[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4386 Reported in House (RH)]

                                                 Union Calendar No. 364

103d CONGRESS

  2d Session

                               H. R. 4386

                          [Report No. 103-669]

_______________________________________________________________________

                                 A BILL

  To amend title 38, United States Code, authorizing the Secretary of 
  Veterans Affairs to provide compensation to veterans suffering from 
  disabilities resulting from illnesses attributed to service in the 
  Persian Gulf theater of operations during the Persian Gulf War, to 
provide for increased research into illnesses reported by Persian Gulf 
                 War veterans, and for other purposes.

_______________________________________________________________________

                             August 4, 1994

  Reported with an amendment, committed to the Committee of the Whole 
       House on the State of the Union, and ordered to be printed





                                                 Union Calendar No. 364
103d CONGRESS
  2d Session
                                H. R. 4386

                          [Report No. 103-669]

  To amend title 38, United States Code, authorizing the Secretary of 
  Veterans Affairs to provide compensation to veterans suffering from 
  disabilities resulting from illnesses attributed to service in the 
  Persian Gulf theater of operations during the Persian Gulf War, to 
provide for increased research into illnesses reported by Persian Gulf 
                 War veterans, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 11, 1994

Mr. Montgomery (for himself, Mr. Slattery, Mr. Rowland, Mr. Bilirakis, 
  Mr. Kennedy, Mr. Clement, Mr. Stearns, Mr. Bishop, Mr. Parker, Mr. 
 Kreidler, Mr. Hall of Ohio, Mr. Tejeda, Mr. Stump, Mr. Applegate, Mr. 
   Bachus of Alabama, Mr. Sangmeister, Mr. Jacobs, Mr. Gonzalez, Mr. 
 Cooper, Mr. Edwards of Texas, Mr. Kyl, Mr. Taylor of Mississippi, Mr. 
   Brown of Ohio, Ms. Brown of Florida, Mr. Swett, Mr. Smith of New 
Jersey, Mr. Quinn, Mr. Bevill, Mr. Canady, Mr. Collins of Georgia, Mr. 
     McHale, Mr. Hefner, Mr. Machtley, Mr. Coyne, Mrs. Johnson of 
Connecticut, Mr. Gordon, Mr. Skelton, Mr. Walsh, Mr. Rahall, Mrs. Meek 
   of Florida, Mr. Boehlert, Mr. Callahan, Mr. Myers of Indiana, Mr. 
 McCurdy, Mr. Orton, Mrs. Lloyd, Mr. Ackerman, Mr. Ortiz, Mr. Bateman, 
Mr. Dellums, Mr. Camp, Mr. Hochbrueckner, Mr. Weldon, Mr. Lipinski, Mr. 
  Pete Geren of Texas, Mr. Price of North Carolina, Mr. Gene Green of 
 Texas, Mr. Filner, Mr. Frost, Mr. Burton of Indiana, Mr. Hancock, Mr. 
 Ridge, Mr. Kingston, Mr. Lancaster, Mr. Browder, Mr. Hutchinson, Mr. 
 Buyer, Mr. Shaw, Mr. Cramer, Mr. Fingerhut, Mr. Wilson, Mr. Lewis of 
    Florida, Mrs. Vucanovich, Mr. Pickett, Mr. Farr, Mr. Johnson of 
      Georgia, Mr. Traficant, Mr. Carr of Michigan, Mr. Frank of 
 Massachusetts, Mr. Coleman, Mr. Deal, Mrs. Schroeder, Mr. Richardson, 
Mr. Everett, Mr. Solomon, Mr. Cunningham, Mr. Brown of California, Mr. 
     Saxton, Mr. Lewis of California, Mr. Laughlin, Mr. Minge, Mr. 
   Torkildsen, Mr. Hunter, Mr. Barlow, Mr. Williams, Mr. Klein, Mr. 
Greenwood, Mr. Barca of Wisconsin, Mr. Whitten, Mr. Schiff, Mr. Barcia 
   of Michigan, Mr. Dooley, Mr. Rose, Mr. Pallone, Mr. DeFazio, Mr. 
   Bacchus of Florida, Mr. de la Garza, Mrs. Morella, Mr. Clay, Mr. 
Oberstar, Ms. Eddie Bernice Johnson of Texas, Mr. Durbin, Mr. de Lugo, 
  Mr. Michel, Mr. Quillen, Mr. Hansen, Mr. Miller of California, Mr. 
Baker of Louisiana, Mr. Bonilla, Mr. Mann, Mr. Peterson of Florida, Mr. 
  Engel, Mr. LaFalce, Mr. Inglis of South Carolina, Mr. Moakley, Mr. 
  Synar, Mr. Neal of North Carolina, Mr. Diaz-Balart, Mr. Barrett of 
Wisconsin, Mr. Levy, Mr. Gilman, Mr. Stupak, Mr. Shays, Mr. Spence, Ms. 
 Kaptur, Mrs. Maloney, Mr. Washington, Mr. Mineta, Mr. Gunderson, Mr. 
   Thornton, Mr. Duncan, Mr. King, Mr. Tucker, Mr. Faleomavaega, Mr. 
   Torres, Mr. Gingrich, Mr. Pastor, Mr. Neal of Massachusetts, Mr. 
 Johnson of South Dakota, Mr. Hoagland, Mr. Dixon, Mr. Romero Barcelo, 
 Mr. Thompson of Mississippi, Mr. Emerson, Mr. Linder, Mr. Torricelli, 
  Mr. Calvert, Ms. Furse, Ms. English of Arizona, Mr. Jefferson, Mr. 
   Strickland, Mr. Stenholm, Mr. Payne of Virginia, Mr. Chapman, Mr. 
  McNulty, Mrs. Clayton, Mr. Hall of Texas, Mrs. Byrne, Ms. Pryce of 
Ohio, and Mr. Evans) introduced the following bill; which was referred 
                 to the Committee on Veterans' Affairs

                             August 4, 1994

  Reported with an amendment, committed to the Committee of the Whole 
       House on the State of the Union, and ordered to be printed
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]
[For text of introduced bill, see copy of bill as introduced on May 11, 
                                 1994]

_______________________________________________________________________

                                 A BILL


 
  To amend title 38, United States Code, authorizing the Secretary of 
  Veterans Affairs to provide compensation to veterans suffering from 
  disabilities resulting from illnesses attributed to service in the 
  Persian Gulf theater of operations during the Persian Gulf War, to 
provide for increased research into illnesses reported by Persian Gulf 
                 War 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' Persian Gulf War Benefits 
Act''.

SEC. 2. CONGRESSIONAL FINDINGS.

    The Congress makes the following findings:
            (1) During the Persian Gulf War, members of the Armed 
        Forces were exposed to numerous potentially toxic substances, 
        including fumes and smoke from military operations, oil well 
        fires, diesel exhaust, paints, pesticides, depleted uranium, 
        infectious agents, chemoprophylactic agents, and indigenous 
        diseases, and were also given multiple immunizations. It is not 
        known whether these servicemembers were exposed to chemical or 
        biological warfare agents. However, threats of enemy use of 
        chemical and biological warfare heightened the psychological 
        stress associated with the military operation.
            (2) Significant numbers of veterans of the Persian Gulf War 
        are suffering from illnesses, or are exhibiting symptoms of 
        illness, that cannot now be diagnosed or clearly defined. As a 
        result, many of these conditions or illnesses are not 
        considered to be service connected under current law for 
        purposes of benefits administered by the Department of Veterans 
        Affairs.
            (3) The Technology Assessment Workshop on the Persian Gulf 
        Experience and Health conducted by the National Institutes of 
        Health concluded 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 that no single 
        disease entity or syndrome exists. Rather, it appears that the 
        illnesses suffered by those veterans result from multiple 
        illnesses with overlapping symptoms and causes that have yet to 
        be defined.
            (4) 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.
            (5) In response to concerns regarding the health-care needs 
        of Persian Gulf War veterans, particularly those who suffer 
        from illnesses or conditions for which no diagnosis has been 
        made, the Congress, in Public Law 102-585, directed the 
        establishment of a Persian Gulf War Veterans Health Registry, 
        authorized health examinations for veterans of the Persian Gulf 
        War, 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 
        Persian Gulf theater of operations and to develop 
        recommendations on avenues for research regarding such health 
        consequences. In Public Law 103-210, the Congress authorized 
        the Department of Veterans Affairs to provide health care 
        services on a priority basis to Persian Gulf War veterans. The 
        Congress also provided in Public Law 103-160 (the National 
        Defense Authorization Act for Fiscal Year 1994) for the 
        establishment of a specialized environmental medical facility 
        for the conduct of research into the possible health effects of 
        exposure to low levels of hazardous chemicals, especially among 
        Persian Gulf veterans, and for research into the possible 
        health effects of battlefield exposure in such veterans to 
        depleted uranium.
            (6) Further research and studies must 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 as the result of such 
        illnesses should be given the benefit of the doubt and be 
        provided compensation benefits to offset the impairment in 
        earnings capacities they may be experiencing.

SEC. 3. PURPOSES.

    The purposes of this Act are--
            (1) to provide compensation to Persian Gulf War veterans 
        who suffer disabilities resulting from illnesses that cannot 
        now be diagnosed or defined, and for which other causes cannot 
        be identified,
            (2) to require the Secretary of Veterans Affairs to develop 
        at the earliest possible date case assessment strategies and 
        definitions or diagnoses of such illnesses,
            (3) to promote greater outreach to Persian Gulf War 
        veterans and their families to inform them of ongoing research 
        activities, as well as the services and benefits to which they 
        are currently entitled, and
            (4) to ensure that research activities and accompanying 
        surveys of Persian Gulf War veterans are appropriately funded 
        and undertaken by the Department of Veterans Affairs.

SEC. 4. DEVELOPMENT OF CASE ASSESSMENT PROTOCOL AND CASE DEFINITIONS.

    (a) In General.--The Secretary of Veterans Affairs shall--
            (1) develop and implement at the earliest possible date a 
        uniform case assessment protocol that will ensure thorough 
        assessment, diagnosis, and treatment of all Persian Gulf War 
        veterans suffering from illness attributed to service in the 
        Southwest Asia theater of operations during the Persian Gulf 
        War; and
            (2) develop at the earliest possible date case definitions 
        or diagnoses for illnesses associated with such service.
    (b) Consultation.--Development of a uniform case assessment 
protocol under subsection (a)(1) and development of case definitions or 
diagnoses under subsection (a)(2) shall be carried out by the Secretary 
of Veterans Affairs in consultation with the Secretary of Defense and 
the Secretary of Health and Human Services.
    (c) Reports.--The Secretary shall submit to the Committees on 
Veterans' Affairs of the Senate and House of Representatives an annual 
report on the status of the activities required by this section. The 
first such report shall be submitted not later than six months after 
the date of the enactment of this Act.

SEC. 5. PROVISION OF INFORMATION TO VETERANS OF THE PERSIAN GULF WAR.

    (a) Outreach Program.--The Secretary of Veterans Affairs shall 
develop and implement a comprehensive outreach program and information 
system to provide Persian Gulf War veterans and their families with 
information regarding the following:
            (1) The Persian Gulf War Veterans Health Registry 
        established by the Persian Gulf War Veterans' Health Status Act 
        (38 U.S.C. 527 note).
            (2) Access to health services and health-related benefits 
        provided by or under the auspices of the Department of Veterans 
        Affairs, including--
                    (A) marriage and family counseling available under 
                section 121 of the Veterans' Medical Programs 
                Amendments of 1992 (38 U.S.C. 1712A note);
                    (B) health care available under section 
                1710(e)(1)(C) of title 38, United States Code; and
                    (C) health examinations, consultation, and 
                counseling available under section 703 of the Persian 
                Gulf War Veterans' Health Status Act (38 U.S.C. 527 
                note).
            (3) Compensation and benefits related to disabilities 
        resulting from service in the Persian Gulf War, including 
        disabilities resulting from illness that resulted from such 
        service.
            (4) Significant developments in research relating to the 
        health consequences of service in the Persian Gulf War.
            (5) Any other information that the Secretary determines to 
        be appropriate.
    (b) Toll-Free Telephone Number.--The information system required by 
subsection (a) shall include the establishment and staffing of a toll-
free telephone number for the use of such veterans and their families.
    (c) Further Information.--Section 702(f) of the Persian Gulf War 
Veterans' Health Status Act (38 U.S.C. 527 note) is amended to read as 
follows:
    ``(f) Ongoing Outreach to Individuals Listed in Registry.--(1) The 
Secretary of Veterans Affairs shall notify each individual listed in 
the Registry or, in the case of such an individual who is deceased, the 
surviving spouse, children, or parents of such individual, at least 
quarterly, by newsletter or by other means that the Secretary 
determines to be appropriate, of--
            ``(A) the status and findings of federally sponsored 
        research relating to the illnesses of individuals who served as 
        members of the Armed Forces in the Persian Gulf theater of 
        operations during the Persian Gulf War or to the illnesses of 
        the family members of such individuals;
            ``(B) compensation and benefits, including health care and 
        other health-related benefits, that may be provided by the 
        Department of Veterans Affairs or the Department of Defense to 
        an individual who served as a member of the Armed Forces in the 
        Persian Gulf theater of operations during the Persian Gulf War 
        or, in the case of such an individual who is deceased, to the 
        surviving spouse, children, or parents of such an individual; 
        and
            ``(C) any other information that the Secretary determines 
        to be appropriate.
    ``(2) In preparing the newsletter or other means used to provide 
information as required by paragraph (1), the Secretary shall consult 
with veterans' service organizations.
    ``(3) The requirement of paragraph (1) shall not apply regarding 
notification of any individual if that individual makes a written 
request to the Secretary of Veterans Affairs that the notification not 
be provided.''.

SEC. 6. COMPENSATION BENEFITS FOR DISABILITY RESULTING FROM ILLNESS 
              ATTRIBUTED TO 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 II the following new 
section:
``Sec. 1117. Compensation for disabilities associated with Persian Gulf 
              War
    ``(a) The Secretary shall pay compensation under this subchapter to 
a Persian Gulf veteran suffering from a chronic disability resulting 
from an undiagnosed illness (or combination of undiagnosed illnesses) 
that became manifest to a degree of 10 percent or more before the later 
of (1) October 1, 1996, or (2) the end of the two-year period beginning 
on the last date on which the veteran performed active military, naval, 
or air service in the Southwest Asia theater of operations while on 
active duty.
    ``(b) A disability for which compensation under this subchapter is 
payable shall be considered to be service connected for purposes of all 
other laws of the United States.
    ``(c) Compensation may not be paid under this section with respect 
to a disability occurring in a veteran--
            ``(1) where there is affirmative evidence that the 
        disability was not incurred by the veteran during service in 
        the Persian Gulf theater of operations during the Persian Gulf 
        War; or
            ``(2) where there is affirmative 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 that theater of 
        operations while on active duty and the onset of the 
        disability.
    ``(d) The Secretary may not make payments under this section with 
respect to a disability for which compensation is paid under this 
section for any month after the month during which the Secretary 
determines that such disability was not incurred as the result of 
service in the Southwest Asia theater of operations during the Persian 
Gulf War.
    ``(e) 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.
    ``(f)(1) No payment may be made under this section for any month 
that begins after the end of the three-year period beginning on the 
date of the enactment of this section.
    ``(2) If, before the end of such three-year period, the Secretary 
submits to the Committees on Veterans' Affairs of the Senate and House 
of Representatives a report stating that, as of the date of the report, 
no diagnoses for the illnesses referred to in subsection (a) can be 
made based on current medical knowledge, such three-year period shall 
continue for an additional three years.
    ``(3) The Secretary shall submit to those committees a report 
addressing the issue of diagnoses of such illnesses not later than 
April 1, 1997.''.
    (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. Compensation for disabilities associated with 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. AUTHORIZATION OF APPROPRIATIONS FOR PERSIAN GULF ILLNESS 
              RESEARCH.

    There is authorized to be appropriated to the Department of 
Veterans Affairs $5,000,000 for each of fiscal years 1995 through 1997 
for the conduct of research, which the Secretary of Veterans Affairs, 
in consultation with the Secretary of Defense and the Secretary of 
Health and Human Services, determines would advance understanding of 
health risks and effects of service during the Persian Gulf War and 
effective means of treating such health effects.

SEC. 8. SURVEY OF PERSIAN GULF VETERANS.

    (a) In General.--There is authorized to be appropriated to the 
Department of Veterans Affairs such sums as are needed for fiscal year 
1995 for the conduct of a survey of Persian Gulf veterans to gather 
information on the incidence and nature of health problems occurring in 
Persian Gulf veterans and their families.
    (b) Coordination With Department of Defense.--The survey under 
subsection (a) shall be carried out in coordination with the Secretary 
of Defense.
    (c) Persian Gulf Veteran.--For purposes of this section, a Persian 
Gulf veteran is an individual who served on active duty in the Armed 
Forces in the Southwest Asia theater of operations during the Persian 
Gulf War as defined in section 101(33) of title 38, United States Code.

SEC. 9. AUTHORIZATION FOR EPIDEMIOLOGICAL STUDIES.

    (a) Study of Health Consequences of Persian Gulf Service.--If the 
National Academy of Sciences includes in the report required by section 
706(b) of the Veterans Health Care Act of 1992 (Public Law 102-585) a 
finding that there is a sound basis for an epidemiological study or 
studies on the health consequences of service in the Persian Gulf 
theater of operations during the Persian Gulf War and recommends the 
conduct of such a study or studies, the Secretary of Veterans Affairs 
is authorized to carry out such study.
    (b) Oversight.--(1) The Secretary shall seek to enter into an 
agreement with the Medical Follow-Up Agency (MFUA) of the Institute of 
Medicine of the National Academy of Sciences for (A) the review of 
proposals to conduct the research referred to 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 make available for the purposes of any study described in subsection 
(a) all data that the Secretary, in consultation with the National 
Academy of Sciences and the contractor, considers relevant to the 
study.
    (d) Authorization.--There are authorized to be appropriated to the 
Department such sums as are necessary for the conduct of studies 
described in subsection (a).

SEC. 10. EXTENSION OF MARRIAGE AND FAMILY COUNSELING AVAILABILITY FOR 
              PERSIAN GULF WAR VETERANS.

    (a) In General.--Section 121(a) of the Veterans' Medical Programs 
Amendments of 1992 (38 U.S.C. 1712A note) is amended by striking out 
``September 30, 1994'' and inserting in lieu thereof ``December 31, 
1998''.
    (b) Authorization of Appropriations.--Section 121(g) of the 
Veterans' Medical Programs Amendments of 1992 (38 U.S.C. 1712A note) is 
amended by striking out ``and 1994'' and inserting in lieu thereof 
``through 1999''.

SEC. 11. COST-SAVINGS PROVISIONS.

    (a) Election of Death Pension by Surviving Spouse.--Section 1317 of 
title 38, United States Code, is amended--
            (1) by striking out ``No person'' and inserting in lieu 
        thereof ``(a) Except as provided in subsection (b), no 
        person''; and
            (2) by adding at the end the following:
    ``(b) A surviving spouse who is eligible for dependency and 
indemnity compensation by reason of any death occurring after December 
31, 1956, may elect to receive death pension instead of such 
compensation.''.
    (b) Policy Regarding Cost-of-Living Adjustment in Compensation 
Rates for Fiscal Year 1995.--The fiscal year 1995 cost-of-living 
adjustments in the rates of and limitations for compensation payable 
under chapter 11 of title 38, United States Code, and of dependency and 
indemnity compensation payable under chapter 13 of such title will be 
no more than a percentage equal to the percentage by which benefit 
amounts payable under title II of the Social Security Act (42 U.S.C. 
401 et seq.) are increased effective December 1, 1994, as a result of a 
determination under section 215(i) of such Act (42 U.S.C. 415(i)), with 
all increased monthly rates and limitations (other than increased rates 
or limitations equal to a whole dollar amount) rounded down to the next 
lower dollar.
HR 4386 RH----2