FASTER Presumptions Act

I 117TH CONGRESS 1ST SESSION H. R. 2607 To amend title 38, United States Code, to establish in the Department of Veterans Affairs procedures to determine presumptions of service connection based on toxic exposure, and for other purposes. IN THE HOUSE OF REPRESENTATIVES APRIL 15, 2021 Mr. TRONE introduced the following bill; which was referred to the Committee on Veterans’ Affairs, and in addition to the Committee on Armed Serv- ices, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL To amend title 38, United States Code, to establish in the Department of Veterans Affairs procedures to determine presumptions of service connection based on toxic expo- sure, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Fairly Assessing Serv- 4 ice-related Toxic Exposure Residuals Presumptions Act’’ 5 or the ‘‘FASTER Presumptions Act’’. 6 VerDate Sep 11 2014 23:43 Jun 01, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H2607.IH H2607 kjohnson on DSK79L0C42PROD with BILLS 2 •HR 2607 IH SEC. 2. IMPROVEMENTS TO ABILITY OF DEPARTMENT OF 1 VETERANS AFFAIRS TO ESTABLISH PRE- 2 SUMPTIONS OF SERVICE CONNECTION 3 BASED ON TOXIC EXPOSURE. 4 (a) ADVISORY COMMITTEES, PANELS, AND 5 BOARDS.— 6 (1) ESTABLISHMENT.—Chapter 11 of title 38, 7 United States Code, is amended by adding at the 8 end the following new subchapter: 9 ‘‘SUBCHAPTER VII—RESEARCH AND DETER- 10 MINATIONS RELATING TO PRESUMPTIONS 11 OF SERVICE CONNECTION BASED ON TOXIC 12 EXPOSURE 13 ‘‘§ 1171. Procedures to determine presumptions of 14 service connection based on toxic expo- 15 sure; definitions 16 ‘‘(a) PROCEDURES.—The Secretary shall determine 17 whether to establish, or to remove, presumptions of service 18 connection based on toxic exposure pursuant to this sub- 19 chapter, whereby— 20 ‘‘(1) the Formal Advisory Committee on Toxic 21 Exposure under section 1172 assesses research re- 22 garding veterans who, during active military, naval, 23 or air service, were exposed to toxic substances, com- 24 missions additional research, and provides nomina- 25 VerDate Sep 11 2014 23:43 Jun 01, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2607.IH H2607 kjohnson on DSK79L0C42PROD with BILLS 3 •HR 2607 IH tions for the Science Review Board to evaluate the 1 research; 2 ‘‘(2) the Science Review Board under section 3 1173 evaluates research nominated by the Formal 4 Advisory Committee on Toxic Exposure and deter- 5 mines the strength of evidence supporting a positive 6 association between exposure to a toxic substance 7 and an illness; 8 ‘‘(3) the Working Group under section 1174 9 evaluates the conclusions of the Science Review 10 Board and recommends to the Secretary whether to 11 establish or modify a presumption of service connec- 12 tion; and 13 ‘‘(4) the Secretary prescribes regulations under 14 section 1175. 15 ‘‘(b) ILLNESS DEFINED.—In this subchapter, the 16 term ‘illness’ includes a disease or other condition affect- 17 ing the health of an individual. 18 ‘‘(c) NONAPPLICATION OF SUNSET REQUIRE- 19 MENTS.—Section 14 of the Federal Advisory Committee 20 Act (5 U.S.C. App.) shall not apply to an entity estab- 21 lished under this subchapter. 22 VerDate Sep 11 2014 23:43 Jun 01, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2607.IH H2607 kjohnson on DSK79L0C42PROD with BILLS 4 •HR 2607 IH ‘‘§ 1172. Formal Advisory Committee on Toxic Expo- 1 sure 2 ‘‘(a) ESTABLISHMENT.—(1) There is in the Veterans 3 Benefits Administration of the Department the Formal 4 Advisory Committee on Toxic Exposure (in this section 5 referred to as the ‘Committee’). 6 ‘‘(2) The Secretary shall appoint not more than 10 7 members to the Committee, of which— 8 ‘‘(A) at least one member shall be appointed 9 from among individuals who are officials or employ- 10 ees of the Veterans Benefits Administration or the 11 Veterans Health Administration; 12 ‘‘(B) at least one member shall be appointed 13 from among individuals who are officials or employ- 14 ees of other departments or agencies of the Federal 15 Government, including the Department of Defense 16 and the Agency of Toxic Substances and Disease 17 Registry of the Centers for Disease Control and Pre- 18 vention; 19 ‘‘(C) at least three members shall be appointed 20 from among individuals who are representatives of 21 disabled veterans; and 22 ‘‘(D) at least one member shall be appointed 23 from among individuals in the private sector, State 24 or local government, or academia, who are experts in 25 toxicology and epidemiology. 26 VerDate Sep 11 2014 23:43 Jun 01, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2607.IH H2607 kjohnson on DSK79L0C42PROD with BILLS 5 •HR 2607 IH ‘‘(3) The Secretary shall determine the pay and al- 1 lowances of the members, including with respect to any 2 additional pay and allowances for members who are offi- 3 cials or employees of the Federal Government. 4 ‘‘(4) Each member of the Committee shall be ap- 5 pointed for a two-year term, and may serve not more than 6 three successive terms. 7 ‘‘(5) A vacancy in the Committee shall be filled in 8 the manner in which the original appointment was made. 9 ‘‘(b) CONSULTATION.—The Secretary may consult 10 with, and seek the advice of, the Committee with respect 11 to disability-related questions relating to veterans who, 12 during active military, naval, or air service, are suspected 13 of having been exposed to toxic substances. 14 ‘‘(c) ASSESSMENTS.—(1) The Committee shall assess 15 the exposure of veterans to toxic substances that occurred 16 during active military, naval, or air service. 17 ‘‘(2) The assessments under paragraph (1) shall 18 cover suspected and known toxic exposures occurring dur- 19 ing active military, naval, or air service, including by iden- 20 tifying and evaluating new and emerging exposures that 21 are not recognized under existing presumptions of service 22 connection. 23 ‘‘(3) The Committee may conduct an assessment 24 under paragraph (1) in response to a recommendation by 25 VerDate Sep 11 2014 23:43 Jun 01, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H2607.IH H2607 kjohnson on DSK79L0C42PROD with BILLS 6 •HR 2607 IH the Science Review Board pursuant to section 1 1173(c)(2)(B) of this title or the Working Group under 2 section 1174(c)(1)(B). 3 ‘‘(4) In assessing the exposure of veterans to toxic 4 substances under paragraph (1), the Commission shall de- 5 termine whether— 6 ‘‘(A) under subsection (d), further research into 7 the exposure is warranted; 8 ‘‘(B) under subsection (e), the existing research 9 being assessed is sufficient to nominate to the 10 Science Review Board under section 1173 of this 11 title for evaluation; 12 ‘‘(C) under subsection (f), there is sufficient 13 evidence regarding an existing presumption of serv- 14 ice connection for review by the Science Review 15 Board or Working Group under section 1174 of this 16 title, as the case may be; or 17 ‘‘(D) no further action is warranted. 18 ‘‘(d) RESEARCH.—(1)(A) Following an assessment of 19 the exposure of veterans to toxic substances that occurred 20 during active military, naval, or air service under sub- 21 section (c), the Committee may commission an appropriate 22 entity (including an element of the Department, an aca- 23 demic entity, or a private-sector entity) to conduct addi- 24 tional research into the exposure and the health effects 25 VerDate Sep 11 2014 23:43 Jun 01, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H2607.IH H2607 kjohnson on DSK79L0C42PROD with BILLS 7 •HR 2607 IH of the exposure, including such research to be conducted 1 in response to data and analyses provided by the Secretary 2 of Defense or the Secretary of Veterans Affairs relating 3 to suspected toxic exposure occurring during such service. 4 ‘‘(B) In carrying out subparagraph (A), the Com- 5 mittee shall determine whether additional research is 6 needed with respect to the following: 7 ‘‘(i) Identification of the composition of sus- 8 pected toxic substances. 9 ‘‘(ii) Exposure assessments. 10 ‘‘(iii) Epidemiological studies. 11 ‘‘(iv) Toxicology and mechanistic studies. 12 ‘‘(C) In carrying out subparagraph (A), the Com- 13 mittee shall consider the following information: 14 ‘‘(i) All available health tracking data. 15 ‘‘(ii) All available surveillance data. 16 ‘‘(iii) All germane research previously consid- 17 ered by the Committee. 18 ‘‘(2) In assessing the suitability of topics for addi- 19 tional research pursuant to subparagraph (A), the Com- 20 mittee shall consider the following: 21 ‘‘(A) Conditions of service in the active military, 22 naval, or air service, known or suspected exposure to 23 agents, and circumstances of exposure. 24 VerDate Sep 11 2014 23:43 Jun 01, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H2607.IH H2607 kjohnson on DSK79L0C42PROD with BILLS 8 •HR 2607 IH ‘‘(B) Existing evidence of a connection between 1 illnesses and service in the active military, naval, or 2 air service, and the size or ability to define the 3 group of affected veterans. 4 ‘‘(C) In accordance with subsection (g), input 5 from persons who may be affected by the actions of 6 the Committee. 7 ‘‘(D) Exposure assessments, including data on 8 activities of the Armed Forces or exposures that 9 may be classified. 10 ‘‘(E) Existing health tracking and surveillance, 11 including veterans and members of the active mili- 12 tary, naval, or air service, such as the burn pit reg- 13 istry established under section 201 of the Dignified 14 Burial and Other Veterans’ Benefits Improvement 15 Act of 2012 (Public Law 112–260; 38 U.S.C. 527 16 note). 17 ‘‘(F) Research, including laboratory research 18 discoveries and findings from studies of members of 19 the active military, naval, or air service and civilian 20 workers who were exposed to toxic substances. 21 ‘‘(G) The effect of sex, gender, age, race, and 22 ethnicity on health outcomes. 23 ‘‘(3) The Committee shall ensure that the research 24 commissioned under paragraph (1) is tailored to produce 25 VerDate Sep 11 2014 23:43 Jun 01, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H2607.IH H2607 kjohnson on DSK79L0C42PROD with BILLS 9 •HR 2607 IH results or conclusions necessary for the Science Review 1 Board to make a fully informed assessment. 2 ‘‘(e) NOMINATION.—If the Committee determines 3 further action is appropriate with respect to an assessment 4 of the exposure of veterans to toxic substances that oc- 5 curred during active military, naval, or air service under 6 subsection (c), the Committee may nominate the Science 7 Review Board to evaluate either or both, as the case may 8 be— 9 ‘‘(1) the existing research included in the as- 10 sessment; or 11 ‘‘(2) the further research conducted pursuant to 12 subsection (d). 13 ‘‘(f) REVIEW OF EXISTING PRESUMPTIONS.—(1) 14 Upon receipt of evidence suggesting that previous findings 15 supporting a positive association between an exposure and 16 an illness are no longer valid, the Committee may nomi- 17 nate such exposure or illness for review by the Science Re- 18 view Board. 19 ‘‘(2) Upon receipt of evidence suggesting that pre- 20 vious findings regarding the periods and locations of expo- 21 sure covered by an existing presumption of service connec- 22 tion are no longer supported, the Committee may nomi- 23 nate such evidence for evaluation by the Working Group 24 to modify the periods and locations. 25 VerDate Sep 11 2014 23:43 Jun 01, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H2607.IH H2607 kjohnson on DSK79L0C42PROD with BILLS 10 •HR 2607 IH ‘‘(g) INPUT.—(1) Not less than quarterly, the Com- 1 mittee shall provide an opportunity for persons described 2 in paragraph (2) to present written or oral comments to 3 the Committee. 4 ‘‘(2) The persons described in this paragraph are per- 5 sons who may be affected by the actions of the Committee, 6 including— 7 ‘‘(A) veterans, the families of veterans, veterans 8 service organizations and representatives, research- 9 ers, and other members of the general public; and 10 ‘‘(B) departments and agencies of the Federal 11 Government. 12 ‘‘(h) REPORTS TO CONGRESS.—On a biennial basis, 13 the Committee shall submit to the Committees on Vet- 14 erans’ Affairs of the House of Representatives and the 15 Senate, and make publicly available, a report on the ac- 16 tions of the Committee. Each such report shall include, 17 with respect to the period covered by the report, the fol- 18 lowing: 19 ‘‘(1) A description of— 20 ‘‘(A) the exposure and evidence considered 21 by the Committee; 22 ‘‘(B) any research commissioned by the 23 Committee; and 24 VerDate Sep 11 2014 23:43 Jun 01, 2021 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H2607.IH H2607 kjohnson on DSK79L0C42PROD with BILLS 11 •HR 2607 IH ‘‘(C) the rationale of the nominations made 1 by the Committee to the Science Review Board 2 for further evaluation. 3 ‘‘(2) A description of each specific action rec- 4 ommended by the Committee described in subsection 5 (c)(3). 6 ‘‘(3) Each report received by the Committee 7 under section 1173(c)(2) of this title. 8 ‘‘§ 1173. Science Review Board 9 ‘‘(a) ESTABLISHMENT.—(1) There is in the Depart- 10 ment the Science Review Board (in this section referred 11 to as the ‘Board’). 12 ‘‘(2)(A) The members of the Board shall be appointed 13 by the Secretary from the general public from among indi- 14 viduals who are distinguished in the fields of medicine, bio- 15 logical sciences, or health administration. 16 ‘‘(B) An individual may not concurrently serve on the 17 Board and the Formal Advisory Committee on Toxic Ex- 18 posure under section 1172 of this title. 19 ‘‘(C) The Secretary shall determine the number, 20 terms of service, and pay and allowances of members of 21 the Board appointed by the Secretary. 22 ‘‘(b) DUTIES.—(1) Upon receiving a nomination for 23 the evaluation of research on the health effects of exposure 24 of members of the active military, naval, or air service to 25 VerDate Sep 11 2014 23:43 Jun 01, 2021 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H2607.IH H2607 kjohnson on DSK79L0C42PROD with BILLS 12 •HR 2607 IH toxic substances made by the Formal Advisory Committee 1 on Toxic Exposure pursuant to section 1172 of this title, 2 the Board shall— 3 ‘‘(A) evaluate the likelihood that an illness is 4 associated with an exposure to a toxic substance 5 while serving in the active m [Text truncated for display. 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