[Congressional Record Volume 140, Number 72 (Friday, June 10, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: June 10, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Mr. DASCHLE (for himself and Mr. Akaka):
  S. 2178. 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; to the Committee on Veterans' Affairs.


          persian gulf war veterans' compensation act of 1994

 Mr. DASCHLE. Mr. President, almost 4 years ago, the nation of 
Kuwait was invaded by Saddam Hussein, and then-President George Bush 
ordered the deployment of American forces to the gulf. Fighting 
alongside other coalition forces, American service men and women 
defended Saudi Arabia against a possible Iraqi invasion and went on the 
drive Hussein's forces out of Kuwait.
  From the homefront, the Persian Gulf war seemed like a rather neat 
and tidy conflict. The ground war lasted a mere 4 days. American 
casualties were relatively few, thanks to our technologically advanced 
weaponry. And our first troops were on their way home just 7 months 
after the conflict began.
  Unfortunately, this picture does not reflect the true nature of the 
Persian Gulf conflict. Many American soldiers were in the Persian Gulf 
long after the war had ended. And to paraphrase Jesse Brown, Secretary 
of Veterans' Affairs, this was actually a very dirty war.
  Those who served in the gulf during Operation Desert Shield/Desert 
Storm were potentially exposed to a wide range of toxins and 
environmental hazards. The list includes possible exposures to: smoke 
from oil well fires set by retreating Iraqi soldiers; industrial 
chemicals and pesticides; depleted uranium used in munitions; diseases 
endemic to the Persian Gulf; vaccines to prevent anthrax and botulism; 
anti-nerve agent pills; and chemical and/or biological agents.
  After all that, is it really any surprise that many gulf war veterans 
are now sick?
  We've all heard about their mystery illness, which has become known 
as Persian Gulf syndrome. Common symptoms include extreme fatigue, 
joint and muscle pain, short-term memory loss, diarrhea, unexplained 
rashes, night sweats, headaches, and bleeding gums. In addition, women 
veterans have experienced chronic or recurring yeast infections and 
menstrual irregularities.
  So far, a single cause for all these problems has yet to be found.
  To add to the mystery, these health problems are no longer limited to 
those who actually spent time in the gulf. Many ill veterans have 
watched helplessly as their spouses and even their children have become 
afflicted with unexplained ailments. There have also been many reports 
of miscarriages by military wives and birth defects in children born 
after the gulf war.
  I do want to acknowledge that many research efforts are underway to 
determine the cause or causes of these illnesses. But we are far from 
any answers. At a recent symposium sponsored by the National Institutes 
of Health and the VA experts concluded that the complex environment in 
the gulf war theater caused complex adverse health effects, and that it 
thus appears these veterans have multiple illnesses with overlapping 
symptoms and causes.
  And in the meantime, while we wait for those answers, veterans and 
their families are suffering.
  The men and women who served in the Persian Gulf war did so with 
distinction and with honor. They were summoned to a distant country by 
their government and they went, leaving their loved ones behind and 
putting their lives on hold. Their government needed their help, and 
they responded.
  Now many of these fine soldiers are ill as a result of their service 
in the gulf. They are having difficulty receiving quality and timely 
health care from the VA. Many cannot pay their bills because they are 
too sick to work.
  These veterans need help from their government, and I believe the 
government has an obligation to respond.
  Under title 38 of the United States Code, a veteran is entitled to 
compensation for ``disability resulting from personal injury suffered 
or disease contracted in the line of duty.'' At present, however, the 
VA will not provide such a compensation unless a veteran's health 
problems can be explained by a specific diagnosis. This is true even if 
the veteran was clearly healthy before being deployed to the gulf and 
became disabled by sickness upon return.
  Secretary Brown believes that the VA does not have the authority to 
extend compensation to gulf war veterans suffering from undiagnosed 
illnesses. Yesterday, however, he announced that the administration 
would support legislation giving that authority to the VA.
  I was encouraged by Secretary Brown's announcement. Never before has 
our government embraced the principle of providing compensation to 
veterans for illnesses which have not yet been defined.
  However, I disagee with the Secretary on the issue of VA's authority. 
Like the other members of the Senate Veterans' Affairs Committee, I 
believe that the VA already has the authority to compensate for 
undiagnosed illness. The requirement of a diagnosis is a convention 
adopted by the VA to make its compensation decisions easier. It is not 
a requirement of law.
  Nevertheless, my good friend Senator Akaka and I have decided to 
introduce legislation on this issue for two reasons. First, our bill 
will make it clear that VA is to provide compensation to ill gulf 
veterans, even if we don't yet know what is making them sick. This will 
clear up the current disagreement over VA's authority in this area.

  Second, our bill goes beyond the approach that was endorsed by 
Secretary Brown and the administration. To them, it is acceptable to 
cut off compensation after 3 years and to limit it to veterans who get 
sick within 2 years after coming home from the gulf.
  To us, that approach is too limited.
  The legislation we are introducing today would require the VA to 
provide compensation to veterans disabled by undiagnosed illnesses 
which have become manifest within 3 years of their return from the 
gulf. Further, it would specify that VA must pay this compensation 
until such time as it can show that a veteran's illness is unrelated to 
his or her gulf war service.
  Our bill also seeks to expand outreach and research efforts by the 
VA. It would require the establishment of a program to keep Persian 
Gulf veterans and their families informed of ongoing research 
activities, as well as the services and benefits to which they are 
entitled. Specific measures would include the creation of a newsletter 
to be sent to those on the VA Persian Gulf Registry and a toll-free 
information line.
  Additional funds for scientific research would be authorized. 
Specifically, the bill would provide funding for an epidemiological 
study by the National Academy of Sciences on the health risks and 
health effects of gulf war service on veterans and their families. A 
minimum of $7.5 million per year for fiscal years 1995 through 2000 
would be authorized for this purpose. Annual reports to Congress on the 
study's progress would be required. This legislation would also 
authorize $5 million per year for fiscal years 1995 through 1998 for 
other research relating to the health effects of gulf war service.
  I would like to note that this legislation is identical to H.R. 4540, 
which was introduced in the House on Wednesday by my friend, 
Representative Lane Evans. Representative Evans and I have worked 
closely over the years on veterans' issues, and I want to commend him 
for his leadership on issues of concern to gulf war veterans.
  Mr. President, for more than a decade, I fought to gain compensation 
for veterans whose illnesses were caused by their exposure to the toxic 
herbicide agent orange during the Vietnam war. This battle was 
eventually won on the basis of scientific evidence which showed an 
association between agent orange and these illnesses. But for the more 
than 10 years it took to discover this connection, ill veterans and 
their families suffered needlessly. We must not allow the same scenario 
to happen here.
  I ask that a copy of this legislation be printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 2178

       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.
       ``(i) 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.
       ``(j) 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.
       ``(k) 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.

                          ____________________