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 Services, and Education and Labor, 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 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. 

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

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Presumptive Benefits 

5 for War Fighters Exposed to Burn Pits and Other Toxins 

6 Act of 2020’’. 


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1 SEC. 2. PRESUMPTION OF SERVICE CONNECTION FOR CER2 TAIN DISEASES ASSOCIATED WITH EXPO3 SURE TO OPEN BURN PITS AND OTHER TOX4 INS. 

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

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

7 end the following new section: 

8 ‘‘§ 1119. Presumption of service connection for cer9 tain diseases associated with exposure to 

10 open burn pits and other toxins 

11 ‘‘(a) PRESUMPTION OF SERVICE CONNECTION.—(1) 

12 For the purposes of section 1110 of this title, and subject 

13 to section 1113 of this title, a disease specified in para14 graph (2) becoming manifest in a veteran described in 

15 paragraph (3) shall be considered to have been incurred 

16 in or aggravated during active military, naval, or air serv17 ice, notwithstanding that there is no record of evidence 

18 of such disease during the period of such service. 

19 ‘‘(2) The diseases specified in this paragraph are the 

20 following: 

21 ‘‘(A) Asthma that was diagnosed after service 

22 in a country or territory listed under paragraph 

23 (4)(B). 

24 ‘‘(B) Cancer of any type. 

25 ‘‘(C) Chronic bronchitis. 

26 ‘‘(D) Chronic obstructive pulmonary disease. 


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1 ‘‘(E) Constrictive bronchiolitis or obliterative 

2 bronchiolitis. 

3 ‘‘(F) Emphysema. 

4 ‘‘(G) Granulomatous disease. 

5 ‘‘(H) Interstitial lung disease. 

6 ‘‘(I) Lymphoma. 

7 ‘‘(J) Pleuritis. 

8 ‘‘(K) Pulmonary fibrosis. 

9 ‘‘(L) Sarcoidosis. 

10 ‘‘(M) Any other disease with respect to which 

11 final regulations have been prescribed under sub12 section (c)(3). 

13 ‘‘(3) A veteran described in this paragraph is any vet14 eran who— 

15 ‘‘(A) on or after January 1, 1990— 

16 ‘‘(i) served as a member of the Armed 

17 Forces in support of a military operation de18 scribed in paragraph (4); and 

19 ‘‘(ii) was present for 15 or more cumu20 lative days in a country or territory listed under 

21 subparagraph (B) of that paragraph; or 

22 ‘‘(B) was awarded a campaign medal in rec23 ognition of service in any of the following— 

24 ‘‘(i) Operation Enduring Freedom; 

25 ‘‘(ii) Operation Iraqi Freedom; 


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1 ‘‘(iii) Operation Nomad Shadow; 

2 ‘‘(iv) Operation New Dawn; 

3 ‘‘(v) Operation Inherent Resolve; 

4 ‘‘(vi) Operation Freedom’s Sentinel; 

5 ‘‘(vii) Operation Odyssey Lightning; or 

6 ‘‘(viii) Operation Pacific Eagle. 

7 ‘‘(4) A military operation described in this paragraph 

8 is any of the following: 

9 ‘‘(A) A contingency operation (as defined in 

10 section 101(a)(13) of title 10). 

11 ‘‘(B) A military operation in any of the fol12 lowing countries or territories: 

13 ‘‘(i) Afghanistan. 

14 ‘‘(ii) Bahrain. 

15 ‘‘(iii) Burkina Faso. 

16 ‘‘(iv) Cameroon. 

17 ‘‘(v) Chad. 

18 ‘‘(vi) Diego Garcia. 

19 ‘‘(vii) Djibouti. 

20 ‘‘(viii) Egypt. 

21 ‘‘(ix) Ethiopia. 

22 ‘‘(x) Gabon. 

23 ‘‘(xi) Ghana. 

24 ‘‘(xii) Iraq. 

25 ‘‘(xiii) Jordan. 


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1 ‘‘(xiv) Kenya. 

2 ‘‘(xv) Kuwait. 

3 ‘‘(xvi) Kyrgyzstan. 

4 ‘‘(xvii) Libya. 

5 ‘‘(xviii) Mali. 

6 ‘‘(xix) Niger. 

7 ‘‘(xx) Nigeria. 

8 ‘‘(xxi) Oman. 

9 ‘‘(xxii) Pakistan. 

10 ‘‘(xxiii) Philippines. 

11 ‘‘(xxiv) Saudi Arabia. 

12 ‘‘(xxv) Somalia. 

13 ‘‘(xxvi) South Sudan. 

14 ‘‘(xxvii) Sudan. 

15 ‘‘(xxviii) Syria. 

16 ‘‘(xxix) Tajikistan. 

17 ‘‘(xxx) Tunisia. 

18 ‘‘(xxxi) United Arab Emirates. 

19 ‘‘(xxxii) Uzbekistan. 

20 ‘‘(xxxiii) Yemen. 

21 ‘‘(b) PROCESS TO ADD DISEASES THROUGH WRIT22 TEN PETITION.—(1) In the case that the Secretary re23 ceives a written petition from an interested party to add 

24 a disease to the list of diseases specified in subsection 

25 (a)(2), not later than 90 days after the date of receipt 


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1 of such petition, the Secretary shall request a determina2 tion by the National Academies of Sciences, Engineering, 

3 and Medicine (referred to in this section as the ‘National 

4 Academies’) with respect to whether there is a positive as5 sociation between— 

6 ‘‘(A) the exposure of humans to one or more 

7 covered toxins, including emissions from open burn 

8 pits; and 

9 ‘‘(B) the occurrence of the disease in humans. 

10 ‘‘(2) For purposes of this subsection, the term ‘inter11 ested party’ includes a representative of— 

12 ‘‘(A) a congressionally chartered veterans serv13 ice organization; 

14 ‘‘(B) an organization that— 

15 ‘‘(i) is described in section 501(c)(3) of the 

16 Internal Revenue Code of 1986 and exempt 

17 from taxation under section 501(a) of such 

18 Code; 

19 ‘‘(ii) serves veterans or members of the 

20 Armed Forces; and 

21 ‘‘(iii) has continuously operated for a pe22 riod of five years or more preceding the date of 

23 the submittal of the written petition under 

24 paragraph (1); 


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1 ‘‘(C) a collective bargaining agent for civilian 

2 employees of the United States Government; 

3 ‘‘(D) a nationally recognized medical associa4 tion; 

5 ‘‘(E) the National Academies; or 

6 ‘‘(F) a State or political subdivision of a State. 

7 ‘‘(c) DETERMINATIONS BY NATIONAL ACADEMIES.— 

8 (1) If the Secretary receives a determination described in 

9 paragraph (2), not later than 180 days after receipt of 

10 such determination, the Secretary shall— 

11 ‘‘(A) publish in the Federal Register proposed 

12 regulations to add the disease covered by the deter13 mination to the list of diseases specified in sub14 section (a)(2); 

15 ‘‘(B) publish in the Federal Register, and sub16 mit to the Committee on Veterans’ Affairs of the 

17 Senate and the Committee on Veterans’ Affairs of 

18 the House of Representatives— 

19 ‘‘(i) the decision of the Secretary not to 

20 publish such proposed regulations; and 

21 ‘‘(ii) the basis for such decision, including 

22 specific medical science refuting the determina23 tion; or 


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1 ‘‘(C) publish in the Federal Register a decision 

2 that insufficient evidence exists to take action under 

3 subparagraph (A) or (B). 

4 ‘‘(2) A determination described in this paragraph— 

5 ‘‘(A) is a determination by the National Acad6 emies that there is a positive association between— 

7 ‘‘(i) the exposure humans to one or more 

8 covered toxins, including emissions from open 

9 burn pits; and 

10 ‘‘(ii) the occurrence of the disease in hu11 mans; and 

12 ‘‘(B) may be made pursuant to— 

13 ‘‘(i) a request from the Secretary under 

14 subsection (b); or 

15 ‘‘(ii) an agreement between the Secretary 

16 and the National Academies under section 3 of 

17 the Presumptive Benefits for War Fighters Ex18 posed to Burn Pits and Other Toxins Act of 

19 2020. 

20 ‘‘(3)(A) Not later than 180 days after the date on 

21 which the Secretary publishes any proposed regulations 

22 under paragraph (1)(A) for a disease, the Secretary shall 

23 prescribe final regulations for that disease. 

24 ‘‘(B) Such regulations shall be effective on the date 

25 of issuance. 


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1 ‘‘(d) REFERENCE TO NATIONAL ACADEMIES.—In the 

2 case that the Secretary enters into an agreement with an3 other organization as described in section 3(h)(1) of the 

4 Presumptive Benefits for War Fighters Exposed to Burn 

5 Pits and Other Toxins Act of 2020, any reference in this 

6 section to the National Academies shall be treated as a 

7 reference to the other organization. 

8 ‘‘(e) DEFINITIONS.—In this section: 

9 ‘‘(1) The term ‘covered toxin’ means any toxic 

10 chemical, including— 

11 ‘‘(A) hazardous waste, mixed waste, solid 

12 waste, or used oil (as those terms are defined 

13 in section 1004 of the Solid Waste Disposal Act 

14 (42 U.S.C. 6903)); 

15 ‘‘(B) radiological waste; and 

16 ‘‘(C) any other carcinogen. 

17 ‘‘(2) The term ‘veterans service organization’ 

18 means an organization recognized by the Secretary 

19 for the representation of veterans under section 

20 5902 of this title. 

21 ‘‘(3) The term ‘open burn pit’ means an area 

22 of land located that— 

23 ‘‘(A) is designated by the Secretary of De24 fense to be used for disposing solid waste by 

25 burning in the outdoor air; and 


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1 ‘‘(B) does not contain a commercially man2 ufactured incinerator or other equipment spe3 cifically designed and manufactured for the 

4 burning of solid waste.’’. 

5 (b) EFFECTIVE DATE.— 

6 (1) IN GENERAL.—The amendment made by 

7 subsection (a) shall take effect on the date that is 

8 180 days after the date of the enactment of this Act. 

9 (2) WRITTEN PETITIONS.—With respect to a 

10 written petition described in section 1119(b)(1) of 

11 title 38, United States Code, as added by subsection 

12 (a), that was received by the Secretary of Veterans 

13 Affairs before the effective date described in para14 graph (1), the Secretary shall make a request of the 

15 National Academies of Sciences, Engineering, and 

16 Medicine under such section, as so added, not later 

17 than 90 days after such effective date. 

18 (c) CLERICAL AMENDMENT.—The table of sections 

19 at the beginning of chapter 11 of title 38, United States 

20 Code, is amended by inserting after the item relating to 

21 section 1118 the following new item: 

‘‘1119. Presumption of service connection for certain diseases associated with 

exposure to open burn pits and other toxins.’’. 

22 (d) CONFORMING AMENDMENT.—Section 1113 of 

23 such title is amended by striking ‘‘or 1118’’ each place 

24 it appears and inserting ‘‘1118, or 1119’’. 


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1 SEC. 3. AGREEMENT WITH THE NATIONAL ACADEMIES OF 

2 SCIENCES, ENGINEERING, AND MEDICINE 

3 CONCERNING THE EXPOSURE OF HUMANS TO 

4 OPEN BURN PITS AND OTHER TOXINS. 

5 (a) AGREEMENT.— 

6 (1) IN GENERAL.—The Secretary of Veterans 

7 Affairs shall seek to enter into an agreement with 

8 the National Academies of Sciences, Engineering, 

9 and Medicine (referred to in this section as the ‘‘Na10 tional Academies’’) to perform the services covered 

11 by this section. 

12 (2) TIMING.—The Secretary shall seek to enter 

13 into the agreement described in paragraph (1) not 

14 later than 60 days after the date of the enactment 

15 of this Act. 

16 (b) REVIEWS OF SCIENTIFIC EVIDENCE.— 

17 (1) IN GENERAL.—Under an agreement be18 tween the Secretary and the National Academies, 

19 the National Academies shall review and summarize 

20 the scientific evidence, and assess the strength there21 of, concerning the association between the exposure 

22 of humans to one or more covered toxins, including 

23 emissions from open burn pits, and each disease sus24 pected to be associated with such exposure. 

25 (2) REVIEWS UPON REQUEST.—Under an 

26 agreement between the Secretary and the National 


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1 Academies under this section, the National Acad2 emies shall conduct a review described in paragraph 

3 (1) in response to each request made by the Sec4 retary under section 1119(b)(1) of title 38, United 

5 States Code, as added by section 2(a). 

6 (c) SCIENTIFIC DETERMINATIONS CONCERNING DIS7 EASES.— 

8 (1) IN GENERAL.—For each disease reviewed 

9 under subsection (b), the National Academies shall 

10 determine (to the extent that available scientific data 

11 permit meaningful determinations) whether there is 

12 a positive association between the exposure of hu13 mans to one or more covered toxins, including emis14 sions from open burn pits, and the occurrence of the 

15 disease in humans, taking into account the strength 

16 of the scientific evidence and the appropriateness of 

17 the statistical and epidemiological methods used to 

18 detect the association. 

19 (2) SUBMISSIONS FOR REVIEWS UPON RE20 QUEST.—Under an agreement between the Secretary 

21 and the National Academies under this section, not 

22 later than 270 days after the date on which the Sec23 retary transmits a request to the National Acad24 emies with respect to a disease under section 

25 1119(b)(1) of title 38, United States Code, as added 


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1 by section 2(a), the National Academies shall submit 

2 to the Secretary the determination made with re3 spect to that disease under paragraph (1). 

4 (d) RECOMMENDATIONS FOR ADDITIONAL SCI5 ENTIFIC STUDIES.— 

6 (1) IN GENERAL.—Under an agreement be7 tween the Secretary and the National Academies 

8 under this section, the National Academies shall 

9 make any recommendations it has for additional sci10 entific studies to resolve areas of continuing sci11 entific uncertainty relating to the exposure of hu12 mans to one or more covered toxins, including emis13 sions from open burn pits. 

14 (2) CONSIDERATIONS.—In making rec15 ommendations for additional scientific studies, the 

16 National Academies shall consider— 

17 (A) the scientific information that is avail18 able at the time of the recommendation; 

19 (B) the value and relevance of the informa20 tion that could result from additional studies; 

21 and 

22 (C) the feasibility of carrying out such ad23 ditional studies. 


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1 (e) SUBSEQUENT REVIEWS.—Under an agreement 

2 between the Secretary and the National Academies under 

3 this section, the National Academies shall— 

4 (1) conduct as comprehensive a review as is 

5 practicable of the evidence referred to in subsection 

6 (b)(1) that became available since the last review of 

7 such evidence under this section; and 

8 (2) make determinations and estimates on the 

9 basis of the results of such review and all other re10 views conducted for the purposes of this section. 

11 (f) REPORTS.— 

12 (1) INITIAL REPORT.— 

13 (A) IN GENERAL.—Under an agreement 

14 between the Secretary and the National Acad15 emies under this section, not later than 540 

16 days after the date of the enactment of this 

17 Act, the National Academies shall submit to the 

18 Secretary and the Committee on Veterans’ Af19 fairs of the Senate and the Committee on Vet20 erans’ Affairs of the House of Representatives 

21 a report on the activities of the National Acad22 emies under the agreement. 

23 (B) ELEMENTS.—The report submitted 

24 under subparagraph (A) shall include the fol25 lowing: 


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1 (i) The determinations described in 

2 subsection (c)(1). 

3 (ii) An explanation of the scientific 

4 evidence and reasoning that led to such de5 terminations. 

6 (iii) Any recommendations of the Na7 tional Academies under subsection (d). 

8 (2) PERIODIC UPDATES.—Under an agreement 

9 between the Secretary and the National Academies 

10 under this section, not less frequently than once 

11 every two years, the National Academies shall sub12 mit to the Secretary and the Committee on Vet13 erans’ Affairs of the Senate and the Committee on 

14 Veterans’ Affairs of the House of Representatives an 

15 updated report on the activities of the National 

16 Academies under the agreement. 

17 (g) LIMITATION ON AUTHORITY.—The authority to 

18 enter into agreements under this section shall be effective 

19 for a fiscal year to the extent that appropriations are 

20 available. 

21 (h) ALTERNATIVE CONTRACT SCIENTIFIC ORGANIZA22 TION.— 

23 (1) IN GENERAL.—If the Secretary is unable 

24 within the period prescribed in subsection (a)(2) to 

25 enter into an agreement with the National AcadVerDate Sep 11 2014 18:43 Sep 25, 2020 Jkt 099200 PO 00000 Frm 00015 Fmt 6652 Sfmt 6201 E:\BILLS\H8261.IH H8261

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1 emies on terms acceptable to the Secretary, the Sec2 retary shall seek to enter into such an agreement 

3 with another appropriate scientific organization 

4 that— 

5 (A) is not part of the Government; 

6 (B) operates as a not-for-profit entity; and 

7 (C) has expertise and objectivity com8 parable to that of the National Academies. 

9 (2) TREATMENT.—If the Secretary enters into 

10 an agreement with another organization as described 

11 in paragraph (1), any reference in this section, sec12 tion 4, and section 1119 of title 38, United States 

13 Code, as added by section 2(a), to the National 

14 Academies shall be treated as a reference to the 

15 other organization. 

16 (i) DEFINITIONS.—In this section, the terms ‘‘cov17 ered toxin’’ and ‘‘open burn pit’’ have the meanings given 

18 such terms in section 1119(e) of title 38, United States 

19 Code, as added by section 2(a). 

20 (j) AUTHORIZATION OF APPROPRIATIONS.—There 

21 are authorized to be appropriated to the Department of 

22 Veterans Affairs such sums as may be necessary to carry 

23 out this section. 


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1 SEC. 4. ACCESS OF THE NATIONAL ACADEMIES OF 

2 SCIENCES, ENGINEERING, AND MEDICINE TO 

3 INFORMATION FROM THE DEPARTMENT OF 

4 DEFENSE. 

5 (a) IN GENERAL.—Upon request by the National 

6 Academies of Sciences, Engineering, and Medicine (re7 ferred to in this section as the ‘‘National Academies’’), 

8 the Secretary of Defense shall provide to the National 

9 Academies information in the possession of the Depart10 ment of Defense that the National Academies determines 

11 useful in conducting a review under section 3(b). 

12 (b) INCLUSIONS.—The information described in sub13 section (a) shall include, at a minimum— 

14 (1) all environmental sampling data relative to 

15 any location included in the review; and 

16 (2) a list of all forward deployed positions at 

17 which members of the Armed Forces were deployed 

18 or stationed. 

19 SEC. 5. PRESUMPTION RELATING TO PERSONAL INJURY OF 

20 CERTAIN FEDERAL EMPLOYEES. 

21 (a) IN GENERAL.—Section 8102 of title 5, United 

22 States Code, is amended by adding at the end the fol23 lowing: 

24 ‘‘(c)(1) In this subsection, the term ‘covered em25 ployee’ means an employee who, on or after January 1, 

26 1990, carried out the job responsibilities of the employee 


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1 for not fewer than 15 total days in a country or territory 

2 listed under subparagraph (B) of paragraph (4) of section 

3 1119(a) of title 38, in support of a military operation de4 scribed in that paragraph. 

5 ‘‘(2) Disability or death from a disease described in 

6 paragraph (2) of such section suffered by a covered em7 ployee is deemed to have resulted from personal injury 

8 sustained while in the performance of the duty of the cov9 ered employee, whether or not the covered employee was 

10 engaged in the course of employment when the disability 

11 or disability resulting in death occurred.’’. 

12 (b) EFFECTIVE DATE.—The amendment made by 

13 subsection (a) shall take effect on the date that is 180 

14 days after the date of enactment of this Act. 

Æ 


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