[Congressional Record Volume 167, Number 171 (Thursday, September 30, 2021)]
[Senate]
[Pages S6850-S6852]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

  SA 3834. Mrs. GILLIBRAND submitted an amendment intended to be 
proposed by her to the bill S. 2792, to authorize appropriations for 
fiscal year 2022 for military activities of the Department of Defense, 
for military construction, and for defense activities of the Department 
of Energy, to prescribe military personnel strengths for such fiscal 
year, and for other purposes.; which was ordered to lie on the table; 
as follows:

       At the appropriate place, insert the following:
Subtitle __--Presumptive Benefits for War Fighters Exposed to Burn Pits 
                            and Other Toxins

     SEC. __ 1. SHORT TITLE.

       This subtitle may be cited as the ``Presumptive Benefits 
     for War Fighters Exposed to Burn Pits and Other Toxins Act of 
     2021''.

[[Page S6851]]

  


     SEC. __ 2. PRESUMPTION OF SERVICE CONNECTION FOR CERTAIN 
                   DISEASES ASSOCIATED WITH EXPOSURE TO BURN PITS 
                   AND OTHER TOXINS.

       (a) In General.--Subchapter II of chapter 11 of title 38, 
     United States Code, is amended by adding at the end the 
     following new section:

     ``Sec. 1119. PRESUMPTION OF SERVICE CONNECTION FOR CERTAIN 
                   DISEASES ASSOCIATED WITH EXPOSURE TO BURN PITS 
                   AND OTHER TOXINS

       ``(a) Presumption of Service Connection.--(1) For the 
     purposes of section 1110 of this title, and subject to 
     section 1113 of this title, a disease specified in paragraph 
     (2) becoming manifest in a veteran described in paragraph (3) 
     shall be considered to have been incurred in or aggravated 
     during active military, naval, or air service, 
     notwithstanding that there is no record of evidence of such 
     disease during the period of such service.
       ``(2) The diseases specified in this paragraph are the 
     following:
       ``(A) Asthma that was diagnosed after service in a country 
     or territory for which a medal described in paragraph (3) was 
     awarded.
       ``(B)(i) Head cancer of any type.
       ``(ii) Neck cancer of any type.
       ``(iii) Respiratory cancer of any type.
       ``(iv) Gastrointestinal cancer of any type.
       ``(v) Reproductive cancer of any type.
       ``(vi) Lymphoma cancer of any type.
       ``(vii) Lymphomatic cancer of any type.
       ``(viii) Kidney cancer.
       ``(ix) Brain cancer.
       ``(x) Melanoma.
       ``(C) Chronic bronchitis.
       ``(D) Chronic obstructive pulmonary disease.
       ``(E) Constructive bronchiolitis of obliterative 
     bronchiolitis.
       ``(F) Emphysema.
       ``(G) Granulomatous disease.
       ``(H) Interstitial lung disease.
       ``(I) Pleuritis.
       ``(J) Pulmonary fibrosis.
       ``(K) Sarcoidosis.
       ``(L) Any other disease listed under subsection (a)(2) of 
     section 1116 of this title or for which a presumption of 
     service connection is warranted pursuant to regulations 
     prescribed under section subsection (b)(1) of such section.
       ``(M) Any other disease with respect to which final 
     regulations have been prescribed under subsection (c)(3).
       ``(3) A veteran described in this paragraph is any veteran 
     who on or after August 2, 1990, was awarded any of the 
     following:
       ``(A) The Afghanistan Campaign Medal.
       ``(B) The Armed Forces Expeditionary Medal.
       ``(C) The Armed Forces Reserve Medal with M-device.
       ``(D) The Armed Forces Service Medal.
       ``(E) The Global War On Terrorism Expeditionary Medal.
       ``(F) The Inherent Resolve Campaign Medal.
       ``(G) The Iraqi Campaign Medal.
       ``(H) The Southwest Asia Service Medal.
       ``(b) Process to Add Diseases Through Written Petition.--
     (1) In the case that the Secretary receives a written 
     petition from an interested party to add a disease to the 
     list of diseases specified in subsection (a)(2), not later 
     than 90 days after the date of receipt of such petition, the 
     Secretary shall request a determination by the National 
     Academies of Sciences, Engineering, and Medicine (referred to 
     in this section as the `National Academies') with respect to 
     whether there is a positive association between--
       ``(A) the exposure of humans to one or more covered toxins; 
     and
       ``(B) the occurrence of the disease in humans.
       ``(2) For purposes of this subsection, the term `interested 
     party' includes a representative of--
       ``(A) a congressionally chartered veterans service 
     organization;
       ``(B) an organization that--
       ``(i) is described in section 501(c)(3) of the Internal 
     Revenue Code of 1986 and exempt from taxation under section 
     501(a) of such Code;
       ``(ii) serves veterans or members of the Armed Forces; and
       ``(iii) has continuously operated for a period of five 
     years or more preceding the date of the submittal of the 
     written petition under paragraph (1);
       ``(C) a collective bargaining agent for civilian employees 
     of the United States Government;
       ``(D) a nationally recognized medical association;
       ``(E) the National Academies; or
       ``(F) a State or political subdivision of a State.
       ``(c) Determinations by National Academies.--
       (1) If the Secretary receives a determination described in 
     paragraph (2), not later than 180 days after receipt of such 
     determination, the Secretary shall--
       ``(A) publish in the Federal Register proposed regulations 
     to add the disease covered by the determination to the list 
     of diseases specified in subsection (a)(2);
       ``(B) publish in the Federal Register, and submit to the 
     Committee on Veterans' Affairs of the Senate and the 
     Committee on Veterans' Affairs of the House of 
     Representatives--
       ``(i) the decision of the Secretary not to publish such 
     proposed regulations; and
       ``(ii) the basis for such decision, including specific 
     medical science refuting the determination; or
       ``(C) publish in the Federal Register a decision that 
     insufficient evidence exists to take action under 
     subparagraph (A) or (B).
       ``(2) A determination described in this paragraph--
       ``(A) is a determination by the National Academies that 
     there is a positive association between--
       ``(i) the exposure of humans to one or more covered toxins; 
     and
       ``(ii) the occurrence of the disease in humans; and
       ``(B) may be made pursuant to--
       ``(i) a request from the Secretary under subsection (b); or
       ``(ii) an agreement between the Secretary and the National 
     Academies under section __ 3 of the Presumptive Benefits for 
     War Fighters Exposed to Burn Pits and Other Toxins Act of 
     2021.
       ``(3)(A) Not later than 180 days after the date on which 
     the Secretary publishes any proposed regulations under 
     paragraph (1)(A) for a disease, the Secretary shall prescribe 
     final regulations for that disease.
       ``(B) Such regulations shall be effective on the date of 
     issuance.
       ``(d) Reference to National Academies.--In the case that 
     the Secretary enters into an agreement with another 
     organization as described in section __3(h)(1) of the 
     Presumptive Benefits for War Fighters Exposed to Burn Pits 
     and Other Toxins Act of 2021, any reference in this section 
     to the National Academies shall be treated as a reference to 
     the other organization.
       ``(e) Definitions.--In this section:
       ``(1) The term `covered toxin' includes the following:
       ``(A) Any toxic chemical or toxic fume.
       ``(B) Hazardous waste, mixed waste, solid waste, or used 
     oil (as those terms are defined in section 1004 of the Solid 
     Waste Disposal Act (42 U.S.C. 6903)).
       ``(C) Radiological waste.
       ``(D) Any other carcinogen.
       ``(2) The term `veterans service organization' means an 
     organization recognized by the Secretary for the 
     representation of veterans under section 5902 of this 
     title.''.
       (b) Effective Date.--
       (1) in general.--The amendment made by subsection (a) shall 
     take effect on the date that is 180 days after the date of 
     the enactment of this Act.
       (2) Written Petitions.--With respect to a written petition 
     described in section 1119(b)(1) of title 38, United States 
     Code, as added by subsection (a), that was received by the 
     Secretary of Veterans Affairs before the effective date 
     described in paragraph (1), the Secretary shall make a 
     request of the National Academies of Sciences, Engineering, 
     and Medicine under such section, as so added, not later than 
     90 days after such effective date.
       (c) Clerical Amendment.--The table of sections at the 
     beginning of chapter 11 of title 38, United States Code, is 
     amended by inserting after the item relating to section 1118 
     the following new item:
``1119. Presumption of service connection for certain diseases 
              associated with exposure to burn pits and other 
              toxins.''.
       (d) Conforming Amendment.--Section 1113 of such title is 
     amended by striking ``or 1118'' each place it appears and 
     inserting ``1118, or 1119''.

     SEC.__3. AGREEMENT WITH THE NATIONAL ACADEMIES OF SCIENCES, 
                   ENGINEERING, AND MEDICINE CONCERNING THE 
                   EXPOSURE OF HUMANS TO BURN PITS AND OTHER 
                   TOXINS.

       (a) Agreement.--
       (1) In general.--The Secretary of Veterans Affairs shall 
     seek to enter into an agreement with the National Academies 
     of Sciences, Engineering, and Medicine (referred to in this 
     section as the ``National Academies'') to perform the 
     services covered by this section.
       (2) Timing.--The Secretary shall seek to enter into the 
     agreement described in paragraph (1) not later than 60 days 
     after the date of the enactment of this Act.
       (b) Reviews of Scientific Evidence.--
       (1) In general.--Under an agreement between the Secretary 
     and the National Academies, the National Academies shall 
     review and summarize the scientific evidence, and assess the 
     strength thereof, concerning the association between the 
     exposure of humans to covered toxins and each disease 
     suspected to be associated with such exposure.
       (2) Reviews upon request.--Under an agreement between the 
     Secretary and the National Academies under this section, the 
     National Aeademies shall conduct a review described in 
     paragraph (1) in response to each request made by the 
     Secretary under section 1119(b)(1) of title 38, United States 
     Code, as added by section __2(a).
       (c) Scientific Determinations Concerning Diseases.--
       (1) In general.--For each disease reviewed under subsection 
     (b), the National Academies shall determine (to the extent 
     that available scientific data permit meaningful 
     determinations) whether there is a positive association 
     between the exposure of humans to one or more covered toxins 
     and the occurrence of the disease in humans, taking into 
     account the strength of the scientific evidence and the 
     appropriateness of the statistical and epidemiological 
     methods used to detect the association.
       (2) Submissions for reviews upon request.--Under an 
     agreement between the Secretary and the National Academies 
     under this section, not later than 270 days after the date on 
     which the Secretary transmits a request to the National 
     Academies with respect to a disease under section 1119(b)(1) 
     of title 38, United States Code, as added by section __2(a), 
     the National Academies shall submit to the Secretary the 
     determination

[[Page S6852]]

     made with respect to that disease under paragraph (1).
       (d) Recommendations for Additional Scientific Studies.--
       (1) In general.--Under an agreement between the Secretary 
     and the National Academies under this section, the National 
     Academies shall make any recommendations it has for 
     additional scientific studies to resolve areas of continuing 
     scientific uncertainty relating to the exposure of humans to 
     covered toxins.
       (2) Considerations.--In making recommendations for 
     additional scientific studies, the National Academies shall 
     consider--
       (A) the scientific information that is available at the 
     time of the recommendation;
       (B) the value and relevance of the information that could 
     result from additional studies; and
       (C) the feasibility of carrying out such additional 
     studies.
       (e) Subsequent Reviews.--Under an agreement between the 
     Secretary and the National Academies under this section, the 
     National Academies shall--
       (1) conduct as comprehensive a review as is practicable of 
     the evidence referred to in subsection (b)(1) that became 
     available since the last review of such evidence under this 
     section; and
       (2) make determinations and estimates on the basis of the 
     results of such review and all other reviews conducted for 
     the purposes of this section.
       (f) Reports.--
       (1) Initial Report.--
       (A) In general.--Under an agreement between the Secretary 
     and the National Academies under this section, not later than 
     540 days after the date of the enactment of this Act, the 
     National Academies shall submit to the Secretary and the 
     Committee on Veterans' Affairs of the Senate and the 
     Committee on Veterans' Affairs of the House of 
     Representatives a report on the activities of the National 
     Academies under the agreement.
       (B) Elements.--The report submitted under subparagraph (A) 
     shall include the following:
       (i) The determinations described in subsection (c)(1).
       (ii) An explanation of the scientific evidence and 
     reasoning that led to such determinations.
       (iii) Any recommendations of the National Academies under 
     subsection (d).
       (2) Periodic Updates.--Under an agreement between the 
     Secretary and the National Academies under this section, not 
     less frequently than once every two years, the National 
     Academies shall submit to the Secretary and the Committee on 
     Veterans' Affairs of the Senate and the Committee on 
     Veterans' Affairs of the House of Representatives an updated 
     report on the activities of the National Academies under the 
     agreement.
       (g) Limitation on Authority.--The authority to enter into 
     agreements under this section shall be effective for a fiscal 
     year to the extent that appropriations are available.
       (h) Alternative Contract Scientific Organization.--
       (1) In General.--lf the Secretary is unable within the 
     period prescribed in subsection (a)(2) to enter into an 
     agreement with the National Academies on terms acceptable to 
     the Secretary, the Secretary shall seek to enter into such an 
     agreement with another appropriate scientific organization 
     that--
       (A) is not part of the Government;
       (B) operates as a not-for-profit entity; and
       (C) has expertise and objectivity comparable to that of the 
     National Academies.
       (2) Treatment.--lf the Secretary enters into an agreement 
     with another organization as described in paragraph (1), any 
     reference in this section, section 4, and section 1119 of 
     title 38, United States Code, as added by section __2(a), to 
     the National Academies shall be treated as a reference to the 
     other organization.
       (i) Covered Toxin Defined.--In this section, the term 
     ``covered toxin'' has the meaning given that term in section 
     1119(e) of title 38, United States Code, as added by section 
     __2(a).
       (j) Authorization of Appropriations.--There are authorized 
     to be appropriated to the Department of Veterans Affairs such 
     sums as may be necessary to carry out this section.

     SEC. __4. ACCESS OF THE NATIONAL ACADEMIES OF SCIENCES, 
                   ENGINEERING, AND MEDICINE TO INFORMATION FROM 
                   FEDERAL AGENCIES.

       (a) In General.--Upon request by the National Academies of 
     Sciences, Engineering, and Medicine (referred to in this 
     section as the ``National Academics''), the head of any 
     Federal agency with relevant information shall provide to the 
     National Academies information in the possession of the 
     agency that the National Academies determines useful in 
     conducting a review under section __3(b).
       (b) Federal Agency Defined.--In this section, the term 
     ``Federal agency'' means any agency as that term is defined 
     in section 551 of title 5, United States Code.

     SEC. __5. PRESUMPTION RELATING TO PERSONAL INJURY OF CERTAIN 
                   FEDERAL EMPLOYEES.

       (a) In General.--Section 8102 of title 5, United States 
     Code, is amended by adding at the end the following:
       ``(c)(1) In this subsection, the term `covered employee' 
     means an employee of the Department of State, the Department 
     of Defense, or an element of the intelligence community (as 
     defined in section 3 of the National Security Act of 1947 (50 
     U.S.C. 3003)) who, on or after August 2, 1990, carried out 
     the job responsibilities of the employee for not fewer than 
     30 total days in a country or territory while the United 
     States was conducting a contingency operation (as defined in 
     section 101 of title 10) in that country or territory.
       ``(2) Disability or death from a disease described in 
     paragraph (2) of such section suffered by a covered employee 
     is deemed to have resulted from personal injury sustained 
     while in the performance of the duty of the covered employee, 
     whether or not the covered employee was engaged in the course 
     of employment when the disability or disability resulting in 
     death occurred.''.
       (b) Effective Date.--The amendment made by subsection (a) 
     shall take effect on the date that is 180 days after the date 
     of enactment of this Act.
       (c) Rule of Construction.--Subsection (c) of section 8102 
     of such title, as added by subsection (a), shall not be 
     construed to apply to a contractor of a Federal department or 
     agency.
                                 ______