117TH CONGRESS 

2D SESSION S. 3541 

AN ACT 

To improve health care and services for veterans exposed 

to toxic substances, 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 ‘‘Health Care for Burn 

3 Pit Veterans Act’’. 

4 SEC. 2. EXPANSION OF ELIGIBILITY FOR HEALTH CARE 

5 FROM DEPARTMENT OF VETERANS AFFAIRS 

6 FOR CERTAIN VETERANS EXPOSED TO TOXIC 

7 SUBSTANCES. 

8 (a) IN GENERAL.—Section 1710(e)(3) of title 38, 

9 United States Code, is amended— 

10 (1) in subparagraph (A)— 

11 (A) by striking ‘‘January 27, 2003’’ and 

12 inserting ‘‘September 11, 2001’’; and 

13 (B) by striking ‘‘five-year period’’ and in14 serting ‘‘ten-year period’’; 

15 (2) by amending subparagraph (B) to read as 

16 follows: 

17 ‘‘(B) With respect to a veteran described in 

18 paragraph (1)(D) who was discharged or released 

19 from the active military, naval, air, or space service 

20 after September 11, 2001, and before October 1, 

21 2013, but did not enroll to receive such hospital 

22 care, medical services, or nursing home care under 

23 such paragraph pursuant to subparagraph (A) be24 fore October 1, 2022, the one-year period beginning 

25 on October 1, 2022.’’; and 

26 (3) by striking subparagraph (C). 
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1 (b) CLARIFICATION OF COVERAGE.—Section 

2 1710(e)(1)(D) of such title is amended by inserting after 

3 ‘‘Persian Gulf War’’ the following: ‘‘(to include any vet4 eran who, in connection with service during such period, 

5 received the Armed Forces Expeditionary Medal, Service 

6 Specific Expeditionary Medal, Combat Era Specific Expe7 ditionary Medal, Campaign Specific Medal, or any other 

8 combat theater award established by a Federal statute or 

9 an Executive Order)’’. 

10 (c) REPORT.—Not later than October 1, 2024, the 

11 Secretary of Veterans Affairs shall submit to the Com12 mittee on Veterans’ Affairs of the Senate and the Com13 mittee on Veterans’ Affairs of the House of Representa14 tives a report on— 

15 (1) the number of veterans who enrolled in the 

16 system of annual patient enrollment of the Depart17 ment of Veterans Affairs established and operated 

18 under section 1705(a) of title 38, United States 

19 Code, to receive care pursuant to eligibility under 

20 subparagraph (B) of section 1710(e)(3) of such title, 

21 as amended by subsection (a)(2); and 

22 (2) of the veterans described in paragraph (1), 

23 the number of such veterans who reported a health 

24 concern related to exposure to a toxic substance or 

25 radiation. 
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1 (d) OUTREACH PLAN.—Not later than December 1, 

2 2022, the Secretary shall submit to the Committee on Vet3 erans’ Affairs of the Senate and the Committee on Vet4 erans’ Affairs of the House of Representatives a plan to 

5 conduct outreach to veterans described in subparagraph 

6 (B) of section 1710(e)(3) of title 38, United States Code, 

7 as amended by subsection (a)(2), to notify such veterans 

8 of their eligibility for hospital care, medical services, or 

9 nursing home care under such subparagraph. 

10 (e) EFFECTIVE DATE.—This section and the amend11 ments made by this section shall take effect on October 

12 1, 2022. 

13 SEC. 3. INCORPORATION OF TOXIC EXPOSURE SCREENING 

14 FOR VETERANS. 

15 (a) IN GENERAL.—Beginning not later than 90 days 

16 after the date of the enactment of this Act, the Secretary 

17 of Veterans Affairs shall incorporate a screening to help 

18 determine potential exposures to toxic substances during 

19 active military, naval, air, or space service as part of a 

20 health care screening furnished by the Department of Vet21 erans Affairs to veterans enrolled in the system of annual 

22 patient enrollment of the Department established and op23 erated under section 1705 of title 38, United States Code, 

24 to improve understanding by the Department of exposures 
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1 of veterans to toxic substances while serving in the Armed 

2 Forces. 

3 (b) TIMING.—The Secretary shall ensure that a vet4 eran described in subsection (a) completes the screening 

5 required under such subsection not less frequently than 

6 once every five years. 

7 (c) DETERMINATION OF QUESTIONS.— 

8 (1) IN GENERAL.—The questions included in 

9 the screening required under subsection (a) shall be 

10 determined by the Secretary with input from medical 

11 professionals. 

12 (2) SPECIFIC QUESTIONS.—At a minimum, the 

13 screening required under subsection (a) shall, with 

14 respect to a veteran, include— 

15 (A) a question about the potential exposure 

16 of the veteran to an open burn pit; and 

17 (B) a question regarding exposures that 

18 are commonly associated with service in the 

19 Armed Forces. 

20 (3) OPEN BURN PIT DEFINED.—In this sub21 section, the term ‘‘open burn pit’’ means an area of 

22 land 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 manu2 factured incinerator or other equipment specifi3 cally designed and manufactured for the burn4 ing of solid waste. 

5 (d) PRINT MATERIAL.—In developing the screening 

6 established under subsection (a), the Secretary shall en7 sure that print materials complementary to such screening 

8 that outline related resources for veterans are available at 

9 each medical center of the Department to veterans who 

10 may not have access to the internet. 

11 (e) SCREENING UPDATES.—The Secretary shall con12 sider updates to the content of the screening required 

13 under subsection (a) not less frequently than biennially to 

14 ensure the screening contains the most current informa15 tion. 

16 (f) ACTIVE MILITARY, NAVAL, AIR, OR SPACE SERV17 ICE DEFINED.—In this section, the term ‘‘active military, 

18 naval, air, or space service’’ has the meaning given that 

19 term in section 101(24) of title 38, United States Code. 

20 SEC. 4. TRAINING FOR PERSONNEL OF THE DEPARTMENT 

21 OF VETERANS AFFAIRS WITH RESPECT TO 

22 VETERANS EXPOSED TO TOXIC SUBSTANCES. 

23 (a) HEALTH CARE PERSONNEL.—The Secretary of 

24 Veterans Affairs shall provide to health care personnel of 

25 the Department of Veterans Affairs education and train-
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1 ing to identify, treat, and assess the impact on veterans 

2 of illnesses related to exposure to toxic substances and in3 form such personnel of how to ask for additional informa4 tion from veterans regarding different exposures. 

5 (b) BENEFITS PERSONNEL.— 

6 (1) IN GENERAL.—The Secretary shall incor7 porate a training program for processors of claims 

8 under the laws administered by the Secretary who 

9 review claims for disability benefits relating to serv10 ice-connected disabilities based on exposure to toxic 

11 substances. 

12 (2) ANNUAL TRAINING.—Training provided to 

13 processors under paragraph (1) shall be provided not 

14 less frequently than annually. 

15 SEC. 5. ANALYSIS AND REPORT ON TREATMENT OF VET16 ERANS FOR MEDICAL CONDITIONS RELATED 

17 TO TOXIC EXPOSURE. 

18 (a) IN GENERAL.—The Secretary of Veterans Affairs 

19 shall analyze, on a continuous basis, all clinical data 

20 that— 

21 (1) is obtained by the Department of Veterans 

22 Affairs in connection with hospital care, medical 

23 services, and nursing home care furnished under sec24 tion 1710(a)(2)(F) of title 38, United States Code; 

25 and 
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1 (2) is likely to be scientifically useful in deter2 mining the association, if any, between the medical 

3 condition of a veteran and the exposure of the vet4 eran to a toxic substance. 

5 (b) ANNUAL REPORT.—Not later than one year after 

6 the date of the enactment of this Act, and annually there7 after, the Secretary shall submit to the Committee on Vet8 erans’ Affairs of the Senate and the Committee on Vet9 erans’ Affairs of the House of Representatives a report 

10 containing— 

11 (1) the aggregate data compiled under sub12 section (a); 

13 (2) an analysis of such data; 

14 (3) a description of the types and incidences of 

15 medical conditions identified by the Department 

16 under such subsection; 

17 (4) the explanation of the Secretary for the in18 cidence of such medical conditions and other expla19 nations for the incidence of such conditions as the 

20 Secretary considers reasonable; and 

21 (5) the views of the Secretary on the scientific 

22 validity of drawing conclusions from the incidence of 

23 such medical conditions, as evidenced by the data 

24 compiled under subsection (a), regarding any asso-
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1 ciation between such conditions and exposure to a 

2 toxic substance. 

3 SEC. 6. ANALYSIS RELATING TO MORTALITY OF VETERANS 

4 WHO SERVED IN SOUTHWEST ASIA. 

5 (a) ANALYSIS.— 

6 (1) IN GENERAL.—Not later than 270 days 

7 after the date of the enactment of this Act, the Sec8 retary of Veterans Affairs, in coordination with the 

9 Secretary of Defense, shall conduct an updated anal10 ysis of total and respiratory disease mortality in cov11 ered veterans. 

12 (2) ELEMENTS.—The analysis required by 

13 paragraph (1) shall include, to the extent prac14 ticable, the following with respect to each covered 

15 veteran: 

16 (A) Metrics of airborne exposures. 

17 (B) The location and timing of deploy18 ments of the veteran. 

19 (C) The military occupational specialty of 

20 the veteran. 

21 (D) The Armed Force in which the veteran 

22 served. 

23 (E) Pre-existing health status of the vet24 eran, including with respect to asthma. 
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1 (F) Relevant personal information of the 

2 veteran, including cigarette and e-cigarette 

3 smoking history, diet, sex, gender, age, race, 

4 and ethnicity. 

5 (b) COVERED VETERAN DEFINED.—In this section, 

6 the term ‘‘covered veteran’’ means any veteran who— 

7 (1) on or after August 2, 1990, served on active 

8 duty in— 

9 (A) Bahrain; 

10 (B) Iraq; 

11 (C) Kuwait; 

12 (D) Oman; 

13 (E) Qatar; 

14 (F) Saudi Arabia; 

15 (G) Somalia; or 

16 (H) the United Arab Emirates; or 

17 (2) on or after September 11, 2001, served on 

18 active duty in— 

19 (A) Afghanistan; 

20 (B) Djibouti; 

21 (C) Egypt; 

22 (D) Jordan; 

23 (E) Lebanon; 

24 (F) Syria; or 

25 (G) Yemen. 
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1 SEC. 7. STUDY ON HEALTH TRENDS OF POST 9/11 VET2 ERANS. 

3 The Secretary of Veterans Affairs shall conduct an 

4 epidemiological study on the health trends of veterans who 

5 served in the Armed Forces after September 11, 2001. 

6 SEC. 8. STUDY ON CANCER RATES AMONG VETERANS. 

7 (a) IN GENERAL.—The Secretary of Veterans Affairs 

8 shall conduct a study on the incidence of cancer in vet9 erans to determine trends in the rates of the incidence 

10 of cancer in veterans. 

11 (b) ELEMENTS.—The study required by subsection 

12 (a) shall assess, with respect to each veteran included in 

13 the study, the following: 

14 (1) The age of the veteran. 

15 (2) The period of service and length of service 

16 of the veteran in the Armed Forces. 

17 (3) The military occupational specialty or spe18 cialties of the veteran. 

19 (4) The gender of the veteran. 

20 (5) The type or types of cancer that the veteran 

21 has. 
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1 SEC. 9. PUBLICATION OF LIST OF RESOURCES OF DEPART2 MENT OF VETERANS AFFAIRS FOR VETERANS 

3 EXPOSED TO TOXIC SUBSTANCES AND OUT4 REACH PROGRAM FOR SUCH VETERANS AND 

5 CAREGIVERS AND SURVIVORS OF SUCH VET6 ERANS. 

7 (a) PUBLICATION OF LIST OF RESOURCES.— 

8 (1) IN GENERAL.—Not later than one year 

9 after the date of the enactment of this Act, and an10 nually thereafter, the Secretary of Veterans Affairs 

11 shall publish a list of resources of the Department 

12 of Veterans Affairs for— 

13 (A) veterans who were exposed to toxic 

14 substances; 

15 (B) families and caregivers of such vet16 erans; and 

17 (C) survivors of such veterans who are re18 ceiving death benefits under the laws adminis19 tered by the Secretary. 

20 (2) UPDATE.—The Secretary shall periodically 

21 update the list published under paragraph (1). 

22 (b) OUTREACH.—The Secretary shall develop, with 

23 input from the community, an informative outreach pro24 gram for veterans on illnesses that may be related to expo25 sure to toxic substances, including outreach with respect 

26 to benefits and support programs. 
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1 SEC. 10. REPORT ON INDIVIDUAL LONGITUDINAL EXPO2 SURE RECORD. 

3 (a) IN GENERAL.—Not later than one year after the 

4 date on which the Individual Longitudinal Exposure 

5 Record achieves full operational capability, the Secretary 

6 of Veterans Affairs shall submit to the appropriate com7 mittees of Congress a report on the data quality of the 

8 Individual Longitudinal Exposure Record and the useful9 ness of the Individual Longitudinal Exposure Record in 

10 supporting veterans in receiving health care and benefits 

11 from the Department of Veterans Affairs. 

12 (b) ELEMENTS.—The report required by subsection 

13 (a) shall include the following: 

14 (1) An identification of exposures to toxic sub15 stances that may not be fully captured by the cur16 rent systems for environmental and occupational 

17 health monitoring and recommendations for how to 

18 improve those systems. 

19 (2) An analysis of the quality of the location 

20 data in determining exposures of veterans to toxic 

21 substances and recommendations for how to improve 

22 the quality of that location data. 

23 (3) Recommendations on how to improve the 

24 usefulness of the Individual Longitudinal Exposure 

25 Record. 

26 (c) DEFINITIONS.—In this section: 
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1 (1) APPROPRIATE COMMITTEES OF CONGRESS

2 DEFINED.—The term ‘‘appropriate committees of 

3 Congress’’ means— 

4 (A) the Committee on Armed Services and 

5 the Committee on Veterans’ Affairs of the Sen6 ate; and 

7 (B) the Committee on Armed Services and 

8 the Committee on Veterans’ Affairs of the 

9 House of Representatives. 

10 (2) INDIVIDUAL LONGITUDINAL EXPOSURE

11 RECORD.—The term ‘‘Individual Longitudinal Expo12 sure Record’’ includes any pilot program or other 

13 program used by the Department of Veterans Af14 fairs or the Department of Defense to track how 

15 members of the Armed Forces or veterans have been 

16 exposed to various occupational or environmental 

17 hazards. 

Passed the Senate February 16, 2022. 

Attest: 

Secretary. 

117TH CONGRESS 

2D SESSION S. 3541 

AN ACT 

To improve health care and services for veterans 

exposed to toxic substances, and for other purposes.