[Congressional Record Volume 140, Number 108 (Monday, August 8, 1994)]
[House]
[Page H]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: August 8, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                VETERANS' PERSIAN GULF WAR BENEFITS ACT

  Mr. MONTGOMERY. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 4386) 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, as amended.
  The Clerk read as follows:

                               H.R. 4386

       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.

  The SPEAKER pro tempore (Mr. Traficant). Pursuant to the rule, the 
gentleman from Mississippi [Mr. Montgomery] will be recognized for 20 
minutes and the gentleman from Arizona [Mr. Stump] will be recognized 
for 20 minutes.
  The Chair recognizes the gentleman from Mississippi [Mr. Montgomery].
  (Mr. MONTGOMERY asked and was given permission to revise and extend 
his remarks.)


                             General Leave

  Mr. MONTGOMERY. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in which to revise and extend their 
remarks, and include extraneous matter, on H.R. 4386 and the next 
veterans bill on the agenda, H.R. 4088.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Mississippi?
  There was no objection.
  Mr. MONTGOMERY. Mr. Speaker, I yield myself such time as I may 
consume.
  I am proud to bring before the House H.R. 4386, as amended, the 
Veterans' Persian Gulf War Benefits Act, which I and several of my 
committee colleagues introduced on May 11.
  I want to thank the gentleman from Kansas [Mr. Slattery], the 
gentleman from Florida [Mr. Bilirakis], and the ranking minority member 
of the committee, the gentleman from Arizona, [Mr. Stump], for their 
cooperation in getting this bill to the floor.
  The bill would provide compensation to Persian Gulf veterans who have 
disabilities that may have occurred from undiagnosed illnesses 
following service in the gulf region. We do not know the exact cause of 
these disabilities. Further research would be required and this bill 
provides that authorization.
  VA Secretary Jesse Brown calls this bill a revolutionary measure. I 
agree with the Secretary. What we are doing is unprecedented. But, when 
disabled veterans are unable to work or to get answers about their 
health problems, we must act swiftly and compassionately.
  Under current law, Secretary Brown does not have authority to grant 
compensation in these cases. This is also the administration's view. 
Therefore, we need to pass this bill to help disabled veterans and 
their families.
  H.R. 4386 enjoys strong bipartisan support in the House and is 
strongly supported by the administration. The bill is cosponsored by 
169 Members of the House.
  Mr. Speaker, as I said, no one knows what these illnesses are, nor do 
we know what caused them. Scientists are unable to tell us how long it 
may take to find the answers to these questions. What we do know, 
however, is that there are a number of sick Persian Gulf war veterans 
who are facing serious challenges in their lives and they need help. 
The VA cannot favorably consider claims for compensation because the 
illnesses cannot be diagnosed. The veteran finds himself in a catch-22 
situation. The veteran is suffering from something that is disabling. 
But because it does not have a name, the VA cannot provide benefits.
  As a nation that prides itself on the manner in which it treats its 
veterans, it is very clear to me that we owe this small group of 
Persian Gulf veterans the full range of benefits available to others. I 
have come to this conclusion having heard from many veterans and family 
members during nine hearings in our committee.
  Knowing that answers from the medical community will not be 
forthcoming any time soon, I have concluded that we have a moral 
obligation to grant some monetary relief for their disabilities.

                              {time}  1210

  Mr. Speaker, I will yield such time as he may consume to the very 
able chairman of our Subcommittee on Compensation, Pension and 
Insurance, the gentleman from Kansas [Mr. Slattery]. I want to 
congratulate the gentleman for his primary victory on Tuesday and wish 
him well in November.
  I also want to thank him for moving this legislation quickly to the 
floor and for all of the work he has done, not only for Persian war 
veterans, but for all veterans since coming to the Congress. The 
gentleman from Kansas has stood firmly for our veterans and they are 
grateful for his strong support of programs that enhance their quality 
of life.
  I yield such time as he may consume to the gentleman from Kansas [Mr. 
Slattery].
  (Mr. SLATTERY asked and was given permission to revise and extend his 
remarks, and to include extraneous material.)
  Mr. SLATTERY. Mr. Speaker, I thank the chairman of the committee for 
yielding time to me.
  Mr. Speaker, H.R. 4386, as amended, is landmark legislation that has 
several purposes.
  First, and foremost, it would provide for the payment of compensation 
on a presumptive basis to those veterans of the Persian Gulf war who 
suffer chronic disabilities resulting from undiagnosed illnesses 
attributed to their service in the Persian Gulf region. The Secretary 
of Veterans Affairs has indicated that current law does not permit the 
VA to grant service connection in these cases due to the absence of a 
diagnosis of the underlying illness.
  My colleagues, we cannot let the fact that these illnesses have not 
been diagnosed, prevent the granting of service-connected benefits for 
these wartime veterans. They are suffering as the result of their 
service to their country and we must take responsibility for their 
disabilities. H.R. 4386, as amended, is a reflection of our deep 
concern for these veterans and their families.
  The presumption of service connection would be applied in the case of 
a Persian Gulf war veteran who manifested the disability in question 
within the later of 2 years from the date he or she left the Persian 
Gulf theater, or within a 2-year period following the effective date of 
the new statutory provision, which would be October 1, 1994. The 
committee believes this timeframe is reasonable, given the current 
state of science on these illnesses.
  Second, it would require the Secretary to work with the Secretaries 
of Defense, and Health and Human Services, to develop, at the earliest 
possible date, uniform case assessment protocols and case definitions 
or diagnoses of the mystery illnesses. Recurring status reports would 
be required on these activities.
  It would also direct the Secretary to implement an aggressive 
outreach program for the benefit of Persian Gulf war veterans through 
the establishment of a toll-free hotline and also through a recurring 
newsletter to be sent to Persian Gulf veterans who have signed onto the 
Persian Gulf Veterans Health Registry.
  Third, the bill as amended would authorize funding for the conduct of 
appropriate research activities, which could include an epidmeiolgical 
study, if recommended by the National Academy of Sciences, and the 
conduct of a survey of Persian Gulf veterans to collect additional data 
on their health status. It is agreed by all concerned that further 
research must be conducted into the causes of the ailments from which 
these veterans suffer.
  Fourth, the amended bill would extend the Secretary's authority to 
conduct a program of family counseling for Persian Gulf veterans and 
their families until the end of 1998.
  Finally, Mr. Speaker, I would note that the amended bill contains 
cost-savings provisions sufficient to offset any estimated pay-go 
costs.
  As Secretary Brown testified on June 9, H.R. 4386 has the strong 
support of the administration, and I am confident we will convince our 
colleagues in the other body of the necessity for this legislative 
relief.
  I want to thank my good friend from Florida, Mike Bilirakis, for 
helping me to craft the ultimate compromise on this bill, and I want to 
thank our distinguished ranking member, Mr. Stump, and my able 
colleagues, Lane Evans and Joe Kennedy, for their efforts. But most of 
all, Mr. Speaker, I want to express my gratitude and admiration to my 
chairman, Sonny Montgomery, because had it not been for his vision and 
strong leadership, we would not be acting on this beneficial 
legislation today. This is just another shining example of his 
excellent leadership on behalf of our veterans.
  For the benefit of my colleagues, there follows an excerpt from the 
committee report on H.R. 4386, as amended, which contains a complete 
discussion of the reported bill:

                    Discussion of the Reported Bill

       The reported bill has four main purposes. The primary 
     purpose is to provide disability compensation on a 
     presumptive basis to certain veterans of the Persian Gulf War 
     who suffer chronic disabilities resulting from undiagnosed 
     illnesses attributed to their service in the Persian Gulf. 
     The Secretary of Veterans Affairs has indicated that current 
     law does not permit the VA to grant service connection in 
     these cases due to the absence of a diagnosis of the 
     underlying illness. As indicated in a June 10, 1994, 
     memorandum to the Secretary of Veterans Affairs, it is the 
     opinion of the VA's General Counsel that ``because the VA is 
     authorized to compensate only for disease-caused or injury-
     caused disabilities, unless the VA can ascribe a disability 
     to a disease or injury, there is no authority to compensate. 
     The pending legislation supplies that needed additional 
     authority.''
       The National Institutes of Health Technology Assessment 
     Workshop on the Persian Gulf Experience and Health (NIH 
     Workshop), which met April 27 through April 29, 1994, was 
     unable to develop a working case definition for the so-called 
     ``Persian Gulf Syndrome'', concluding that it was impossible 
     to establish a single case definition. It went on to state 
     that a premature attempt to establish a case definition for 
     this illness may be misleading and inaccurate. The NIH 
     Workshop indicated that no single disease or syndrome is 
     apparent, but rather multiple illnesses with overlapping 
     symptoms and possible causes. See Report, NIH Workshop. 
     (Appendix A)
       The presumption of service connection, as embodied in 
     section 6 of the reported bill, would be granted in the case 
     of a Persian Gulf War veteran who manifested the chronic 
     disability in question within the later of two years from the 
     date he or she left the Persian Gulf theater, or before 
     September 30, 1996, providing a two-year period following the 
     effective date of the new statutory provision.
       The Committee notes that the term ``manifestation'' should 
     not be equated to the filing of a claim for benefits. Rather, 
     the Committee intends that there must be some objective 
     indication or showing of the disability which is observable 
     by a person other than the veteran, or for which medical 
     treatment has been sought.
       As introduced, H.R. 4386 required that the disability be 
     manifested within one year after the date the veteran 
     departed from the Persian Gulf. However, virtually all of the 
     veterans service organizations who testified in support of 
     H.R. 4386 questioned the imposition of a one-year 
     manifestation period, and many indicated that there should be 
     no manifestation period. The Secretary of Veterans Affairs, 
     who testified before the Subcommittee on Compensation, 
     Pension, and Insurance on June 9, 1994, in strong support of 
     H.R. 4386, suggested that a two-year period would be more 
     appropriate. In a letter to the Honorable Jim Slattery, dated 
     June 14, 1994, the Secretary clarified that the suggested 
     two-year period was to begin on the date the veteran departed 
     from the Southwest Asia theater of operations rather than the 
     date on which the veteran was discharged from active duty. 
     After further consideration of the matter, the Committee 
     determined that, in order to ensure that no veteran of the 
     Persian Gulf War be unfairly excluded, the manifestation 
     period should be modified to provide a period of two years 
     from the date the veteran left the Persian Gulf, with 
     consideration given to those veterans who had not, while on 
     active duty, presented themselves for examination due to 
     concerns that they would be medically discharged as a result. 
     In the case of any Persian Gulf veteran discharged prior to 
     October 1, 1994, an additional two-year manifestation period 
     would be provided.
       The Committee wishes to note that, in response to concerns 
     raised about the possibility of a servicemember being 
     discharged because of a disability for which no diagnosis 
     could be made, and in response to considerations regarding 
     issues of compensation, the Honorable William Perry, then 
     Under Secretary of Defense for Personnel and Readiness, 
     indicated in a June 2, 1994, memorandum to the Service 
     Secretaries that:

     no individual on active duty who shows symptoms associated 
     with Persian Gulf illness (may) be retired or separated 
     unless (1) the member requests retirement or separation in 
     writing or (2) the member can be medically retired or 
     separated through the disability system with an established 
     diagnosis.

       The term ``Persian Gulf veteran'' would be defined to mean 
     a veteran who served on active duty in the Armed Forces in 
     the Southwest Asia theater of operations during the Persian 
     Gulf War. Current law defines the Persian Gulf War as the 
     period beginning on August 2, 1990, and ending on the date 
     thereafter prescribed by Presidential proclamation or by law. 
     Consequently, for purposes of benefits administered by the 
     Secretary of Veterans Affairs, the Persian Gulf War is 
     considered open-ended and, as a result, those members of the 
     Armed Forces who are currently stationed in that region, or 
     who may in the future be so located, are ``Persian Gulf 
     veterans'', by definition, for purposes of this provision.
       Payments of compensation under this authority would 
     continue for a three-year period, but would be extended 
     automatically for an additional three-year period if the 
     Secretary reports to the Congress that the illnesses suffered 
     by Persian Gulf veterans remain undiagnosed. The Secretary 
     would be required to submit to the Congress a report 
     addressing the issue of diagnoses of these illnesses not 
     later than April 1, 1997. The Committee wishes to emphasize 
     that there is no intention on the part of the Committee to 
     terminate compensation payments under this new authority for 
     so long as issues concerning the underlying illnesses remain 
     unresolved. If, at the end of the second three-year period 
     provided for in this legislation, the issues surrounding 
     diagnoses of these illnesses remain, it is the express 
     intention of the Committee that appropriate action should be 
     taken by Congress to either further extend the authority or 
     make it a permanent provision. The Committee is committed to 
     giving this group of veterans the benefit of the doubt for as 
     long as it may take to find the answers to the medical 
     questions that now exist. The Committee hopes and believes 
     that these questions will be resolved in the near future and 
     that, once the medical questions are resolved, it is the 
     Committee's intent that the normal disability compensation 
     provisions be applied to this group in the same manner as all 
     other veterans.
       The second purpose of this legislation is to require the 
     Secretary of Veterans Affairs to work with the Secretaries of 
     Defense, and Health and Human Services, to develop, at the 
     earliest possible date, uniform case assessment protocols and 
     case definitions or diagnoses of the mystery illnesses. This 
     was a recommendation of the NIH Workshop, which also 
     indicated that an assessment strategy modeled after the 
     Centers for Disease Control and Prevention (CDC) protocol for 
     chronic fatigue syndrome is recommended. The Committee 
     concurs in this recommendation. Because of the Committee's 
     desire that this action occur as soon as is practicable, the 
     reported bill would require the Secretary to provide 
     recurring status reports on these activities, with the first 
     such report due to the Committees on Veterans' Affairs of the 
     House and Senate not later than six months after the date of 
     enactment of the Act.
       The third purpose of the reported bill is to direct the 
     Secretary to implement an aggressive outreach program for the 
     benefit of Persian Gulf war veterans and their families. The 
     Committee is cognizant of activities the Secretary has 
     already undertaken to reach out to Persian Gulf veterans and 
     appreciates the efforts that have been made on their behalf.
       However, in order to ensure that continued outreach efforts 
     are maintained or improved, the reported bill would require 
     the development and implementation of a comprehensive 
     outreach program and information system to provide 
     information regarding the Persian Gulf War Veterans Health 
     Registry, access to health services and benefits, 
     compensation and benefit entitlement, and health research 
     relating to the health consequences of service in the Persian 
     Gulf to Persian Gulf War veterans and their families. It 
     would require the VA to establish a new toll-free telephone 
     number for the use of Persian Gulf veterans and their 
     families. It is assumed by the Committee that this toll-free 
     number would be staffed in the same manner as the already 
     existing toll-free numbers, such as the Radiation Hotline. In 
     addition, the Persian Gulf War Veterans' Health Status Act 
     (38 U.S.C. 527 note) would be amended to include the 
     provision of a quarterly newsletter to VA Health Registry 
     participants, in consultation with veterans' service 
     organizations, which would include information concerning the 
     status of appropriate health research and benefits, including 
     compensation and health care benefits. The Committee 
     recognizes that the VA has already instituted a newsletter 
     and that, to date, three issues have been published. The 
     requirement for a quarterly newsletter will provide an 
     assurance that regularly published information will be made 
     available to Persian Gulf veterans and their families on a 
     timely and recurring basis.
       The fourth purpose of the reported bill would be to ensure 
     that appropriate research activities and accompanying surveys 
     of Persian Gulf veterans are properly funded and undertaken 
     by the VA. Sections 7 through 9 of the reported bill embody 
     the Committee's intentions in this area.
       Section 7 of the reported bill would authorize the 
     appropriation of $5 million in each of fiscal years 1995 
     through 1997, for the conduct of such research which the 
     Secretary of Veterans Affairs, in consultation with the 
     Secretaries of Defense and Health and Human Services, 
     determines would advance the understanding of the health 
     risks and effects of service during the Persian Gulf War and 
     a productive means of treating these effects. The Committee 
     strongly believes that further research must be conducted 
     into the causes of the ailments from which these veterans 
     suffer. However, it is not clear at this time as to what the 
     nature of these activities should be.
       In Public Law 102-585 the Congress required the Secretaries 
     of Veterans Affairs and Defense to enter into a contract with 
     the National Academy of Sciences (Academy) for the Medical 
     Follow-Up Agency (MFUA) of the Institute of Medicine to 
     review existing scientific, medical, and other information on 
     the health consequences of military service in the Persian 
     Gulf during the Persian Gulf War and required the submission 
     of a report to the Secretaries and the Veterans' Affairs 
     Committees on the results of the review. The law specified 
     that the report include an assessment of the effectiveness of 
     actions taken by the Secretary of Veterans Affairs and the 
     Secretary of Defense to collect and maintain information that 
     is potentially useful for assessing the health consequences 
     of the military service; recommendations on means of 
     improving the collection and maintenance of such information; 
     and recommendations on whether there is sound scientific 
     basis for an epidemiological study or studies on the health 
     consequences of such service, and, if the recommendation is 
     that there is sound scientific basis for such study or 
     studies, the nature of the study or studies. In testimony 
     before the Subcommittee on Compensation, Pension and 
     Insurance on June 9, 1994, Mr. Richard Miller, Director MFUA, 
     indicated that an interim report would be provided to the 
     Committee by December 1994. The Committee has great respect 
     for the opinions of the Academy and expects that the VA will 
     give its recommendations very serious consideration.
       Section 8 of the bill, as reported, would authorize the 
     appropriation of such sums as may be needed in fiscal year 
     1995 for the conduct of a survey of Persian Gulf veterans to 
     gather information concerning the incidence and nature of 
     health problems occurring in this group of veterans and their 
     families. This was also a recommendation of the NIH Workshop. 
     See NIH Workshop Report (Appendix A). During the June 9, 
     1994, hearing before the Subcommittee on Compensation, 
     Pension, and Insurance, Mr. Clyde J. Behney, Assistant 
     Director, Congressional Office of Technology Assessment, 
     testified that a survey should provide information for 
     deciding what types of further studies are necessary. He also 
     stressed that the results of a well-designed and conducted 
     survey are a necessary prerequisite to a decision as to 
     whether other major epidemiologic studies should be 
     conducted.
       Section 9 would authorize the VA to conduct an 
     epidemiological study on the health consequences of service 
     in the Persian Gulf if the Academy finds a basis for and 
     recommends such study in the report required by Public Law 
     102-585 (described above), and would authorize the 
     appropriation of such sums as may be needed to carry out such 
     study. The VA would be authorized to contract with NAS for 
     review of proposals, oversight, and review of findings of the 
     study or with another appropriate scientific organization if 
     it is unable to enter into an agreement with NAS. It would 
     also require DOD and HHS to make relevant data available for 
     the study. In the event that an epidemiological study is 
     recommended by NAS, the Committee would intend that such 
     study be conducted in a timely fashion and that interim 
     progress reports be provided at reasonable intervals.
       An additional purpose of the reported bill, embodied in 
     section 10, would be to extend, through the end of calendar 
     year 1998, the VA's authorization to provide marriage and 
     family counseling to Persian Gulf War veterans, and to extend 
     the authorization for the appropriation of $10 million for 
     each year through fiscal year 1999 for such purpose. In 
     Public Law 102-405, the Congress required the Secretary to 
     establish a program of marriage and family counseling to 
     veterans who were awarded campaign medals for active-duty 
     service during the Persian Gulf War and their spouses and 
     children, and veterans who are or were members of reserve 
     components, including Reserve and National Guard forces, who 
     were called to active duty during the war, as well as their 
     spouses and children. The law specified that the authority to 
     conduct the counseling program would expire at the end of 
     fiscal year 1994. However, because the Committee recognizes 
     that Persian Gulf War veterans and their families may still 
     be suffering from the stress of military deployment in the 
     Persian Gulf region, an extension of this program for an 
     additional period would be appropriate.
       Finally, the reported bill contains two cost-savings 
     provisions that fully offset estimated Pay-Go costs. First, 
     section 11 would provide that new rates in compensation and 
     dependency and indemnity compensation (DIC) which may be 
     enacted for fiscal year 1995 must be rounded down in the same 
     manner as the fiscal year 1994 cost-of-living adjustment. 
     This method for determining the new rates of compensation has 
     been applied in previous years and has only a minimal impact 
     on benefits. Second, the reported bill reflects the adoption 
     of a recommendation by the VA that certain surviving spouses 
     of veterans with no dependents who are receiving nursing-home 
     care under Medicaid programs be permitted to elect to receive 
     death pension in lieu of DIC, and thereby be treated in the 
     same fashion as are veterans under the same circumstances.

  Mr. Speaker, I strongly urge my colleagues to support this bill.
  Mr. STUMP. Mr. Speaker, I yield myself such time as I may consume.
  (Mr. STUMP asked and was given permission to revise and extend his 
remarks.)
  Mr. STUMP. Mr. Speaker, I rise in strong support of H.R. 4386, as 
amended, the Veterans' Persian Gulf War Benefits Act.
  I want to commend the gentleman from Mississippi [Mr. Montgomery] 
chairman of the Veterans' Affairs Committee, for addressing the needs 
of those Persian Gulf veterans who are showing signs of illness. His 
consistent dedication to our Nation's veterans has been unwavering.
  I also want to recognize the gentleman from Kansas [Mr. Slattery], 
chairman of the Compensation, Pension, and Insurance Subcommittee, and 
the gentleman from Florida [Mr. Bilirakis], ranking minority member of 
the subcommittee, for their tireless assistance on developing this 
bipartisan legislation, moving it through the full committee and 
bringing it to the floor.
  Many Persian Gulf war veterans have been suffering disabling illness 
since returning to the United States. Because no exact causes and 
diagnoses have been determined, these former service members have not 
been able to receive compensation from the Department of Veterans' 
Affairs. As of today, the only apparent causal link seems to be active 
duty in the Southwest Asia theater of operations.
  Mr. Speaker, H.R. 4386, as amended, is precedent-setting; for the 
first time, we will be compensating veterans who have returned from war 
with as yet undiagnosed illnesses. This bill authorizes funds for 
further research into the unknown causes of Persian Gulf Syndrome, as 
well as greater outreach to these veterans and their families.
  The Veterans' Affairs Committee is strongly committed to compensating 
the disabled men and women who served our country.
  Mr. Speaker, I urge my colleagues to support H.R. 4386.

                              {time}  1220

  Mr. Speaker, I reserve the balance of my time.
  Mr. MONTGOMERY. Mr. Speaker, I yield 3 minutes to the gentleman from 
Illinois [Mr. Evans], a member of our committee.
  Mr. EVANS. Mr. Speaker, over 3 years have passed since hostilities 
ended in the Persian Gulf war. For many of the men and women who fought 
there, the battle continues.
  Thousands of Persian Gulf war veterans have reported unexpected 
health problems, including, chronic fatigue, weight loss, muscle 
weakness, and lung ailments.
  The Persian Gulf war may have been the dirtiest war that we have ever 
fought. U.S. service personnel were exposed to a variety of toxic 
substances and parasitic diseases. For months, these men and women 
breathed the fumes of burning oil and trash and were given experimental 
drugs by the Department of Defense.
  The reports of adverse health effects cannot be discounted. The 
short- and long-term health effects of exposure to these substances are 
not fully understood. What we do know, however, is that many of our 
veterans are sick and that it is our responsibility to ensure that 
these veterans get the assistance that they need.
  VA's general counsel has decided that the Department lacks the 
authority to provide veterans benefits to Persian Gulf vets with 
undiagnosible diseases. While I disagree with this position, I commend 
Secretary Brown for his strong support of the legislation.
  I also would like to remind our colleagues in the other body that our 
job is to care for veterans. If something is wrong, it is our 
responsibility to fix it. Congress cannot shirk its responsibility by 
simply saying that VA should fix the problem itself.
  Nevertheless, I am very pleased that the House has learned from past 
battles. These veterans will not have to sit around and suffer as 
politicians play the same games that they did with Vietnam veterans 
exposed to agent orange and World War II veterans exposed to ionizing 
radiation.
  Today, we lift the burden off the shoulders of these veterans. With 
the passage of this bill, we give Persian Gulf veterans the benefit of 
the doubt and show our resolve to prevent an awful chapter of history 
from repeating itself.
  H.R. 4386, as amended, recognizes the service and sacrifices of 
Persian Gulf veterans and moves to provide them with their rightful VA 
benefits.
  The measure reflects a solid bipartisan compromise on a variety of 
issues and I thank each of my colleagues who participated in the 
negotiations.
  I would like to thank Jim Slattery for negotiating the compromise and 
to Joe Kennedy, Chairman Montgomery, Mike Bilirakis, and Bob Stump for 
their willingness to move on this measure. I also would like to thank 
the 84 sponsors of my legislation and recognize both the American 
Legion and the Vietnam Veterans of America for their contribution to 
this debate. Their assistance was critical in drafting and furthering 
this legislation.
  On behalf of the men and women who served in the gulf, I urge that 
the Members support H.R. 4386, as amended.
  Mr. STUMP. Mr. Speaker, I have no further requests for time, and I 
yield back the balance of my time.
  Mr. MONTGOMERY. Mr. Speaker, I yield myself 30 seconds.
  Mr. Speaker, I would like to thank the Members who have spoken on 
behalf of this bill today.
  Mr. Speaker, this must be pretty good legislation. The Washington 
Post stated in its lead editorial on July 30 that ``the enactment of 
this legislation will break an old rule and set a new precedent.'' It 
is needed legislation, and I am confident that my colleagues will fully 
support the bill.
  Mr. BILIRAKIS. Mr. Speaker, I rise in strong support of H.R. 4386, 
the Veterans' Persian Gulf War Benefits Act.
  H.R. 4386 will provide compensation to Persian Gulf Veterans who are 
suffering from mysterious illnesses. Currently, these veterans are 
unable to be compensated since, to date, we have been unable to 
precisely define a causal link.
  H.R. 4386 was introduced by our full committee chairman Sonny 
Montgomery. I want to commend Chairman Montgomery for his efforts to 
address the problems facing Persian Gulf veterans.
  The compensation subcommittee adopted an amendment which made 
substantial improvements to H.R. 4386. This amendment was drafted in 
cooperation with Chairman Montgomery, Chairman Slattery, Bob Stump, 
Lane Evans, and Joe Kennedy. I would like to thank my colleagues for 
their valuable input.
  With the passage of H.R. 4386, we will be setting a new precedent in 
veterans benefits. For the first time, we will be providing 
compensation for medical conditions for which there is no definitive 
scientific evidence that they are service-connected.
  While we are setting a new precedent with this legislation, I think 
it is important to remember that we have responsibility for our 
servicemembers' financial well-being as well as their physical well-
being. Many of the veterans suffering from these mysterious illnesses 
are no longer able to work. At the same time, they are unable to 
collect disability compensation from the VA. We cannot ignore the needs 
of our Persian Gulf veterans.
  I believe H.R. 4386, as amended, is an appropriate step toward 
assisting our Persian Gulf war veterans. These veterans answered the 
call to duty, and we should not force them to wait for an irrefutable 
scientific diagnosis before we recognize their claims for disability 
compensation.
  We made that mistake once and thousands of Vietnam veterans and their 
families suffered the consequences of our inaction. We must not allow 
this to happen again.
  I urge my colleagues to support H.R. 4386.
  Mr. BARCA of Wisconsin. Mr. Speaker, I rise today to strongly support 
H.R. 4386, the Persian Gulf war veterans' benefits legislation.
  I commend the Veterans' Affairs Committee chair and members for 
moving this bill to the floor in an expeditious manner.
  A number of constituents and veterans' groups have contacted me to 
describe their personal experiences, or that of family members, as they 
struggle with the baffling and debilitating symptoms of illness 
following their return from service in the gulf war. We must give them 
the support they so justly deserve.
  I am also pleased that on this same day we are considering H.R. 4088, 
Veterans' Disability Compensation. The men and women who served our 
country so valiantly and have suffered service-connected disabilities 
and the families who lost loved ones are surely deserving of increased 
compensation to reflect the increase in the cost-of-living.
  These bills merit our support.
  Mr. GILMAN. Mr. Speaker, I rise in strong support of H.R. 4386, the 
Veterans Persian Gulf War Benefits Act. As a cosponsor of this 
legislation, I am pleased that the House of Representatives has the 
opportunity to discuss this important legislation. Furthermore, I 
praise the leadership of the Committee on Veterans' Affairs; its 
guidance has been invaluable in ensuring that our Persian Gulf war 
veterans receive the medical care and treatment that they have 
valiantly earned.
  For some time, I have been deeply concerned that our Nation's 
veterans were exposed to chemical or biological warfare agents during 
the Persian Gulf war. The relationship between the mystery symptoms 
that many of our Persian Gulf war veterans are experiencing--including 
fatigue, headaches, memory disturbance, skin rashes, and diarrhea--and 
their military service is something that we can no longer ignore. I 
strongly believe that our Nation's veterans should not and cannot be 
penalized for their military service.
  As a supporter of H.R. 4386, I believe that it will assist our 
Nation's veterans in a variety of ways.
  First, effective October 1, 1994, this legislation will provide 
compensation to Persian Gulf war veterans who suffer from chronic 
disabilities that are a result of their military service during the 
Persian Gulf war.
  Also, H.R. 4386 directs the Departments of Veterans Affairs to work 
in conjunction with the Department of Defense and the Department of 
Health and Human Services in implementing uniform case assessment 
protocols for veterans that are displaying symptoms associated with 
their military service during the Persian Gulf war.
  Furthermore, this legislation authorizes $5 million for fiscal year 
1995, 1996, and 1997, to conduct research on Persian Gulf war veterans' 
health risks and treatment.
  I believe this legislation is a positive first step in ensuring that 
our heroes of the Persian Gulf war are fully compensated and provided 
with the medical treatment and health care that they deserve. 
Accordingly, I urge my colleagues to join me in supporting this 
important measure.
  Ms. SNOWE. Mr. Speaker, I rise today to express my strong support for 
H.R. 4386, the Persian Gulf War Veterans' Benefits Act.
  I strongly support the effort to determine the true cause of the gulf 
war syndrome, but despite the best efforts of the medical science we 
have not yet found that cause. In the meantime, this bill is crucially 
important because it ensures the coverage of all the men and women who 
served their country during Desert Storm and are suffering from the 
gulf war syndrome.
  Since the end of Operation Desert Storm, we have been hearing tragic 
stories about American soldiers with debilitating symptoms linked to 
their service in the Persian Gulf. Through the end of June, over 17,000 
gulf war veterans suffering from this syndrome have contacted the 
Department of Veterans Affairs. These veterans are experiencing health 
problems that defy diagnosis.
  The origins of their illnesses are still unknown, and the symptoms of 
this mysterious syndrome range from persistent headaches, unexplained 
weight loss, and fatigue to sore joints, mental confusion, and strange 
rashes. Theories abound about the cause of these symptoms--smoke from 
burning oil wells; unusual responses to vaccines; exposure to 
pesticides or other substances; or possible exposure to Iraqi chemical 
or biological warfare agents.
  The veterans afflicted with this malady and their families have 
endured crippling physical, emotional, and financial hardships because 
of the Persian Gulf syndrome. This bill provides compensation to these 
veterans suffering from chronic disabilities resulting from undiagnosed 
illnesses connected to their service in the Persian Gulf. They 
desperately need this legislation to ensure that they receive the 
assistance necessary for them to put their lives back together.
  When this bill was introduced by the distinguished chairman from 
Mississippi, the Secretary of Veterans Affairs hailed this bill as 
revolutionary. This bill directs the VA, in consultation with the 
Departments of Defense and Health and Human Services, to implement new 
case assessment strategies for veterans with this mystery illness, and 
it authorizes $5 million for the VA to conduct research on Persian Gulf 
war veterans' health risks and treatment. By our action today, the 
House will be sending the clear message that we will not let our 
veterans down.
  We cannot wait while medical science strives to determine the cause 
of the Persian Gulf syndrome, because the brave men and women of our 
Armed Forces that went to the Persian Gulf to turn back the tide of 
aggression and liberate Kuwait need our help and they need it now.
  The fact that the specific cause to the Persian Gulf syndrome is 
still not known does not lessen our responsibility to give our veterans 
the treatment and compensation they rightfully deserve.
  I cannot emphasize enough how important this bill is, and I urge all 
of my colleagues to support it.
  Mr. MONTGOMERY. Mr. Speaker, I have no further requests for time, and 
I yield back the balance of my time.
  The SPEAKER pro tempore (Mr. Traficant). The question is on the 
motion by the gentleman from Mississippi [Mr. Montgomery] that the 
House suspend the rules and pass the bill, H.R. 4386, as amended.
  The question was taken; and (two-thirds having voted in favor 
thereof) the rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

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