Presumptive Benefits for War Fighters Exposed to Burn Pits and Other Toxins Act of 2020

I 116TH CONGRESS 2D SESSION H. R. 8261 To amend title 38, United States Code, to provide for a presumption of service connection for certain diseases associated with exposure to toxins, including emissions from open burn pits, and for other purposes. IN THE HOUSE OF REPRESENTATIVES SEPTEMBER 15, 2020 Mr. RUIZ introduced the following bill; which was referred to the Committee on Veterans’ Affairs, and in addition to the Committees on Armed Serv- ices, and Education and Labor, for a period to be subsequently deter- mined 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 provide for a presumption of service connection for certain diseases associated with exposure to toxins, including emissions from open burn pits, 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 ‘‘Presumptive Benefits 4 for War Fighters Exposed to Burn Pits and Other Toxins 5 Act of 2020’’. 6 VerDate Sep 11 2014 18:43 Sep 25, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H8261.IH H8261 pamtmann on DSKBC07HB2PROD with BILLS 2 •HR 8261 IH SEC. 2. PRESUMPTION OF SERVICE CONNECTION FOR CER- 1 TAIN DISEASES ASSOCIATED WITH EXPO- 2 SURE TO OPEN BURN PITS AND OTHER TOX- 3 INS. 4 (a) IN GENERAL.—Subchapter II of chapter 11 of 5 title 38, United States Code, is amended by adding at the 6 end the following new section: 7 ‘‘§ 1119. Presumption of service connection for cer- 8 tain diseases associated with exposure to 9 open burn pits and other toxins 10 ‘‘(a) PRESUMPTION OF SERVICE CONNECTION.—(1) 11 For the purposes of section 1110 of this title, and subject 12 to section 1113 of this title, a disease specified in para- 13 graph (2) becoming manifest in a veteran described in 14 paragraph (3) shall be considered to have been incurred 15 in or aggravated during active military, naval, or air serv- 16 ice, notwithstanding that there is no record of evidence 17 of such disease during the period of such service. 18 ‘‘(2) The diseases specified in this paragraph are the 19 following: 20 ‘‘(A) Asthma that was diagnosed after service 21 in a country or territory listed under paragraph 22 (4)(B). 23 ‘‘(B) Cancer of any type. 24 ‘‘(C) Chronic bronchitis. 25 ‘‘(D) Chronic obstructive pulmonary disease. 26 VerDate Sep 11 2014 18:43 Sep 25, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H8261.IH H8261 pamtmann on DSKBC07HB2PROD with BILLS 3 •HR 8261 IH ‘‘(E) Constrictive bronchiolitis or obliterative 1 bronchiolitis. 2 ‘‘(F) Emphysema. 3 ‘‘(G) Granulomatous disease. 4 ‘‘(H) Interstitial lung disease. 5 ‘‘(I) Lymphoma. 6 ‘‘(J) Pleuritis. 7 ‘‘(K) Pulmonary fibrosis. 8 ‘‘(L) Sarcoidosis. 9 ‘‘(M) Any other disease with respect to which 10 final regulations have been prescribed under sub- 11 section (c)(3). 12 ‘‘(3) A veteran described in this paragraph is any vet- 13 eran who— 14 ‘‘(A) on or after January 1, 1990— 15 ‘‘(i) served as a member of the Armed 16 Forces in support of a military operation de- 17 scribed in paragraph (4); and 18 ‘‘(ii) was present for 15 or more cumu- 19 lative days in a country or territory listed under 20 subparagraph (B) of that paragraph; or 21 ‘‘(B) was awarded a campaign medal in rec- 22 ognition of service in any of the following— 23 ‘‘(i) Operation Enduring Freedom; 24 ‘‘(ii) Operation Iraqi Freedom; 25 VerDate Sep 11 2014 18:43 Sep 25, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H8261.IH H8261 pamtmann on DSKBC07HB2PROD with BILLS 4 •HR 8261 IH ‘‘(iii) Operation Nomad Shadow; 1 ‘‘(iv) Operation New Dawn; 2 ‘‘(v) Operation Inherent Resolve; 3 ‘‘(vi) Operation Freedom’s Sentinel; 4 ‘‘(vii) Operation Odyssey Lightning; or 5 ‘‘(viii) Operation Pacific Eagle. 6 ‘‘(4) A military operation described in this paragraph 7 is any of the following: 8 ‘‘(A) A contingency operation (as defined in 9 section 101(a)(13) of title 10). 10 ‘‘(B) A military operation in any of the fol- 11 lowing countries or territories: 12 ‘‘(i) Afghanistan. 13 ‘‘(ii) Bahrain. 14 ‘‘(iii) Burkina Faso. 15 ‘‘(iv) Cameroon. 16 ‘‘(v) Chad. 17 ‘‘(vi) Diego Garcia. 18 ‘‘(vii) Djibouti. 19 ‘‘(viii) Egypt. 20 ‘‘(ix) Ethiopia. 21 ‘‘(x) Gabon. 22 ‘‘(xi) Ghana. 23 ‘‘(xii) Iraq. 24 ‘‘(xiii) Jordan. 25 VerDate Sep 11 2014 18:43 Sep 25, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H8261.IH H8261 pamtmann on DSKBC07HB2PROD with BILLS 5 •HR 8261 IH ‘‘(xiv) Kenya. 1 ‘‘(xv) Kuwait. 2 ‘‘(xvi) Kyrgyzstan. 3 ‘‘(xvii) Libya. 4 ‘‘(xviii) Mali. 5 ‘‘(xix) Niger. 6 ‘‘(xx) Nigeria. 7 ‘‘(xxi) Oman. 8 ‘‘(xxii) Pakistan. 9 ‘‘(xxiii) Philippines. 10 ‘‘(xxiv) Saudi Arabia. 11 ‘‘(xxv) Somalia. 12 ‘‘(xxvi) South Sudan. 13 ‘‘(xxvii) Sudan. 14 ‘‘(xxviii) Syria. 15 ‘‘(xxix) Tajikistan. 16 ‘‘(xxx) Tunisia. 17 ‘‘(xxxi) United Arab Emirates. 18 ‘‘(xxxii) Uzbekistan. 19 ‘‘(xxxiii) Yemen. 20 ‘‘(b) PROCESS TO ADD DISEASES THROUGH WRIT- 21 TEN PETITION.—(1) In the case that the Secretary re- 22 ceives a written petition from an interested party to add 23 a disease to the list of diseases specified in subsection 24 (a)(2), not later than 90 days after the date of receipt 25 VerDate Sep 11 2014 18:43 Sep 25, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H8261.IH H8261 pamtmann on DSKBC07HB2PROD with BILLS 6 •HR 8261 IH of such petition, the Secretary shall request a determina- 1 tion by the National Academies of Sciences, Engineering, 2 and Medicine (referred to in this section as the ‘National 3 Academies’) with respect to whether there is a positive as- 4 sociation between— 5 ‘‘(A) the exposure of humans to one or more 6 covered toxins, including emissions from open burn 7 pits; and 8 ‘‘(B) the occurrence of the disease in humans. 9 ‘‘(2) For purposes of this subsection, the term ‘inter- 10 ested party’ includes a representative of— 11 ‘‘(A) a congressionally chartered veterans serv- 12 ice organization; 13 ‘‘(B) an organization that— 14 ‘‘(i) is described in section 501(c)(3) of the 15 Internal Revenue Code of 1986 and exempt 16 from taxation under section 501(a) of such 17 Code; 18 ‘‘(ii) serves veterans or members of the 19 Armed Forces; and 20 ‘‘(iii) has continuously operated for a pe- 21 riod of five years or more preceding the date of 22 the submittal of the written petition under 23 paragraph (1); 24 VerDate Sep 11 2014 18:43 Sep 25, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H8261.IH H8261 pamtmann on DSKBC07HB2PROD with BILLS 7 •HR 8261 IH ‘‘(C) a collective bargaining agent for civilian 1 employees of the United States Government; 2 ‘‘(D) a nationally recognized medical associa- 3 tion; 4 ‘‘(E) the National Academies; or 5 ‘‘(F) a State or political subdivision of a State. 6 ‘‘(c) DETERMINATIONS BY NATIONAL ACADEMIES.— 7 (1) If the Secretary receives a determination described in 8 paragraph (2), not later than 180 days after receipt of 9 such determination, the Secretary shall— 10 ‘‘(A) publish in the Federal Register proposed 11 regulations to add the disease covered by the deter- 12 mination to the list of diseases specified in sub- 13 section (a)(2); 14 ‘‘(B) publish in the Federal Register, and sub- 15 mit to the Committee on Veterans’ Affairs of the 16 Senate and the Committee on Veterans’ Affairs of 17 the House of Representatives— 18 ‘‘(i) the decision of the Secretary not to 19 publish such proposed regulations; and 20 ‘‘(ii) the basis for such decision, including 21 specific medical science refuting the determina- 22 tion; or 23 VerDate Sep 11 2014 18:43 Sep 25, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H8261.IH H8261 pamtmann on DSKBC07HB2PROD with BILLS 8 •HR 8261 IH ‘‘(C) publish in the Federal Register a decision 1 that insufficient evidence exists to take action under 2 subparagraph (A) or (B). 3 ‘‘(2) A determination described in this paragraph— 4 ‘‘(A) is a determination by the National Acad- 5 emies that there is a positive association between— 6 ‘‘(i) the exposure humans to one or more 7 covered toxins, including emissions from open 8 burn pits; and 9 ‘‘(ii) the occurrence of the disease in hu- 10 mans; and 11 ‘‘(B) may be made pursuant to— 12 ‘‘(i) a request from the Secretary under 13 subsection (b); or 14 ‘‘(ii) an agreement between the Secretary 15 and the National Academies under section 3 of 16 the Presumptive Benefits for War Fighters Ex- 17 posed to Burn Pits and Other Toxins Act of 18 2020. 19 ‘‘(3)(A) Not later than 180 days after the date on 20 which the Secretary publishes any proposed regulations 21 under paragraph (1)(A) for a disease, the Secretary shall 22 prescribe final regulations for that disease. 23 ‘‘(B) Such regulations shall be effective on the date 24 of issuance. 25 VerDate Sep 11 2014 18:43 Sep 25, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H8261.IH H8261 pamtmann on DSKBC07HB2PROD with BILLS 9 •HR 8261 IH ‘‘(d) REFERENCE TO NATIONAL ACADEMIES.—In the 1 case that the Secretary enters into an agreement with an- 2 other organization as described in section 3(h)(1) of the 3 Presumptive Benefits for War Fighters Exposed to Burn 4 Pits and Other Toxins Act of 2020, any reference in this 5 section to the National Academies shall be treated as a 6 reference to the other organization. 7 ‘‘(e) DEFINITIONS.—In this section: 8 ‘‘(1) The term ‘covered toxin’ means any toxic 9 chemical, including— 10 ‘‘(A) hazardous waste, mixed waste, solid 11 waste, or used oil (as those terms are defined 12 in section 1004 of the Solid Waste Disposal Act 13 (42 U.S.C. 6903)); 14 ‘‘(B) radiological waste; and 15 ‘‘(C) any other carcinogen. 16 ‘‘(2) The term ‘veterans service organization’ 17 means an organization recognized by the Secretary 18 for the representation of veterans under section 19 5902 of this title. 20 ‘‘(3) The term ‘open burn pit’ means an area 21 of land located that— 22 ‘‘(A) is designated by the Secretary of De- 23 fense to be used for disposing solid waste by 24 burning in the outdoor air; and 25 VerDate Sep 11 2014 18:43 Sep 25, 2020 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H8261.IH H8261 pamtmann on DSKBC07HB2PROD with BILLS 10 •HR 8261 IH ‘‘(B) does not contain a commercially man- 1 ufactured incinerator or other equipment spe- 2 cifically designed and manufactured for the 3 burning of solid waste.’’. 4 (b) EFFECTIVE DATE.— 5 (1) IN GENERAL.—The amendment made by 6 subsection (a) shall take effect on the date that is 7 180 days after the date of the enactment of this Act. 8 (2) WRITTEN PETITIONS.—With respect to a 9 written petition described in section 1119(b)(1) of 10 title 38, United States Code, as added by subsection 11 (a), that was received by the Secretary of Veterans 12 Affairs before the effective date described in para- 13 graph (1), the Secretary shall make a request of the 14 National Academies of Sciences, Engineering, and 15 Medicine under such section, as so added, not later 16 than 90 days after such effective date. 17 (c) CLERICAL AMENDMENT.—The table of sections 18 at the beginning of chapter 11 of title 38, United States 19 Code, is amended by inserting after the item relating to 20 section 1118 the following new item: 21 ‘‘1119. Presumption of service connection for certain diseases associated with exposure to open burn pits and other toxins.’’. (d) CONFORMING AMENDMENT.—Section 1113 of 22 such title is amended by striking ‘‘or 1118’’ each place 23 it appears and inserting ‘‘1118, or 1119’’. 24 VerDate Sep 11 2014 18:43 Sep 25, 2020 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H8261.IH H8261 pamtmann on DSKBC07HB2PROD with BILLS 11 •HR 8261 IH SEC. 3. AGREEMENT WITH THE NATIONAL ACADEMIES OF 1 SCIENCES, ENGINEERING, AND MEDICINE 2 CONCERNING THE EXPOSURE OF HUMANS TO 3 OPEN BURN PITS AND OTHER TOXINS. 4 (a) AGREEMENT.— 5 (1) IN GENERAL.—The Secretary of Veterans 6 Affairs shall seek to enter into an agreement with 7 the National Academies of Sciences, Engineering, 8 and Medicine (referred to in this section as the ‘‘Na- 9 tional Academies’’) to perform the services covered 10 by this section. 11 (2) TIMING.—The Secretary shall seek to enter 12 into the agreement described in paragraph (1) not 13 later than 60 days after the date of the enactment 14 of this Act. 15 (b) REVIEWS OF SCIENTIFIC EVIDENCE.— 16 (1) IN GENERAL.—Under an agreement be- 17 tween the Secretary and the National Academies, 18 the National Academies shall review and summarize 19 the scientific evidence, and assess the strength there- 20 of, concerning the association between the exposure 21 of humans to one or more covered toxins, including 22 emissions from open burn pits, and each disease sus- 23 pected to be associated with such exposure. 24 (2) REVIEWS UPON REQUEST.—Under an 25 agreement between the Secretary and the National 26 VerDate Sep 11 2014 18:43 Sep 25, 2020 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H8261.IH H8261 pamtmann on DSKBC07HB2PROD with BILLS 12 •HR 8261 IH Academies under this section, the National Acad- 1 emies shall conduct a review described in paragraph 2 (1) in response to each request made by the Sec- 3 retary under section 1119(b)(1) of title 38, United 4 States Code, as added by section 2(a). 5 (c) SCIENTIFIC DETERMINATIONS CONCERNING DIS- 6 EASES.— 7 (1) IN GENERAL.—For each disease reviewed 8 under subsection (b), the National Academies shall 9 determine (to the extent that available scientific data 10 permit meaningful determinations) whether there is 11 a positive association between the exposure of hu- 12 mans to one or more covered toxins, including emis- 13 sions from open burn pits, and the occurrence of the 14 disease in humans, taking into account the strength 15 of the scientific evidence and the appropriateness of 16 the statistical and epidemiological methods used to 17 detect the association. 18 (2) SUBMISSIONS FOR REVIEWS UPON RE- 19 QUEST.—Under an agreement between the Secretary 20 and the National Academies under this section, not 21 later than 270 days after the date on which the Sec- 22 retary transmits a request to the National Acad- 23 emies with respect to a disease under section 24 1119(b)(1) of title 38, United States Code, as added 25 VerDate Sep 11 2014 18:43 Sep 25, 2020 Jkt 099200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\H8261.IH H8261 pamtmann on DSKBC07HB2PROD with BILLS 13 •HR 8261 IH by section 2(a), the National Academies shall submit 1 to the Secretary the determination made with re- 2 spect to that disease under paragraph (1). 3 (d) RECOMMENDATIONS FOR ADDITIONAL SCI- 4 ENT [Text truncated for display. Full text available on Congress.gov.]