I 

111TH CONGRESS 

2D SESSION H. R. 4555 

To amend title 38, United States Code, to direct the Secretary of Veterans 

Affairs to furnish hospital care, medical services, and nursing home 

care to veterans who were stationed at Camp Lejeune, North Carolina, 

while the water was contaminated at Camp Lejeune, and for other 

purposes. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 2, 2010 

Mr. MILLER of North Carolina (for himself, Mr. STUPAK, Mr. DINGELL, Mr. 

JONES, Mr. SHULER, Mr. PRICE of North Carolina, Mr. BUTTERFIELD, 

Mr. MCINTYRE, Mr. KISSELL, Mr. ISRAEL, Mr. MASSA, Mr. ROTHMAN

of New Jersey, Mr. KAGEN, Mr. TEAGUE, Mr. AL GREEN of Texas, Mr. 

HODES, Ms. JACKSON LEE of Texas, Mr. BOYD, Ms. GINNY BROWNWAITE of Florida, and Mr. GRIJALVA) introduced the following bill; 

which was referred to the Committee on Veterans’ Affairs 

A BILL 

To amend title 38, United States Code, to direct the Secretary of Veterans Affairs to furnish hospital care, medical services, and nursing home care to veterans who 

were stationed at Camp Lejeune, North Carolina, while 

the water was contaminated at Camp Lejeune, and for 

other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Janey Ensminger 

3 Act’’. 

4 SEC. 2. HOSPITAL CARE, MEDICAL SERVICES, AND NURS5 ING HOME CARE FOR VETERANS STATIONED 

6 AT CAMP LEJEUNE, NORTH CAROLINA, 

7 WHILE THE WATER WAS CONTAMINATED AT 

8 CAMP LEJEUNE. 

9 (a) IN GENERAL.—Section 1710(e)(1) of title 38, 

10 United States Code, is amended by adding at the end the 

11 following new subparagraph: 

12 ‘‘(F) Subject to paragraph (2), a veteran who, as a 

13 member of the Armed Forces, was stationed at Camp 

14 Lejeune, North Carolina, during a period, determined by 

15 the Secretary in consultation with the Agency for Toxic 

16 Substances and Disease Registry, in which the water at 

17 Camp Lejeune was contaminated by volatile organic com18 pounds, including known human carcinogens and probable 

19 human carcinogens, is eligible for hospital care, medical 

20 services, and nursing home care under subsection 

21 (a)(2)(F) for any illness, notwithstanding that there is in22 sufficient medical evidence to conclude that such illness 

23 is attributable to such contamination.’’. 

24 (b) FAMILY MEMBERS.— 


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1 (1) IN GENERAL.—Subchapter VIII of chapter 

2 17 of title 38, United States Code, is amended by 

3 adding at the end the following new section: 

4 ‘‘§ 1786. Health care of family members of veterans 

5 stationed at Camp Lejeune, North Caro6 lina, while the water was contaminated 

7 at Camp Lejeune 

8 ‘‘(a) IN GENERAL.—A family member of a veteran 

9 described in subparagraph (F) of section 1710(e)(1) of 

10 this title who resided at Camp Lejeune, North Carolina, 

11 during the period described in such subparagraph, or who 

12 was in utero during such period while the mother of such 

13 family member resided at such location, shall be eligible 

14 for hospital care, medical services, and nursing home care 

15 furnished by the Secretary for any covered condition, or 

16 any covered disability that is associated with a condition, 

17 that is associated with exposure to the contaminants in 

18 the water at Camp Lejeune during such period. 

19 ‘‘(b) COVERED CONDITIONS AND DISABILITIES.—In 

20 this section, covered conditions and disabilities are those 

21 conditions and disabilities described in section 1119(a)(2) 

22 of this title.’’. 

23 (2) CLERICAL AMENDMENT.—The table of sec24 tions at the beginning of such chapter is amended 


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1 by inserting after the item relating to section 1785 

2 the following new item: 

‘‘1786. Health care of family members of veterans stationed at Camp Lejeune, 

North Carolina, while the water was contaminated at Camp 

Lejeune.’’. 

3 SEC. 3. PRESUMPTIONS OF SERVICE CONNECTION FOR ILL4 NESSES ASSOCIATED WITH CONTAMINANTS 

5 IN THE WATER SUPPLY AT CAMP LEJEUNE, 

6 NORTH CAROLINA. 

7 (a) IN GENERAL.—Subchapter II of chapter 11 of 

8 title 38, United States Code, is amended by adding at the 

9 end the following new section: 

10 ‘‘§ 1119. Presumptions of service connection for ill11 nesses associated with contaminants in 

12 the water supply at Camp Lejeune, North 

13 Carolina 

14 ‘‘(a) PRESUMPTION.—(1) For purposes of section 

15 1110 of this title, and subject to section 1113 of this title, 

16 each illness, if any, described in paragraph (2) shall be 

17 considered to have been incurred in or aggravated by serv18 ice referred to in that paragraph, notwithstanding that 

19 there is no record of evidence of such illness during the 

20 period of such service. 

21 ‘‘(2) An illness referred to in paragraph (1) is any 

22 diagnosed or undiagnosed illness that— 

23 ‘‘(A) the Secretary determines, in consultation 

24 with the Agency for Toxic Substances and Disease 


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1 Registry, in regulations prescribed under this section 

2 to warrant a presumption of service connection by 

3 reason of having a positive association with exposure 

4 to volatile organic compounds, including known 

5 human carcinogens and probable human carcino6 gens, known or presumed to be associated with serv7 ice in the Armed Forces at Camp Lejeune, North 

8 Carolina, during a period determined by the Sec9 retary in consultation with the Agency for Toxic 

10 Substances and Disease Registry; and 

11 ‘‘(B) becomes manifest within the period, if 

12 any, prescribed in such regulations in a veteran who 

13 served on active duty at Camp Lejeune, North Caro14 lina, and by reason of such service was exposed to 

15 such compounds. 

16 ‘‘(3) For purposes of this subsection, a veteran who 

17 served on active duty at Camp Lejeune, North Carolina, 

18 during the period referred to in paragraph (2)(A) and who 

19 has an illness described in paragraph (2) shall be pre20 sumed to have been exposed by reason of such service to 

21 the compound associated with the illness in the regulations 

22 prescribed under this section unless there is conclusive evi23 dence to establish that the veteran was not exposed to the 

24 compound by reason of such service. 


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1 ‘‘(b) DETERMINATIONS RELATING TO DISEASES.— 

2 (1) Whenever the Secretary determines, in consultation 

3 with the Agency for Toxic Substances and Disease Reg4 istry, on the basis of sound medical and scientific evidence, 

5 that a positive association exists between the exposure of 

6 humans to a volatile organic compound known or pre7 sumed to be present in the water supply at Camp Lejeune, 

8 North Carolina, and the occurrence of a disease in hu9 mans, the Secretary shall prescribe regulations providing 

10 that a presumption of service connection is warranted for 

11 that disease for the purposes of this section. 

12 ‘‘(2) In making determinations for the purpose of this 

13 subsection, the Secretary shall take into account all other 

14 sound medical and scientific information and analyses 

15 available to the Secretary. In evaluating any study for the 

16 purpose of making such determinations, the Secretary 

17 shall take into consideration whether the results are statis18 tically significant, are capable of replication, and with19 stand peer review. 

20 ‘‘(3) An association between the occurrence of a dis21 ease in humans and exposure to a volatile organic com22 pound shall be considered to be positive for the purposes 

23 of this section if the credible evidence for the association 

24 is equal to or outweighs the credible evidence against the 

25 association. 


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1 ‘‘(c) REMOVAL OF DISEASES.—Whenever a disease is 

2 removed from regulations prescribed under this section— 

3 ‘‘(1) a veteran who was awarded compensation 

4 for such disease on the basis of the presumption pro5 vided in subsection (a) before the effective date of 

6 the removal shall continue to be entitled to receive 

7 compensation on that basis; and 

8 ‘‘(2) a survivor of a veteran who was awarded 

9 dependency and indemnity compensation for the 

10 death of a veteran resulting from such disease on 

11 the basis of such presumption shall continue to be 

12 entitled to receive dependency and indemnity com13 pensation on such basis.’’. 

14 (b) CLERICAL AMENDMENT.—The table of sections 

15 at the beginning of such chapter is amended by inserting 

16 after the item relating to section 1118 the following new 

17 item: 

‘‘1119. Presumptions of service connection for illnesses associated with contaminants in the water supply at Camp Lejeune, North Carolina.’’. 

Æ 


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