (     
exposure to cov]$ wa/e4  7#c7 ,any type 
( canc]1 or o!r illness associat$ )     
toxic exposure1 t ! vet]an has4  7#d7 ,a
 comp>ison ( ! ov]all heal? condition ( 
! vet]an1 includ+ any illness ( ! vet]an
 id5tifi$ pursuant to p>agraph 7#c71 ) !
 ov]all heal? condition ( pa/ & pres5t  
civilian populations resid+ at ! same   
location ( exposure1 z det]m9$ by !     
,secret>y4  7d7 ,report ,n lat] ?an ?ree
 ye>s aft] ! date ( ! enactm5t ( ?is    
,act1 ! ,secret>y %all submit to !      
,committee on ,vet]ans' ,affairs ( !    
,s5ate & ! ,committee on ,vet]ans'      
,affairs ( ! ,h\se ( ,repres5tatives a  
report on ! /udy "u subsection 7a7 &    
include 9 su* report an analysis ( !    
data available & data reliability4  7e7 
,def9itions ,9 ?is section3 7#a7 ,active
 milit>y1 naval1 air1 or space s]vice2  
toxic exposure ,! t]ms active milit>y1  

naval1 air1 or space s]vice & toxic     
exposure h ! mean+s giv5 ^? t]ms 9      
section #aja ( title #ch1 ,unit$ ,/ates 
,code1 z add$ by section #ajb7;b74  7#b7
 ,cov]$ wa/e ,! t]m cov]$ wa/e means any
 wa/e aris+ f activities c>ri$ out 9    
connection ) ! ,manhattan ,project4     
7#c7 ,illness ,! t]m illness has ! mean+
 giv5 t t]m 9 section #aaga ( title #ch1
 ,unit$ ,/ates ,code1 z add$ by section 
#bjb4  7#d7 ,toxic exposure ,! t]m toxic
 exposure has ! mean+ giv5 su* t]m 9    
section #aja ( title #ch1 ,unit$ ,/ates 
,code1 z am5d$ by section #ajb7;b74     
#ejg4 ,/udy on toxic exposure & m5tal   
heal? outcomes  7a7 ,/udy requir$ ,n    
lat] ?an #ahj days aft] ! date ( !      
enactm5t ( ?is ,act1 ! ,secret>y (      
,vet]ans ,affairs %all ent] into an     
agreem5t ) ! ,national ,academies (     
,sci5ces1 ,eng9e]+1 & ,m$ic9e = !       
conduct ( a /udy ( vet]ans to assess    
possible relation%ips betwe5 toxic      
exposures exp]i5c$ dur+ s]vice 9 ! ,arm$
 ,=ces & m5tal heal? conditions1 includ+

 *ronic multisymptom illness1 traumatic 
bra9 injury1 po/-traumatic /ress        
disord]1 depression1 episodes (         
psy*osis1 s*izophr5ia1 bipol> disord]1  
suicide attempts1 & suicide dea?s4  7b7 
,elem5ts ,= ea* vet]an includ$ 9 ! /udy 
"u subsection 7a71 ! foll[+ in=mation   
%all be collect$ & assess$3 7#a7 ,age4  
7#b7 ,sex4  7#c7 ,race & e?nicity4  7#d7
 ,p]iod & l5g? ( s]vice 9 ! ,arm$ ,=ces4
  7#e7 ,! milit>y occupational specialty
 or specialties ( ! vet]an4  7#f7       
,hi/ory ( toxic exposure dur+ s]vice 9 !
 ,arm$ ,=ces4  7#g7 ,any diagnosis (    
*ronic multisymptom illness4  7#h7 ,any 
diagnosis ( a m5tal heal? or cognitive  
disord]4  7#i7 ,any hi/ory ( suicide    
attempt or suicidality4  7#aj7 ,if !    
vet]an di$ by suicide4  7#aa7 ,any      
conf\nd+ traumatic exp]i5ces t c\ld     
affect a vet]an's m5tal heal?4  7c7     
,report ,n lat] ?an ?ree ye>s aft] !    
date ( ! enactm5t ( ?is ,act1 !         
,secret>y %all submit to ! ,committee on
 ,vet]ans' ,affairs ( ! ,s5ate & !      

,committee on ,vet]ans' ,affairs ( !    
,h\se ( ,repres5tatives a report conta9+
 ! f9d+s ( ! ,national ,academies (     
,sci5ces1 ,eng9e]+1 & ,m$ic9e ) respect 
to ! /udy conduct$ "u subsection 7a74   
#ejh4 ,/udy on vet]ans 9 ,t]ritories ( !
 ,unit$ ,/ates  7a7 ,,gao /udy  7#a7 ,9 
g5]al ,! ,comptroll] ,g5]al ( ! ,unit$  
,/ates %all conduct a /udy on ! /ate (  
access & b>ri]s to b5efits & s]vices    
furni%$ by ! ,vet]ans ,b5efits          
,adm9i/ration & ! ,vet]ans ,heal?       
,adm9i/ration "u laws adm9i/]$ by !     
,secret>y ( ,vet]ans ,affairs to vet]ans
 9 ,t]ritories & ,freely ,associat$     
,/ates ( ! ,unit$ ,/ates1 includ+       
deficits 9 ! availability &             
accessibility ( su* b5efits & s]vices   
comp>$ to vet]ans else:]e 9 ! ,unit$    
,/ates4  7#b7 ,elem5ts ,! /udy "u       
p>agraph 7#a7 %all include-- 7,a7 !     
numb] ( vet]ans 9 ea* ,t]ritory &       
,freely ,associat$ ,/ate ( ! ,unit$     
,/ates2  7,b7 ! numb] ( vet]ans 9 ea*   
,t]ritory & ,freely ,associat$ ,/ate :o 

are enroll$ 9 ! sy/em ( annual pati5t   
enrollm5t ( ! ,dep>tm5t ( ,vet]ans      
,affairs "u section #agje7;a7 ( title   
#ch1 ,unit$ ,/ates ,code2  7,c7 a       
description ( h[ ! ,dep>tm5t e/imates ! 
numb] ( vet]ans 9 ea* ,t]ritory &       
,freely ,associat$ ,/ate :o are eligible
 = s]vices "u section #agaj ( su* title 
b :o are n enroll$ z describ$ 9         
subp>agraph 7,b72  7,d7 a detail$       
description ( ob/acles fac+ vet]ans 9   
ea* ,t]ritory & ,freely ,associat$ ,/ate
 9 access+ heal? c>e s]vices1 includ+ ^?
 involv+ ! availability ( su* s]vices to
 vet]ans 9 ! ,t]ritory or ,freely       
,associat$ ,/ate 9 :i* ! vet]ans reside1
 & any di/ance imp$im5ts to receiv+     
s]vices at a regional m$ical c5t] ( !   
,vet]ans ,heal? ,adm9i/ration1 a        
community-bas$ outpati5t cl9ic1 ano!r   
full-s]vice m$ical facility ( !         
,dep>tm5t1 or a ,vet ,c5t]1             
respectively2  7,e7 a detail$           
description ( ob/acles fac+ vet]ans 9   
ea* ,t]ritory & ,freely ,associat$ ,/ate

 9 access+ readju/m5t c\nsel+ s]vices1  
includ+ ^? involv+ ! availability ( su* 
s]vices to vet]ans 9 ! ,t]ritory 9 :i* !
 vet]ans reside1 & any di/ance imp$im5ts
 to receiv+ s]vices at a readju/m5t     
c\nsel+ s]vices c5t] ( ! ,dep>tm5t2     
7,f7 a detail$ description ( ob/acles   
fac+ vet]ans 9 ea* ,t]ritory & ,freely  
,associat$ ,/ate 9 access+ non-heal? c>e
 vet]ans b5efits1 includ+ ^? involv+ !  
availability ( b5efits & s]vices to     
vet]ans 9 ! ,t]ritory or ,freely        
,associat$ ,/ate 9 :i* ! vet]ans reside1
 & any di/ance imp$im5ts to access+ !   
ne>e/ (fice ( ! ,vet]ans ,b5efits       
,adm9i/ration2  7,g7 an analysis ( !    
/aff+ & quality ( ! (fices ( ! ,vet]ans 
,b5efits ,adm9i/ration & ,vet]ans ,heal?
 ,adm9i/ration *>g$ ) s]v+ vet]ans 9 !  
,t]ritories & ,freely ,associat$ ,/ates1
 includ+ ! availability ( ! full- &     
"p-"t /aff ( ea* (fice to ! vet]ans !y  
are *>g$ ) s]v+2  7,h7 an analysis ( !  
availability ( ! ,vet]ans ,community    
,c>e ,program e/abli%$ "u section #agjc 

( title #ch1 ,unit$ ,/ates ,code1 to    
vet]ans 9 ea* ,t]ritory & ,freely       
,associat$ ,/ate2  7,i7 an analysis ( ! 
economic & heal? outcomes = vet]ans 9   
ea* ,t]ritory or ,freely ,associat$     
,/ate result+ f ob/acles to access+     
adequate assi/ance & heal? c>e at       
facilities ( ! ,dep>tm5t2  7,j7 an      
analysis ( ! access to b5efit assi/ance 
& heal? c>e provid$ to vet]ans 9 !      
aft]ma? ( major disa/]s decl>$ 9 ea* ( !
 ,t]ritories & ,freely ,associat$ ,/ates
 s9ce ,septemb] #d1 #bjag2 &  7,k7 su*  
recomm5dations z ! ,comptroll] ,g5]al   
consid]s appropriate = improv+ access ( 
vet]ans 9 ! ,t]ritories & ,freely       
,associat$ ,/ates to b5efits & heal? c>e
 s]vices furni%$ by ! ,secret>y1 & r$uc+
 b>ri]s & deficits 9 ! availability &   
accessibility ( su* b5efits & s]vices   
comp>$ to vet]ans else:]e 9 ! ,unit$    
,/ates4  7b7 ,brief+ ,n lat] ?an "o ye> 
aft] ! date ( ! enactm5t ( ?is ,act1 !  
,comptroll] ,g5]al %all provide to !    
,committee on ,vet]ans' ,affairs ( !    

,s5ate & ! ,committee on ,vet]ans'      
,affairs ( ! ,h\se ( ,repres5tatives a  
brief+ sett+ =? ! results ( ! /udy      
conduct$ "u subsection 7a71 includ+ any 
recomm5dations develop$ "u p>agraph     
7#b77,k7 ( su* subsection4  7c7         
,def9itions ,9 ?is section3  7#a7       
,freely ,associat$ ,/ate ,! t]m ,freely 
,associat$ ,/ate includes ! ,f$]at$     
,/ates ( ,micronesia1 ! ,republic ( !   
,m>%all ,isl&s1 & ! ,republic ( ,palau4 
7#b7 ,t]ritory ,! t]m ,t]ritory includes
 ,am]ican ,samoa1 ! ,commonweal? ( !    
,nor!rn ,m>ianas ,isl&s1 ,guam1 ,pu]to  
,rico1 & ! ,virg9 ,isl&s4  7#c7 ,vet    
,c5t] ,! t]m ,vet ,c5t] has ! mean+ giv5
 t t]m 9 section #agab;,a7h7 ( title    
#ch1 ,unit$ ,/ates ,code4  #eji4        
,dep>tm5t ( ,vet]ans ,affairs public    
website = toxic exposure rese>*  7a7    
,website ,n lat] ?an "o ye> aft] ! date 
( ! enactm5t ( ?is ,act1 ! ,secret>y (  
,vet]ans ,affairs %all e/abli%1 & ma9ta9
 !reaft]1 a publicly accessible int]net 
website ( ! ,dep>tm5t ( ,vet]ans        

,affairs t s]ves z a cle>+h\se = !      
publication ( all toxic exposure rese>* 
c>ri$ out or fund$ by ! executive bran* 
( ! ,f$]al ,gov]nm5t4  7b7 ,coord9ation 
,9 c>ry+ out subsection 7a71 ! ,secret>y
 %all coord9ate )-- 7#a7 ! heads ( ea*  
,f$]al ag5cy c>ry+ out or fund+ toxic   
exposure rese>*2  7#b7 ! ,w> ,relat$    
,illness & ,injury ,/udy ,c5t] ( !      
,dep>tm5t ( ,vet]ans ,affairs1 or       
successor c5t]2 &  7#c7 any work+ gr\p (
 ! ,dep>tm5t ( ,vet]ans ,affairs or o!r 
simil> entity responsible = coord9at+   
toxic exposure rese>*4  7c7 ,def9itions 
,9 ?is section3 7#a7 ,toxic exposure ,! 
t]m toxic exposure has ! mean+ giv5 t   
t]m 9 section #aja ( title #ch1 ,unit$  
,/ates ,code1 z add$ by section         
#ajb7;b74  7#b7 ,toxic exposure rese>*  
,! t]m toxic exposure rese>* means      
rese>* on ! heal? consequ5ces ( toxic   
exposures exp]i5c$ dur+ s]vice 9 ! ,arm$
 ,=ces4  #eaj4 ,report on heal? effects 
( jet fuels us$ by ,arm$ ,=ces  7a7     
,initial report ,n lat] ?an "o ye> aft] 

! date ( ! enactm5t ( ?is ,act1 !       
,secret>y ( ,vet]ans ,affairs %all      
submit to ! ,committee on ,vet]ans'     
,affairs ( ! ,s5ate & ! ,committee on   
,vet]ans' ,affairs ( ! ,h\se (          
,repres5tatives1 & make publicly        
available1 a report on heal? effects (  
jet fuels us$ by ! ,arm$ ,=ces4  7b7    
,cont5ts ,! report submitt$ "u          
subsection 7a7 %all include ! foll[+3   
7#a7 ,a discussion ( ! effect ( v>i\s   
diff]5t types ( jet fuels us$ by ! ,arm$
 ,=ces on ! heal? ( individuals by l5g? 
( exposure4  7#b7 ,an id5tification ( ! 
imm$iate symptoms ( jet fuel exposure t 
may indicate future heal? risks4  7#c7  
,a *ronology ( heal? safegu>ds implem5t$
 by ! ,arm$ ,=ces int5d$ to r$uce !     
exposure ( memb]s ( ! ,arm$ ,=ces to jet
 fuel4  7#d7 ,an id5tification ( any    
areas relat+ to jet fuel exposure ab\t  
:i* new rese>* ne$s to be conduct$4  7c7
 ,foll[-up report ,n lat] ?an five ye>s 
aft] ! date ( ! submittal ( ! report "u 
subsection 7a71 ! ,secret>y %all submit 

to ! committees ref]r$ to 9 su*         
subsection an update to su* report4     
,,vi ,improvem5t ( res\rces & tra9+     
reg>d+ toxic-expos$ vet]ans  #fja4 ,%ort
 title2 def9itions  7a7 ,%ort title ,?is
 title may be cit$ z ! ,fairly ,assess+ 
,s]vice-relat$ ,toxic ,exposure         
,residuals ,presumptions ,act ( #bjbb or
 ! ,,fa/] ,presumption ,act ( #bjbb4    
7b7 ,def9itions ,9 ?is title1 ! t]ms    
active milit>y1 naval1 air1 or space    
s]vice1 toxic exposure1 & toxic-expos$  
vet]an h ! mean+s giv5 ^? t]ms 9 section
 #aja ( title #ch1 ,unit$ ,/ates ,code1 
z am5d$ by section #ajb4  #fjb4         
,publication ( li/ ( res\rces (         
,dep>tm5t ( ,vet]ans ,affairs =         
toxic-expos$ vet]ans & vet]ans :o report
 toxic exposures & outrea* program = su*
 vet]ans & c>egiv]s & survivors ( su*   
vet]ans  7a7 ,publication ( li/ (       
res\rces  7#a7 ,9 g5]al ,n lat] ?an "o  
ye> aft] ! date ( ! enactm5t ( ?is ,act1
 & annually !reaft]1 ! ,secret>y (      
,vet]ans ,affairs %all publi% a li/ (   

res\rces ( ! ,dep>tm5t ( ,vet]ans       
,affairs =-- 7,a7 toxic-expos$ vet]ans &
 vet]ans :o report toxic exposure2  7,b7
 families & c>egiv]s ( su* vet]ans2 &   
7,c7 survivors ( su* vet]ans :o are     
receiv+ dea? b5efits "u ! laws adm9i/]$ 
by ! ,secret>y4  7#b7 ,update ,!        
,secret>y %all p]iodically update ! li/ 
publi%$ "u p>agraph 7#a74  7b7 ,outrea* 
,! ,secret>y %all develop1 ) input f !  
community1 an in=mative outrea* program 
= vet]ans on illnesses t may be relat$  
to toxic exposures1 includ+ outrea* )   
respect to b5efits & support programs4  
#fjc4 ,incorporation ( toxic exposure   
scre5+ = vet]ans  7a7 ,9 g5]al ,beg9n+ n
 lat] ?an #ij days aft] ! date ( !      
enactm5t ( ?is ,act1 ! ,secret>y (      
,vet]ans ,affairs %all incorporate a    
scre5+ to help det]m9e pot5tial toxic   
exposures dur+ active milit>y1 naval1   
air1 or space s]vice z "p ( a heal? c>e 
scre5+ furni%$ by ! ,dep>tm5t ( ,vet]ans
 ,affairs to vet]ans enroll$ 9 ! sy/em (
 annual pati5t enrollm5t ( ! ,dep>tm5t  

e/abli%$ & op]at$ "u section #agje (    
title #ch1 ,unit$ ,/ates ,code1 to      
improve und]/&+ by ! ,dep>tm5t ( toxic  
exposures :ile s]v+ 9 ! ,arm$ ,=ces4    
7b7 ,tim+ ,! ,secret>y %all ensure t a  
vet]an describ$ 9 subsection 7a7        
completes ! scre5+ requir$ "u su*       
subsection n less frequ5tly ?an once e  
five ye>s4  7c7 ,det]m9ation ( que/ions 
7#a7 ,9 g5]al ,! que/ions includ$ 9 !   
scre5+ requir$ "u subsection 7a7 %all be
 det]m9$ by ! ,secret>y ) input f m$ical
 pr(essionals4  7#b7 ,specific que/ions 
,at a m9imum1 ! scre5+ requir$ "u       
subsection 7a7 %all1 ) respect to a     
vet]an1 include--  7,a7 a "q ab\t !     
pot5tial exposure ( ! vet]an to an op5  
burn pit2 &  7,b7 a "q reg>d+ toxic     
exposures t are commonly associat$ )    
s]vice 9 ! ,arm$ ,=ces4  7#c7 ,op5 burn 
pit def9$ ,9 ?is subsection1 ! t]m op5  
burn pit means an area ( l& t-- 7,a7 is 
designat$ by ! ,secret>y ( ,def5se to be
 us$ = dispos+ solid wa/e by burn+ 9 !  
outdoor air2 &  7,b7 does n conta9 a    

comm]cially manufactur$ inc9]ator or o!r
 equipm5t specifically design$ &        
manufactur$ = ! burn+ ( solid wa/e4  7d7
 ,pr9t mat]ial ,9 develop+ ! scre5+     
e/abli%$ "u subsection 7a71 ! ,secret>y 
%all ensure t pr9t mat]ials complem5t>y 
to su* scre5+ t outl9e relat$ res\rces =
 vet]ans are available at ea* m$ical    
c5t] ( ! ,dep>tm5t to vet]ans :o may n h
 access to ! int]net4  7e7 ,scre5+      
updates ,! ,secret>y %all consid]       
updates to ! cont5t ( ! scre5+ requir$  
"u subsection 7a7 n less frequ5tly ?an  
bi5nially to ensure ! scre5+ conta9s !  
mo/ curr5t in=mation4  #fjd4 ,tra9+ =   
p]sonnel ( ! ,dep>tm5t ( ,vet]ans       
,affairs ) respect to vet]ans :o report 
toxic exposures  7a7 ,heal? c>e p]sonnel
 ,! ,secret>y ( ,vet]ans ,affairs %all  
provide to heal? c>e p]sonnel ( !       
,dep>tm5t ( ,vet]ans ,affairs education 
& tra9+ to id5tify1 treat1 & assess !   
impact on vet]ans ( illnesses relat$ to 
toxic exposures & in=m su* p]sonnel ( h[
 to ask = additional in=mation f vet]ans

 reg>d+ diff]5t toxic exposures4  7b7   
,b5efits p]sonnel  7#a7 ,9 g5]al ,!     
,secret>y %all incorporate a tra9+      
program = processors ( claims "u ! laws 
adm9i/]$ by ! ,secret>y :o review claims
 = disability b5efits relat+ to         
s]vice-connect$ disabilities bas$ on    
toxic exposures4  7#b7 ,annual tra9+    
,tra9+ provid$ to processors "u p>agraph
 7#a7 %all be provid$ n less frequ5tly  
?an annually4  ,,vii ,res\rc+  #gja4    
,au?ority to use appropriations to      
enhance claims process+ capacity &      
automation  7a7 ,au?ority ,! ,secret>y (
 ,vet]ans ,affairs may use1 f am\nts    
appropriat$ to ! ,co/ ( ,w> ,toxic      
,exposures ,fund e/abli%$ by section    
#cbd ( title #ch1 ,unit$ ,/ates ,code1 z
 add$ by section #hje ( ?is ,act1 su*   
am\nts z may be necess>y to cont9ue !   
mod]nization1 developm5t1 & expansion ( 
capabilities & capacity ( in=mation     
te*nology sy/ems & infra/ructure ( !    
,vet]ans ,b5efits ,adm9i/ration1 includ+
 = claims automation1 to support expect$

 increas$ claims process+ = newly       
eligible vet]ans pursuant to ?is ,act4  
7b7 ,plan = mod]nization ( ,vet]ans     
,b5efits ,adm9i/ration in=mation        
te*nology sy/ems  7#a7 ,9 g5]al ,n lat] 
?an #ahj days aft] ! date ( ! enactm5t (
 ?is ,act1 ! ,secret>y ( ,vet]ans       
,affairs %all submit to ! appropriate   
congressional committees a plan = !     
mod]nization ( ! in=mation te*nology    
sy/ems ( ! ,vet]ans ,b5efits            
,adm9i/ration4 ,! plan %all cov] ! fir/ 
fiscal ye> t beg9s aft] ! date ( !      
enactm5t ( ?is ,act & ! subsequ5t f\r   
fiscal ye>s & %all include ea* ( !      
foll[+3  7,a7 ,an id5tification ( any   
in=mation sy/em to be mod]niz$ or       
retir$1 if applicable1 dur+ ! p]iod     
cov]$ by ! plan4  7,b7 ,a description ( 
h[ ! ,secret>y int5ds to incorporate !  
foll[+ pr9ciples into ! mod]nization (  
su* in=mation sy/ems3  7i7 ,! purpose ( 
automation %\ld be to increase ! spe$ & 
accuracy ( claims process+ decisions4   
7ii7 ,automation %\ld be conduct$ 9 a   

mann] t enhances ! productivity (       
employees ( ! ,dep>tm5t ( ,vet]ans      
,affairs4  7iii7 ,automation %\ld be    
c>ri$ out 9 a mann] t a*ieves great]    
consi/5cy 9 ! process+ & rat+ ( claims  
by rely+ on patt]ns ( simil> evid5ce 9  
claim files4  7iv7 ,to ! greate/ ext5t  
possible1 automation %\ld be c>ri$ out  
by draw+ f in=mation 9 ! possession ( ! 
,dep>tm5t1 o!r ,gov]nm5t ag5cies1 &     
applicants = b5efits4  7v7 ,automation (
 any claims analysis or det]m9ation     
process %\ld n be end-to-end or lack    
int]m$iation4  7vi7 ,employees ( !      
,dep>tm5t %\ld cont9ue to make decisions
 ) respect to ! approval ( claims & !   
grant+ ( b5efits4  7vii7 ,automation    
%\ld n be c>ri$ out 9 a mann] t r$uces  
or infr+es ^u ! due process rights (    
applicants = b5efits "u ! laws adm9i/]$ 
by ! ,secret>y2 or ! duties ( !         
,secret>y to assi/ & notify claimants4  
7viii7 ,automation %\ld be c>ri$ out    
:ile tak+ all necess>y measures to      
protect ! privacy ( claimants & _!      

p]sonally id5tifiable in=mation4  7ix7  
,automation ( claims process+ %\ld n    
elim9ate or r$uce ! work=ce ( ! ,vet]ans
 ,b5efits ,adm9i/ration4  7,c7 ,an      
id5tification ( t>gets1 = ea* fiscal    
ye>1 by :i* ! ,secret>y int5ds to       
complete ! mod]nization ( ea* in=mation 
sy/em or major compon5t or functionality
 ( su* sy/em id5tifi$ "u subp>agraph    
7,a74  7,d7 ,co/ e/imates = !           
mod]nization ( ea* in=mation sy/em      
id5tifi$ "u p>agraph 7,a7 = ea* fiscal  
ye> cov]$ by ! plan & 9 total4  7#b7    
,appropriate congressional committees ,9
 ?is section1 ! t]m appropriate         
congressional committees means--  7,a7 !
 ,committee on ,vet]ans' ,affairs & !   
,subcommittee on ,milit>y ,con/ruction1 
,vet]ans ,affairs1 & ,relat$ ,ag5cies ( 
! ,committee on ,appropriations ( !     
,s5ate2 &  7,b7 ! ,committee on         
,vet]ans' ,affairs & ! ,subcommittee on 
,milit>y ,con/ruction1 ,vet]ans         
,affairs1 & ,relat$ ,ag5cies ( !        
,committee on ,appropriations ( ! ,h\se 

( ,repres5tatives4  #gjb4 ,au?orization 
( major m$ical facility leases (        
,dep>tm5t ( ,vet]ans ,affairs = fiscal  
ye> #bjbc  7a7 ,9 g5]al ,! ,secret>y (  
,vet]ans ,affairs may c>ry out ! foll[+ 
major m$ical facility leases 9 fiscal   
ye> #bjbc3 7#a7 ,lease = an outpati5t   
cl9ic 9 ! vic9ity ( ,all5t[n1           
,p5nsylvania1 9 an e/imat$ am\nt (      
#ca1hcb1jjj4  7#b7 ,lease = a facility =
 memb] s]vices = ! ,vet]ans ,heal?      
,adm9i/ration 9 ! vic9ity ( ,atlanta1   
,georgia1 9 an e/imat$ am\nt (          
#bg1acd1jjj4  7#c7 ,lease = an outpati5t
 cl9ic 9 ! vic9ity ( ,baltimore1 ,m>yl&1
 9 an e/imat$ am\nt ( #dc1jda1jjj4  7#d7
 ,lease = an outpati5t cl9ic 9 ! vic9ity
 ( ,baton ,r\ge1 ,l\isiana1 9 an e/imat$
 am\nt ( #bi1eej1jjj4  7#e7 ,lease = an 
outpati5t cl9ic 9 ! vic9ity ( ,beau=t1  
,s\? ,c>ol9a1 9 an e/imat$ am\nt (      
#bd1bed1jjj4  7#f7 ,lease = an outpati5t
 cl9ic 9 ! vic9ity ( ,beaumont1 ,texas1 
9 an e/imat$ am\nt ( #ae1fcb1jjj4  7#g7 
,lease = an outpati5t cl9ic 9 ! vic9ity 

( ,bra9]d1 ,m9nesota1 9 an e/imat$ am\nt
 ( #ad1ffi1jjj4  7#h7 ,lease = a        
facility = rese>* 9 ! vic9ity (         
,buffalo1 ,new ,york1 9 an e/imat$ am\nt
 ( #aa1ajf1jjj4  7#i7 ,lease = an       
outpati5t cl9ic 9 ! vic9ity (           
,cl>ksville1 ,t5nessee1 9 an e/imat$    
am\nt ( #ge1ace1jjj4  7#aj7 ,lease ( a  
facility = rese>* 9 ! vic9ity (         
,columbia1 ,miss\ri1 9 an e/imat$ am\nt 
( #bj1gbf1jjj4  7#aa7 ,lease = an       
outpati5t cl9ic 9 ! vic9ity (           
,cookeville1 ,t5nessee1 9 an e/imat$    
am\nt ( #aj1ieh1jjj4  7#ab7 ,lease = a  
resid5tial treatm5t facility 9 ! vic9ity
 ( ,d5v]1 ,colorado1 9 an e/imat$ am\nt 
( #i1acc1jjj4  7#ac7 ,lease = an        
outpati5t cl9ic 9 ! vic9ity (           
,elizabe?t[n1 ,k5tucky1 9 an e/imat$    
am\nt ( #af1fga1jjj4  7#ad7 ,lease = an 
outpati5t cl9ic 9 ! vic9ity ( ,f>m+ton1 
,miss\ri1 9 an e/imat$ am\nt (          
#ag1idj1jjj4  7#ae7 ,lease = an         
outpati5t cl9ic 9 ! vic9ity ( ,hampton1 
,virg9ia1 9 an e/imat$ am\nt (          

#fc1jhe1jjj4  7#af7 ,lease = an         
outpati5t cl9ic 9 ! vic9ity (           
,jacksonville1 ,nor? ,c>ol9a1 9 an      
e/imat$ am\nt ( #fa1dej1jjj4  7#ag7     
,lease = an outpati5t cl9ic 9 ! vic9ity 
( ,kille51 ,texas1 9 an e/imat$ am\nt ( 
#fa1jcj1jjj4  7#ah7 ,lease = an         
outpati5t cl9ic 9 ! vic9ity ( ,lawr5ce1 
,indiana1 9 an e/imat$ am\nt (          
#ae1haa1jjj4  7#ai7 ,lease = an         
outpati5t cl9ic 9 ! vic9ity ( ,lecanto1 
,florida1 9 an e/imat$ am\nt (          
#ae1cgc1jjj4  7#bj7 ,lease = an         
outpati5t cl9ic 9 ! vic9ity ( ,na%ville1
 ,t5nessee1 9 an e/imat$ am\nt (        
#eh1jch1jjj4  7#ba7 ,lease = an         
outpati5t cl9ic 9 ! vic9ity ( ,nor?     
,kansas ,city1 ,miss\ri1 9 an e/imat$   
am\nt ( #dj1jbg1jjj4  7#bb7 ,lease = an 
outpati5t cl9ic 9 ! vic9ity (           
,pflug]ville1 ,texas1 9 an e/imat$ am\nt
 ( #af1fed1jjj4  7#bc7 ,lease = an      
outpati5t cl9ic 9 ! vic9ity ( ,plano1   
,texas1 9 an e/imat$ am\nt (            
#cb1gif1jjj4  7#bd7 ,lease = an         

outpati5t cl9ic 9 ! vic9ity ( ,pr9ce    
,george's ,c\nty1 ,m>yl&1 9 an e/imat$  
am\nt ( #ca1ged1jjj4  7#be7 ,lease = an 
outpati5t cl9ic 9 ! vic9ity ( ,rolla1   
,miss\ri1 9 an e/imat$ am\nt (          
#ba1ceb1jjj4  7#bf7 ,lease = an         
outpati5t cl9ic 9 ! vic9ity ( ,salt     
,lake ,city1 ,utah1 9 an e/imat$ am\nt (
 #bi1dff1jjj4  7#bg7 ,lease = an        
outpati5t cl9ic 9 ! vic9ity ( ,s>asota1 
,florida1 9 an e/imat$ am\nt (          
#cf1eag1jjj4  7#bh7 ,lease = an         
outpati5t cl9ic 9 ! vic9ity (           
,spr+field1 ,massa*usetts1 9 an e/imat$ 
am\nt ( #cj1iah1jjj4  7#bi7 ,lease = a  
community liv+ c5t] 9 ! vic9ity (       
,tampa1 ,florida1 9 an e/imat$ am\nt (  
#ea1fhb1jjj4  7#cj7 ,lease = an         
outpati5t cl9ic 9 ! vic9ity ( ,!        
,villages1 ,florida1 9 an e/imat$ am\nt 
( #dh1bfg1jjj4  7#ca7 ,lease = an       
outpati5t cl9ic 9 ! vic9ity (           
,tri-,cities1 ,wa%+ton1 9 an e/imat$    
am\nt ( #cf1acf1jjj4  7b7 ,treatm5t (   
au?orizations ,! au?orization ( leases  

"u subsection 7a7 %all be consid]$ to be
 a specific au?orization by law ( !     
funds = su* leases = purposes ( section 
#hajd7;a77#b7 ( title #ch1 ,unit$ ,/ates
 ,code1 z 9 effect on ! day be=e ! date 
( ! enactm5t ( ?is ,act4  7c7           
,au?orization ( appropriations ,!re is  
au?oriz$ to be appropriat$ to !         
,secret>y ( ,vet]ans ,affairs = fiscal  
ye> #bjbc1 or ! ye> 9 :i* funds are     
appropriat$ = ! ,m$ical ,facilities     
acc\nt1 #iih1acg1jjj = ! leases au?oriz$
 9 subsection 7a74  #gjc4 ,treatm5t (   
major m$ical facility leases ( !        
,dep>tm5t ( ,vet]ans ,affairs  7a7      
,congressional approval ( major m$ical  
facility leases ,p>agraph 7#b7 (        
subsection 7a7 ( section #hajd ( title  
#ch1 ,unit$ ,/ates ,code1 is am5d$--    
7#a7 by /rik+ ,no funds & ins]t+ 7,a7   
,no funds2  7#b7 by /rik+ or any major  
m$ical facility lease2  7#c7 by /rik+ or
 lease2 &  7#d7 by add+ at ! end !      
foll[+ new subp>agraph3  7,b7 ,no funds 
may be appropriat$ = any fiscal ye>1 & !

 ,secret>y may n obligate or exp5d funds
 7o!r ?an = advance plann+ & design71 = 
any major m$ical facility lease unless !
 ,committee on ,vet]ans' ,affairs ( !   
,s5ate & ! ,committee on ,vet]ans'      
,affairs ( ! ,h\se ( ,repres5tatives ea*
 adopt a resolution approv+ ! lease4  4 
7b7 ,modification ( def9ition ( major   
m$ical facility lease ,subp>agraph 7,b7 
( p>agraph 7#c7 ( su* subsection is     
am5d$ to read z foll[s3  7,b7 ,! t]m    
major m$ical facility lease--  7i7 means
 a lease = space = use z a new m$ical   
facility approv$ ?r\gh ! ,g5]al ,s]vices
 ,adm9i/ration "u section #ccjg7;a7 (   
title #dj at an av]age annual r5t equal 
to or great] ?an ! appropriate doll>    
?re%old describ$ 9 su* section1 :i* %all
 be subject to annual adju/m5t 9        
accordance ) section #ccjg7;h7 ( su*    
title2 &  7ii7 does n include a lease = 
space = use z a %>$ ,f$]al m$ical       
facility = :i* ! ,dep>tm5t's e/imat$ %>e
 ( ! lease co/s does n exce$ su* doll>  
?re%old4  4  7c7 ,sep>ate prospectus    

requirem5t = major m$ical facility      
leases ,subsection 7b7 ( su* section is 
am5d$-- 7#a7 by /rik+ p>agraph 7#g72    
7#b7 9 p>agraph 7#a71 by r$esignat+     
subp>agraphs 7,a7 ?r\gh 7,e7 z clauses  
7i7 ?r\gh 7v71 respectively2  7#c7 9    
p>agraph 7#f71 by r$esignat+            
subp>agraphs 7,a7 ?r\gh 7,c7 z clauses  
7i7 ?r\gh 7iii71 respectively2  7#d7 by 
r$esignat+ p>agraphs 7#a7 ?r\gh 7#f7 z  
subp>agraphs 7,a7 ?r\gh 7,f71           
respectively2  7#e7 9 ! matt] prec$+    
subp>agraph 7,a71 z r$esignat$ by       
p>agraph 7#d7--  7,a7 by /rik+ ,:5ev] ! 
,presid5t & ins]t+ 7#a7 ,:5ev] !        
,presid5t2  7,b7 by /rik+ ! ,congress & 
ins]t+ ,congress2 &  7,c7 by /rik+ or a 
major m$ical facility lease 7z def9$ 9  
subsection 7a77#c77;b772  7#f7 9        
subp>agraph 7,a71 z r$esignat$ by       
p>agraph 7#d71 by /rik+ leas$12  7#g7 9 
subp>agraph 7,e71 z r$esignat$ by       
p>agraph 7#d7-- 7,a7 by /rik+ or lease  
ea* place x appe>s2 &  7,b7 by /rik+ or 
leases2 &  7#h7 by add+ at ! end !      

foll[+ new p>agraph3  7#b7 ,:5ev] !     
,presid5t or ! ,secret>y submit to      
,congress a reque/ = ! fund+ ( a major  
m$ical facility lease 7z def9$ 9        
subsection 7a77#c77;,b771 ! ,secret>y   
%all submit to ea* committee1 on ! same 
day1 a prospectus ( ! propos$ m$ical    
facility4 ,any su* prospectus %all      
include ! foll[+3 7,a7 ,a description ( 
! facility to be leas$4  7,b7 ,an       
e/imate ( ! co/ to ! ,f$]al ,gov]nm5t ( 
! facility to be leas$4  7,c7 ,an       
e/imate ( ! en]gy p]=mance ( ! propos$  
lease space1 to include a description ( 
anticipat$ utilization ( r5ewable en]gy1
 en]gy effici5t & climate resili5t      
elem5ts1 & relat$ matt]s4  7,d7 ,curr5t 
& project$ workload & utilization data  
reg>d+ ! facility to be leas$1 includ+  
in=mation on project$ *anges 9 workload 
& utilization ov] a five-ye> p]iod1 a   
t5-ye> p]iod1 & a tw5ty-ye> p]iod4  7,e7
 ,a detail$ analysis ( h[ ! lease is    
expect$ to comply ) ,(fice ( ,managem5t 
& ,budget ,circul> ,a-#aa & section     

#acda ( title #ca 7commonly ref]r$ to z 
! ,anti-,defici5cy ,act74 ,any su*      
analysis %all include--  7i7 an analysis
 ( ! classification ( ! lease z a lease 
pur*ase1 a capital lease1 or an op]at+  
lease z ^? t]ms are def9$ 9 ,(fice (    
,managem5t & ,budget ,circul> ,a-#aa2   
7ii7 an analysis ( ! obligation (       
budget>y res\rces associat$ ) ! lease2 &
  7iii7 an analysis ( ! me?odology us$ 9
 det]m9+ ! asset co/1 fair m>ket value1 
& cancellation co/s ( ! lease4  4  7d7  
,int]im leas+ actions ,su* section is   
fur!r am5d$ by add+ at ! end ! foll[+   
new subsection3  7i7  7#a7 ,not)/&+     
subsection 7a77#b77;,b71 ! ,secret>y may
 c>ry out int]im leas+ actions z !      
,secret>y consid]s necess>y = ! foll[+  
leases3 7,a7 ,major m$ical facility     
leases 7z def9$ 9 subsection            
7a77#c77;,b77 approv$ pursuant to ?is   
section & = :i* a prospectus = a        
replacem5t lease has be5 submitt$ to    
,congress pursuant to subsection        
7b77#b74  7,b7 ,replacem5t leases t d n 

require approval "u ?is section & = :i* 
a prospectus has be5 submitt$ to        
,congress pursuant to subsection        
7b77#b74  7#b7 ,9 ?is subsection1 ! t]m 
int]im leas+ actions has ! mean+ giv5 t 
t]m by ! ,adm9i/rator ( ! ,g5]al        
,s]vices ,adm9i/ration4  4  7e7 ,pur*ase
 ,options ,su* section is fur!r am5d$ by
 add+ at ! end ! foll[+ new subsection3 
7j7 ,! ,secret>y may obligate & exp5d   
funds to ex]cise a pur*ase option       
includ$ 9 any major m$ical facility     
lease 7z def9$ 9 subsection             
7a77#c77;,b774  4  7f7 ,applicability ,!
 am5dm5ts made by ?is section %all apply
 ) respect to any lease t has n be5     
specifically au?oriz$ by law on or be=e 
! date ( ! enactm5t ( ?is ,act4  #gjd4  
,au?ority to ent] into agreem5ts )      
academic affiliates & o!r entities to   
acquire space = ! purpose ( provid+     
heal?-c>e res\rces to vet]ans ,section  
#hajc ( title #ch1 ,unit$ ,/ates ,code1 
is am5d$ by add+ at ! end ! foll[+ new  
subsection3  7h7  7#a7 ,not)/&+ any o!r 

provision ( law requir+ ! use (         
competitive proc$ures1 includ+ section  
#bcjd ( title #aj1 :5 ! ,secret>y       
det]m9es x to be 9 ! be/ int]e/ ( !     
,dep>tm5t1 ! ,secret>y may ent] into a  
lease ) an academic affiliate or cov]$  
entity to acquire space = ! purpose (   
provid+ heal?-c>e res\rces to vet]ans4  
7#b7 ,9 ?is subsection3  7,a7 ,! t]m    
academic affiliate means an in/itution  
or organization describ$ 9 section      
#gcjb7;d7 ( ?is title4  7,b7 ,! t]m     
cov]$ entity means a unit or subdivision
 ( a ,/ate1 local1 or municipal         
gov]nm5t1 public or nonpr(it ag5cy1     
in/itution1 or organization1 or o!r     
in/itution or organization z ! ,secret>y
 consid]s appropriate t owns prop]ty    
controll$ by an academic affiliate to be
 leas$ "u ?is subsection4  7,c7 ,! t]m  
heal?-c>e res\rce has ! mean+ giv5 t t]m
 9 section #haeb7a7 ( ?is title4  7,d7  
,! t]m space means any room1 unit1      
floor1 w+1 build+1 p>k+ facility1 or o!r
 subdivision ( a build+ or facility own$

 or controll$ by an academic affiliate4 
4  #gje4 ,modifications to enhanc$-use  
lease au?ority ( ,dep>tm5t ( ,vet]ans   
,affairs  7a7 ,modifications to au?ority
 ,p>agraph 7#b7 ( section #hafb7;a7 (   
title #ch1 ,unit$ ,/ates ,code1 is am5d$
 to read z foll[s3  7#b7 7,a7 ,!        
,secret>y may ent] into an enhanc$-use  
lease on or aft] ! date ( ! enactm5t (  
?is p>agraph only if ! ,secret>y        
det]m9es--  7i7 t ! lease w n be        
inconsi/5t )1 & w n adv]sely affect--   
7,i7 ! mission ( ! ,dep>tm5t2 or  7,,ii7
 ! op]ation ( facilities1 programs1 &   
s]vices ( ! ,dep>tm5t 9 ! area ( ! leas$
 prop]ty2 &  7ii7 t--  7,i7 ! lease w   
enhance ! use ( ! leas$ prop]ty by      
directly or indirectly b5efitt+ vet]ans2
 or  7,,ii7 ! leas$ prop]ty w provide   
supportive h\s+4  7,b7 ,! ,secret>y %all
 give priority to enhanc$-use leases t1 
on ! leas$ prop]ty-- 7i7 provide        
supportive h\s+ = vet]ans2  7ii7 provide
 direct s]vices or b5efits t>get$ to    
vet]ans2 or  7iii7 provide s]vices or   

b5efits t indirectly support vet]ans4  4
  7b7 ,ext5sion ( maximum t]m (         
enhanc$-use lease ,section #hafb7;b77#b7
 ( su* title is am5d$ by /rik+ #ge ye>s 
& ins]t+ #ii ye>s4  7c7 ,modification ( 
use ( proce$s ,section #hafe7;a77#a7 (  
su* title is am5d$ by /rik+ %all be     
deposit$ 9 ! ,dep>tm5t ( ,vet]ans       
,affairs ,m$ical ,c>e ,collections ,fund
 e/abli%$ "u section #agbi;,a ( ?is     
title4 & ins]t+ 8%all1 at ! discretion (
 ! ,secret>y1 be deposit$ 9--  7,a7 !   
,dep>tm5t ( ,vet]ans ,affairs ,m$ical   
,c>e ,collections ,fund e/abli%$ "u     
section #agbi;,a ( ?is title2 or  7,b7 !
 ,m$ical ,facilities or ,con/ruction1   
,m9or ,projects acc\nt ( ! ,dep>tm5t to 
be us$ to defray ! co/s ( adm9i/ration1 
ma9t5ance1 repair1 & relat$ exp5ses     
incurr$ by ! ,dep>tm5t ) respect to     
prop]ty t is own$ by or "u !            
jurisdiction or control ( ! ,dep>tm5t4  
4  7d7 ,repeal ( sunset ,section #hafi (
 su* title is repeal$4  7e7             
,appropriation ,9 addition to am\nts    

o!rwise available1 !re is appropriat$ = 
fiscal ye> #bjbb1 out ( any funds 9 !   
,treasury n o!rwise appropriat$1        
#ibb1jjj1jjj = an additional am\nt = !  
,dep>tm5t ( ,vet]ans ,affairs1 to rema9 
available until exp5d$1 to ent] into    
enhanc$-use leases pursuant to section  
#hafb ( title #ch1 ,unit$ ,/ates ,code1 
z am5d$ by ?is section4  #gjf4 ,au?ority
 = jo9t leas+ actions ( ,dep>tm5t (     
,def5se & ,dep>tm5t ( ,vet]ans ,affairs 
7a7 ,dep>tm5t ( ,def5se ,section        
#aajd;,a ( title #aj1 ,unit$ ,/ates     
,code1 is am5d$-- 7#a7 by ins]t+ 1 or ! 
leas+1 aft] design1 & con/ruction ea*   
place x appe>s2 &  7#b7 9 subsection    
7c77#b71 by ins]t+ 1 or ! leas+1 aft]   
design4  7b7 ,dep>tm5t ( ,vet]ans       
,affairs ,section #haaa;,b ( title #ch1 
,unit$ ,/ates ,code1 is am5d$--  7#a7 9 
subsection 7a71 by ins]t+ 1 or ! leas+1 
aft] design1 & con/ruction2  7#b7 9     
subsection 7b71 by add+ at ! end !      
foll[+ new p>agraph3  7#c7 ,! ,secret>y 
( ,vet]ans ,affairs may transf] to !    

,dep>tm5t ( ,def5se am\nts appropriat$  
to ! ,m$ical ,facilities acc\nt ( !     
,dep>tm5t ( ,vet]ans ,affairs = !       
purpose ( leas+ space = a %>$ m$ical    
facility if ! e/imat$ %>e ( ! ,dep>tm5t 
( ,vet]ans ,affairs = ! lease co/s does 
n exce$ ! am\nt specifi$ 9 section      
#hajd7;a77#c77;,b7 ( ?is title4  2 &    
7#c7 9 subsection 7c71 by add+ at ! end 
! foll[+ new p>agraph3  7#c7 ,any am\nt 
transf]r$ to ! ,secret>y ( ,vet]ans     
,affairs by ! ,secret>y ( ,def5se = !   
purpose ( leas+ space = a %>$ m$ical    
facility may be cr$it$ to ! ,m$ical     
,facilities acc\nt ( ! ,dep>tm5t (      
,vet]ans ,affairs & may be us$ = su*    
purpose4  4  #gjg4 ,appropriation (     
am\nts = major m$ical facility leases   
7a7 ,fiscal ye> #bjbc ,9 addition to    
am\nts o!rwise available1 !re is        
appropriat$ = fiscal ye> #bjbc1 out (   
any funds 9 ! ,treasury n o!rwise       
appropriat$1 #a1hhj1jjj1jjj = an        
additional am\nt = ! ,m$ical ,facilities
 acc\nt ( ! ,dep>tm5t ( ,vet]ans        

,affairs1 to rema9 available until      
exp5d$1 = major m$ical facility leases  
au?oriz$ by section #gjb4  7b7          
,additional ye>s ,9 addition to am\nts  
o!rwise available1 !re is appropriat$1  
out ( any funds 9 ! ,treasury n o!rwise 
appropriat$1 = an additional am\nt = !  
,m$ical ,facilities acc\nt ( ! ,dep>tm5t
 ( ,vet]ans ,affairs1 to rema9 available
 until exp5d$1 = major m$ical facility  
leases au?oriz$ by section #gjb or      
approv$ pursuant to sub*apt] ,i ( *apt] 
#ha ( title #ch1 ,unit$ ,/ates ,code1 z 
am5d$ by section #gjc-- 7#a7            
#ajj1jjj1jjj = fiscal ye> #bjbd2  7#b7  
#bjj1jjj1jjj = fiscal ye> #bjbe2  7#c7  
#djj1jjj1jjj = fiscal ye> #bjbf2  7#d7  
#dej1jjj1jjj = fiscal ye> #bjbg2  7#e7  
#fjj1jjj1jjj = fiscal ye> #bjbh2  7#f7  
#faj1jjj1jjj = fiscal ye> #bjbi2  7#g7  
#fbj1jjj1jjj = fiscal ye> #bjcj2 &  7#h7
 #fej1jjj1jjj = fiscal ye> #bjca4       
,,viii ,records & o!r matt]s  #hja4     
,epidemiological /udy on ,=t ,mc,clellan
 vet]ans ,! ,secret>y ( ,vet]ans        

,affairs %all conduct an epidemiological
 /udy on ! heal? tr5ds ( vet]ans :o s]v$
 9 ! ,arm$ ,=ces at ,=t ,mc,clellan at  
any "t dur+ ! p]iod beg9n+ ,janu>y #a1  
#aice1 & end+ on ,may #bj1 #aiii4  #hjb4
 ,bi5nial brief+ on ,individual         
,longitud9al ,exposure ,record  7a7 ,9  
g5]al ,n lat] ?an "o ye> aft] ! date on 
:i* ! ,individual ,longitud9al ,exposure
 ,record a*ieves full op]ational        
capability1 z det]m9$ by ! ,secret>y (  
,def5se1 & e two ye>s !reaft]1 !        
,secret>y ( ,def5se1 9 consultation ) ! 
,secret>y ( ,vet]ans ,affairs1 %all     
provide ! appropriate committees (      
,congress a brief+ on-- 7#a7 ! quality (
 ! databases ( ! ,dep>tm5t ( ,def5se t  
provide ! in=mation pres5t$ 9 su*       
,individual ,longitud9al ,exposure      
,record2 &  7#b7 ! usefulness ( su*     
,individual ,longitud9al ,exposure      
,record or sy/em 9 support+ memb]s ( !  
,arm$ ,=ces & vet]ans 9 receiv+ heal?   
c>e & b5efits f ! ,dep>tm5t ( ,def5se & 
! ,dep>tm5t ( ,vet]ans ,affairs4  7b7   

,elem5ts ,ea* brief+ requir$ by         
subsection 7a7 %all include1 = ! p]iod  
cov]$ by ! report1 ! foll[+3  7#a7 ,an  
id5tification ( pot5tial exposures to   
occupational or environm5tal haz>ds     
captur$ by ! curr5t sy/ems ( ! ,dep>tm5t
 ( ,def5se = environm5tal1 occupational1
 & heal? monitor+1 & recomm5dations = h[
 to improve ^? sy/ems4  7#b7 ,an        
analysis ( ! quality & accuracy ( !     
location data us$ by ! ,dep>tm5t (      
,def5se 9 det]m9+ pot5tial exposures to 
occupational or environm5tal haz>ds by  
memb]s ( ! ,arm$ ,=ces & vet]ans1 &     
recomm5dations = h[ to improve ! quality
 ( su* data if necess>y4  7c7           
,def9itions ,9 ?is section3 7#a7        
,appropriate committees ( ,congress ,!  
t]m appropriate committees ( ,congress  
means--  7,a7 ! ,committee on ,arm$     
,s]vices & ! ,committee on ,vet]ans'    
,affairs ( ! ,s5ate2 &  7,b7 !          
,committee on ,arm$ ,s]vices & !        
,committee on ,vet]ans' ,affairs ( !    
,h\se ( ,repres5tatives4  7#b7          

,individual ,longitud9al ,exposure      
,record ,! t]m ,individual ,longitud9al 
,exposure ,record has ! mean+ giv5 su*  
t]m 9 section #aaga ( title #ch1 ,unit$ 
,/ates ,code1 z add$ by section #bjb4   
#hjc4 ,correction ( exposure records by 
memb]s ( ! ,arm$ ,=ces & vet]ans  7a7 ,9
 g5]al ,! ,secret>y ( ,vet]ans ,affairs 
%all coord9ate ) ! ,secret>y ( ,def5se  
to provide a means = vet]ans to update  
_! records z necess>y to reflect        
exposures to occupational or            
environm5tal haz>ds by su* memb] or     
vet]an 9 ! ,individual ,longitud9al     
,exposure ,record4  7b7 ,evid5ce  7#a7  
,provision ( evid5ce ,to update a record
 "u subsection 7a71 a vet]an %all       
provide su* evid5ce z ! ,secret>y (     
,vet]ans ,affairs consid]s necess>y4    
7#b7 ,regulations ,! ,secret>y (        
,vet]ans ,affairs %all prescribe by     
regulation ! evid5ce consid]$ necess>y  
"u p>agraph 7#a74  7c7 ,def9itions ,9   
?is section3 7#a7 ,individual           
,longitud9al ,exposure ,record ,! t]m   

,individual ,longitud9al ,exposure      
,record has ! mean+ giv5 su* t]m 9      
section #aaga ( title #ch1 ,unit$ ,/ates
 ,code1 z add$ by section #bjb4  7#b7   
,toxic exposure ,! t]m toxic exposure   
has ! mean+ giv5 su* t]m 9 section #aja 
( title #ch1 ,unit$ ,/ates ,code1 z     
am5d$ by section #ajb7;b74  #hjd4 ,f$]al
 cause ( action relat+ to wat] at ,camp 
,lejeune1 ,nor? ,c>ol9a  7a7 ,%ort title
 ,?is section may be cit$ z ! ,camp     
,lejeune ,ju/ice ,act ( #bjbb4  7b7 ,9  
g5]al ,an individual1 includ+ a vet]an  
7z def9$ 9 section #aja ( title #ch1    
,unit$ ,/ates ,code71 or ! legal        
repres5tative ( su* an individual1 :o   
resid$1 work$1 or 0 o!rwise expos$      
7includ+ 9 ut]o exposure7 = n less ?an  
#cj days dur+ ! p]iod beg9n+ on ,augu/  
#a1 #aiec1 & end+ on ,decemb] #ca1      
#aihg1 to wat] at ,camp ,lejeune1 ,nor? 
,c>ol9a1 t 0 suppli$ by1 or on behalf (1
 ! ,unit$ ,/ates may br+ an action 9 !  
,unit$ ,/ates ,di/rict ,c\rt = ! ,ea/]n 
,di/rict ( ,nor? ,c>ol9a to obta9       

appropriate relief = h>m t 0 caus$ by   
exposure to ! wat] at ,camp ,lejeune4   
7c7 ,burd5s & /&>d ( pro(  7#a7 ,9 g5]al
 ,! burd5 ( pro( %all be on ! p>ty fil+ 
! action to %[ "o or m relation%ips     
betwe5 ! wat] at ,camp ,lejeune & ! h>m4
  7#b7 ,/&>ds ,to meet ! burd5 ( pro(   
describ$ 9 p>agraph 7#a71 a p>ty %all   
produce evid5ce %[+ t ! relation%ip     
betwe5 exposure to ! wat] at ,camp      
,lejeune & ! h>m is-- 7,a7 suffici5t to 
conclude t a causal relation%ip exi/s2  
or  7,b7 suffici5t to conclude t a      
causal relation%ip is at lea/ z likely z
 n4  7d7 ,exclusive jurisdiction & v5ue 
,! ,unit$ ,/ates ,di/rict ,c\rt = !     
,ea/]n ,di/rict ( ,nor? ,c>ol9a %all h  
exclusive jurisdiction ov] any action   
fil$ "u subsection 7b71 & %all be !     
exclusive v5ue = su* an action4 ,no?+ 9 
?is subsection %all impair ! "r ( any   
p>ty to a trial by jury4  7e7 ,exclusive
 rem$y  7#a7 ,9 g5]al ,an individual1 or
 legal repres5tative ( an individual1 :o
 br+s an action "u ?is section = a h>m  

describ$ 9 subsection 7b71 includ+ a    
lat5t disease1 may n !reaft] br+ a tort 
action aga9/ ! ,unit$ ,/ates = su* h>m  
pursuant to any o!r law4  7#b7 ,heal? & 
disability b5efits relat+ to wat]       
exposure ,any aw>d made to an           
individual1 or legal repres5tative ( an 
individual1 "u ?is section %all be (fset
 by ! am\nt ( any disability aw>d1      
paym5t1 or b5efit provid$ to !          
individual1 or legal repres5tative--    
7,a7 "u-- 7i7 any program "u ! laws     
adm9i/]$ by ! ,secret>y ( ,vet]ans      
,affairs2  7ii7 ! ,m$ic>e program "u    
title ,,xviii ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acie et seq472 or      
7iii7 ! ,m$icaid program "u title ,,xix 
( ! ,social ,security ,act 7#db         
,u4,s4,c4 #acif et seq472 &  7,b7 9     
connection ) heal? c>e or a disability  
relat+ to exposure to ! wat] at ,camp   
,lejeune4  7f7 ,immunity limitation ,!  
,unit$ ,/ates may n ass]t any claim to  
immunity 9 an action "u ?is section t   
w\ld o!rwise be available "u section    

#bfhj7;a7 ( title #bh1 ,unit$ ,/ates    
,code4  7g7 ,no punitive damages        
,punitive damages may n be aw>d$ 9 any  
action "u ?is section4  7h7 ,disposition
 by ,f$]al ag5cy requir$ ,an individual 
may n br+ an action "u ?is section be=e 
comply+ ) section #bfge ( title #bh1    
,unit$ ,/ates ,code4  7i7 ,exception =  
combatant activities ,?is section does n
 apply to any claim or action aris+ out 
( ! combatant activities ( ! ,arm$      
,=ces4  7j7 ,applicability2 p]iod = fil+
  7#a7 ,applicability ,?is section %all 
apply only to a claim accru+ be=e ! date
 ( enactm5t ( ?is ,act4  7#b7 ,/atute ( 
limitations ,a claim 9 an action "u ?is 
section may n be comm5c$ aft] ! lat] (--
 7,a7 ! date t is two ye>s aft] ! date (
 enactm5t ( ?is ,act2 or  7,b7 ! date t 
is #ahj days aft] ! date on :i* ! claim 
is d5i$ "u section #bfge ( title #bh1   
,unit$ ,/ates ,code4  7#c7              
,inapplicability ( o!r limitations ,any 
applicable /atute ( repose or /atute (  
limitations1 o!r ?an "u p>agraph 7#b71  

%all n apply to a claim "u ?is section4 
#hje4 ,co/ ( ,w> ,toxic ,exposures ,fund
  7a7 ,9 g5]al ,*apt] #c is am5d$ by    
add+ at ! end ! foll[+ new section3     
#cbd4 ,co/ ( ,w> ,toxic ,exposures ,fund
  7a7 ,e/abli%m5t ,!re is h]eby e/abli%$
 9 ! ,treasury ( ! ,unit$ ,/ates an     
acc\nt to be kn[n z ! ,co/ ( ,w> ,toxic 
,exposures ,fund 7! ,fund71 to be       
adm9i/]$ by ! ,secret>y4  7b7 ,deposits 
,!re %all be deposit$ 9 ! ,fund su*     
am\nts z may be appropriat$ to ! ,fund  
pursuant to subsection 7c74  7c7        
,au?orization ( appropriations ,!re is  
au?oriz$ to be appropriat$ to ! ,fund = 
fiscal ye> #bjbc & ea* subsequ5t fiscal 
ye> su* sums z are necess>y to increase 
fund+1 ov] ! fiscal ye> #bjba level1 =  
inve/m5t 9--  7#a7 ! deliv]y ( vet]ans' 
heal? c>e associat$ ) exposure to       
environm5tal haz>ds 9 ! active milit>y1 
naval1 air1 or space s]vice 9 programs  
adm9i/]$ by ! ,"u ,secret>y = ,heal?2   
7#b7 any exp5ses incid5t to ! deliv]y ( 
vet]ans' heal? c>e & b5efits associat$ )

 exposure to environm5tal haz>ds 9 !    
active milit>y1 naval1 air1 or space    
s]vice1 includ+ adm9i/rative exp5ses1   
su* z in=mation te*nology & claims      
process+ & appeals1 & exclud+ leases z  
au?oriz$ or approv$ "u section #hajd (  
?is title2 &  7#c7 m$ical & o!r rese>*  
relat+ to exposure to environm5tal      
haz>ds4  7d7 ,budget scorekeep+  7#a7   
,imm$iately ^u enactm5t ( ! ,s]geant    
,fir/ ,class ,hea? ,rob9son ,honor+ our 
,promise to ,address ,compreh5sive      
,toxics ,act ( #bjbb1 exp5ses au?oriz$  
to be appropriat$ to ! ,fund 9          
subsection 7c7 %all be e/imat$ = fiscal 
ye> #bjbc & ea* subsequ5t fiscal ye> &  
treat$ z budget au?ority t is consid]$  
to be direct sp5d+--  7,a7 9 ! basel9e =
 purposes ( section #beg ( ! ,balanc$   
,budget & ,em]g5cy ,deficit ,control    
,act ( #aihe 7#b ,u4,s4,c4 #ijg72  7,b7 
by ! ,*airman ( ! ,committee on !       
,budget ( ! ,s5ate & ! ,*air ( !        
,committee on ! ,budget ( ! ,h\se (     
,repres5tatives1 z appropriate1 =       

purposes ( budget en=cem5t 9 ! ,s5ate & 
! ,h\se ( ,repres5tatives2  7,c7 "u !   
,congressional ,budget ,act ( #aigd 7#b 
,u4,s4,c4 #fba et seq471 includ+ 9 !    
reports requir$ by section #cjh7;b7 (   
su* ,act 7#b ,u4,s4,c4 #fci72 &  7,d7 = 
purposes ( ! ,/atutory ,pay-,z-,y-,g    
,act ( #bjaj 7#b ,u4,s4,c4 #ica et      
seq474  7#b7 ,no am\nt appropriat$ to ! 
,fund 9 fiscal ye> #bjbc or any         
subsequ5t fiscal ye> pursuant to ?is    
section %all be c\nt$ z discretion>y    
budget au?ority & outlays or z direct   
sp5d+ = any e/imate ( an appropriation  
,act "u ! ,congressional ,budget &      
,imp\ndm5t ,control ,act ( #aigd 7#b    
,u4,s4,c4 #fba et seq47 & any o!r ,act4 
7#c7 ,not)/&+ ! ,budget ,scorekeep+     
,guidel9es & ! accompany+ li/ ( programs
 & acc\nts set =? 9 ! jo9t explanatory  
/atem5t ( ! committee ( conf]5ce        
accompany+ ,conf]5ce ,report #aje-bag1 &
 = purposes ( ! ,balanc$ ,budget &      
,em]g5cy ,deficit ,control ,act ( #aihe 
7#b ,u4,s4,c4 #ijj et seq47 & !         

,congressional ,budget ,act ( #aigd 7#b 
,u4,s4,c4 #fba et seq471 ! ,fund %all be
 treat$ z if x 7 an acc\nt designat$ z  
,appropriat$ ,entitlem5ts & ,m&atories =
 ,fiscal ,ye> #aiig 9 ! jo9t explanatory
 /atem5t ( ! committee ( conf]5ce       
accompany+ ,conf]5ce ,report #aje-bag4  
7e7 ,e/imates = congressional           
consid]ation ,! ,secret>y %all include 9
 docum5ts submitt$ to ,congress 9       
support ( ! ,presid5t's budget submitt$ 
pursuant to section #aaje ( title #ca   
detail$ e/imates ( ! sums describ$ 9    
subsection 7c7 = ! applicable fiscal    
ye>4  7f7 ,proc$ures = e/imates ,!      
,secret>y may1 aft] consultation ) !    
,committee on ,appropriations ( ! ,s5ate
 & ! ,committee on ,appropriations ( !  
,h\se ( ,repres5tatives1 e/abli%        
policies & proc$ures = develop+ ! annual
 detail$ e/imates requir$ by subsection 
7e74  4  7b7 ,seque/ration ,section     
#bef7;h77#d7 ( ! ,balanc$ ,budget &     
,em]g5cy ,deficit ,control ,act ( #aihe 
7#b ,u4,s4,c4 #ijf7;h77#d77 is am5d$ by 

add+ at ! end ! foll[+ new subp>agraph3 
7,g7 ,co/ ( ,w> ,toxic ,exposures ,fund4
  4  #hjf4 ,appropriation = fiscal ye>  
#bjbb  7a7 ,appropriation ,9 addition to
 am\nts o!rwise available1 !re is       
appropriat$ = fiscal ye> #bjbb1 out (   
any funds 9 ! ,treasury n o!rwise       
appropriat$1 #ejj1jjj1jjj = ! ,co/ ( ,w>
 ,toxic ,exposures ,fund1 e/abli%$ by   
section #cbd ( title #ch1 ,unit$ ,/ates 
,code1 z add$ by section #hje ( ?is     
,act1 to rema9 available until ,septemb]
 #cj1 #bjbd4  7b7 ,sp5d plan ,n lat] ?an
 #cj days aft] enactm5t ( ?is ,act1 !   
,secret>y ( ,vet]ans ,affairs %all      
submit a plan = exp5d+ am\nts made      
available by subsection 7a7 by program1 
project or activity to ! ,committee on  
,appropriations ( ! ,s5ate & !          
,committee on ,appropriations ( ! ,h\se 
( ,repres5tatives4 ,funds may n be      
obligat$ until su* ,committees issue an 
approval1 or abs5t a response1 a p]iod (
 #cj days has elaps$4  #hjg4            
,au?orization ( electronic notice 9     

claims "u laws adm9i/]$ by ! ,secret>y (
 ,vet]ans ,affairs  7a7 ,9 g5]al ,title 
#ch1 ,unit$ ,/ates ,code1 is am5d$ z    
foll[s3 7#a7 ,by /rik+ section #eajj &  
ins]t+ ! foll[+3  #eajj4 ,def9itions ,9 
?is *apt]3 7#a7 ,! t]m claimant means   
any individual apply+ =1 or submitt+ a  
claim =1 any b5efit "u ! laws adm9i/]$  
by ! ,secret>y4  7#b7 ,! t]m notice     
means a communication issu$ ?r\gh means 
7includ+ electronic means7 prescrib$ by 
! ,secret>y4  4  7#b7 ,9 section #eajd1 
by add+ at ! end ! foll[+ new           
subsection3  7c7 ,! ,secret>y may       
provide notice "u subsection 7a7        
electronically if a claimant 7or !      
claimant's repres5tative7 elects to     
receive su* notice electronically4 ,a   
claimant 7or ! claimant's repres5tative7
 may revoke su* an election at any "t1  
by means prescrib$ by ! ,secret>y4  7d7 
,! ,secret>y %all annually--  7#a7      
solicit recomm5dations f /akehold]s on  
h[ to improve notice "u ?is section2 &  
7#b7 publi% su* recomm5dations on a     

publicly available website ( !          
,dep>tm5t4  4  7#c7 ,9 section          
#eajd;,b7c71 9 ! matt] prec$+ p>agraph  
7#a7 by /rik+ 9 writ+ & ins]t+ to !     
claimant 7& any repres5tative ( su*     
claimant74  7#d7 ,9 section             
#eaab7;b77#f71 by /rik+ 7at ! payee's   
la/ address ( record74  7#e7 ,9 section 
#gajd-- 7,a7 9 ! head+1 by add+ 2       
decisions2 notice at ! end2 &  7,b7 by  
/rik+ subsection 7e7 & ins]t+ ! foll[+3 
7e7 ,aft] rea*+ a decision on an appeal1
 ! ,bo>d %all promptly issue notice 7z t
 t]m is def9$ 9 section #eajj ( ?is     
title7 ( su* decision to ! foll[+3  7#a7
 ,! appellant4  7#b7 ,any o!r p>ty ) a  
"r to notice ( su* decision4  7#c7 ,any 
au?oriz$ repres5tative ( ! appellant or 
p>ty describ$ 9 p>agraph 7#b74  7f7 7#a7
 ,! ,secret>y may provide notice "u     
subsection 7e7 electronically if a      
claimant 7or ! claimant's repres5tative7
 elects to receive su* notice           
electronically4  7#b7 ,a claimant 7or ! 
claimant's repres5tative7 may revoke su*

 an election at any "t1 by means        
prescrib$ by ! ,secret>y4  4  7#f7 ,9   
section #gaje7;b77#a77;,a71 by /rik+    
mail+ & ins]t+ issuance4  7#g7 ,9       
section #gaje;,a7a71 by /rik+ mail$ &   
ins]t+ issu$4  7#h7 ,9 section          
#gbff7;a71 by /rik+ mail$ & ins]t+      
issu$4  7b7 ,rule ( con/ruction ,none ( 
! am5dm5ts made by ?is section %all be  
con/ru$ to apply section #eajd7;a7 ( su*
 title to decisions ( ! ,bo>d (         
,vet]ans' ,appeals "u *apt] #ga ( su*   
title4  #hjh4 ,burn pit transp>5cy  7a7 
,annual report on disability claims     
7#a7 ,9 g5]al ,n lat] ?an #ahj days aft]
 ! date ( ! enactm5t ( ?is ,act1 &      
annually !reaft]1 ! ,secret>y ( ,vet]ans
 ,affairs %all submit to ! appropriate  
congressional committees a report       
detail+ ! foll[+3  7,a7 ,! total numb] (
 cov]$ vet]ans4  7,b7 ,! total numb] (  
claim$ issues = disability comp5sation  
"u *apt] #aa ( title #ch1 ,unit$ ,/ates 
,code1 approv$ & ! total numb] d5i$ by !
 ,secret>y ( ,vet]ans ,affairs ) respect

 to a cov]$ vet]an1 & a breakd[n ( !    
reasons = ! d5ials4  7,c7 ,a            
compreh5sive li/ ( ! top #aj conditions 
f ea* body sy/em = :i* ! ,secret>y aw>d$
 s]vice connection = cov]$ vet]ans4     
7,d7 ,any updates or tr5ds ) respect to 
! in=mation describ$ 9 subp>agraphs     
7,a71 7,b71 & 7,c71 t ! ,secret>y       
det]m9es appropriate4  7#b7 ,cov]$      
vet]an def9$ ,9 ?is subsection1 ! t]m   
cov]$ vet]an means a vet]an :o deploy$  
to ! ,s\?we/ ,asia !at] ( op]ations any 
"t aft] ,augu/ #aiij1 or ,afghani/an1   
,syria1 ,djib\ti1 or ,uzbeki/an aft]    
,septemb] #ai1 #bjja1 & :o submits a    
claim = disability comp5sation "u *apt] 
#aa ( title #ch1 ,unit$ ,/ates ,code4   
7b7 ,in=mation reg>d+ ! ,airborne       
,haz>ds & ,op5 ,burn ,pit ,regi/ry  7#a7
 ,notice ,! ,secret>y ( ,vet]ans        
,affairs %all ensure t a m$ical         
pr(essional ( ! ,dep>tm5t ( ,vet]ans    
,affairs in=ms a vet]an ( ! ,airborne   
,haz>ds & ,op5 ,burn ,pit ,regi/ry if ! 
vet]an pres5ts at a m$ical facility ( ! 

,dep>tm5t = treatm5t t ! vet]an         
describes z be+ relat$ to1 or ancill>y  
to1 ! exposure ( ! vet]an to toxic      
airborne *emicals & fumes caus$ by op5  
burn pits4  7#b7 ,display ,9 mak+       
in=mation public reg>d+ ! numb] (       
p>ticipants 9 ! ,airborne ,haz>ds & ,op5
 ,burn ,pit ,regi/ry1 ! ,secret>y %all  
display su* numb]s by bo? ,/ate & by    
congressional di/rict4  7c7 ,def9itions 
,9 ?is section3  7#a7 ,airborne ,haz>ds 
& ,op5 ,burn ,pit ,regi/ry ,! t]m       
,airborne ,haz>ds & ,op5 ,burn ,pit     
,regi/ry means ! regi/ry e/abli%$ by !  
,secret>y ( ,vet]ans ,affairs "u section
 #bja ( ! ,dignifi$ ,burial & ,o!r      
,vet]ans' ,b5efits ,improvem5t ,act (   
#bjab 7,public ,law #aab-bfj2 #ch       
,u4,s4,c4 #ebg note74  7#b7 ,appropriate
 congressional committees ,! t]m        
appropriate congressional committees    
means--  7,a7 ! ,committee on ,vet]ans' 
,affairs & ! ,committee on ,arm$        
,s]vices ( ! ,s5ate2 &  7,b7 ,!         
,committee on ,vet]ans' ,affairs & !    

,committee on ,arm$ ,s]vices ( ! ,h\se (
 ,repres5tatives4  7#c7 ,op5 burn pit ,!
 t]m op5 burn pit has ! mean+ giv5 t t]m
 9 section #bja7;c7 ( ! ,dignifi$       
,burial & ,o!r ,vet]ans' ,b5efits       
,improvem5t ,act ( #bjab 7,public ,law  
#aab-bfj2 #ch ,u4,s4,c4 #ebg note74     
,,ix ,improvem5t ( work=ce ( ,dep>tm5t (
 ,vet]ans ,affairs  #ija4 ,national     
rural recruitm5t & hir+ plan = ,vet]ans 
,heal? ,adm9i/ration  7a7 ,9 g5]al ,n   
lat] ?an #ah mon?s aft] ! date ( !      
enactm5t ( ?is ,act1 ! ,secret>y (      
,vet]ans ,affairs1 9 collaboration ) !  
directors ( ea* community-bas$ outpati5t
 cl9ic & m$ical c5t] ( ! ,dep>tm5t (    
,vet]ans ,affairs1 %all develop &       
implem5t a national rural recruitm5t &  
hir+ plan = ! ,vet]ans ,heal?           
,adm9i/ration to--  7#a7 recruit heal?  
c>e pr(essionals = rural & highly rural 
community-bas$ outpati5t cl9ics & rural 
& highly rural m$ical c5t]s ( !         
,dep>tm5t2  7#b7 det]m9e :i* su* cl9ics 
or c5t]s h a /aff+ %ortage ( heal? c>e  

pr(essionals2  7#c7 develop be/         
practices & te*niques = recruit+ heal?  
c>e pr(essionals = su* cl9ics & c5t]s2  
7#d7 n less frequ5tly ?an annually1     
provide virtually bas$1 on-dem& tra9+ to
 human res\rces pr(essionals ( !        
,vet]ans ,heal? ,adm9i/ration on ! be/  
practices & te*niques develop$ "u       
p>agraph 7#c72 &  7#e7 provide          
recruitm5t res\rces1 su* z pamphlets &  
m>ket+ mat]ial to-- 7,a7 ,vet]ans       
,integrat$ ,s]vice ,networks ( !        
,dep>tm5t2  7,b7 rural & highly rural   
community-bas$ outpati5t cl9ics ( !     
,dep>tm5t2 &  7,c7 rural & highly rural 
m$ical c5t]s ( ! ,dep>tm5t4  7b7 ,annual
 report ,n lat] ?an #ah mon?s aft] !    
date ( ! enactm5t ( ?is ,act1 & annually
 !reaft]1 ! ,secret>y %all submit to !  
,committee on ,vet]ans' ,affairs ( !    
,s5ate & ! ,committee on ,vet]ans'      
,affairs ( ! ,h\se ( ,repres5tatives a  
report t includes-- 7#a7 ! plan develop$
 & implem5t$ "u subsection 7a72 &  7#b7 
an assessm5t ( ! outcomes relat$ to     

recruitm5t & ret5tion ( employees ( !   
,vet]ans ,heal? ,adm9i/ration at rural &
 highly rural facilities ( ! ,dep>tm5t4 
7c7 ,def9itions ,9 ?is section1 ! t]ms  
rural & highly rural h ! mean+s giv5 ^? 
t]ms "u ! rural-urban commut+ areas cod+
 sy/em ( ! ,dep>tm5t ( ,agriculture4    
#ijb4 ,au?ority to buy out s]vice       
contracts = c]ta9 heal? c>e pr(essionals
 9 ex*ange = employm5t at rural or      
highly rural facilities ( ,dep>tm5t (   
,vet]ans ,affairs  7a7 ,9 g5]al ,= any  
cov]$ heal? c>e pr(essional to :om !    
,secret>y ( ,vet]ans ,affairs has (f]$  
employm5t ) ! ,dep>tm5t ( ,vet]ans      
,affairs1 ! ,secret>y may buy out !     
non-,dep>tm5t s]vice contract ( su*     
individual 9 ex*ange = su* individual   
agree+ to be employ$ at a rural or      
highly rural facility ( ! ,dep>tm5t = a 
p]iod ( obligat$ s]vice specifi$ 9      
subsection 7c74  7b7 ,paym5t ( am\nts   
7#a7 ,9 g5]al ,paym5t ( any am\nts = a  
buy out ( a s]vice contract = a cov]$   
heal? c>e pr(essional "u subsection 7a7 

%all be made directly to ! individual or
 entity ) respect to :i* ! cov]$ heal?  
c>e pr(essional has a s]vice obligation 
"u su* contract4  7#b7 ,limitation on   
total am\nt ,! total am\nt paid by !    
,dep>tm5t "u ?is section %all n exce$   
#dj1jjj1jjj p] fiscal ye>4  7c7         
,obligat$ s]vice ,9 ex*ange = a contract
 buy out "u subsection 7a71 a cov]$     
heal? c>e pr(essional %all agree to be  
employ$ = n less ?an f\r ye>s at a rural
 or highly rural facility ( ! ,dep>tm5t4
  7d7 ,liability  7#a7 ,9 g5]al ,except 
z provid$ 9 p>agraph 7#b71 if a cov]$   
heal? c>e pr(essional fails = any reason
 to complete ! p]iod ( obligat$ s]vice (
 ! individual "u subsection 7c71 !      
,unit$ ,/ates %all be entitl$ to recov] 
f ! individual an am\nt equal to-- 7,a7 
! total am\nt paid "u subsection 7a7 to 
buy out ! non-,dep>tm5t s]vice contract 
( ! individual2 multipli$ by  7,b7 a    
fraction-- 7i7 ! num]ator ( :i* is--    
7,i7 ! total numb] ( mon?s 9 ! p]iod (  
obligat$ s]vice ( ! individual2 m9us    

7,,ii7 ! numb] ( mon?s s]v$ by !        
individual2 &  7ii7 ! d5om9ator ( :i* is
 ! total numb] ( mon?s 9 ! p]iod (      
obligat$ s]vice ( ! individual4  7#b7   
,exception ,liability %all n arise "u   
p>agraph 7#a7 9 ! case ( an individual  
cov]$ by t p>agraph if ! individual does
 n obta91 or fails to ma9ta91 employm5t 
z an employee ( ! ,dep>tm5t due to /aff+
 *anges approv$ by ! ,"u ,secret>y =    
,heal?4  7e7 ,annual report  7#a7 ,9    
g5]al ,n lat] ?an #ah mon?s aft] ! date 
( ! enactm5t ( ?is ,act1 & n less       
frequ5tly ?an annually !reaft]1 !       
,secret>y ( ,vet]ans ,affairs %all      
submit to ! ,committee on ,vet]ans'     
,affairs ( ! ,s5ate & ! ,committee on   
,vet]ans' ,affairs ( ! ,h\se (          
,repres5tatives a report on ! use by !  
,secret>y ( ! au?ority "u ?is section4  
7#b7 ,elem5ts ,ea* report requir$ by    
p>agraph 7#a7 %all include ! foll[+3    
7,a7 ,! numb] ( heal? c>e pr(essionals =
 :om a s]vice contract buy\t paym5t 0   
made "u subsection 7a7 9 ! previ\s      

fiscal ye>1 disaggregat$ by occupation  
or specialty4  7,b7 ,! av]age1 highe/1 &
 l[e/ am\nt ( ! s]vice contract buy\t   
paym5ts made "u subsection 7a7 = ea*    
occupation or specialty 9 ! previ\s     
fiscal ye>4  7,c7 ,ea* location :]e     
contract buy\t au?ority "u subsection   
7a7 0 utiliz$ & ! numb] ( cov]$ heal?   
c>e pr(essionals :o agre$ to be employ$ 
at su* location 9 ! previ\s fiscal ye>4 
7f7 ,def9itions ,9 ?is section3  7#a7   
,cov]$ heal? c>e pr(essional ,! t]m     
cov]$ heal? c>e pr(essional means a     
physician1 nurse ane/heti/1 physician   
assi/ant1 or nurse practition] (f]$     
employm5t ) ! ,dep>tm5t reg>dless ( !   
au?ority "u :i* su* employm5t is (f]$4  
7#b7 ,rural2 highly rural ,! t]ms rural 
& highly rural h ! mean+s giv5 ^? t]ms  
"u ! rural-urban commut+ areas cod+     
sy/em ( ! ,dep>tm5t ( ,agriculture4  7g7
 ,sunset ,?is section %all t]m9ate on   
,septemb] #cj1 #bjbg4  #ijc4            
,qualifications = human res\rces        
positions )9 ,dep>tm5t ( ,vet]ans       

,affairs & plan to recruit & reta9 human
 res\rces employees  7a7 ,e/abli%m5t (  
qualifications ,n lat] ?an #ahj days    
aft] ! date ( ! enactm5t ( ?is ,act1 !  
,secret>y ( ,vet]ans ,affairs %all--    
7#a7 e/abli% qualifications = ea* human 
res\rces position )9 ! ,dep>tm5t (      
,vet]ans ,affairs 9 coord9ation ) !     
,(fice ( ,p]sonnel ,managem5t2  7#b7    
e/abli% /&>diz$ p]=mance metrics = ea*  
su* position2 &  7#c7 submit to !       
,committee on ,vet]ans' ,affairs ( !    
,s5ate & ! ,committee on ,vet]ans'      
,affairs ( ! ,h\se ( ,repres5tatives a  
report conta9+ ! qualifications &       
/&>diz$ p]=mance metrics e/abli%$ "u    
p>agraphs 7#a7 & 7#b74  7b7 ,improvem5t 
( human res\rces actions ,n lat] ?an #ij
 days aft] ! date ( ! enactm5t ( ?is    
,act1 ! ,secret>y %all e/abli% or       
enhance sy/ems ( ! ,dep>tm5t to monitor 
! hir+ & o!r human res\rces actions t   
occur at ! local1 regional1 & national  
levels ( ! ,dep>tm5t to improve !       
p]=mance ( ^? actions4  7c7 ,report ,n  

lat] ?an "o ye> aft] ! e/abli%m5t ( !   
qualifications & p]=mance metrics "u    
subsection 7a71 ! ,comptroll] ,g5]al ( !
 ,unit$ ,/ates %all submit to !         
,committee on ,vet]ans' ,affairs ( !    
,s5ate & ! ,committee on ,vet]ans'      
,affairs ( ! ,h\se ( ,repres5tatives a  
report conta9+-- 7#a7 a description ( ! 
implem5tation ( su* qualifications &    
p]=mance metrics2  7#b7 an assessm5t ( !
 quality ( su* qualifications & p]=mance
 metrics2  7#c7 an assessm5t ( p]=mance 
& outcomes bas$ on su* metrics2 &  7#d7 
su* o!r matt]s z ! ,comptroll] ,g5]al   
consid]s appropriate4  7d7 ,plan to     
recruit & reta9 human res\rces employees
 ,n lat] ?an "o ye> aft] ! date ( !     
enactm5t ( ?is ,act1 ! ,secret>y (      
,vet]ans ,affairs %all submit to !      
,committee on ,vet]ans' ,affairs ( !    
,s5ate & ! ,committee on ,vet]ans'      
,affairs ( ! ,h\se ( ,repres5tatives a  
plan = ! recruitm5t & ret5tion ( human  
res\rces employees )9 ! ,dep>tm5t (     
,vet]ans ,affairs4  #ijd4 ,modification 

( pay cap = c]ta9 employees ( ,vet]ans  
,heal? ,adm9i/ration  7a7 ,9 g5]al      
,section #gdee7;c7 is am5d$-- 7#a7 9    
p>agraph 7#a71 by /rik+ #cj p]c5t ins]t+
 #ej p]c5t2  7#b7 9 p>agraph 7#b71 by   
/rik+ level ,,iv ins]t+ level ,,ii2 &   
7#c7 by add+ at ! end ! foll[+ new      
p>agraph3  7#c7  7,a7 ,not)/&+ section  
#ecjd ( title #e or any o!r provision ( 
law1 b subject to ! limitation "u       
p>agraph 7#b71 pursuant to an increase  
"u subsection 7a71 ! ,secret>y may pay a
 special rate or an adju/$ rate ( basic 
pay 9 excess ( ! rate ( basic pay       
payable = level ,,iv ( ! ,executive     
,s*$ule4  7,b7 ,if an employee is 9     
receipt ( a special rate ( pay "u       
subp>agraph 7,a7 9 excess ( ! rate (    
basic pay payable = level ,,iv ( !      
,executive ,s*$ule ) an e/abli%$ special
 rate supplem5t ( great] value ?an a    
supplem5t bas$ on ! applicable          
locality-bas$ comp>ability paym5t       
p]c5tage "u section #ecjd ( title #e1 b 
a pay adju/m5t w\ld cause su* e/abli%$  

special rate supplem5t to be ( less]    
value1 ! special rate supplem5t %all be 
conv]t$ to a supplem5t bas$ on !        
applicable locality-bas$ comp>ability   
p]c5tage unless ! ,secret>y det]m9es t  
"s o!r action is appropriate4  4  7b7   
,pay = critical positions ,section      
#gdjd7;a77#a77;,b7 is am5d$ by ins]t+   
#gcjf or be=e #gdja7d74  #ije4          
,expansion ( opportunities = h\sekeep+  
aides ,section #ccaj ( title #e1 ,unit$ 
,/ates ,code1 is am5d$ by ins]t+ 7o!r   
?an = positions ( h\sekeep+ aides 9 !   
,dep>tm5t ( ,vet]ans ,affairs7 aft]     
competitive s]vice4  #ijf4 ,modification
 ( au?ority ( ! ,secret>y ( ,vet]ans    
,affairs relat+ to h\rs1 conditions (   
employm5t1 & pay = c]ta9 employees (    
,vet]ans ,heal? ,adm9i/ration  7a7      
,expansion ( eligibility ( employees =  
c]ta9 aw>ds ,section #gdjd7;c7 is       
am5d$-- 7#a7 by /rik+ ,not)/&+ & ins]t+ 
7#a7 ,not)/&+2  7#b7 by ins]t+ or       
#gdja7d7 aft] section #gcjf2  7#c7 by   
/rik+ :o is n eligible = pay "u sub*apt]

 ,,iii & ins]t+ or 9 a cov]$ executive  
position "u section #gdja7a7 ( ?is      
title2  7#d7 by /rik+ sections #dejg &  
#echd & ins]t+ section #dejg2 &  7#e7 by
 add+ at ! end ! foll[+ new p>agraph3   
7#b7 ,9 ?is subsection1 ! t]m cov]$     
executive position means a position t ! 
,secret>y has det]m9$ is ( equival5t    
rank to a ,s5ior ,executive ,s]vice     
position 7z su* t]m is def9$ 9 section  
#cacb7;a7 ( title #e7 & is subject to an
 ag5cy p]=mance managem5t sy/em4  4  7b7
 ,au?ority = aw>ds programs ( ,dep>tm5t 
( ,vet]ans ,affairs  7#a7 ,9 g5]al      
,sub*apt] ,i ( *apt] #gd is am5d$ by    
ins]t+ aft] section #gdjd ! foll[+ new  
section3  #gdjd;,a4 ,aw>ds  7a7 ,sup]ior
 accompli%m5ts & p]=mance aw>ds program 
,! ,secret>y may e/abli% an aw>ds       
program = p]sonnel li/$ 9 section       
#gdba7;b7 ( ?is title consi/5t ) *apt]  
#de ( title #e1 to ! ext5t practicable4 
7b7 ,executive p]=mance aw>ds program   
,not)/&+ section #gdbe ( ?is title or   
any o!r provision ( law1 ! ,secret>y may

 e/abli% a p]=mance aw>ds program       
consi/5t ) section #echd ( title #e =-- 
7#a7 p]sonnel appo9t$ "u section        
#gdja7a7 ( ?is title = a position t !   
,secret>y has det]m9$ is ( equival5t    
rank to a ,s5ior ,executive ,s]vice     
position 7z su* t]m is def9$ 9 section  
#cacb7;a7 ( title #e7 & is subject to an
 ag5cy p]=mance managem5t sy/em2 &  7#b7
 p]sonnel appo9t$ "u section #gcjf or   
#gdja7d7 ( ?is title4  7c7 ,paym5t (    
aw>ds ,aw>ds "u ?is section may be paid 
bas$ on crit]ia e/abli%$ by ! ,secret>y 
& %all n be consid]$ 9 calculat+ !      
limitation "u section #gdca7;e77#d7 (   
?is title4  7d7 ,n consid]$ basic pay   
,aw>ds "u ?is section %all n be consid]$
 basic pay = any purpose4  7e7          
,regulations ,! ,secret>y may prescribe 
regulations = ! adm9i/ration ( ?is      
section4  4  7#b7 ,limitation on pa/    
aw>ds ,not)/&+ any o!r provision ( law1 
aw>ds made by ! ,secret>y ( ,vet]ans    
,affairs = any p]iod on or aft] ,janu>y 
#a1 #bjag1 & be=e ! date ( ! enactm5t ( 

?is ,act = an employee "u section #gcjf 
or #gdja7d7 ( title #ch1 ,unit$ ,/ates  
,code1 or = a position describ$ 9       
section #gdja7a7 ( su* title t !        
,secret>y has det]m9$ is ( equival5t    
rank to a ,s5ior ,executive ,s]vice     
position 7z su* t]m is def9$ 9 section  
#cacb7;a7 ( title #e1 ,unit$ ,/ates     
,code71 may be subject to section       
#gdjd;,a ( title #ch1 ,unit$ ,/ates     
,code1 z add$ by p>agraph 7#a74  7c7    
,modification ( employees subject to    
regulation by ,secret>y ( ,vet]ans      
,affairs ( h\rs & conditions ( employm5t
 & leaves ( abs5ce  7#a7 ,9 g5]al       
,section #gdba is am5d$-- 7,a7 9        
subsection 7a71 by /rik+ *apt] & ins]t+ 
title2 &  7,b7 9 subsection 7b71 by add+
 at ! end ! foll[+ new p>agraph3  7#i7  
,any position = :i* ! employee is       
appo9t$ "u section #gcjf or #gdja7d7 (  
?is title4  4  7#b7 ,adm9i/ration (     
full-"t employees ,section #gdbc is     
am5d$-- 7,a7 9 subsection 7a77#b71 by   
add+ at ! end ! foll[+ new subp>agraph3 

7,d7 ,! ,secret>y may exclude f !       
requirem5ts ( p>agraph 7#a7 employees   
hir$ "u section #gcjf or #gdja7d7 ( ?is 
title or = a position describ$ 9 section
 #gdja7a7 ( ?is title t ! ,secret>y has 
det]m9$ is ( equival5t rank to a ,s5ior 
,executive ,s]vice position 7z su* t]m  
is def9$ 9 section #cacb7;a7 ( title    
#e74  2 &  7,b7 9 subsection 7e77#a71 by
 /rik+ #gdja7a7 & ins]t+ #gdba7;b74     
7#c7 ,additional pay au?orities ,section
 #gdaj7;a7 is am5d$-- 7,a7 by /rik+ ,!  
,secret>y & ins]t+ 7#a7 ,! ,secret>y2   
7,b7 by /rik+ ! p]sonnel describ$ 9     
p>agraph 7#a7 ( section #gdja ( ?is     
title & ins]t+ p]sonnel appo9t$ "u      
section #gcjf ( ?is title or section    
#gdja7d7 ( ?is title1 or p]sonnel       
describ$ 9 section #gdja7a7 ( ?is       
title12 &  7,c7 by /rik+ 9 ! same mann]1
 & subject to ! same limitations1 z 9 ! 
case ( & ins]t+ 9 a mann] consi/5t )2 & 
7,d7 by add+ at ! end ! foll[+ new      
p>agraph3  7#b7 ,paym5ts "u p>agraph    
7#a7 %all n be consid]$ 9 calculat+ !   

limitation "u section #gdca7;e77#d7 (   
?is title4  4  7#d7 ,treatm5t ( pay     
au?ority *anges ,= ! purposes ( !       
am5dm5ts made by p>agraph 7#c71 !       
,secret>y ( ,vet]ans ,affairs %all treat
 any aw>d or paym5t made by ! ,secret>y 
betwe5 ,janu>y #a1 #bjag1 & ! date ( !  
enactm5t ( ?is ,act to employees appo9t$
 "u sections #gcjf1 #gdja7a71 & #gdja7d7
 ( title #ch1 ,unit$ ,/ates ,code1 t !  
,secret>y has det]m9$ are ( equival5t   
rank to a ,s5ior ,executive ,s]vice     
position 7z su* t]m is def9$ 9 section  
#cacb7;a7 ( title #e1 ,unit$ ,/ates     
,code71 z if su* am5dm5ts _h be5 9      
effect at ! "t ( su* aw>d or paym5t4    
7#e7 ,treatm5t ( prior leave balances   
,not)/&+ any o!r provision ( law1 !     
,secret>y may adju/ ! leave balance &   
c>ryov] leave balance ( any employee    
describ$ 9 section #gdba7;b77#i7 ( title
 #ch1 ,unit$ ,/ates ,code1 z am5d$ by   
p>agraph 7#a77;,b71 to ensure any leave 
accru$ or c>ri$ ov] be=e ! date ( !     
enactm5t ( ?is ,act rema9s available to 

su* employee4  7d7 ,treatm5t ( c]ta9    
employees z appo9t$ "u section #gcjf    
,section #gcjf is am5d$-- 7#a7 9        
subsection 7a71 by r$esignat+ ! second  
p>agraph 7#aa7 z p>agraph 7#ab72 &  7#b7
 by add+ at ! end ! foll[+ new          
subsection3  7g7 ,= purposes ( apply+   
any provision ( *apt] #gd ( ?is title1  
includ+ sections #gdjd1 #gdaj1 & #gdba1 
or any o!r provision ( law1 ! ,secret>y 
may treat any appo9tm5t = a position "u 
?is *apt] to be an appo9tm5t "u ?is     
section4  4  7e7 ,con=m+ am5dm5t        
,section #gdca7;e77#d7 is am5d$ by /rik+
 ,9 no case & ins]t+ ,except z provid$ 9
 sections #gdjd;,a7c7 & #gdaj7;a77#b7 ( 
?is title1 9 no case4  #ijg4 ,waiv] (   
pay limitation = c]ta9 employees (      
,dep>tm5t ( ,vet]ans ,affairs ,sub*apt] 
,i ( *apt] #g is am5d$ by ins]t+ aft]   
section #gjc ! foll[+ new section3      
#gjd4 ,waiv] ( pay limitation = c]ta9   
employees  7a7 ,employees ( ,vet]ans    
,heal? ,adm9i/ration impact$ by closure 
or realignm5t ,not)/&+ any o!r provision

 ( law1 ! ,secret>y may waive any annual
 premium or aggregate limitation on pay 
= an employee ( ! ,vet]ans ,heal?       
,adm9i/ration = ! cal5d> ye> dur+ :i*-- 
7#a7 ! (ficial duty /ation ( ! employee 
is clos$2 or  7#b7 ! (fice1 facility1   
activity1 or organization ( ! employee  
is realign$4  7b7 ,employees provid+ c>e
 to vet]ans expos$ to op5 burn pits     
7#a7 ,9 g5]al ,not)/&+ any o!r provision
 ( law1 ! ,secret>y may waive any annual
 premium or aggregate limitation on pay 
= an employee ( ! ,dep>tm5t ^: prim>y   
duties include provid+ exp&$ c>e =      
vet]ans expos$ to op5 burn pits4  7#b7  
,op5 burn pit def9$ ,9 ?is subsection1 !
 t]m op5 burn pit has ! mean+ giv5 t t]m
 9 section #bja7;c7 ( ! ,dignifi$       
,burial & ,o!r ,vet]ans' ,b5efits       
,improvem5t ,act ( #bjab 7,public ,law  
#aab-bfj2 #ch ,u4,s4,c4 #ebg note74  7c7
 ,coord9ation ) ,(fice ( ,p]sonnel      
,managem5t ,9 implem5t+ ?is section1 !  
,secret>y %all coord9ate ) ! ,director (
 ! ,(fice ( ,p]sonnel ,managem5t4  7d7  

,reports  7#a7 ,9 g5]al ,= ea* qu>t] t !
 ,secret>y waives a limitation "u ?is   
section1 ! ,secret>y %all submit to !   
,committee on ,vet]ans' ,affairs ( !    
,s5ate1 ! ,committee on ,vet]ans'       
,affairs ( ! ,h\se ( ,repres5tatives1 & 
! ,(fice ( ,p]sonnel ,managem5t a report
 on ! waiv] or waiv]s4  7#b7 ,cont5ts   
,ea* report submitt$ "u p>agraph 7#a7 ) 
respect to a waiv] or waiv]s %all       
include ! foll[+3  7,a7 ,:]e ! waiv] or 
waiv]s 7 us$1 includ+ 9 :i* compon5t ( !
 ,dep>tm5t &1 z ! case may be1 :i*      
m$ical c5t] ( ! ,dep>tm5t4  7,b7 ,= h[  
_m employees ! waiv] or waiv]s 7 us$1   
disaggregat$ by compon5t ( ! ,dep>tm5t  
&1 if applicable1 m$ical c5t] ( !       
,dep>tm5t4  7,c7 ,! av]age am\nt by :i* 
ea* paym5t exce$$ ! pay limitation t 0  
waiv$1 disaggregat$ by compon5t ( !     
,dep>tm5t &1 if applicable1 m$ical c5t] 
( ! ,dep>tm5t4  7e7 ,employee def9$ ,9  
?is section1 ! t]m employee means any   
employee reg>dless ( ! au?ority "u :i* !
 employee 0 hir$4  7f7 ,t]m9ation ,?is  

section %all t]m9ate on ,septemb] #cj1  
#bjbg4  4  #ijh4 ,elim9ation (          
limitation on aw>ds & bonus = employees 
( ,dep>tm5t ( ,vet]ans ,affairs  7a7 ,9 
g5]al ,section #gje7;a7 ( ! ,vet]ans    
,access1 ,*oice1 & ,acc\ntability ,act (
 #bjad 7,public ,law #aac-adf2 #ch      
,u4,s4,c4 #gjc note7 is am5d$ by /rik+  
p>agraph 7#c74  7b7 ,applicability      
,subsection 7a7 %all take effect on !   
date ( ! enactm5t ( ?is ,act & apply z  
if su* subsection _h be5 enact$ on      
,septemb] #cj1 #bjba4  #iji4 ,additional
 au?ority ( ! ,secret>y ( ,vet]ans      
,affairs relat+ to recruitm5t & ret5tion
 ( p]sonnel ,sub*apt] ,i ( *apt] #g is  
am5d$ by ins]t+ aft] section #gje !     
foll[+ new section3  #gjf4 ,additional  
au?ority relat+ to recruitm5t & ret5tion
 ( p]sonnel  7a7 ,recruitm5t &          
relocation bonuses ,! ,secret>y may pay 
a recruitm5t or relocation bonus "u     
section #egec7;e7 ( title #e )\t reg>d  
to any requirem5ts = c]tification or    
approval "u t section4  7b7 ,ret5tion   

bonuses  7#a7 ,! ,secret>y may pay a    
ret5tion bonus "u section #eged7;f7 (   
title #e )\t reg>d to any requirem5t =  
c]tification or approval "u t           
subsection4  7#b7 ,! ,secret>y may pay a
 ret5tion bonus z specifi$ 9 subsection 
7e77#b7 ( section #eged ( title #e & may
 pay ! bonus z a s+le lump-sum paym5t at
 ! beg9n+ ( ! full p]iod ( s]vice       
requir$ by an agreem5t "u subsection 7d7
 ( su* section4  7c7 ,m]it aw>ds ,!     
,secret>y may grant a ca% aw>d "u       
section #dejb7;b7 ( title #e )\t reg>d  
to any requirem5t = c]tification or     
approval "u t section4  7d7 ,inc5tives =
 critical skills  7#a7 ,subject to !    
provisions ( ?is p>agraph1 ! ,secret>y  
may provide a critical skill inc5tive to
 an employee 9 a case 9 :i* ! ,secret>y 
det]m9es-- 7,a7 ! employee possesses a  
high-dem& skill or skill t is at a      
%ortage2  7,b7 su* skill is directly    
relat$ to ! duties & responsibilities ( 
! employee's position2 &  7,c7 employm5t
 ( an individual ) su* skill 9 su*      

position s]ves a critical mission-relat$
 ne$ ( ! ,dep>tm5t4  7#b7 ,an inc5tive  
provid$ to an employee "u p>agraph 7#a7 
may n to exce$ #be p]c5t ( ! basic pay (
 ! employee4  7#c7 ,provision ( an      
inc5tive "u p>agraph 7#a7 %all be       
cont+5t on ! employee ent]+ into a      
writt5 agreem5t to complete a p]iod (   
employm5t ) ! ,dep>tm5t4  7#d7 ,an      
inc5tive provid$ "u p>agraph 7#a7 %all n
 be consid]$ basic pay = any purpose4   
7#e7 ,! ,secret>y may prescribe         
conditions1 includ+ ) respect to        
eligibility1 & limitations on provision 
( inc5tive "u p>agraph 7#a74  7#f7      
,inc5tive provid$ "u p>agraph 7#a7 %all 
n be includ$ 9 ! calculation ( total    
am\nt ( comp5sation "u section          
#gdca7;e77#d7 ( ?is title4  7e7 ,/ud5t  
loan repaym5ts  7#a7 ,subject to !      
provisions ( ?is subsection1 ! ,secret>y
 may repay a /ud5t loan pursuant to     
section #ecgi7;b7 ( title #e4  7#b7     
,p>agraph 7#b7 ( su* section %all n     
apply to paym5t "u ?is subsection4  7#c7

 ,paym5t "u ?is subsection %all be made 
subject to su* t]ms1 limitations1 or    
conditions z may be mutually agre$ to by
 ! ,secret>y & ! employee conc]n$1      
except t ! am\nt paid by ! ,secret>y "u 
?is subsection may n exce$--  7,a7      
#dj1jjj = any employee 9 any cal5d> ye>2
 or  7,b7 a total ( #ajj1jjj 9 ! case ( 
any employee4  7f7 ,exp$it$ hir+        
au?ority = college graduates2           
competitive s]vice  7#a7 ,subject to    
p>agraph 7#b7 ( ?is subsection1 !       
,secret>y may exp$ite hir+ = college    
graduates "u section #caae ( title #e   
)\t reg>d to subsection 7e7 ( su*       
section or any regulations prescrib$ by 
! ,(fice ( ,p]sonnel ,managem5t =       
adm9i/ration ( su* subsection4  7#b7 ,! 
numb] ( employees ! ,secret>y may appo9t
 "u section #caae ( title #e may n exce$
 ! numb] equal to #be p]c5t (           
individuals t ! ,secret>y appo9t$ dur+ !
 previ\s fiscal ye> to a position 9 !   
competitive s]vice classifi$ 9 a        
pr(essional or adm9i/rative occupational

 category1 at ! ,,gs-#aa level1 or an   
equival5t level1 or bel[1 "u a          
competitive exam9+ proc$ure4  7g7       
,exp$it$ hir+ au?ority = po/-second>y   
/ud5ts2 competitive s]vice  7#a7        
,subject to p>agraph 7#b7 ( ?is         
subsection1 ! ,secret>y may exp$ite hir+
 ( po/-second>y /ud5ts "u section #caaf 
( title #e1 )\t reg>d to subsection 7d7 
( su* section or any regulations        
prescrib$ by ! ,(fice ( ,p]sonnel       
,managem5t = adm9i/ration ( su*         
subsection4  7#b7 ,! numb] ( employees !
 ,secret>y may appo9t "u section #caaf (
 title #e may n exce$ ! numb] equal to  
#be p]c5t ( ! numb] ( /ud5ts t !        
,secret>y appo9t$ dur+ ! previ\s fiscal 
ye> to a position at ! ,,gs-#aa level1  
or an equival5t level1 or bel[4  7h7    
,pay au?ority = critical positions  7#a7
 ,subject to ! provisions ( ?is         
subsection1 ! ,secret>y may au?orize !  
fix+ ( ! rate ( pay = a critical        
position 9 ! ,dep>tm5t consi/5t ) !     
au?orities & requirem5ts ( section #ecgg

 ( title #e t apply to ! ,(fice (       
,p]sonnel ,managem5t4  7#b7 ,! ,secret>y
 may fix ! rate ( pay = a critical      
position "u ?is subsection 9 excess ( ! 
limitation set =? by section            
#ecgg7;d77#b7 ( su* title4  7#c7 ,basic 
pay may n be fix$ "u ?is subsection at a
 rate great] ?an ! rate payable = !     
,vice ,presid5t ( ! ,unit$ ,/ates       
e/abli%$ "u section #ajd ( title #c1    
except ^u writt5 approval ( ! ,presid5t4
  7#d7 ,not)/&+ section #ecgg7;f7 (     
title #e1 ! ,secret>y may au?orize !    
ex]cise ( au?ority "u ?is subsection )  
respect to up to #bjj positions at any  
"t4  7i7 ,rates ( special pay  7#a7 ,!  
,secret>y may e/abli% a rate = special  
pay "u section #ecje7;a77#a7 ( title #e4
  7#b7 ,9 apply+ su* section to !       
,secret>y's au?ority "u p>agraph 7#a7-- 
7,a7 #ej p]c5t %all be sub/itut$ = #cj  
p]c5t2 &  7,b7 level ,,ii ( ! ,executive
 ,s*$ule %all be sub/itut$ = level ,,iv 
( ! ,executive ,s*$ule4  7j7 ,waiv] (   
limitations on c]ta9 paym5ts "u pay     

comp>ability sy/em ,! ,secret>y may     
waive ! limitation 9 section #ecjg (    
title #e = an employee or a paym5t4  7k7
 ,t]m9ation ,! au?orities "u ?is section
 %all t]m9ate on ,septemb] #cj1 #bjbg4  
4  ,cl]k4