II 

110TH CONGRESS 

1ST SESSION S. 1682 

To amend title 10, United States Code, to improve the management of 

medical care for members of the Armed Forces, to improve the speed 

and efficiency of the physical disability evaluation system of the Department of Defense, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

JUNE 22, 2007 

Ms. SNOWE (for herself and Mrs. LINCOLN) introduced the following bill; 

which was read twice and referred to the Committee on Armed Services 

A BILL 

To amend title 10, United States Code, to improve the 

management of medical care for members of the Armed 

Forces, to improve the speed and efficiency of the physical disability evaluation system of the Department of 

Defense, 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 ‘‘Servicemembers’ 

5 Healthcare Benefits and Rehabilitation Enhancement Act 

6 of 2007’’. 


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1 SEC. 2. IMPROVEMENTS TO MEDICAL AND DENTAL CARE 

2 FOR RECOVERING SERVICE MEMBERS. 

3 (a) IN GENERAL.—Chapter 55 of title 10, United 

4 States Code, is amended by inserting after section 1074k 

5 the following new section: 

6 ‘‘SEC. 1074l. MANAGEMENT OF MEDICAL AND DENTAL CARE 

7 FOR RECOVERING SERVICE MEMBERS. 

8 ‘‘(a) MEDICAL CARE MANAGERS.—(1) The Secretary 

9 of Defense shall assign a medical care manager to each 

10 recovering service member. 

11 ‘‘(2)(A) The duties of the medical care manager shall 

12 include the following with respect to the recovering service 

13 member: 

14 ‘‘(i) To assist in understanding the recovering 

15 service member’s medical status. 

16 ‘‘(ii) To assist in receiving prescribed medical 

17 care. 

18 ‘‘(iii) To conduct a review, at least once a week, 

19 of the recovering service member’s medical status. 

20 ‘‘(B) The weekly medical status review described in 

21 subparagraph (A)(iii) shall be conducted in person with— 

22 ‘‘(i) in the case the recovering service member 

23 is not incapacitated, the recovering service member; 

24 or 

25 ‘‘(ii) in the case the recovering service member 

26 is incapacitated— 


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1 ‘‘(I) in the case a family member of the re2 covering service member is available, such fam3 ily member; or 

4 ‘‘(II) in the case a family member of the 

5 recovering service member is not available, an 

6 independent service member advocate from a 

7 veterans service organization. 

8 ‘‘(3) Each medical care manager shall not be as9 signed at any one time to manage more than 17 recovering 

10 service members. 

11 ‘‘(4)(A) The Secretary of Defense shall establish a 

12 standard training and certification program and cur13 riculum for medical care managers. 

14 ‘‘(B) Successful completion of the training program 

15 and annual certification shall be required before a person 

16 may assume the duties of a medical care case manager. 

17 ‘‘(b) CASEWORKERS.—(1) The Secretary of Defense 

18 shall assign a caseworker to each recovering service mem19 ber. 

20 ‘‘(2) The duties of a caseworker shall include assist21 ing each such recovering service member and their family 

22 members in obtaining all the information necessary for the 

23 following: 

24 ‘‘(A) The recovery of such recovering service 

25 member from an injury or illness. 


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1 ‘‘(B) The transition of such recovering service 

2 member to civilian life or to other duties within the 

3 Department of Defense. 

4 ‘‘(C) The receipt of benefits to which such re5 covering service member is entitled under the laws 

6 administered by the Secretary of Defense. 

7 ‘‘(3) Each caseworker shall not be assigned at any 

8 one time to manage more than 34 recovering service mem9 bers. 

10 ‘‘(4)(A) The Secretary of Defense shall establish a 

11 standard training and certification program and cur12 riculum for caseworkers. 

13 ‘‘(B) Successful completion of the training program 

14 and annual certification shall be required before a person 

15 may assume the duties of a caseworker. 

16 ‘‘(5) Each caseworker shall report to the department17 wide Ombudsman Office established by section 3 of the 

18 Servicemembers’ Healthcare Benefits and Rehabilitation 

19 Enhancement Act of 2007. 

20 ‘‘(c) INDEPENDENT SERVICE MEMBER ADVO21 CATES.—The Secretary of Defense shall work to expand 

22 access to veterans service organizations to provide inde23 pendent service member advocates to recovering service 

24 members that— 

25 ‘‘(1) do not report to the Secretary of Defense; 


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1 ‘‘(2) advise recovering service members on 

2 issues related to the medical records and service 

3 records of such recovering service members; and 

4 ‘‘(3) provide recovering service members with 

5 such information as may be necessary for such re6 covering service members to prepare for reviews by 

7 physical evaluation boards. 

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

9 ‘‘(1) The term ‘family member’, with respect to 

10 a recovering service member, has the meaning given 

11 that term in section 411h(b) of title 37. 

12 ‘‘(2) The term ‘physical disability evaluation 

13 system’ means the Department of Defense system or 

14 process for evaluating the nature of and extent of 

15 disabilities affecting members of the armed forces 

16 (other than the Coast Guard) and comprised of med17 ical evaluation boards, physical evaluation boards, 

18 counseling of members, and final disposition by ap19 propriate personnel authorities, as operated by the 

20 Secretaries concerned, and, in the case of the Coast 

21 Guard, a similar system or process operated by the 

22 Secretary of Homeland Security. 

23 ‘‘(3) The term ‘recovering service member’ 

24 means a member of the armed forces, including a 

25 member of the National Guard or a Reserve, who is 


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1 undergoing medical treatment, recuperation, or ther2 apy, or is otherwise in medical hold or holdover sta3 tus, for an injury, illness, or disease incurred or ag4 gravated while on active duty in the armed forces. 

5 ‘‘(4) The term ‘veterans service organization’ 

6 means any organization organized by the Secretary 

7 of Veterans Affairs for the representation of vet8 erans under section 5902 of title 38.’’. 

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

10 at the beginning of such chapter is amended by adding 

11 at the end the following new item: 

‘‘1074l. Management of medical and dental care for recovering service members.’’. 

12 SEC. 3. ESTABLISHMENT OF OMBUDSMAN OFFICE FOR EN13 TIRE DEPARTMENT OF DEFENSE. 

14 (a) ESTABLISHMENT.—The Secretary of Defense 

15 shall establish within the Office of the Secretary of De16 fense a department-wide Ombudsman Office (in this sub17 section referred to as the ‘‘Ombudsman Office’’). 

18 (b) FUNCTIONS.—The functions of the Ombudsman 

19 Office established under subsection (a) are— 

20 (1) to provide policy guidance to, and oversight 

21 of, the ombudsman offices in the military depart22 ments; and 

23 (2) to monitor the medical system of the De24 partment of Defense, including the following: 


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1 (A) The physical disability evaluation sys2 tem. 

3 (B) The caseworkers, medical care man4 agers, and independent advocates described in 

5 section 1074l of title 10, United States Code, 

6 as added by section 2 of this Act. 

7 (C) The condition of health care treatment 

8 facilities of the Department of Defense. 

9 (D) The transition of care for recovering 

10 service members from care provided by the De11 partment of Defense to care provided by the 

12 Department of Veterans Affairs. 

13 SEC. 4. IMPROVEMENT OF PHYSICAL DISABILITY EVALUA14 TION SYSTEM, SCHEDULE FOR RATING DIS15 ABILITIES, AND DISABILITY RETIREMENT 

16 EVALUATION. 

17 (a) IMPROVEMENT OF PHYSICAL DISABILITY EVAL18 UATION SYSTEM.—Section 1222 of title 10, United States 

19 Code, is amended by adding at the end the following new 

20 subsection: 

21 ‘‘(d) EFFORTS TO IMPROVE SPEED AND EFFICIENCY

22 OF PHYSICAL DISABILITY EVALUATION SYSTEM.—(1) 

23 The Secretary of Defense shall undertake efforts to im24 prove the speed and efficiency of the physical disability 

25 evaluation system. 


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1 ‘‘(2) The Secretary of Defense shall place the phys2 ical evaluation boards of each military department under 

3 one command to make the physical disability evaluation 

4 system more expeditious. 

5 ‘‘(3) In this subsection, the term ‘physical disability 

6 evaluation system’ means the Department of Defense sys7 tem or process for evaluating the nature of and extent of 

8 disabilities affecting members of the armed forces (other 

9 than the Coast Guard) and comprised of medical evalua10 tion boards, physical evaluation boards, counseling of 

11 members, and final disposition by appropriate personnel 

12 authorities, as operated by the Secretaries concerned, and, 

13 in the case of the Coast Guard, a similar system or process 

14 operated by the Secretary of Homeland Security.’’. 

15 (b) JOINT REPORT ON MODERNIZATION OF THE

16 SCHEDULE FOR RATING DISABILITIES IN USE BY DE17 PARTMENT OF VETERANS AFFAIRS.—Not later than 180 

18 days after the date of the enactment of this Act, the Sec19 retary of Veterans Affairs shall submit to the appropriate 

20 committees of Congress a plan to update the schedule for 

21 rating disabilities in use by the Department of Veterans 

22 Affairs to reflect the effects of mental health disorders, 

23 including traumatic brian injury and post-traumatic stress 

24 disorder, on the modern workforce. 


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1 (c) RETIREMENT OR SEPARATION FOR PHYSICAL

2 DISABILITY.— 

3 (1) IN GENERAL.—Chapter 61 of title 10, 

4 United States Code, is amended by adding at the 

5 end the following new section: 

6 ‘‘§ 1223. Members with multiple disabilities 

7 ‘‘In making a determination under this chapter, the 

8 Secretary concerned shall consider all of the disabilities, 

9 injuries, illnesses, or disease of a member incurred or ag10 gravated while on active duty and consider the cumulative 

11 severity of all of those disabilities, injuries, illnesses, or 

12 diseases.’’. 

13 (2) CLERICAL AMENDMENT.—The table of sec14 tions at the beginning of chapter 61 is amended by 

15 adding at the end the following new item: 

‘‘1223. Members with multiple disabilities.’’. 

16 (d) PRIORITIZATION OF RETIREMENT PROC17 ESSING.—The Secretary of Defense shall establish a sys18 tem for the prioritization of processing the separation of 

19 members of the Armed Forces. Such system shall place 

20 the highest priority on recovering service members. 

21 (e) NO REDUCTION IN DISABILITY RATING.—Once 

22 a disability rating is assigned by an informal physical eval23 uation board, the Secretary of Defense may not reduce 

24 such rating upon appeal. 


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1 SEC. 5. ESTABLISHMENT OF MEDICAL RECORD DATABASE. 

2 (a) IN GENERAL.—The Secretary of Defense shall es3 tablish a medical record database to track and record the 

4 medical status of all members of the Armed Forces. 

5 (b) DATABASE DESIGN.—To the extent practicable, 

6 the database established under subsection (a) shall be sub7 stantially the same as the Computerized Patient Record 

8 System of the Department of Veterans Affairs’ Veterans 

9 Health Information Systems and Technology Architecture 

10 (VistA). 

11 (c) ACCESS TO DEPARTMENT OF DEFENSE MEDICAL

12 RECORD DATABASE BY DEPARTMENT OF VETERANS AF13 FAIRS.—The Secretary of Defense shall make such system 

14 accessible to the Department of Veterans Affairs through 

15 the Joint Patient Tracking Application of the Department 

16 of Defense. 

17 (d) PRIVACY AND SECURITY.—The Secretary of De18 fense shall— 

19 (1) ensure that the system conforms with all 

20 applicable privacy laws; and 

21 (2) take appropriate measures to ensure the se22 curity of the system. 

23 (e) TRACKING OF MEMBERS OF THE ARMED FORCES

24 AND VETERANS WITH TRAUMATIC BRAIN INJURY.— 

25 (1) MEMBERS OF THE ARMED FORCES.—The 

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1 lished under subsection (a) to track members of the 

2 Armed Forces who have been diagnosed with trau3 matic brain injury. 

4 (2) VETERANS.—The Secretary of Veterans Af5 fairs shall use the Veterans Health Information Sys6 tems and Technology Architecture (VistA) to track 

7 veterans who have been diagnosed with traumatic 

8 brain injury. 

9 SEC. 6. ASSESSING THE MENTAL HEALTH OF MEMBERS OF 

10 THE ARMED FORCES BEFORE AND AFTER DE11 PLOYMENT IN A COMBAT THEATER. 

12 (a) IN GENERAL.—The Secretary of Defense shall as13 sess the mental health of each member of the Armed 

14 Forces who is deployed to a combat theater, or who the 

15 Secretary expects to deploy to a combat theater, at least 

16 once during— 

17 (1) the 240-day period beginning 120 days be18 fore the date on which a member is deployed in a 

19 combat theater; 

20 (2) the 60-day period beginning on the date 

21 that such member returns from deployment in a 

22 combat theater; and 

23 (3) the predischarge physical of such member. 

24 (b) TESTING OF NEUROCOGNITIVE FUNCTIONING.— 

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1 cordance with subsection (a)(1) shall test the 

2 neurocognitive functioning of such member. 

3 (c) TESTING FOR TRAUMATIC BRAIN INJURY.—A 

4 mental health assessment provided to a member in accord5 ance with paragraphs (2) and (3) of subsection (a) shall 

6 include a comprehensive screening for mild, moderate, and 

7 severe cases of traumatic brain injury. 

8 SEC. 7. REPORT ON ACCESS TO PRIVATE HEALTH CARE. 

9 Not later than 180 days after the date of the enact10 ment of this Act, the Secretary of Defense and the Sec11 retary of Veterans Affairs shall submit to the appropriate 

12 committees of Congress a report detailing plans to in13 crease the role of eligible private sector rehabilitation pro14 viders in the provision of comprehensive post acute inpa15 tient and outpatient rehabilitation by the Department of 

16 Veterans Affairs to members and former members of the 

17 Armed Forces with traumatic brain injury or post-trau18 matic stress disorder when the Department is unable to 

19 provide such services without the assistance. 

20 SEC. 8. NOTIFICATION TO CONGRESS OF HOSPITALIZATION 

21 OF COMBAT WOUNDED SERVICE MEMBERS. 

22 (a) NOTIFICATION REQUIRED.—Chapter 55 of title 

23 10, United States Code, is further amended by inserting 

24 after section 1074l, as added by section 2 of this Act, the 

25 following new section: 


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1 ‘‘§ 1074m. Notification to Congress of hospitalization 

2 of combat wounded members 

3 ‘‘(a) NOTIFICATION REQUIRED.—The Secretary con4 cerned shall provide to the appropriate Members of Con5 gress notification of the hospitalization of any recovering 

6 service member (within the meaning of section 1074l(d)(3) 

7 of this title) evacuated from a theater of combat to allow 

8 such Members of Congress to provide such recovering 

9 service member with assistance if necessary. 

10 ‘‘(b) APPROPRIATE MEMBERS.—In this section, the 

11 term ‘appropriate Members of Congress’, with respect to 

12 the member of the armed forces about whom notification 

13 is being made, means the Senators and the Members of 

14 the House of Representatives representing the States or 

15 districts, respectively, that include the member’s home of 

16 record and, if different, the residence of the next of kin, 

17 or a different location as provided by the member. 

18 ‘‘(c) CONSENT OF MEMBER REQUIRED.—The notifi19 cation under subsection (a) may be provided only with the 

20 consent of the member of the armed forces about whom 

21 notification is to be made. In the case of a member who 

22 is unable to provide consent, information and consent may 

23 be provided by next of kin.’’. 

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

25 at the beginning of such chapter is amended by adding 

26 at the end the following new item: 


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‘‘1074m. Notification to Congress of hospitalization of combat wounded members.’’. 

1 SEC. 9. DEFINITIONS. 

2 In this Act: 

3 (1) APPROPRIATE COMMITTEES OF CON4 GRESS.—The term ‘‘appropriate committees of Con5 gress’’ means— 

6 (A) the Committees on Armed Services 

7 and Veterans’ Affairs of the Senate; and 

8 (B) the Committees on Armed Services 

9 and Veterans’ Affairs of the House of Rep10 resentatives. 

11 (2) PHYSICAL DISABILITY EVALUATION SYS12 TEM.—The term ‘‘physical disability evaluation sys13 tem’’ means the Department of Defense system or 

14 process for evaluating the nature of and extent of 

15 disabilities affecting members of the Armed Forces 

16 (other than the Coast Guard) and comprised of med17 ical evaluation boards, physical evaluation boards, 

18 counseling of members, and final disposition by ap19 propriate personnel authorities, as operated by the 

20 Secretaries of the military departments, and, in the 

21 case of the Coast Guard, a similar system or process 

22 operated by the Secretary of Homeland Security. 

23 (3) RECOVERING SERVICE MEMBER.—The term 

24 ‘‘recovering service member’’ means a member of the 


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1 Armed Forces, including a member of the National 

2 Guard or a Reserve, who is undergoing medical 

3 treatment, recuperation, or therapy, or is otherwise 

4 in medical hold or holdover status, for an injury, ill5 ness, or disease incurred or aggravated while on ac6 tive duty in the Armed Forces. 

7 (4) COMBAT THEATER.—The term ‘‘combat 

8 theater’’ means the geographical area outside the 

9 continental United States required by combat and 

10 support forces for the conduct of military operations. 

11 (5) NEUROCOGNITIVE.—The term 

12 ‘‘neurocognitive’’ means of, relating to, or involving 

13 the central nervous system and cognitive or informa14 tion processing abilities (thinking, memory, and rea15 soning), as well as sensory processing (sight, hear16 ing, touch, taste, and smell), and communication 

17 (expression and understanding). 

Æ 


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