Veterans' Toxic Wounds Research Act of 2014 - Directs the Secretary of Veterans Affairs (VA) to establish a master registry of veterans who experienced toxic exposures while serving in the Armed Forces. Includes in the master registry the registries for:
Directs the Secretary to enter into an agreement with the National Academy of Sciences (NAS) to review published scientific information and studies, and make recommendations for future research, on the health effects: (1) of the toxic exposures covered in those registries, and (2) on the children and grandchildren of veterans who had a toxic exposure covered in those registries. Requires those reviews to inform the Secretary's selection of research to be conducted or funded by the VA.
Establishes a presumption of a service connection, for the purpose of veterans' disability and survivor benefits, for an illness that:
Requires the Secretary's service connection determinations to be based on sound medical and scientific evidence that a positive association exists between: (1) the exposure of humans or animals to a toxic substance covered in the master registry, and (2) the occurrence of a diagnosed or undiagnosed illness in humans or animals.
Directs the Secretary, in implementing the VA's electronic health record system, to include specified information in each individual's electronic health record, including whether the individual served in the Armed Forces and, if so, the locations and dates of such service.
[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5680 Introduced in House (IH)]
113th CONGRESS
2d Session
H. R. 5680
To direct the Secretary of Veterans Affairs to establish a registry for
certain toxic exposures, to direct the Secretary to include certain
information in the electronic health records of veterans, and for other
purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
September 19, 2014
Mr. Walz introduced the following bill; which was referred to the
Committee on Veterans' Affairs
_______________________________________________________________________
A BILL
To direct the Secretary of Veterans Affairs to establish a registry for
certain toxic exposures, to direct the Secretary to include certain
information in the electronic health records of veterans, and for other
purposes.
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 ``Veterans' Toxic Wounds Research Act
of 2014''.
SEC. 2. COMPREHENSIVE PROGRAM OF RESEARCH INTO TOXIC EXPOSURES
ENCOUNTERED BY VETERANS DURING MILITARY SERVICE.
(a) Registry of Toxic Exposures.--
(1) Establishment.--Not later than 180 days after the date
of the enactment of this Act, the Secretary of Veterans Affairs
shall establish a master registry of veterans who experienced
toxic exposures while serving in the Armed Forces.
(2) Elements.--The master registry established under
paragraph (1) shall consist of the registries described in
paragraph (3). The Secretary shall establish each such registry
using the Clinical Case Registry of the Department of Veterans
Affairs as a model.
(3) Registries described.--The registries described in this
paragraph are registries for each of the following:
(A) Agent Orange.
(B) Exposure to toxins relating to a deployment
during the Persian Gulf War (as defined in section
101(33) of title 38, United States Code), including
with respect to such exposures leading to Gulf War
Illness (as defined by the Institute of Medicine of the
National Academies).
(C) Exposure to toxins relating to a deployment
during Operation Iraqi Freedom, Operation New Dawn,
Operation Enduring Freedom, or the Global War on
Terror.
(D) Exposure to toxins relating to a deployment to
Bosnia, Somalia, the Philippines, or other locations
determined appropriate by the Secretary.
(E) Exposure to toxins relating to being stationed
at a military installation potentially contaminated by
toxic substances, including Camp Lejeune, North
Carolina, Fort McClellan, Alabama, and such
installations in Guam.
(F) Any other toxic exposure the Secretary
determines appropriate.
(b) Review.--The Secretary of Veterans Affairs shall enter into an
agreement with the National Academy of Sciences to review published
scientific information and studies on the health effects of toxic
exposures covered in a registry described in subsection (a)(3). Under
such agreement, the Institute of Medicine of the National Academies
shall submit to the Secretary on a biennial basis a report on toxic
substance exposure-related illnesses. Such report shall include--
(1) a review of all scientific studies and research on the
association between toxic substance exposures and specific
diseases covered in such a registry, including the level of
association between such exposures and the specific diseases;
and
(2) recommendations for future research.
(c) Research Into the Effects of Toxic Exposure on Second and Third
Generations.--In addition to the reviews under subsection (b), the
Secretary shall enter into an agreement with the National Academy of
Sciences to review published scientific information and studies on the
health effects on the children and grandchildren of veterans with toxic
exposures covered in a registry described in subsection (a)(3). Under
such agreement, the Institute of Medicine of the National Academies
shall submit to the Secretary on a biennial basis a report on toxic
substance exposure-related illnesses. Such report shall include--
(1) a review of all scientific studies and research on the
association between toxic substance exposures and specific
diseases covered in such a registry in such children and
grandchildren, including the level of association between such
exposures and the specific diseases; and
(2) recommendations for future research.
(d) Research.--The Secretary shall use the reviews conducted under
subsections (b) and (c) to inform the decisions made by the Secretary
with respect to selecting the research to be conducted or funded by the
Department of Veterans Affairs. The Secretary shall submit to the
Committees on Veterans' Affairs of the House of Representatives and the
Senate a report describing how the Secretary used such reviews to make
such selections.
SEC. 3. PRESUMPTIONS OF SERVICE CONNECTION FOR ILLNESSES ASSOCIATED
WITH TOXIC EXPOSURES ENCOUNTERED BY VETERANS DURING
MILITARY SERVICE.
(a) In General.--Subchapter II of chapter 11 of title 38, United
States Code, is amended by adding at the end the following new section:
``Sec. 1119. Presumptions of service connection for illnesses
associated with toxic exposures
``(a) Presumption.--(1) For purposes of section 1110 of this title,
and subject to section 1113 of this title, each illness, if any,
described in paragraph (2) shall be considered to have been incurred in
or aggravated by service referred to in that paragraph, notwithstanding
that there is no record of evidence of such illness during the period
of such service.
``(2) An illness referred to in paragraph (1) is any diagnosed or
undiagnosed illness that--
``(A) the Secretary determines in regulations prescribed
under this section to warrant a presumption of service
connection by reason of having a positive association with
exposure to a toxic substance covered in the master registry;
and
``(B) becomes manifest within the period, if any,
prescribed in such regulations in a veteran who served in the
Armed Forces and by reason of such service experienced such
exposure.
``(3) For purposes of this subsection, a veteran who served in the
Armed Forces in a location recognized under the master registry as
being a source of exposure and has an illness described in paragraph
(2) shall be presumed to have been exposed by reason of such service
unless there is conclusive evidence to establish that the veteran was
not so exposed by reason of such service.
``(b)(1)(A) Whenever the Secretary makes a determination described
in subparagraph (B), the Secretary shall prescribe regulations
providing that a presumption of service connection is warranted for the
illness covered by that determination for purposes of this section.
``(B) A determination referred to in subparagraph (A) is a
determination based on sound medical and scientific evidence that a
positive association exists between--
``(i) the exposure of humans or animals to a toxic
substance covered in the master registry; and
``(ii) the occurrence of a diagnosed or undiagnosed illness
in humans or animals.
``(2)(A) In making determinations for purposes of paragraph (1),
the Secretary shall take into account--
``(i) the reports submitted to the Secretary by the
National Academy of Sciences under section 2(b) of the
Veterans' Toxic Wounds Research Act of 2014; and
``(ii) all other sound medical and scientific information
and analyses available to the Secretary.
``(B) In evaluating any report, information, or analysis for
purposes of making such determinations, the Secretary shall take into
consideration whether the results are statistically significant, are
capable of replication, and withstand peer review.
``(3) An association between the occurrence of an illness in humans
or animals and exposure to a toxic substance covered in the master
registry shall be considered to be positive for purposes of this
subsection if the credible evidence for the association is equal to or
outweighs the credible evidence against the association.
``(c)(1) Not later than 60 days after the date on which the
Secretary receives a report from the National Academy of Sciences under
section 2(b) of the Veterans' Toxic Wounds Research Act of 2014, the
Secretary shall determine whether or not a presumption of service
connection is warranted for each illness, if any, covered by the
report.
``(2) If the Secretary determines under this subsection that a
presumption of service connection is warranted, the Secretary shall,
not later than 60 days after making the determination, issue proposed
regulations setting forth the Secretary's determination.
``(3)(A) If the Secretary determines under this subsection that a
presumption of service connection is not warranted, the Secretary
shall, not later than 60 days after making the determination, publish
in the Federal Register a notice of the determination. The notice shall
include an explanation of the scientific basis for the determination.
``(B) If an illness already presumed to be service connected under
this section is subject to a determination under subparagraph (A), the
Secretary shall, not later than 60 days after publication of the notice
under that subparagraph, issue proposed regulations removing the
presumption of service connection for the illness.
``(4) Not later than 90 days after the date on which the Secretary
issues any proposed regulations under this subsection, the Secretary
shall issue final regulations. Such regulations shall be effective on
the date of issuance.
``(d) Whenever the presumption of service connection for an illness
under this section is removed under subsection (c)--
``(1) a veteran who was awarded compensation for the
illness on the basis of the presumption before the effective
date of the removal of the presumption shall continue to be
entitled to receive compensation on that basis; and
``(2) a survivor of a veteran who was awarded dependency
and indemnity compensation for the death of a veteran resulting
from the illness on the basis of the presumption before that
date shall continue to be entitled to receive dependency and
indemnity compensation on that basis.
``(e) Master Registry Defined.--In this section, the term `master
registry' means the registry of veterans who experienced toxic
exposures established by section 2 of the Veterans' Toxic Wounds
Research Act of 2014.''.
(b) Clerical Amendment.--The table of sections at the beginning of
such chapter is amended by inserting after the item relating to section
1118 the following new item:
``1119. Presumptions of service connection for illnesses associated
with toxic exposures.''.
SEC. 4. INCLUSION OF CERTAIN INFORMATION IN ELECTRONIC HEALTH RECORDS.
In implementing the electronic health record system of the
Department of Veterans Affairs, the Secretary of Veterans Affairs shall
ensure that the electronic health record of each individual includes,
at a minimum, the following information:
(1) Whether the individual served in the Armed Forces.
(2) The Armed Force in which the individual served.
(3) The locations in which the individual was stationed or
deployed to during such service.
(4) The dates of such service.
(5) The military occupational specialty of the individual.
(6) The results of any tests or assessments of the
individual regarding--
(A) vision;
(B) hearing;
(C) hepatitis C;
(D) HIV;
(E) blood pressure;
(F) cholesterol;
(G) blood glucose test and diabetes information;
(H) body mass index measurement;
(I) bone density, as appropriate based on the age
or sex of the individual;
(J) cancer screenings (as appropriate based on the
age, sex, race, or ethnicity of the individual) for--
(i) breast cancer;
(ii) colorectal cancer;
(iii) lung cancer;
(iv) prostate cancer; and
(v) skin cancer;
(K) preventive immunizations, if not current;
(L) spirometry (for lung function);
(M) smoking;
(N) a mental health evaluation;
(O) substance abuse; or
(P) infectious diseases or parasites or other
adverse health conditions endemic to where the
individual served while in the military.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Veterans' Affairs.
Referred to the Subcommittee on Health.
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