I 118TH CONGRESS 1ST SESSION H. R. 2441 To amend title 38, United States Code, to expand health care and benefits from the Department of Veterans Affairs for military sexual trauma, and for other purposes. IN THE HOUSE OF REPRESENTATIVES MARCH 30, 2023 Ms. PINGREE introduced the following bill; which was referred to the Com- mittee on Veterans’ Affairs, and in addition to the Committee on Armed Services, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdic- tion of the committee concerned A BILL To amend title 38, United States Code, to expand health care and benefits from the Department of Veterans Af- fairs for military sexual trauma, 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; TABLE OF CONTENTS. 3 (a) SHORT TITLE.—This Act may be cited as the 4 ‘‘Servicemembers and Veterans Empowerment and Sup- 5 port Act of 2023’’. 6 (b) TABLE OF CONTENTS.—The table of contents for 7 this Act is as follows: 8 VerDate Sep 11 2014 20:28 Apr 12, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H2441.IH H2441 pbinns on DSKJLVW7X2PROD with $$_JOB 2 •HR 2441 IH Sec. 1. Short title; table of contents. TITLE I—DEFINING MILITARY SEXUAL TRAUMA Sec. 101. Report on military sexual trauma in the digital age. TITLE II—DISABILITY COMPENSATION AND CLAIMS PROCESSING Sec. 201. Definition of military sexual trauma. Sec. 202. Conforming changes relating to specialized teams to evaluate claims involving military sexual trauma. Sec. 203. Evaluation of claims involving military sexual trauma. Sec. 204. Choice of location of Department of Veterans Affairs medical exam- ination for assessment of claims for compensation relating to disability resulting from military sexual trauma. Sec. 205. Communications from the Department of Veterans Affairs to individ- uals who have experienced military sexual trauma. Sec. 206. Study on training and processing relating to claims for disability compensation relating to military sexual trauma. Sec. 207. Annual special focus review of claims for disability compensation for disabilities relating to military sexual trauma. TITLE III—ACCESS TO HEALTH CARE Sec. 301. Expansion of eligibility for counseling and treatment for military sex- ual trauma to include all former members of the reserve com- ponents of the Armed Forces. Sec. 302. Connection to Veterans Health Administration when a disability claim related to military sexual trauma is submitted to Vet- erans Benefits Administration. Sec. 303. Pilot program for interim access to mental health care for individuals who have experienced military sexual trauma. Sec. 304. Comptroller General study on access to care from Department of Vet- erans Affairs for individuals who have experienced military sex- ual trauma. TITLE I—DEFINING MILITARY 1 SEXUAL TRAUMA 2 SEC. 101. REPORT ON MILITARY SEXUAL TRAUMA IN THE 3 DIGITAL AGE. 4 (a) REPORT REQUIRED.—Not later than one year 5 after the date of the enactment of this Act, the Secretary 6 of Veterans Affairs shall submit to the Committee on Vet- 7 erans’ Affairs of the Senate and the Committee on Vet- 8 erans’ Affairs of the House of Representatives a report 9 on military sexual trauma in the digital age. 10 VerDate Sep 11 2014 20:28 Apr 12, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2441.IH H2441 pbinns on DSKJLVW7X2PROD with $$_JOB 3 •HR 2441 IH (b) REQUIREMENTS.—The report required under 1 subsection (a) shall include the following: 2 (1) A comprehensive evaluation and assessment 3 of current Department of Veterans Affairs statutes, 4 regulations, and agency guidance relating to military 5 sexual trauma for the purposes of access to health 6 care under chapter 17 of title 38, United States 7 Code, and compensation under chapter 11 of such 8 title to identify— 9 (A) gaps in coverage for health care and 10 compensation eligibility relating to military sex- 11 ual trauma involving online or other techno- 12 logical communications; and 13 (B) the feasibility and advisability of ex- 14 panding health care and compensation for trau- 15 ma that is nonsexual in nature involving online 16 or other technological communications. 17 (2) Recommendations for revising statutes, reg- 18 ulations, and agency guidance in response to the 19 evaluation and assessment under paragraph (1). 20 (c) CONSULTATION.—In carrying out subsection (a), 21 the Secretary of Veterans Affairs shall consult veterans 22 service organizations and such other stakeholders as the 23 Secretary considers relevant and appropriate. 24 VerDate Sep 11 2014 20:28 Apr 12, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2441.IH H2441 pbinns on DSKJLVW7X2PROD with $$_JOB 4 •HR 2441 IH (d) MILITARY SEXUAL TRAUMA DEFINED.—In this 1 section, the term ‘‘military sexual trauma’’— 2 (1) with respect to eligibility for health care, 3 has the meaning given such term in section 4 1720D(f) of title 38, United States Code, as added 5 by section 301; and 6 (2) with respect to eligibility for compensation, 7 has the meaning given such term in section 1169(i) 8 of title 38, United States Code, as added by section 9 203(a). 10 TITLE II—DISABILITY COM- 11 PENSATION AND CLAIMS 12 PROCESSING 13 SEC. 201. DEFINITION OF MILITARY SEXUAL TRAUMA. 14 In this title, the term ‘‘military sexual trauma’’ has 15 the meaning given such term in section 1169(i) of title 16 38, United States Code, as added by section 203(a). 17 SEC. 202. CONFORMING CHANGES RELATING TO SPECIAL- 18 IZED TEAMS TO EVALUATE CLAIMS INVOLV- 19 ING MILITARY SEXUAL TRAUMA. 20 Subsection (d) of section 1166 of title 38, United 21 States Code, is amended to read as follows: 22 ‘‘(a) DEFINITIONS.—In this section, the terms ‘cov- 23 ered mental health condition’ and ‘military sexual trauma’ 24 VerDate Sep 11 2014 20:28 Apr 12, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2441.IH H2441 pbinns on DSKJLVW7X2PROD with $$_JOB 5 •HR 2441 IH have the meanings given those terms in section 1169(i) 1 of this title.’’. 2 SEC. 203. EVALUATION OF CLAIMS INVOLVING MILITARY 3 SEXUAL TRAUMA. 4 (a) IN GENERAL.—Subchapter VI of chapter 11 of 5 such title is amended by inserting after section 1166 the 6 following new section: 7 ‘‘§ 1166A. Evaluation of claims involving military sex- 8 ual trauma 9 ‘‘(a) IN GENERAL.—(1) In the case of any veteran 10 who claims that a covered mental health condition based 11 on military sexual trauma was incurred in or aggravated 12 by active military, naval, air, or space service, the Sec- 13 retary shall consider the following: 14 ‘‘(A) A diagnosis of such mental health condi- 15 tion by a mental health professional. 16 ‘‘(B) A link, established by medical evidence, 17 between current symptoms and a military sexual 18 trauma. 19 ‘‘(C) Credible supporting evidence, in accord- 20 ance with subsections (b) and (c) that the claimed 21 military sexual trauma occurred. 22 ‘‘(2) The reasons for granting or denying service-con- 23 nection in each case described in paragraph (1) shall be 24 recorded in full. 25 VerDate Sep 11 2014 20:28 Apr 12, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H2441.IH H2441 pbinns on DSKJLVW7X2PROD with $$_JOB 6 •HR 2441 IH ‘‘(b) NONMILITARY SOURCES OF EVIDENCE.—(1) 1 For purposes of subsection (a), evidence from sources 2 other than official records of the Department of Defense 3 regarding the veteran’s active military, naval, air, or space 4 service may corroborate the veteran’s account of the trau- 5 ma. 6 ‘‘(2) Examples of evidence described in paragraph (1) 7 include the following: 8 ‘‘(A) Records from law enforcement authorities, 9 rape crisis centers, mental health counseling centers, 10 hospitals, and physicians. 11 ‘‘(B) Pregnancy tests and tests for sexually 12 transmitted diseases. 13 ‘‘(C) Statements from family members, room- 14 mates, other members of the Armed Forces or vet- 15 erans, and clergy. 16 ‘‘(c) EVIDENCE OF BEHAVIOR CHANGES.—(1) For 17 purposes of subsection (a), evidence of a behavior change 18 following military sexual trauma is one type of relevant 19 evidence that may be found in sources described in such 20 subsection. 21 ‘‘(2) Examples of behavior changes that may be rel- 22 evant evidence of military sexual trauma include the fol- 23 lowing: 24 VerDate Sep 11 2014 20:28 Apr 12, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H2441.IH H2441 pbinns on DSKJLVW7X2PROD with $$_JOB 7 •HR 2441 IH ‘‘(A) A request for a transfer to another mili- 1 tary duty assignment. 2 ‘‘(B) Deterioration in work performance. 3 ‘‘(C) Substance abuse or substance use dis- 4 order. 5 ‘‘(D) Episodes of depression, panic attacks, or 6 anxiety without an identifiable cause. 7 ‘‘(E) Unexplained economic or social behavior 8 changes. 9 ‘‘(d) NOTICE AND OPPORTUNITY TO SUPPLY EVI- 10 DENCE.—The Secretary may not deny a claim of a veteran 11 for compensation under this chapter for a covered mental 12 health condition that is based on military sexual trauma 13 without first— 14 ‘‘(1) advising the veteran that evidence de- 15 scribed in subsections (b) and (c) may constitute 16 credible corroborating evidence of the military sexual 17 trauma; and 18 ‘‘(2) allowing the veteran an opportunity to fur- 19 nish such corroborating evidence or advise the Sec- 20 retary of potential sources of such evidence. 21 ‘‘(e) REVIEW OF EVIDENCE.—In reviewing a claim 22 for compensation described in subsection (a)(1), for any 23 evidence identified as part of such claim that is described 24 in subsection (b) or (c), the Secretary shall submit such 25 VerDate Sep 11 2014 20:28 Apr 12, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H2441.IH H2441 pbinns on DSKJLVW7X2PROD with $$_JOB 8 •HR 2441 IH evidence to such medical or mental health professional as 1 the Secretary considers appropriate, including clinical and 2 counseling experts employed by the Department, to obtain 3 an opinion as to whether the evidence indicates that a mili- 4 tary sexual trauma occurred. 5 ‘‘(f) POINT OF CONTACT.—The Secretary shall en- 6 sure that each document provided to a veteran relating 7 to a claim for compensation described in subsection (a)(1) 8 includes contact information for an appropriate point of 9 contact with the Department. 10 ‘‘(g) SPECIALIZED TEAMS.—The Secretary shall en- 11 sure that all claims for compensation described in sub- 12 section (a)(1) are reviewed and processed by a specialized 13 team established under section 1166 of this title. 14 ‘‘(h) RULE OF CONSTRUCTION REGARDING APPLICA- 15 TION TO NONSEXUAL PERSONAL ASSAULT.—The Sec- 16 retary shall not construe this section as supplanting the 17 standard of proof or evidence required for claims for 18 posttraumatic stress disorder based on nonsexual personal 19 assault, which the Secretary shall continue to define in 20 regulation. 21 ‘‘(i) DEFINITIONS.—In this section: 22 ‘‘(1) The term ‘covered mental health condition’ 23 means post-traumatic stress disorder, anxiety, de- 24 pression, or other mental health diagnosis that the 25 VerDate Sep 11 2014 20:28 Apr 12, 2023 Jkt 039200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H2441.IH H2441 pbinns on DSKJLVW7X2PROD with $$_JOB 9 •HR 2441 IH Secretary determines to be related to military sexual 1 trauma and which may be service-connected under 2 section 1110 of this title. 3 ‘‘(2) The term ‘mental health professional’ 4 means a provider in the field of mental health who 5 meets the credential, licensure, education, and train- 6 ing requirements established by the Secretary. 7 ‘‘(3) The term ‘military sexual trauma’ means, 8 with respect to a veteran, a physical assault of a sex- 9 ual nature, battery of a sexual nature, or sexual har- 10 assment that occurred while the veteran was serving 11 in the active military, naval, air, or space service.’’. 12 (b) OUTREACH.—Not later than 180 days after the 13 date of the enactment of this Act, the Secretary of Vet- 14 erans Affairs shall implement, with input from the veteran 15 community, an informative outreach program for veterans 16 regarding the standard of proof for evaluation of claims 17 relating to military sexual trauma, including requirements 18 for a medical examination and opinion. 19 (c) CLERICAL AMENDMENT.—The table of sections 20 at the beginning of such chapter is amended by inserting 21 after the item relating to section 1166 the following new 22 item: 23 ‘‘1166A. Evaluation of claims involving military sexual trauma.’’. VerDate Sep 11 2014 20:28 Apr 12, 2023 Jkt 039200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6211 E:\BILLS\H2441.IH H2441 pbinns on DSKJLVW7X2PROD with $$_JOB 10 •HR 2441 IH SEC. 204. CHOICE OF LOCATION OF DEPARTMENT OF VET- 1 ERANS AFFAIRS MEDICAL EXAMINATION FOR 2 ASSESSMENT OF CLAIMS FOR COMPENSA- 3 TION RELATING TO DISABILITY RESULTING 4 FROM MILITARY SEXUAL TRAUMA. 5 (a) IN GENERAL.—Section 1165 of title 38, United 6 States Code, is amended— 7 (1) in the section heading, by inserting ‘‘and 8 location of medical examination’’ after ‘‘ex- 9 aminer’’; 10 (2) in subsection (a), by striking ‘‘a physical as- 11 sault of a sexual nature, battery of a sexual nature, 12 or sexual harassment’’ and inserting ‘‘military sexual 13 trauma (as defined in section 1166A(i) of this 14 title)’’; 15 (3) by redesignating subsection (c) as sub- 16 section (d); and 17 (4) by inserting after subsection (b) the fol- 18 lowing new subsection (c): 19 ‘‘(c) CHOICE OF EXAMINATION LOCATION.—(1) The 20 Secretary shall ensure that a veteran who requires a med- 21 ical examination in support of a claim described in sub- 22 section (a) may request that the medical examination take 23 place at a medical facility of the Department by a qualified 24 employee of the Department rather than at a location des- 25 VerDate Sep 11 2014 20:28 Apr 12, 2023 Jkt 039200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H2441.IH H2441 pbinns on DSKJLVW7X2PROD with $$_JOB 11 •HR 2441 IH ignated by a Department contractor that performs such 1 examinations on behalf of the Department. 2 ‘‘(2) The Secretary— 3 ‘‘(A) shall grant any request under paragraph 4 (1) if a medical facility of the Department is avail- 5 able not further than 100 miles from the veteran’s 6 home; and 7 ‘‘(B) may not issue a decision on a claim de- 8 scribed in such paragraph before the requested ex- 9 amination is completed, or notice is provided per 10 paragraph (c)(3). 11 ‘‘(3) If a medical facility of the Department is not 12 available within 100 miles of the veteran’s home, the Sec- 13 retary shall notify the veteran and provide the veteran the 14 opportunity— 15 ‘‘(A) to have the exami [Text truncated for display. 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