I
103D CONGRESS
2D SESSION
H. R. 4540
To provide a program of compensation and health research for illnesses
arising from service in the Armed Forces during the Persian Gulf War.
IN THE HOUSE OF REPRESENTATIVES
JUNE 8, 1994
Mr. EVANS (for himself, Mr. BROWDER, Mr. DELLUMS, Mr. GUTIERREZ, Mr.
MCCLOSKEY, Mr. OBERSTAR, Mr. GONZALEZ, Mr. BROWN of California,
Mrs. SCHROEDER, Mr. FILNER, Ms. WATERS, Mr. KENNEDY, Mr. BOU-
CHER, Mr. FALEOMAVAEGA, Mr. HOLDEN, Mr. ACKERMAN, Mr.
HOCHBRUECKNER, Mr. WASHINGTON, Mr. CARR of Michigan, Mr. FARR
of California, Mr. FRANK of Massachusetts, Mr. COOPER, Mr. GEJDEN-
SON, Mr. SANDERS, Ms. SLAUGHTER, Mr. SERRANO, Mr. KREIDLER, Mr.
BARLOW, Mr. TRAFICANT, Mrs. LOWEY, Mr. BARRETT of Wisconsin, Mr.
HALL of Ohio, Mr. ANDREWS of Maine, Mr. KOPETSKI, Mr. ORTON, Mr.
OLVER, Mr. UNDERWOOD, Mr. KLECZKA, Mr. EDWARDS of California,
Mr. MARKEY, Mr. JOHNSTON
of Florida, Mr. JEFFERSON, Mr.
FINGERHUT, Mr. MANTON, Mr. STRICKLAND, Mr. LANCASTER, Mr. MI-
NETA, Mr. SWETT, Mr. DEUTSCH, Mr. BONIOR, Mr. BILBRAY, Mrs.
UNSOELD, Mr. PETERSON of Florida, and Mr. RICHARDSON) introduced
the following bill; which was referred to the Committee on Veterans’ Af-
fairs
A BILL
To provide a program of compensation and health research
for illnesses arising from service in the Armed Forces
during the Persian Gulf War.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Persian Gulf War Vet-
erans’ Compensation Act of 1994’’.
SEC. 2. CONGRESSIONAL FINDINGS.
The Congress makes the following findings:
(1) The United States bears responsibility for
the care and treatment of illnesses and disabilities
connected with service in the Armed Forces. When
the etiology of a specific condition occurring in vet-
erans is unknown, it is the Government’s responsibil-
ity to give veterans the benefit of the doubt and to
provide appropriate treatment and compensation
until the scientific evidence warrants otherwise.
(2) During the Persian Gulf War, members of
the Armed Forces (A) were exposed to numerous po-
tentially toxic substances (including fumes and
smoke from petrochemicals and depleted uranium),
to infectious agents, to chemoprophylactic agents,
and to indigenous diseases, (B) received multiple im-
munizations and (C) may have been exposed to var-
ious chemical and biological warfare agents. Threats
of enemy use of chemical and biological weapons
heightened the psychological stress otherwise associ-
ated with the military operation.
(3) Significant numbers of veterans of the Per-
sian Gulf War are suffering from illnesses, or are ex-
hibiting symptoms of illnesses, that cannot (as of the
enactment of this Act) be diagnosed or clearly de-
fined. As a result, many of these conditions or ill-
nesses are not considered to be service connected for
purposes of benefits administered by the Secretary
of Veterans Affairs.
(4) The Technology Assessment Workshop on
the Persian Gulf Experience and Health conducted
by the National Institutes of Health found that the
complex biological, chemical, physical, and psycho-
logical environment of the Southwest Asia theater of
operations produced complex adverse health effects
in Persian Gulf War veterans and that it appears as
if there is no single condition or illness among af-
fected Persian Gulf War veterans, but rather mul-
tiple illnesses with overlapping symptoms and
causes.
(5) That workshop concluded that the data con-
cerning the range and intensity of exposure to toxic
substances by military personnel in the Southwest
Asia theater of operations are very limited and that
such data were collected only after a considerable
delay.
(6) In response to concerns regarding the
health care needs of Persian Gulf War veterans, par-
ticularly those who suffer from undiagnosable condi-
tions or illnesses, the Congress, in Public Law 102–
585, directed the establishment of the Persian Gulf
War Veterans Health Registry, authorized health ex-
aminations for Persian Gulf War veterans, and pro-
vided for the National Academy of Sciences to con-
duct a comprehensive review and assessment of in-
formation regarding the health consequences of mili-
tary service in the theater of operations during the
Persian Gulf War and to develop recommendations
for research on such health consequences. In Public
Law 103–210, Congress authorized the Department
of Veterans Affairs to provide health care services on
a priority basis to Persian Gulf War veterans. In
Public Law 103–160, Congress provided funding for
the establishment of a specialized environmental
medical facility for the conduct of research into the
potential health effects of low-level chemical expo-
sure and for research on the potential health effects
of battlefield exposure to depleted uranium.
(7) The workshop referred to in paragraph (4)
noted that well-designed epidemiological studies have
not been conducted to link the conditions or illnesses
of the military personnel with exposures in the thea-
ter of operations during the Persian Gulf War and
found that the absence of such studies has hampered
efforts to provide treatment and compensation to
veterans of the Persian Gulf War. Accordingly, fur-
ther research and studies should be undertaken to
determine the underlying causes of the illnesses suf-
fered by Persian Gulf War veterans and, pending
the outcome of such research, veterans who are seri-
ously ill and whose illness may be related to their
military service should receive compensation benefits
to offset the impairment in earnings capacities they
may be experiencing.
SEC. 3. PURPOSES.
The purposes of this Act are—
(1) to require the Secretary of Veterans Affairs
to provide compensation to Persian Gulf War veter-
ans who have disabilities resulting from an illness or
illnesses that cannot (as of the enactment of this
Act) be diagnosed or defined and for which other
causes cannot (as of the enactment of this Act) be
identified until such time as scientific evidence dem-
onstrates that the illnesses are unrelated to military
service during the Persian Gulf War;
(2) to require the Secretary of Veterans Affairs
to develop case assessment protocols and case defini-
tions for such illnesses;
(3) to establish an outreach program to Persian
Gulf War veterans and their families to inform them
of ongoing research activities as well as the services
and benefits for which they are eligible; and
(4) to authorize further research activities, in-
cluding an epidemiological study, on the health risks
and effects of military service in the Southwest thea-
ter of operations during the Persian Gulf War.
SEC. 4. DEVELOPMENT OF CASE ASSESSMENT PROTOCOLS
AND CASE DEFINITIONS.
(a) UNIFORM CASE ASSESSMENT PROTOCOL.—(1)
The Secretary of Veterans Affairs shall develop and imple-
ment a uniform case assessment protocol that will ensure
thorough assessment, diagnosis, and treatment of all Per-
sian Gulf War veterans suffering from illnesses the origins
of which are (as of the enactment of this Act) unknown
and that may be attributable to service in the Southwest
Asia theater of operations during the Persian Gulf War.
(2) If such a uniform case assessment protocol is not
implemented before the end of the 120-day period begin-
ning on the date of the enactment of this Act, the Sec-
retary shall, before the end of such period, submit to the
Committees on Veterans’ Affairs of the Senate and House
of Representatives a report as to why such a protocol has
not yet been developed.
(b) CASE DEFINITIONS.—(1) The Secretary shall de-
velop case definitions or diagnoses for illnesses, the origins
of which are (as of the enactment of this Act) unknown
and that may be associated with service in the Persian
Gulf War.
(2) If such case definitions and diagnoses are not de-
veloped before the end of the 120-day period beginning
on the date of the enactment of this Act, the Secretary
shall, before the end of such period, submit to the Commit-
tees on Veterans’ Affairs of the Senate and House of Rep-
resentatives a report as to why such case definitions and
diagnoses have not yet been developed.
(c) CONSULTATION.—Subsections (a) and (b) shall be
carried out in consultation with the Secretary of Defense
and the Secretary of Health and Human Services.
SEC. 5. OUTREACH TO PERSIAN GULF VETERANS.
(a) IN GENERAL.—The Secretary of Veterans Affairs
shall implement a comprehensive outreach program to in-
form Persian Gulf War veterans and their families of the
medical care and other benefits that may be provided by
the Department of Veterans Affairs and the Department
of Defense arising from service in the Persian Gulf War.
(b) NEWSLETTER.—The outreach program shall in-
clude a newsletter which shall be updated and distributed
at least annually and shall be distributed to the veterans
listed on the Persian Gulf War Veterans Health Registry.
The newsletter shall include summaries of the status and
findings of Government sponsored research on illnesses of
Persian Gulf War veterans and their families as well as
on benefits available to such individuals through the De-
partment of Veterans Affairs. The newsletter shall be pre-
pared in consultation with veterans service organizations.
(c) TOLL-FREE NUMBER.—The outreach program
shall include establishment of a toll-free telephone number
to provide Persian Gulf War veterans and their families
information on the Persian Gulf War Veterans Health
Registry, health care and other benefits provided by the
Department of Veterans Affairs, and such other informa-
tion as the Secretary considers appropriate. Such toll-free
telephone number shall be established not later than 90
days after the date of the enactment of this Act.
SEC. 6. COMPENSATION FOR DISABILITIES RESULTING
FROM ILLNESSES ASSOCIATED WITH SERV-
ICE DURING THE PERSIAN GULF WAR.
(a) IN GENERAL.—
(1) Chapter 11 of title 38, United States Code,
is amended by adding at the end of subchapter I the
following new section:
‘‘§ 1117. Compensation for conditions or illnesses of
unknown origin associated with service
during the Persian Gulf War
‘‘(a) The Secretary shall pay compensation under this
subchapter to a Persian Gulf War veteran suffering from
a disability resulting from an undiagnosed illness, or com-
bination of illness, that becomes manifest to a degree of
10 percent or more within three years of separation from
active military, naval, or air service.
‘‘(b)(1) The Secretary shall issue, within 90 days of
the date of the enactment of this section, preliminary reg-
ulations governing the award of such compensation.
‘‘(2) The percentage of disability that equals 10 per-
cent shall be described as ‘mild impairment of social and
industrial adaptability’.
‘‘(3) The percentage of disability that equals a total
or 100 percent rating shall be described as ‘demonstra-
tively unable to obtain or retain substantial gainful em-
ployment’.
‘‘(4) In determining the rating schedule for such dis-
ability, the Secretary should examine analogous ratings.
‘‘(5) In determining eligibility for compensation
under this section, the Secretary shall give due consider-
ation to ‘lay evidence’, including testimony provided by the
claimant, supporting witnesses, and independent medical
experts.
‘‘(c) Not later than 60 days after the date on which
the Secretary issues any proposed regulations pursuant to
this section, the Secretary shall issue final regulations
under this section. Such regulations shall be effective on
the date of issuance.
‘‘(d) A disability for which compensation under this
section is awarded shall be considered to be service con-
nected for purposes of all other laws of the United States.
‘‘(e) Compensation may not be paid under this sec-
tion for a disability occurring in a veteran—
‘‘(1) where there is a preponderance of evidence
that the disability was not incurred by the veteran
in the Southwest Asia theater of operations during
the Persian Gulf War; or
‘‘(2) where there is a preponderance of evidence
to establish that an intercurrent injury or illness
which is a recognized cause of the disability was suf-
fered by the veteran between the date of the veter-
an’s most recent departure from the Southwest Asia
theater of operations while on active duty and the
onset of the disability.
‘‘(f) For purposes of this section, the term ‘Persian
Gulf veteran’ means a veteran who served on active duty
in the Armed Forces in the Southwest Asia theater of op-
erations during the Persian Gulf War.
‘‘(g) Payments shall be made under this section to
a veteran until such time as the scientific evidence dem-
onstrates that the illnesses for which compensation is
awarded under this section are not connected to service
in the Southwest Asia theater of operations during the
Persian Gulf War. The Secretary may cease payments
under this section only after providing a report describing
the Secretary’s intentions, as well as the scientific basis
for ceasing such payments, at least 90 days before imple-
mentation of such action to the Committees on Veterans
Affairs of the Senate and House of Representatives.
‘‘(h) Compensation awarded under this section shall
not preclude a veteran from receiving retroactive com-
pensation for a benefit claim that was filed before the date
of the enactment of this section if the veteran’s illness or
illnesses are later found to be service connected.
‘‘(i) The Secretary shall consider having all claims for
compensation under this section adjudicated on a priority
basis at a single Department facility in order to better
ensure the consistency of rating decisions.
‘‘(j) The Secretary shall have all claims for service-
connected benefits connected to an undiagnosable illness
or illnesses in veterans of the Persian Gulf War that were
denied before the date of the enactment of this section
reopened and adjudicated as original claims. In such a
case, the date of claim shall be considered to be the date
on which the original claim was filed.’’.
(2) The table of sections at the beginning of
such chapter is amended by inserting after the item
relating to section 1116 the following new item:
‘‘1117. Presumption of service connection for illnesses associated with the Per-
sian Gulf War.’’.
(b) EFFECTIVE DATE.—Section 1117 of title 38,
United States Code, as added by subsection (a), shall take
effect on October 1, 1994.
SEC. 7. RESULTS OF EXAMINATIONS AND TREATMENT OF
PERSIAN 
GULF 
WAR 
VETERANS 
WITH
UNDIAGNOSABLE ILLNESSES.
(a) ACCESS TO DATA.—The Secretary of Veterans
Affairs shall enter into an agreement with the Secretary
of Defense to have access to all clinical data of the Depart-
ment of Defense on veterans of the Persian Gulf War who
remain on active duty.
(b) ONGOING COMPILATION
OF DATA.—The Sec-
retary of Veterans Affairs shall compile and analyze, on
a continuing basis, all clinical data obtained on veterans
of the Persian Gulf War in connection with examinations
and treatment furnished by the Department of Veterans
Affairs and the Department of Defense that are likely (1)
to be scientifically useful in determining the association
between the undiagnosable illnesses of veterans and their