I 
116TH CONGRESS 
2D SESSION 
H. R. 8506 
To improve the provision of health care and other benefits from the Depart-
ment of Veterans Affairs for veterans who were exposed to toxic sub-
stances, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 2, 2020 
Mr. BILIRAKIS (for himself, Mr. DAVID P. ROE of Tennessee, Mr. WENSTRUP, 
Mr. BOST, and Mr. MAST) introduced the following bill; which was re-
ferred to the Committee on Veterans’ Affairs 
A BILL 
To improve the provision of health care and other benefits 
from the Department of Veterans Affairs for veterans 
who were exposed to toxic substances, and for other 
purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Toxic Exposure in the American Military Act of 2020’’ 
or the ‘‘TEAM Act of 2020’’. 
(b) TABLE OF CONTENTS.—The table of contents for 
this Act is as follows: 
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Sec. 1. Short title; table of contents. 
Sec. 2. Definitions. 
TITLE I—EXPANSION OF HEALTH CARE AND BENEFITS FOR 
VETERANS EXPOSED TO TOXIC SUBSTANCES 
Sec. 101. Expansion of health care eligibility for certain individuals exposed to 
open burn pits and other toxic substances. 
Sec. 102. Expansion of health care eligibility for veterans awarded certain med-
als. 
Sec. 103. Presumptions of service connection for diseases associated with expo-
sure to certain toxic substances. 
TITLE II—RESEARCH AND REVIEW REGARDING EXPOSURE TO 
TOXIC SUBSTANCES 
Sec. 201. Establishment of Toxic Exposure Review Commission. 
Sec. 202. Agreement with National Academies of Sciences, Engineering, and 
Medicine concerning the exposure of humans to toxic sub-
stances. 
Sec. 203. Collection, analysis, and report on treatment of veterans for medical 
conditions related to exposure to toxic substances. 
TITLE III—IMPROVEMENT OF RESOURCES OF DEPARTMENT OF 
VETERANS AFFAIRS REGARDING EXPOSURES TO TOXIC SUB-
STANCES 
Sec. 301. Publication of list of resources of Department of Veterans Affairs for 
veterans exposed to toxic substances and outreach program for 
such veterans and caregivers and survivors of such veterans. 
Sec. 302. Incorporation of toxic exposure questionnaire during primary care ap-
pointments. 
Sec. 303. Sense of Congress on portal for access by veterans to Individual Lon-
gitudinal Exposure Record. 
Sec. 304. Training of health care personnel of Department of Veterans Affairs 
on illnesses related to exposure to toxic substances. 
SEC. 2. DEFINITIONS. 
In this Act: 
(1) ACTIVE MILITARY, NAVAL, OR AIR SERV-
ICE.—The term ‘‘active military, naval, or air serv-
ice’’ has the meaning given that term in section 101 
of title 38, United States Code. 
(2) OPEN BURN PIT.—The term ‘‘open burn 
pit’’ has the meaning given that term in section 
201(c) of the Dignified Burial and Other Veterans’ 
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Benefits Improvement Act of 2012 (Public Law 
112–260; 38 U.S.C. 527 note). 
(3) TOXIC SUBSTANCE.—The term ‘‘toxic sub-
stance’’ has the meaning given that term in subpara-
graph (G)(iv) of section 1710(e)(1) of such title, as 
added by section 101(a). 
TITLE I—EXPANSION OF HEALTH 
CARE 
AND 
BENEFITS 
FOR 
VETERANS 
EXPOSED 
TO 
TOXIC SUBSTANCES 
SEC. 101. EXPANSION OF HEALTH CARE ELIGIBILITY FOR 
CERTAIN INDIVIDUALS EXPOSED TO OPEN 
BURN PITS AND OTHER TOXIC SUBSTANCES. 
(a) IN GENERAL.—Section 1710(e) of title 38, 
United States Code, is amended— 
(1) in paragraph (1), by adding at the end the 
following new subparagraph: 
‘‘(G)(i) Subject to paragraph (2), a covered individual 
is eligible for hospital care, medical services, and nursing 
home care under subsection (a)(2)(F) for any illness. 
‘‘(ii) For purposes of this subparagraph, a covered 
individual is an individual who— 
‘‘(I) is eligible for inclusion in the Airborne 
Hazards and Open Burn Pit Registry; or 
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‘‘(II) has been identified by the Secretary of 
Defense to have been possibly exposed, inside or out-
side the United States, during active duty, active 
duty for training, or inactive duty training, to— 
‘‘(aa) an open burn pit; 
‘‘(bb) a toxic substance; or 
‘‘(cc) a site included in a database main-
tained by the Department of Defense and 
shared with the Department of Veterans affairs 
to serve as the central portal for exposure-re-
lated data that compiles, collates, presents, and 
provides available occupational and environ-
mental exposure information to support the 
needs of the Department of Defense and the 
Department of Veterans Affairs. 
‘‘(iii) A covered individual shall be enrolled in the sys-
tem of annual patient enrollment of the Department in 
the priority group under subsection (a)(6) of section 1705 
of this title. 
‘‘(iv) In this subparagraph: 
‘‘(I) The term ‘Airborne Hazards and Open 
Burn Pit Registry’ means the registry established by 
the Secretary under section 201 of the Dignified 
Burial and Other Veterans’ Benefits Improvement 
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Act of 2012 (Public Law 112–260; 38 U.S.C. 527 
note). 
‘‘(II) The term ‘open burn pit’ has the meaning 
given that term in section 201(c) of the Dignified 
Burial and Other Veterans’ Benefits Improvement 
Act of 2012 (Public Law 112–260; 38 U.S.C. 527 
note). 
‘‘(III) The term ‘toxic substance’ means a toxi-
cant or a toxin. 
‘‘(IV) The term ‘toxicant’ means any substance 
that can injure or kill humans, animals, or plants 
and that is produced by humans or is a by-product 
of human activities. 
‘‘(V) The term ‘toxin’ means any substance 
that can injure or kill humans, animals, or plants 
and that is produced naturally.’’; and 
(2) in paragraph (2)(B), by striking ‘‘or (F)’’ 
and inserting ‘‘(F), or (G)’’. 
(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall take effect on the date that is 90 days 
after the date of the enactment of this Act. 
(c) DETERMINATIONS OF EXPOSURE.— 
(1) IN GENERAL.—The Secretary of Veterans 
Affairs shall, to the extent practicable, establish and 
maintain a mechanism by which veterans may deter-
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mine whether or not they have been possibly exposed 
to an open burn pit or toxic substance described in 
subparagraph (G)(ii)(II) of section 1710(e)(1) of 
title 38, United States Code, as added by subsection 
(a), for purposes of being considered as covered vet-
erans under such subparagraph. 
(2) APPROVAL
OF
SECRETARY.—Any deter-
mination made under paragraph (1) shall be subject 
to the approval of the Secretary. 
(3) APPEALS.—The Secretary shall establish a 
mechanism for appealing a decision made by the 
Secretary under paragraph (2). 
(d) REPORT.— 
(1) IN GENERAL.—Not later than 30 days after 
the date on which the Secretary of Defense identifies 
the individuals described in subparagraph (G)(ii)(II) 
of section 1710(e)(1) of title 38, United States 
Code, as added by subsection (a), the Secretary, in 
consultation with the Secretary of Veterans Affairs, 
shall submit to the appropriate committees of Con-
gress a report. 
(2) ELEMENTS.—The report required by para-
graph (1) shall include the following: 
(A) The duty locations or units of the indi-
viduals described in paragraph (1), or other in-
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formation on groups to which such individuals 
belong. 
(B) The evidence considered in identifying 
individuals who were possibly exposed to an 
open burn pit, toxic substance, or site as de-
scribed in subparagraph (G)(ii)(II) of section 
1710(e)(1) of title 38, United States Code, as 
added by subsection (a). 
(C) The criteria used to determine whether 
an individual was so exposed. 
(3) 
APPROPRIATE
COMMITTEES
OF
CON-
GRESS.—In this subsection, the term ‘‘appropriate 
committees of Congress’’ means— 
(A) the Committee on Veterans’ Affairs 
and the Committee on Armed Services of the 
Senate; and 
(B) the Committee on Veterans’ Affairs 
and the Committee on Armed Services of the 
House of Representatives. 
SEC. 102. EXPANSION OF HEALTH CARE ELIGIBILITY FOR 
VETERANS AWARDED CERTAIN MEDALS. 
(a) IN GENERAL.—Section 1710(e) of title 38, 
United States Code, as amended by section 101(a), is fur-
ther amended— 
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(1) in paragraph (1), by adding at the end the 
following new subparagraph: 
‘‘(H)(i) Subject to paragraph (2), a veteran is eligible 
for hospital care, medical services, and nursing home care 
under subsection (a)(2)(F) for any illness if the veteran 
was awarded any of the following: 
‘‘(I) The Armed Forces Service Medal. 
‘‘(II) The Afghanistan Campaign Medal. 
‘‘(III) The Global War on Terrorism Expedi-
tionary Medal. 
‘‘(IV) The Inherent Resolve Campaign Medal. 
‘‘(V) The Iraq Campaign Medal. 
‘‘(VI) The Southwest Asia Service Medal. 
‘‘(ii) A veteran described in clause (i) shall be enrolled 
in the system of annual patient enrollment of the Depart-
ment in the priority group under subsection (a)(6) of sec-
tion 1705 of this title.’’; and 
(2) in paragraph (2), by striking ‘‘or (G)’’ and 
inserting ‘‘(G), or (H)’’. 
(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall take effect on the date that is 90 days 
after the date of the enactment of this Act. 
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SEC. 103. PRESUMPTIONS OF SERVICE CONNECTION FOR 
DISEASES ASSOCIATED WITH EXPOSURE TO 
CERTAIN TOXIC SUBSTANCES. 
(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 dis-
eases associated with exposure to certain 
toxic substances 
‘‘(a) PRESUMPTIONS OF SERVICE CONNECTION.—(1) 
For purposes of section 1110 of this title, and subject to 
section 1113 of this title, each disease specified in para-
graph (2) becoming manifest as specified in that para-
graph shall be considered to have been incurred in or ag-
gravated by service referred to in that paragraph, notwith-
standing that there is no record of evidence of such disease 
during the period of such service. 
‘‘(2) A disease specified in this paragraph is any dis-
ease that— 
‘‘(A) the Secretary determines in regulations 
prescribed under this section warrants a presump-
tion of service connection by reason of having suffi-
cient evidence of positive association with exposure 
to a toxic substance; and 
‘‘(B) becomes manifest within the period, if 
any, prescribed in such regulations in a veteran who 
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was exposed to that toxic substance during active 
military, naval, or air service. 
‘‘(3)(A) For purposes of this subsection, the Sec-
retary may presume that a veteran who has a disease spec-
ified in paragraph (2) was exposed to the toxic substance 
for which the Secretary has determined under paragraph 
(2)(A) warrants a presumption of service connection by 
reason of having sufficient evidence of positive association 
with exposure to the toxic substance, notwithstanding that 
there is no record of evidence of such exposure, if the Sec-
retary determines based on one or more of the factors set 
forth in subparagraph (B) that a presumption of exposure 
is warranted. 
‘‘(B) The factors set forth in this subparagraph are 
as follows: 
‘‘(i) The duty location of the veteran. 
‘‘(ii) The length of service of the veteran. 
‘‘(iii) Such other factors as the Secretary con-
siders appropriate. 
‘‘(b) DETERMINATIONS RELATING TO DISEASES.— 
(1) Whenever the Secretary determines, on the basis of 
sound medical and scientific evidence, that sufficient evi-
dence of positive association exists between the exposure 
of humans to a toxic substance and the occurrence of a 
disease in humans, the Secretary shall prescribe regula-
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tions providing that a presumption of service connection 
is warranted for that disease for purposes of this section. 
‘‘(2) In making determinations under paragraph (1), 
the Secretary shall take into account— 
‘‘(A) reports received by the Secretary from the 
National Academies of Sciences, Engineering, and 
Medicine under section 202(g) of the Toxic Expo-
sure in the American Military Act of 2020; and 
‘‘(B) all other sound medical and scientific in-
formation and analyses available to the Secretary. 
‘‘(3)(A) In evaluating any report, information, or 
analysis for purposes of making such determinations, the 
Secretary shall consider only scientific studies that are 
valid in accordance with contemporary scientific stand-
ards. 
‘‘(B) The Secretary may define the standards de-
scribed in subparagraph (A) for purposes of that subpara-
graph. 
‘‘(c) RESPONSE
TO REPORTS
BY
THE NATIONAL 
ACADEMIES
OF SCIENCES, ENGINEERING, AND MEDI-
CINE.—(1) Not later than 60 days after the date on which 
the Secretary receives a report from the National Acad-
emies of Sciences, Engineering, and Medicine under sec-
tion 202(g) of the Toxic Exposure in the American Mili-
tary Act of 2020, the Secretary shall determine whether 
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a presumption of service connection is warranted for each 
disease covered by the report. 
‘‘(2) If the Secretary determines under paragraph (1) 
that a presumption of service connection is warranted for 
a disease, the Secretary shall, not later than 60 days after 
making the determination, issue proposed regulations set-
ting forth the determination. 
‘‘(3)(A) If the Secretary makes a determination de-
scribed in subparagraph (B), the Secretary shall, not later 
than 60 days after making the determination, publish in 
the Federal Register a notice of the determination. 
‘‘(B) A determination described in this subparagraph 
is a determination by the Secretary under paragraph (1) 
that a presumption of service connection is not warranted 
for a disease as to which the National Academies of 
Sciences, Engineering, and Medicine determined that 
there was— 
‘‘(i) sufficient evidence of an association be-
tween the exposure of humans to a toxic substance 
and the occurrence of the disease in humans; or 
‘‘(ii) limited evidence or suggestive evidence of 
such an association. 
‘‘(C) Any notice published under subparagraph (A) 
shall include an explanation of the scientific basis for the 
determination described in subparagraph (B). 
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‘‘(D) If a disease already presumed to be service con-
nected under this section is subject to a determination de-
scribed in subparagraph (B), the Secretary shall, not later 
than 60 days after publication of the notice under sub-
paragraph (A), issue proposed regulations removing the 
presumption of service connection for the disease. 
‘‘(4) Not later than 180 days after the date on which 
the Secretary issues any proposed regulations under this 
subsection, the Secretary shall issue final regulations. 
‘‘(d) REMOVAL OF PRESUMPTION OF SERVICE CON-
NECTION.—Whenever the presumption of service connec-
tion for a disease under this section is removed under sub-
section (c)— 
‘‘(1) a veteran who was awarded compensation 
for the disease on the basis of the presumption be-
fore the effective date of the removal of the pre-
sumption 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 the disease on the 
basis of the presumption before that date shall con-
tinue to be entitled to receive dependency and in-
demnity compensation on that basis. 
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‘‘(e) REFERENCE
TO NATIONAL ACADEMIES
OF 
SCIENCES, ENGINEERING, AND MEDICINE.—In the case 
that the Secretary enters into an agreement with another 
organization as described in section 202(h)(1) of the Toxic 
Exposure in the American Military Act of 2020, any ref-
erence in this section to the National Academies of 
Sciences, Engineering, and Medicine shall be treated as 
a reference to the other organization. 
‘‘(f) DEFINITIONS.—In this section: 
‘‘(1) The term ‘sufficient evidence of positive 
association’ means, with respect to an association 
between exposure to a toxic substance and the occur-
rence of a disease in humans, that— 
‘‘(A) there is credible evidence for the asso-
ciation and such evidence is equal to or out-
weighs the credible evidence against the associa-
tion; and 
‘‘(B) the association has been observed in 
studies in which chance, bias, and confounding 
can be ruled out with reasonable confidence. 
‘‘(2) The term ‘toxic substance’ has the mean-
ing given that term in section 1710(e)(1)(G)(iv) of 
this title.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of chapter 11 of such title is amended 
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by inserting after the item relating to section 1118 the 
following new item: 
‘‘1119. Presumptions of service connection for diseases associated with exposure 
to certain toxic substances.’’. 
(c) CONFORMING AMENDMENT.—Section 1113 of 
such title is amended by striking ‘‘or 1118’’ each place 
it appears and inserting ‘‘1118, or 1119’’. 
TITLE II—RESEARCH AND RE-
VIEW REGARDING EXPOSURE 
TO TOXIC SUBSTANCES 
SEC. 201. ESTABLISHMENT OF TOXIC EXPOSURE REVIEW 
COMMISSION. 
(a) IN GENERAL.—Subchapter III of chapter 5 of 
title 38, United States Code, is amended by adding at the 
end the following new section: 
‘‘§ 547. Toxic Exposure Review Commission 
‘‘(a) ESTABLISHMENT.—The Secretary shall estab-
lish an independent commission to be known as the ‘Toxic 
Exposure Review Commission’ (in this section referred to 
as the ‘Commission’). 
‘‘(b) PURPOSE.—The Commission shall— 
‘‘(1) advise the Secretary on questions relating 
to exposure to toxic substances that require sci-
entific research; and 
‘‘(2) assist in the consideration of possible pre-
sumptions of service connection. 
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‘‘(c) DUTIES.—The Commission shall carry out the 
following duties: 
‘‘(1) Collect any relevant information from the 
Department of Defense and other sources to identify 
possible toxic exposures related to service during ac-
tive duty, active duty for training, or inactive duty 
training in order to determine the need for a com-
prehensive review under an agreement under section 
202 of the Toxic Exposure in the American Military 
Act of 2020. Relevant information may be collected 
from the following: 
‘‘(A) Any Federal agency, as the Commis-
sion considers necessary to carry out this sec-
tion. Upon request of the Chair, the head of 
such agency shall furnish such information to 
the Commission, unless such information is 
classified. 
‘‘(B) Public meetings or hearings, which 
may be held to take such testimony and receive 
such evidence as the Commission considers ad-
visable to carry out the duties of the Commis-
sion. 
‘‘(2) Recommend to the Secretary, by majority 
vote, whether a comprehensive scientific review 
should be conducted by the National Academies of 
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Sciences, Engineering, and Medicine under an agree-
ment under section 202 of the Toxic Exposure in the 
American Military Act of 2020. 
‘‘(3) Recommend to the Secretary, by majority 
vote, whether new, independent studies regarding 
the health outcomes of exposure to toxic substances, 
or any other new, independent studies that the Com-
mission deems necessary and appropriate, should be 
conducted. 
‘‘(4) Annually report to Congress on progress 
regarding the duties set forth in paragraphs (1) 
through (3), any recommendations made to the Sec-
retary, and any responses of the Secretary to such 
recommendations. 
‘‘(d) MEMBERSHIP.—(1)(A) The Commission shall be 
composed of 9 members, appointed as follows: 
‘‘(i) Two members appointed by the Speaker of 
the House of Representatives. 
‘‘(ii) Two members appointed by the minority 
leader of the House of Representatives. 
‘‘(iii) Two members appointed by the majority 
leader of the Senate. 
‘‘(iv) Two members appointed by the minority 
leader of the Senate. 
‘‘(v) One member appointed by the Secretary. 
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‘‘(B) The initial members of the Commission shall be 
appointed under subparagraph (A) not later than 180 
days after the date of the enactment of the Toxic Expo-
sure in the American Military Act of 2020. 
‘‘(2) In appointing individuals under paragraph 
(1)(A), the Speaker of the House of Representatives, the 
minority leader of the House of Representatives, the ma-
jority leader of the Senate, the minority leader of the Sen-
ate, and the Secretary shall ensure that at least five mem-
bers of the Commission are scientists or health care pro-
fessionals— 
‘‘(A) of whom— 
‘‘(i) one has a background in the field of 
respiratory medicine; 
‘‘(ii) one has a background in the field of 
endocrinology and metabolic medicine; 
‘‘(iii) one has a background in hematology; 
‘‘(iv) one has a background in oncology; 
and 
‘‘(v) one has a background in occupational 
and environmental health; and 
‘‘(B) who are not officials or employees of the 
Federal Government. 
‘‘(3) In appointing individuals under paragraph 
(1)(A), the Speaker of the House of Representatives, the 
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minority leader of the House of Representatives, the ma-
jority leader of the Senate, the minority leader of the Sen-
ate, and the Secretary shall ensure that at least two mem-
bers of the Commission represent an organization recog-
nized by the Secretary for the representation of veterans 
under section 5902 of this title. 
‘‘(4) In appointing individuals under paragraph 
(1)(A), the Speaker of the House of Representatives, the 
minority leader of the House of Representatives, the ma-
jority leader of the Senate, the minority leader of the Sen-
ate, and the Secretary shall give consideration to including 
in the Commission at least one member who works with 
survivors of illnesses related to exposure to toxic sub-
stances and has a background in the field of study of expo-
sure to toxic substances. 
‘‘(e) MEETINGS.—(1) The Commission shall meet not 
less frequently than twice each year. 
‘‘(2)(A) Each meeting of the Commission shall be 
open to the public. 
‘‘(B) All the proceedings, information, and delibera-
tions of the Commission shall be available for review by 
the public. 
‘‘(C) Meetings of the Commission may be carried out 
through the use of telephonic or other appropriate tele-
communication technology if the Commission determines 
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that such technology will allow the members to commu-
nicate simultaneously. 
‘‘(f) CHAIR AND VICE CHAIR.—At the initial meeting 
of the Commission under subsection (e), the Commission 
shall select a Chair and Vice Chair from among the mem-
bers of the Commission by a majority vote of the members 
of the Commission. 
‘‘(g) PERIOD OF APPOINTMENT; VACANCIES.—(1) A 
member of the Commission shall be appointed for a term 
that may not exceed four years. 
‘‘(2) The Secretary shall ensure that terms of mem-
bers of the Commission are staggered so that no such 
terms end on the same date. 
‘‘(3) A vacancy in the Commission shall be filled in 
the same manner as the original appointment, but the in-
dividual appointed to fill the vacancy shall serve only for 
the unexpired portion of the term for which the individ-
ual’s predecessor was appointed. 
‘‘(4) In appointing the initial members of the Com-
mission, each official who is authorized to appoint two 
members of the Commission shall appoint— 
‘‘(A) one member whose term expires after two 
years; and 
‘‘(B) one member whose term expires after four 
years. 
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‘‘(h) PAY.—(1) Members of the Commission shall 
serve without pay. 
‘‘(2) Each member of the Commission who is an offi-
cer or employee of the United States shall serve without 
compensation in addition to that received for service as 
an officer or employee of the United States. 
‘‘(3) Members shall receive travel expenses, including 
per diem in lieu of subsistence, in accordance with sections 
5702 and 5703 of title 5. 
‘‘(i) DIRECTOR
OF STAFF.—(1) The Commission 
shall appoint a Director who— 
‘‘(A) has not served as an employee of the De-
partment during the one-year period preceding the 
date of such appointment; and 
‘‘(B) is not otherwise barred or prohibited from 
serving as Director under Federal ethics laws and 
regulations, by reason of post-employment conflict of 
interest. 
‘‘(2) The Director shall be paid at the rate of basic 
pay payable for level IV of the Executive Schedule under 
section 5315 of title 5. 
‘‘(j) STAFF.—(1) Subject to paragraphs (2) and (3), 
the Director, with the approval of the Commission, may 
appoint and fix the pay of additional personnel. 
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‘‘(2) The Director may make such appointments 
without regard to the provisions of title 5 governing ap-
pointments in the competitive service, and any personnel 
so appointed may be paid without regard to the provisions 
of chapter 51 and subchapter III of chapter 53 of that 
title relating to classification and General Schedule pay 
rates, except that an individual so appointed may not re-
ceive pay in excess of the annual rate of basic pay payable 
for GS–15 of the General Schedule. 
‘‘(3)(A) Not more than two-thirds of the personnel 
employed by or detailed to the Commission may be on de-
tail from the Department. 
‘‘(B) Not more than half of the professional analysts 
of the Commission staff may be persons detailed from the 
Department to the Commission. 
‘‘(4) Subject to paragraph (3), the head of any Fed-
eral agency, upon the request of the Director, may detail 
any of the personnel of that agency to the Commission 
to assist the Commission in carrying out its duties under 
this section. 
‘‘(5) The Commission may secure directly from any 
Federal agency such information as the Commission con-
siders necessary to carry out this section. Upon request 
of the Chair, the head of such agency shall furnish such 
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information to the Commission, unless such information 
is classified. 
‘‘(k) OTHER AUTHORITY.—(1) The Commission may 
procure by contract, to the extent funds are available, the 
temporary or intermittent services of experts or consult-
ants pursuant to section 3109 of title 5. 
‘‘(2) To the extent funds are available, the Commis-
sion may lease real property and acquire personal property 
either of its own accord or in consultation with the General 
Services Administration. 
‘‘(l) COMMUNICATIONS.—(1)(A) Except as provided 
in subparagraph (B), no person may restrict an employee 
of the Department in communicating with the Commis-
sion. 
‘‘(B) Subparagraph (A) does not apply to a commu-
nication that is unlawful. 
‘‘(2) All ex parte communications with the Commis-
sion shall be made part of the public record. 
‘‘(m) REFERENCE
TO NATIONAL ACADEMIES
OF 
SCIENCES, ENGINEERING, AND MEDICINE.—In the case 
that the Secretary enters into an agreement with another 
organization as described in section 202(h)(1) of the Toxic 
Exposure in the American Military Act of 2020, any ref-
erence in this section to the National Academies of 
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Sciences, Engineering, and Medicine shall be treated as 
a reference to the other organization. 
‘‘(n) TOXIC SUBSTANCE DEFINED.—In this section, 
the term ‘toxic substance’ has the meaning given that 
term in subparagraph (G)(iv) of section 1710(e)(1) of this 
title.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of chapter 5 of such title is amended by 
adding at the end the following new item: 
‘‘547. Toxic Exposure Review Commission.’’. 
SEC. 202. AGREEMENT WITH NATIONAL ACADEMIES OF 
SCIENCES, 
ENGINEERING, 
AND 
MEDICINE 
CONCERNING THE EXPOSURE OF HUMANS TO 
TOXIC SUBSTANCES. 
(a) PURPOSE.—The purpose of this section is to pro-
vide for the National Academies of Sciences, Engineering, 
and Medicine (in this section referred to as the ‘‘Acad-
emies’’), an independent nonprofit scientific organization 
with appropriate expertise that is not part of the Federal 
Government, to review and evaluate the available scientific 
evidence regarding associations between diseases and ex-
posure to toxic substances. 
(b) AGREEMENT.— 
(1) IN GENERAL.—The Secretary of Veterans 
Affairs shall seek to enter into a five-year agreement 
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with the Academies to perform the services covered 
by this section. 
(2) TIMING.—The Secretary shall seek to enter 
into an agreement described in paragraph (1) not 
later than 60 days after the date of the enactment 
of this Act. 
(3) EXTENSION.—An agreement under this sec-
tion may be extended in five-year increments. 
(c) REVIEW OF SCIENTIFIC EVIDENCE.—Under an 
agreement between the Secretary and the Academies 
under this section, the Academies shall review and summa-
rize the scientific evidence, and assess the strength there-
of, concerning the association between exposure to toxic 
substances during active military, naval, or air service and 
each disease suspected to be associated with such exposure 
in the human population. 
(d) SCIENTIFIC DETERMINATIONS CONCERNING DIS-
EASES.—For each disease reviewed under subsection (c), 
the Academies shall determine, to the extent that available 
scientific data permit meaningful determinations— 
(1) whether an association exists between expo-
sure to toxic substances and the occurrence of the 
disease, taking into account the strength of the sci-
entific evidence and the appropriateness of the sta-
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