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 BROWN- 
WAITE 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 Sec-
retary of Veterans Affairs to furnish hospital care, med-
ical 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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Janey Ensminger 
Act’’. 
SEC. 2. HOSPITAL CARE, MEDICAL SERVICES, AND NURS-
ING HOME CARE FOR VETERANS STATIONED 
AT 
CAMP 
LEJEUNE, 
NORTH 
CAROLINA, 
WHILE THE WATER WAS CONTAMINATED AT 
CAMP LEJEUNE. 
(a) IN GENERAL.—Section 1710(e)(1) of title 38, 
United States Code, is amended by adding at the end the 
following new subparagraph: 
‘‘(F) Subject to paragraph (2), a veteran who, as a 
member of the Armed Forces, was stationed at Camp 
Lejeune, North Carolina, during a period, determined by 
the Secretary in consultation with the Agency for Toxic 
Substances and Disease Registry, in which the water at 
Camp Lejeune was contaminated by volatile organic com-
pounds, including known human carcinogens and probable 
human carcinogens, is eligible for hospital care, medical 
services, and nursing home care under subsection 
(a)(2)(F) for any illness, notwithstanding that there is in-
sufficient medical evidence to conclude that such illness 
is attributable to such contamination.’’. 
(b) FAMILY MEMBERS.— 
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(1) IN GENERAL.—Subchapter VIII of chapter 
17 of title 38, United States Code, is amended by 
adding at the end the following new section: 
‘‘§ 1786. Health care of family members of veterans 
stationed at Camp Lejeune, North Caro-
lina, while the water was contaminated 
at Camp Lejeune 
‘‘(a) IN GENERAL.—A family member of a veteran 
described in subparagraph (F) of section 1710(e)(1) of 
this title who resided at Camp Lejeune, North Carolina, 
during the period described in such subparagraph, or who 
was in utero during such period while the mother of such 
family member resided at such location, shall be eligible 
for hospital care, medical services, and nursing home care 
furnished by the Secretary for any covered condition, or 
any covered disability that is associated with a condition, 
that is associated with exposure to the contaminants in 
the water at Camp Lejeune during such period. 
‘‘(b) COVERED CONDITIONS AND DISABILITIES.—In 
this section, covered conditions and disabilities are those 
conditions and disabilities described in section 1119(a)(2) 
of this title.’’. 
(2) CLERICAL AMENDMENT.—The table of sec-
tions at the beginning of such chapter is amended 
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by inserting after the item relating to section 1785 
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.’’. 
SEC. 3. PRESUMPTIONS OF SERVICE CONNECTION FOR ILL-
NESSES ASSOCIATED WITH CONTAMINANTS 
IN THE WATER SUPPLY AT CAMP LEJEUNE, 
NORTH CAROLINA. 
(a) IN GENERAL.—Subchapter II of chapter 11 of 
title 38, United States Code, is amended by adding at the 
end the following new section: 
‘‘§ 1119. Presumptions of service connection for ill-
nesses associated with contaminants in 
the water supply at Camp Lejeune, North 
Carolina 
‘‘(a) PRESUMPTION.—(1) For purposes of section 
1110 of this title, and subject to section 1113 of this title, 
each illness, if any, described in paragraph (2) shall be 
considered to have been incurred in or aggravated by serv-
ice referred to in that paragraph, notwithstanding that 
there is no record of evidence of such illness during the 
period of such service. 
‘‘(2) An illness referred to in paragraph (1) is any 
diagnosed or undiagnosed illness that— 
‘‘(A) the Secretary determines, in consultation 
with the Agency for Toxic Substances and Disease 
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Registry, in regulations prescribed under this section 
to warrant a presumption of service connection by 
reason of having a positive association with exposure 
to volatile organic compounds, including known 
human carcinogens and probable human carcino-
gens, known or presumed to be associated with serv-
ice in the Armed Forces at Camp Lejeune, North 
Carolina, during a period determined by the Sec-
retary in consultation with the Agency for Toxic 
Substances and Disease Registry; and 
‘‘(B) becomes manifest within the period, if 
any, prescribed in such regulations in a veteran who 
served on active duty at Camp Lejeune, North Caro-
lina, and by reason of such service was exposed to 
such compounds. 
‘‘(3) For purposes of this subsection, a veteran who 
served on active duty at Camp Lejeune, North Carolina, 
during the period referred to in paragraph (2)(A) and who 
has an illness described in paragraph (2) shall be pre-
sumed to have been exposed by reason of such service to 
the compound associated with the illness in the regulations 
prescribed under this section unless there is conclusive evi-
dence to establish that the veteran was not exposed to the 
compound by reason of such service. 
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‘‘(b) DETERMINATIONS RELATING TO DISEASES.— 
(1) Whenever the Secretary determines, in consultation 
with the Agency for Toxic Substances and Disease Reg-
istry, on the basis of sound medical and scientific evidence, 
that a positive association exists between the exposure of 
humans to a volatile organic compound known or pre-
sumed to be present in the water supply at Camp Lejeune, 
North Carolina, and the occurrence of a disease in hu-
mans, the Secretary shall prescribe regulations providing 
that a presumption of service connection is warranted for 
that disease for the purposes of this section. 
‘‘(2) In making determinations for the purpose of this 
subsection, the Secretary shall take into account all other 
sound medical and scientific information and analyses 
available to the Secretary. In evaluating any study for the 
purpose of making such determinations, the Secretary 
shall take into consideration whether the results are statis-
tically significant, are capable of replication, and with-
stand peer review. 
‘‘(3) An association between the occurrence of a dis-
ease in humans and exposure to a volatile organic com-
pound shall be considered to be positive for the purposes 
of this section if the credible evidence for the association 
is equal to or outweighs the credible evidence against the 
association. 
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‘‘(c) REMOVAL OF DISEASES.—Whenever a disease is 
removed from regulations prescribed under this section— 
‘‘(1) a veteran who was awarded compensation 
for such disease on the basis of the presumption pro-
vided in subsection (a) before the effective date of 
the removal shall continue to be entitled to receive 
compensation on that basis; and 
‘‘(2) a survivor of a veteran who was awarded 
dependency and indemnity compensation for the 
death of a veteran resulting from such disease on 
the basis of such presumption shall continue to be 
entitled to receive dependency and indemnity com-
pensation on such basis.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of such chapter is amended by inserting 
after the item relating to section 1118 the following new 
item: 
‘‘1119. Presumptions of service connection for illnesses associated with contami-
nants in the water supply at Camp Lejeune, North Carolina.’’. 
Æ 
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