[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[S. 2178 Introduced in Senate (IS)]
103d CONGRESS
2d Session
S. 2178
To provide a program of compensation and health research for illnesses
arising from service in the Armed Forces during the Persian Gulf War.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
June 10 (legislative day, June 7), 1994
Mr. Daschle (for himself and Mr. Akaka) introduced the following bill;
which was read twice and referred to the Committee on Veterans' Affairs
_______________________________________________________________________
A BILL
To provide a program of compensation and health research for illnesses
arising from service in the Armed Forces during the Persian Gulf War.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Persian Gulf War Veterans'
Compensation Act of 1994''.
SEC. 2. CONGRESSIONAL FINDINGS.
The Congress makes the following findings:
(1) The United States bears responsibility for the care and
treatment of illnesses and disabilities connected with service
in the Armed Forces. When the etiology of a specific condition
occurring in veterans is unknown, it is the Government's
responsibility to give veterans the benefit of the doubt and to
provide appropriate treatment and compensation until the
scientific evidence warrants otherwise.
(2) During the Persian Gulf War, members of the Armed
Forces (A) were exposed to numerous potentially toxic
substances (including fumes and smoke from petrochemicals and
depleted uranium), to infectious agents, to chemoprophylactic
agents, and to indigenous diseases, (B) received multiple
immunizations and (C) may have been exposed to various chemical
and biological warfare agents. Threats of enemy use of chemical
and biological weapons heightened the psychological stress
otherwise associated with the military operation.
(3) Significant numbers of veterans of the Persian Gulf War
are suffering from illnesses, or are exhibiting symptoms of
illnesses, that cannot (as of the enactment of this Act) be
diagnosed or clearly defined. As a result, many of these
conditions or illnesses are not considered to be service
connected for purposes of benefits administered by the
Secretary of Veterans Affairs.
(4) The Technology Assessment Workshop on the Persian Gulf
Experience and Health conducted by the National Institutes of
Health found that the complex biological, chemical, physical,
and psychological environment of the Southwest Asia theater of
operations produced complex adverse health effects in Persian
Gulf War veterans and that it appears as if there is no single
condition or illness among affected Persian Gulf War veterans,
but rather multiple illnesses with overlapping symptoms and
causes.
(5) That workshop concluded that the data concerning the
range and intensity of exposure to toxic substances by military
personnel in the Southwest Asia theater of operations are very
limited and that such data were collected only after a
considerable delay.
(6) In response to concerns regarding the health care needs
of Persian Gulf War veterans, particularly those who suffer
from undiagnosable conditions or illnesses, the Congress, in
Public Law 102-585, directed the establishment of the Persian
Gulf War Veterans Health Registry, authorized health
examinations for Persian Gulf War veterans, and provided for
the National Academy of Sciences to conduct a comprehensive
review and assessment of information regarding the health
consequences of military service in the theater of operations
during the Persian Gulf War and to develop recommendations for
research on such health consequences. In Public Law 103-210,
Congress authorized the Department of Veterans Affairs to
provide health care services on a priority basis to Persian
Gulf War veterans. In Public Law 103-160, Congress provided
funding for the establishment of a specialized environmental
medical facility for the conduct of research into the potential
health effects of low-level chemical exposure and for research
on the potential health effects of battlefield exposure to
depleted uranium.
(7) The workshop referred to in paragraph (4) noted that
well-designed epidemiological studies have not been conducted
to link the conditions or illnesses of the military personnel
with exposures in the theater of operations during the Persian
Gulf War and found that the absence of such studies has
hampered efforts to provide treatment and compensation to
veterans of the Persian Gulf War. Accordingly, further research
and studies should be undertaken to determine the underlying
causes of the illnesses suffered by Persian Gulf War veterans
and, pending the outcome of such research, veterans who are
seriously ill and whose illness may be related to their
military service should receive compensation benefits to offset
the impairment in earnings capacities they may be experiencing.
SEC. 3. PURPOSES.
The purposes of this Act are--
(1) to require the Secretary of Veterans Affairs to provide
compensation to Persian Gulf War veterans who have disabilities
resulting from an illness or illnesses that cannot (as of the
enactment of this Act) be diagnosed or defined and for which
other causes cannot (as of the enactment of this Act) be
identified until such time as scientific evidence demonstrates
that the illnesses are unrelated to military service during the
Persian Gulf War;
(2) to require the Secretary of Veterans Affairs to develop
case assessment protocols and case definitions for such
illnesses;
(3) to establish an outreach program to Persian Gulf War
veterans and their families to inform them of ongoing research
activities as well as the services and benefits for which they
are eligible; and
(4) to authorize further research activities, including an
epidemiological study, on the health risks and effects of
military service in the Southwest theater of operations during
the Persian Gulf War.
SEC. 4. DEVELOPMENT OF CASE ASSESSMENT PROTOCOLS AND CASE DEFINITIONS.
(a) Uniform Case Assessment Protocol.--(1) The Secretary of
Veterans Affairs shall develop and implement a uniform case assessment
protocol that will ensure thorough assessment, diagnosis, and treatment
of all Persian Gulf War veterans suffering from illnesses the origins
of which are (as of the enactment of this Act) unknown and that may be
attributable to service in the Southwest Asia theater of operations
during the Persian Gulf War.
(2) If such a uniform case assessment protocol is not implemented
before the end of the 120-day period beginning on the date of the
enactment of this Act, the Secretary shall, before the end of such
period, submit to the Committees on Veterans' Affairs of the Senate and
House of Representatives a report as to why such a protocol has not yet
been developed.
(b) Case Definitions.--(1) The Secretary shall develop case
definitions or diagnoses for illnesses, the origins of which are (as of
the enactment of this Act) unknown and that may be associated with
service in the Persian Gulf War.
(2) If such case definitions and diagnoses are not developed before
the end of the 120-day period beginning on the date of the enactment of
this Act, the Secretary shall, before the end of such period, submit to
the Committees on Veterans' Affairs of the Senate and House of
Representatives a report as to why such case definitions and diagnoses
have not yet been developed.
(c) Consultation.--Subsections (a) and (b) shall be carried out in
consultation with the Secretary of Defense and the Secretary of Health
and Human Services.
SEC. 5. OUTREACH TO PERSIAN GULF VETERANS.
(a) In General.--The Secretary of Veterans Affairs shall implement
a comprehensive outreach program to inform Persian Gulf War veterans
and their families of the medical care and other benefits that may be
provided by the Department of Veterans Affairs and the Department of
Defense arising from service in the Persian Gulf War.
(b) Newsletter.--The outreach program shall include a newsletter
which shall be updated and distributed at least annually and shall be
distributed to the veterans listed on the Persian Gulf War Veterans
Health Registry. The newsletter shall include summaries of the status
and findings of Government sponsored research on illnesses of Persian
Gulf War veterans and their families as well as on benefits available
to such individuals through the Department of Veterans Affairs. The
newsletter shall be prepared in consultation with veterans service
organizations.
(c) Toll-Free Number.--The outreach program shall include
establishment of a toll-free telephone number to provide Persian Gulf
War veterans and their families information on the Persian Gulf War
Veterans Health Registry, health care and other benefits provided by
the Department of Veterans Affairs, and such other information as the
Secretary considers appropriate. Such toll-free telephone number shall
be established not later than 90 days after the date of the enactment
of this Act.
SEC. 6. COMPENSATION FOR DISABILITIES RESULTING FROM ILLNESSES
ASSOCIATED WITH SERVICE DURING THE PERSIAN GULF WAR.
(a) In General.--
(1) Chapter 11 of title 38, United States Code, is amended
by adding at the end of subchapter I the following new section:
``Sec. 1117. Compensation for conditions or illnesses of unknown origin
associated with service during the Persian Gulf War
``(a) The Secretary shall pay compensation under this subchapter to
a Persian Gulf War veteran suffering from a disability resulting from
an undiagnosed illness, or combination of illness, that becomes
manifest to a degree of 10 percent or more within three years of
separation from active military, naval, or air service.
``(b)(1) The Secretary shall issue, within 90 days of the date of
the enactment of this section, preliminary regulations governing the
award of such compensation.
``(2) The percentage of disability that equals 10 percent shall be
described as `mild impairment of social and industrial adaptability'.
``(3) The percentage of disability that equals a total or 100
percent rating shall be described as `demonstratively unable to obtain
or retain substantial gainful employment'.
``(4) In determining the rating schedule for such disability, the
Secretary should examine analogous ratings.
``(5) In determining eligibility for compensation under this
section, the Secretary shall give due consideration to `lay evidence',
including testimony provided by the claimant, supporting witnesses, and
independent medical experts.
``(c) Not later than 60 days after the date on which the Secretary
issues any proposed regulations pursuant to this section, the Secretary
shall issue final regulations under this section. Such regulations
shall be effective on the date of issuance.
``(d) A disability for which compensation under this section is
awarded shall be considered to be service connected for purposes of all
other laws of the United States.
``(e) Compensation may not be paid under this section for a
disability occurring in a veteran--
``(1) where there is a preponderance of evidence that the
disability was not incurred by the veteran in the Southwest
Asia theater of operations during the Persian Gulf War; or
``(2) where there is a preponderance of evidence to
establish that an intercurrent injury or illness which is a
recognized cause of the disability was suffered by the veteran
between the date of the veteran's most recent departure from
the Southwest Asia theater of operations while on active duty
and the onset of the disability.
``(f) For purposes of this section, the term `Persian Gulf veteran'
means a veteran who served on active duty in the Armed Forces in the
Southwest Asia theater of operations during the Persian Gulf War.
``(g) Payments shall be made under this section to a veteran until
such time as the scientific evidence demonstrates that the illnesses
for which compensation is awarded under this section are not connected
to service in the Southwest Asia theater of operations during the
Persian Gulf War. The Secretary may cease payments under this section
only after providing a report describing the Secretary's intentions, as
well as the scientific basis for ceasing such payments, at least 90
days before implementation of such action to the Committees on Veterans
Affairs of the Senate and House of Representatives.
``(h) Compensation awarded under this section shall not preclude a
veteran from receiving retroactive compensation for a benefit claim
that was filed before the date of the enactment of this section if the
veteran's illness or illnesses are later found to be service connected.
``(i) The Secretary shall consider having all claims for
compensation under this section adjudicated on a priority basis at a
single Department facility in order to better ensure the consistency of
rating decisions.
``(j) The Secretary shall have all claims for service-connected
benefits connected to an undiagnosable illness or illnesses in veterans
of the Persian Gulf War that were denied before the date of the
enactment of this section reopened and adjudicated as original claims.
In such a case, the date of claim shall be considered to be the date on
which the original claim was filed.''.
(2) The table of sections at the beginning of such chapter
is amended by inserting after the item relating to section 1116
the following new item:
``1117. Presumption of service connection for illnesses associated with
the Persian Gulf War.''.
(b) Effective Date.--Section 1117 of title 38, United States Code,
as added by subsection (a), shall take effect on October 1, 1994.
SEC. 7. RESULTS OF EXAMINATIONS AND TREATMENT OF PERSIAN GULF WAR
VETERANS WITH UNDIAGNOSABLE ILLNESSES.
(a) Access to Data.--The Secretary of Veterans Affairs shall enter
into an agreement with the Secretary of Defense to have access to all
clinical data of the Department of Defense on veterans of the Persian
Gulf War who remain on active duty.
(b) Ongoing Compilation of Data.--The Secretary of Veterans Affairs
shall compile and analyze, on a continuing basis, all clinical data
obtained on veterans of the Persian Gulf War in connection with
examinations and treatment furnished by the Department of Veterans
Affairs and the Department of Defense that are likely (1) to be
scientifically useful in determining the association between the
undiagnosable illnesses of veterans and their service in the Southwest
Asia theater of operations during the Persian Gulf War, and (2) to be
useful in the development of case assessment protocols or case
definitions.
(c) Annual Report.--The Secretary shall submit to the Committees on
Veterans' Affairs of the Senate and House of Representatives an annual
report containing--
(1) the information compiled in accordance with subsection
(b);
(2) the Secretary's analysis of such information;
(3) a discussion of the incidence of illnesses identified
or treated by the Department of Veterans Affairs in the case of
veterans referred to in subsection (b); and
(4) the Secretary's explanation for the incidence of such
illnesses and disabilities.
SEC. 8. EPIDEMIOLOGICAL RESEARCH.
(a) Contract.--The Secretary of Veterans Affairs shall enter into a
contract for the conduct of an epidemiological study designed to assess
both the short- and long-term health consequences of service in the
Southwest Asia theater of operations during the Persian Gulf War on
veterans of the Persian Gulf War and their immediate family members.
(b) Oversight.--(1) The Secretary shall seek to enter into an
agreement with the National Academy of Sciences for the Medical Follow-
Up Agency (MFUA) of the Institute of Medicine of the Academy for (A)
the review of proposals to conduct the research specified in subsection
(a), (B) oversight of such research, and (C) review of the research
findings.
(2) If the Secretary is unable to enter into an agreement under
paragraph (1) with the entity specified in that paragraph, the
Secretary shall enter into an agreement described in that paragraph
with another appropriate scientific organization which does not have a
connection to the Department of Veterans Affairs. In such a case, the
Secretary shall submit to the Committees on Veterans' Affairs of the
Senate and House of Representatives, at least 90 days before the date
on which the agreement is entered into, notice in writing identifying
the organization with which the Secretary intends to enter into the
agreement.
(c) Access to Data.--The Secretary shall enter into agreements with
the Secretary of Defense and the Secretary of Health and Human Services
to access and make available to the contractor under subsection (a) all
data that the Secretary, in consultation with the National Academy of
Sciences and the contractor, considers relevant to the study.
(d) Status Report.--Within 180 days after the date of the enactment
of this Act, the Secretary shall submit to the Committees on Veterans
Affairs of the Senate and House of Representatives a report on the
status of the contract specified in subsection (a).
(e) Authorization.--There is authorized to be appropriated to the
Department $7,500,000 for each of fiscal years 1995 through 2000 for
the conduct of the research specified in subsection (a). In addition to
amounts for such research appropriated pursuant to the preceding
sentence, the Secretary may provide funds for such research from any
funds appropriated for any fiscal year after fiscal year 1994 for the
purpose of research sponsored by the Department.
(f) Annual Report.--For each year of the study, the Secretary shall
submit to the Committees on Veterans Affairs of the Senate and House of
Representatives a report accompanying the budget for that year
containing--
(1) the methodology and status of the study specified in
subsection (a); and
(2) any preliminary analyses of the information compiled in
accordance with subsection (a), including that provided by the
National Academy of Sciences.
(g) Final Report.--At the conclusion of the study, the Secretary
shall submit to the Committees on Veterans Affairs of the Senate and
House of Representatives a report accompanying the budget containing--
(1) the methodology of the study specified in subsection
(a);
(2) the analysis of the information compiled in accordance
with subsection (a), including that provided by the National
Academy of Sciences;
(3) a discussion of incidence of illnesses observed in
veterans of the Persian Gulf War and their families;
(4) the National Academy of Sciences conclusions concerning
the health consequences of service in the Southwest Asia
theater of operations during the Persian Gulf War on veterans
and their immediate family members; and
(5) the Secretary's explanation for the incidence of such
illnesses and disabilities and recommendations for future
action.
SEC. 9. AUTHORIZATION FOR OTHER RESEARCH.
There is authorized to be appropriated to the Department of
Veterans Affairs $5,000,000 for each of fiscal years 1995 through 1998
for the conduct of research which the Secretary, in consultation with
the Secretary of Defense and the Secretary of Health and Human
Services, determines could advance understanding of health risks and
effects of service during the Persian Gulf War and the means of
treating those health effects.
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