I 
117TH CONGRESS 
1ST SESSION H. R. 2268 
To amend title 38, United States Code, to ensure that certain diseases 
are covered by the presumption of service connection relating to the 
exposure to herbicides by certain veterans who served in the Republic 
of Vietnam, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 26, 2021 
Mr. WESTERMAN
(for himself, Mr. THOMPSON
of California, Mrs. 
HARSHBARGER, Mr. NEGUSE, Mr. BERGMAN, Ms. PINGREE, Mr. 
BRENDAN F. BOYLE of Pennsylvania, Mr. MORELLE, Mr. DELGADO, Ms. 
OMAR, Mr. COHEN, Mr. BILIRAKIS, Mrs. WALORSKI, Mrs. RADEWAGEN, 
Mr. RUTHERFORD, Mr. GRIFFITH, Mr. KIM of New Jersey, Mrs. AXNE, 
Mr. FITZPATRICK, and Ms. PORTER) introduced the following bill; which 
was referred to the Committee on Veterans’ Affairs 
A BILL 
To amend title 38, United States Code, to ensure that cer-
tain diseases are covered by the presumption of service 
connection relating to the exposure to herbicides by cer-
tain veterans who served in the Republic of Vietnam, 
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. 
This Act may be cited as the ‘‘Keeping Our Promises 
Act’’. 
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SEC. 2. ADDITION OF DISEASES TO PRESUMPTION OF 
SERVICE CONNECTION FOR VETERANS EX-
POSED 
TO 
CERTAIN 
HERBICIDES 
WHILE 
SERVING IN THE REPUBLIC OF VIETNAM. 
(a) SPECIFIED DISEASES.—Subsection (a)(2) of sec-
tion 1116 of title 38, United States Code, is amended by 
adding at the end the following new subparagraphs: 
‘‘(L) Prostate cancer becoming manifest to a 
degree of disability of 10 percent or more. 
‘‘(M) AL amyloidosis becoming manifest to a 
degree of disability of 10 percent or more. 
‘‘(N) Early-onset peripheral neuropathy becom-
ing manifest to a degree of 10 percent or more with-
in one year after the last date on which the veteran 
was exposed to an herbicide agent during active mili-
tary, naval, or air service. 
‘‘(O) Ischemic heart disease becoming manifest 
to a degree of disability of 10 percent or more. 
‘‘(P) Stroke becoming manifest to a degree of 
disability of 10 percent or more. 
‘‘(Q) Hypertension becoming manifest to a de-
gree of disability of 10 percent or more.’’. 
(b) ADDITIONAL DISEASES.— 
(1) EXTENSION OF SUNSET.—Subsection (e) of 
such section 1116 is amended by striking ‘‘2015’’ 
and inserting ‘‘2030’’. 
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(2) PROHIBITION OF COST AS FACTOR.—Sub-
section (b) of such section 1116 is amended by add-
ing at the end the following new paragraph: 
‘‘(4) In making determinations for the purpose of this 
subsection, the Secretary may not take into account the 
costs to the United States relating to paying compensation 
under this section pursuant to such determination.’’. 
(3) TIMING AND SUBMISSION OF DETERMINA-
TIONS.—Subsection (c)(1) of such section 1116 is 
amended— 
(A) in subparagraph (A), by striking ‘‘60 
days’’ both places it appears and inserting ‘‘120 
days’’; and 
(B) in subparagraph (B)— 
(i) by inserting ‘‘and submit to the 
Committees on Veterans’ Affairs of the 
House of Representatives and the Senate’’ 
after ‘‘publish in the Federal Register’’; 
and 
(ii) by inserting ‘‘, and any other fac-
tor that contributed to,’’ after ‘‘scientific 
basis for’’. 
Æ 
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