I 
109TH CONGRESS 
1ST SESSION H. R. 1588 
To improve programs for the identification and treatment of post-deployment 
mental health conditions, including post-traumatic stress disorder, in 
veterans and members of the Armed Forces, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 13, 2005 
Mr. EVANS (for himself, Mr. FILNER, Mr. GUTIERREZ, Ms. CORRINE BROWN 
of Florida, Mr. MICHAUD, Ms. HERSETH, Mr. STRICKLAND, Ms. BERK-
LEY, Mr. UDALL of New Mexico, Mrs. DAVIS of California, Mr. BISHOP 
of Georgia, Mr. DEFAZIO, Mr. LYNCH, Ms. DELAURO, Mr. GRIJALVA, 
Mr. VAN HOLLEN, Ms. EDDIE BERNICE JOHNSON of Texas, Mr. 
MCDERMOTT, Mr. SCHIFF, Mr. ABERCROMBIE, Mr. CASE, Mr. MCGOV-
ERN, Mr. PETERSON of Minnesota, Mrs. JONES of Ohio, Ms. BORDALLO, 
Mr. ORTIZ, Mr. GEORGE MILLER of California, Mr. ANDREWS, Mr. 
BAIRD, Mr. KENNEDY of Rhode Island, Mr. LANGEVIN, Mr. KUCINICH, 
Mr. EMANUEL, and Mr. TAYLOR of Mississippi) introduced the following 
bill; which was referred to the Committee on Veterans’ Affairs, and in 
addition to the Committee on Armed Services, for a period to be subse-
quently determined by the Speaker, in each case for consideration of such 
provisions as fall within the jurisdiction of the committee concerned 
A BILL 
To improve programs for the identification and treatment 
of post-deployment mental health conditions, including 
post-traumatic stress disorder, in veterans and members 
of the Armed Forces, 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. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Comprehensive Assistance for Veterans Exposed to 
Traumatic Stressors Act of 2005’’. 
(b) TABLE OF CONTENTS.—The table of contents for 
this Act is as follows: 
Sec. 1. Short title. 
Sec. 2. Definition. 
TITLE I—VETERANS OF PAST DEPLOYMENTS 
Sec. 101. Six-year extension of eligibility for readjustment counseling services 
for Vietnam-era veterans. 
TITLE II—MILITARY ISSUES 
Sec. 201. Department of Veterans Affairs-Department of Defense Health Care 
Sharing Incentive Fund. 
Sec. 202. Collection of data from pre- and post-deployment health assessments. 
Sec. 203. Preventative maintenance post-deployment intervention. 
TITLE III—PREVENTION, EARLY DETECTION, AND TREATMENT 
FOR RETURNING TROOPS 
Sec. 301. Study to identify factors that decrease the likelihood of the develop-
ment of chronic PTSD despite combat exposure. 
Sec. 302. Extension of period of enhanced eligibility for VA health services for 
veterans who served in combat theaters of operations. 
Sec. 303. Demonstration project to station Department of Veterans Affairs psy-
chologists and psychiatrists at major demobilization sites and 
military treatment facilities. 
Sec. 304. Model programs for post-deployment mental health practice. 
Sec. 305. Performance measures for Department of Veterans Affairs health 
care administrators. 
TITLE IV—DEPARTMENT OF DEFENSE/DEPARTMENT OF VET-
ERANS AFFAIRS COUNCIL ON POST-DEPLOYMENT MENTAL 
HEALTH 
Sec. 401. Establishment of Council. 
Sec. 402. Duties of Council. 
TITLE V—CAPACITY BUILDING IN DEPARTMENT OF VETERANS 
AFFAIRS 
Sec. 501. Plan for expansion of Department of Veterans Affairs system to ex-
pand access to specialized PTSD care. 
Sec. 502. Additional Department of Veterans Affairs resources. 
TITLE VI—FAMILY THERAPY
Sec. 601. Eligibility for family counseling and bereavement counseling. 
TITLE VII—EDUCATIONAL INITIATIVES 
Sec. 701. Training program for health-care providers. 
Sec. 702. Curriculum and protocols for cross-training of Department of Vet-
erans Affairs clinicians. 
Sec. 703. Publication of state-of-the-art post-deployment mental health prob-
lems diagnosis and treatment. 
Sec. 704. Protocols for pain management for PTSD and war-related pain. 
Sec. 705. Protocols for treatment of substance use disorders. 
Sec. 706. Protocols for diagnosis of post-traumatic stress disorder. 
TITLE VIII—NATIONAL STEERING COMMITTEE ON PTSD 
EDUCATION 
Sec. 801. National steering committee. 
Sec. 802. Funding support for National Center for PTSD. 
Sec. 803. Continuing education to mental health providers. 
Sec. 804. Web-based curriculum to sponsor clinician training initiatives. 
TITLE IX—BENEFITS 
Sec. 901. Identification of deficiencies in PTSD disability examinations. 
Sec. 902. Criteria for determining medical conditions associated with PTSD. 
TITLE X—PUBLIC AWARENESS 
Sec. 1001. Public awareness program. 
Sec. 1002. Web site and materials for general campaign of awareness of PTSD. 
SEC. 2. DEFINITION. 
In this Act, the term ‘‘PTSD’’ means post-traumatic 
stress disorder. 
TITLE I—VETERANS OF PAST 
DEPLOYMENTS 
SEC. 101. SIX-YEAR EXTENSION OF ELIGIBILITY FOR READ-
JUSTMENT 
COUNSELING 
SERVICES 
FOR 
VIETNAM-ERA VETERANS. 
Section 1712A(a)(1)(B)(ii) of title 38, United States 
Code, is amended by striking ‘‘January 1, 2004’’ and in-
serting ‘‘January 1, 2010’’.
TITLE II—MILITARY ISSUES 
SEC. 201. DEPARTMENT OF VETERANS AFFAIRS-DEPART-
MENT OF DEFENSE HEALTH CARE SHARING 
INCENTIVE FUND. 
(a) IN GENERAL.—The Secretary of Veterans Affairs 
and the Secretary of Defense shall jointly take such steps 
as necessary to implement the proposal of the Center for 
the Study of Traumatic Stress at the Uniformed Services 
University of the Health Sciences for a Department of 
Veterans Affairs-Department of Defense Health Care 
Sharing Incentive Fund. 
(b) TELECOMMUNICATIONS SUPPORT.—As part of 
the implementation of the proposal referred to in sub-
section (a), the two Secretaries shall provide for a system 
of telecommunications to support the following: 
(1) Continuing education and support for front- 
line (forward-deployed) providers of health-care serv-
ices. 
(2) Enhanced treatment capacity for addressing 
acute episodes of PTSD and other mental health 
disorders in combat theaters, including— 
(A) real-time access to clinical specialty 
support;
(B) web-based information on state-of-the- 
art protocols for the treatment and diagnosis of 
PTSD and other mental health disorders; and 
(C) 
educational 
programs 
concerning 
PTSD and other mental health disorders com-
monly associated with deployment. 
SEC. 202. COLLECTION OF DATA FROM PRE- AND POST-DE-
PLOYMENT HEALTH ASSESSMENTS. 
(a) DATA COLLECTION.—The Secretary of Defense 
shall take appropriate steps to assist the Secretary of Vet-
erans Affairs with the collection of data from pre- and 
post-deployment health assessments of members of the 
Armed Forces that may be relevant for identification and 
treatment by the Secretary of Veterans Affairs of PTSD 
and other post-deployment mental health issues. The Sec-
retary of Defense may provide such information in aggre-
gate, unidentified format and may provide such informa-
tion on a monthly basis or on such other schedule as the 
two Secretaries may agree to. 
(b) CONSENT FORMS.—The Secretary of Defense 
shall develop forms for use in obtaining the written con-
sent of members of the Armed Forces to allow the Depart-
ment of Veterans Affairs to collect data contained on pre- 
deployment and post-deployment health assessment forms 
with relevant treatment information concerning PTSD
and other mental health problems that may be associated 
with combat stress or readjustment to civilian life from 
those members of the Armed Forces to be discharged or 
demobilized within 90 days. Such consent forms shall be 
developed and made available for use by members of the 
Armed Forces covered by the preceding sentence not later 
than 60 days after the date of the enactment of this Act. 
(c) IDENTIFICATION
OF
SUBSTANCE
USE
DIS-
ORDERS.—The Secretary of Defense shall include in pre- 
deployment and post-deployment health assessments ques-
tions to assist in identification of existing or potential sub-
stance use disorders among members of the Armed 
Forces. 
SEC. 203. PREVENTATIVE MAINTENANCE POST-DEPLOY-
MENT INTERVENTION. 
(a) IN GENERAL.—The Secretary of Veterans Affairs 
shall conduct routine preventative maintenance interven-
tion for all members of the Armed Forces returning from 
deployment in a combat theater. Such intervention shall 
be conducted between 90 and 180 days after such mem-
bers return from such deployment. 
(b) PERSONNEL.—For purposes of such intervention, 
the Secretary of Veterans Affairs may use— 
(1) staff of the Department of Veterans Affairs, 
including readjustment counseling staff; and
(2) persons trained by the Department of Vet-
erans Affairs, including volunteers from military 
unit associations, veteran service organizations, or 
other nonprofit organizations. 
(c) SIZE.—Such intervention shall be conducted with 
no more than six returning servicemembers at a time. 
(d) PURPOSE.—The purpose of such intervention 
shall be the following: 
(1) To identify and distinguish symptoms of 
‘‘common’’ acute stress reactions from those of 
chronic and severe post-traumatic stress disorder. 
(2) To discuss concerns of combat personnel 
and those expressed by their family members. 
(3) To refer returning servicemembers to ap-
propriate services, as necessary. 
(4) To disseminate educational materials about 
post-deployment mental health issues, including 
PTSD to servicemembers. 
(5) To provide follow-up educational materials 
by mail to family members. 
(6) To provide information concerning home-
lessness, including risk factors, awareness assess-
ment, and contact information for preventative as-
sistance associated with homelessness.
(e) VA PARTICIPATION IN ADDITIONAL DEMOBILIZA-
TION ACTIVITIES.—The Secretary of Defense shall provide 
for the Secretary of Veterans Affairs to participate in ad-
ditional demobilization activities, including the Transi-
tional Assistance Program, that are conducted within the 
Department of Defense for the purposes specified in sub-
section (d). 
TITLE III—PREVENTION, EARLY 
DETECTION, 
AND 
TREAT-
MENT 
FOR 
RETURNING 
TROOPS 
SEC. 301. STUDY TO IDENTIFY FACTORS THAT DECREASE 
THE LIKELIHOOD OF THE DEVELOPMENT OF 
CHRONIC PTSD DESPITE COMBAT EXPOSURE. 
(a) STUDY.—The Secretary of Veterans Affairs shall 
provide for a study, to be conducted by an entity other 
than the Department of Veterans Affairs and the Depart-
ment of Defense, to identify factors that decrease the like-
lihood of the development of chronic post-traumatic stress 
disorder (PTSD) in servicemembers and veterans who 
have had combat exposure, including exposure to guerilla 
warfare. 
(b) REPORT.—The Secretary shall provide for the en-
tity conducting the study under subsection (a) to submit 
a report on the results of the study to the Secretary and
the Congress not later than one year after the date of the 
enactment of this Act. 
SEC. 302. EXTENSION OF PERIOD OF ENHANCED ELIGI-
BILITY FOR VA HEALTH SERVICES FOR VET-
ERANS WHO SERVED IN COMBAT THEATERS 
OF OPERATIONS. 
Section 1710(e)(3)(C) of title 38, United States 
Code, is amended by striking ‘‘2 years’’ and inserting ‘‘five 
years’’. 
SEC. 303. DEMONSTRATION PROJECT TO STATION DEPART-
MENT OF VETERANS AFFAIRS PSYCHOLO-
GISTS AND PSYCHIATRISTS AT MAJOR DEMO-
BILIZATION SITES AND MILITARY TREAT-
MENT FACILITIES. 
(a) DEMONSTRATION PROJECT.—The Secretary of 
Defense and the Secretary of Veterans Affairs shall jointly 
provide for the conduct of a demonstration project under 
which Department of Veterans Affairs psychologists and 
psychiatrists are stationed at major demobilization sites 
and military treatment facilities. 
(b) PURPOSE.—The purposes of the demonstration 
project shall be as follows: 
(1) Identify, on an aggregate level, need for 
mental health services among active-duty, Reserve, 
and National Guard members.
(2) Provide such services or refer members for 
necessary services. 
(3) Advise servicemembers of the need for con-
tinuous services. 
(4) Identify the obstacles servicemembers have 
in seeking appropriate mental health care. 
(c) FUNDING.—There is authorized to be appro-
priated such sums as may be necessary for each of fiscal 
years 2006, 2007, and 2008 for the conduct of the dem-
onstration project. Amounts for the conduct of the project 
shall be provided equally by the Secretary of Veterans Af-
fairs and the Secretary of Defense. 
(d) ELIGIBILITY CRITERIA.—Based on the results of 
the demonstration project, the Secretaries shall identify 
appropriate eligibility criteria for programs to best re-
spond to the needs of veterans, servicemembers, and their 
families for post-deployment mental health services. The 
criteria identified shall be included in the report under 
subsection (e). 
(e) REPORT.—The Secretary of Veterans Affairs 
shall submit to the Committees on Veterans’ Affairs of 
the Senate and House of Representatives a report pro-
viding the results of the demonstration project. The report 
shall be submitted not later than 18 months after the date 
of the enactment of this Act.
SEC. 304. MODEL PROGRAMS FOR POST-DEPLOYMENT MEN-
TAL HEALTH PRACTICE. 
(a) MODEL PROGRAMS.—The Secretary of Veterans 
Affairs, in consultation with the Secretary of Defense, 
shall develop model programs to respond to a variety of 
mental health disorders prevalent among veterans of serv-
ice in Operation Iraqi Freedom and Operation Enduring 
Freedom. The program shall be implemented at three sites 
selected by the Secretary, of which— 
(1) at least one site shall assign case managers 
to veterans receiving care under such program; and 
(2) at least one site shall use an integrated 
mental health and primary care model for post-de-
ployment mental health practice. 
(b) PURPOSE.—The purpose of the model program 
shall be as follows: 
(1) Development of training protocols for in-
volved clinicians. 
(2) Identification of medical conditions which 
may be associated with post-deployment mental 
health problems including PTSD. 
(3) Identification of ‘‘best practices’’ for treat-
ment of post-deployment mental health problems in-
cluding PTSD. 
(4) Dissemination of results to the Veterans 
Health Administration and the Veterans Benefits
Administration of the Department of Veterans Af-
fairs. 
(c) AUTHORIZATION.—There is authorized to be ap-
propriated for the purposes of subsection (a) the amount 
of $5,000,000 for each of fiscal years 2006, 2007, and 
2008. 
SEC. 305. PERFORMANCE MEASURES FOR DEPARTMENT OF 
VETERANS AFFAIRS HEALTH CARE ADMINIS-
TRATORS. 
(a) PERFORMANCE MEASURES.—The Secretary of 
Defense and the Secretary of Veterans Affairs, acting 
through the Department of Defense/Department of Vet-
erans Affairs Council on Post-Deployment Mental Health 
established under section 401, shall develop performance 
measures for Department of Veterans Affairs regional 
health-care directors (referred to as VISN directors) and 
Department of Defense TRICARE regional managers to 
ensure the appropriate deployment of resources to imple-
ment the treatment protocols referred to as ‘‘Iraq War 
Clinical Practice Guidelines’’. 
(b) USE OF PERFORMANCE MEASURES.—The per-
formance measures under subsection (a) shall be designed 
to assess—
(1) access and availability of PTSD treatment 
for servicemembers returned from deployment in a 
combat theater; and 
(2) implementation of protocols referred to in 
subsection (a). 
TITLE IV—DEPARTMENT OF DE-
FENSE/DEPARTMENT OF VET-
ERANS AFFAIRS COUNCIL ON 
POST-DEPLOYMENT 
MENTAL 
HEALTH 
SEC. 401. ESTABLISHMENT OF COUNCIL. 
The Secretary of Defense and the Secretary of Vet-
erans Affairs shall jointly establish a council to be known 
as the Department of Defense/Department of Veterans Af-
fairs Council on Post-Deployment Mental Health. The 
council shall be composed of leadership of the two depart-
ments in the areas of mental health, PTSD, substance 
abuse, and military sexual trauma. The council shall be 
established not later than 120 days after the date of the 
enactment of this Act. 
SEC. 402. DUTIES OF COUNCIL. 
(a) DUTIES.—The Department of Defense/Depart-
ment of Veterans Affairs Council on Post-Deployment 
Mental Health shall have the following duties:
(1) Review of the continuum of care between 
the Department of Defense and the Department of 
Veterans Affairs for mental health, PTSD, sub-
stance abuse, and military sexual trauma. 
(2) Identification of gaps in the treatment capa-
bility of the health-care systems of the Department 
of Defense and Department of Veterans Affairs for 
mental health, PTSD, substance abuse, and military 
sexual trauma and expected gaps in such continuum, 
with emphasis on access to services in rural areas, 
to meet the expected demand from current users and 
servicemembers returning from Operation Iraqi 
Freedom and Operation Enduring Freedom and 
other deployments. 
(3) Promotion, within both systems, of an edu-
cational program to implement the jointly developed 
Iraq War Clinical Practice Guidelines. 
(4) Development of outcome monitors and qual-
ity improvement instruments to ensure that internal 
policy regarding PTSD is implemented (including 
TRICARE and VISN directors’ performance meas-
ures under section 307). 
(5) Recommendation of policies to reduce the 
stigma associated with the seeking of mental health
care by active-duty, Reserve, and National Guard 
members. 
(6) Identification of the highest post-deploy-
ment mental health research priorities for the two 
departments. 
(7) Communications to inform active-duty 
servicemembers and veterans of matters relating to 
PTSD. 
(b) ANNUAL MEETING WITH STAKEHOLDERS.—The 
Council shall meet at least annually with stakeholder 
groups comprised of veterans, veterans service organiza-
tions, and family members of veterans receiving care from 
the Department of Veterans Affairs mental health pro-
grams, and mental health associations. 
(c) REPORT.—The Council shall prepare a report 
based on the reviews under paragraphs (1) and (2) of sub-
section (a) to identify the necessary resources to create 
or enhance PTSD treatment capabilities. The report shall 
be made available to the Secretary of both Departments 
for comment. The Secretaries shall indicate recommenda-
tions in which they concur or disagree and include specific 
plans for implementation of any recommendations accept-
ed. The report, with the comments and recommendations 
of the two Secretaries shall be submitted to the Commit-
tees on Veterans’ Affairs and the Committees on Armed
Services of the Senate and House of Representatives not 
later than one year after the date of the enactment of this 
Act. The report shall include priority listing of sites which 
require investments according to the greatest perceived 
need for PTSD services. 
TITLE V—CAPACITY BUILDING 
IN 
DEPARTMENT 
OF 
VET-
ERANS AFFAIRS 
SEC. 501. PLAN FOR EXPANSION OF DEPARTMENT OF VET-
ERANS AFFAIRS SYSTEM TO EXPAND ACCESS 
TO SPECIALIZED PTSD CARE. 
(a) DEVELOPMENT OF PLAN.—Based upon the re-
port under section 402(b), the Secretary of Veterans Af-
fairs shall develop a plan for the Department of Veterans 
Affairs to expand access to specialized PTSD care 
through— 
(1) Readjustment Counseling Service centers 
operated under section 1712A of title 38, United 
States Code; 
(2) community-based outpatient clinics; and 
(3) telemedicine. 
(b) INSPECTOR GENERAL INVESTIGATION.—The In-
spector General of the Department of Veterans Affairs 
shall investigate specialized programs of the Department
of Veterans Affairs for the treatment of post-traumatic 
stress disorder in order to determine— 
(1) the current workloads of those programs; 
(2) staff associated with each of those pro-
grams; 
(3) funds obligated for those programs; and 
(4) any waiting times associated with those pro-
grams. 
(c) REPORT.—The Inspector General shall submit to 
the Committees on Veterans’ Affairs of the Senate and 
House of Representatives a report containing the Inspec-
tor General’s findings under subsection (b), together with 
an assessment of the ability of the Department of Vet-
erans Affairs to address such findings, along with rec-
ommendations for accommodating— 
(1) the current workload of the Department in 
specialized treatment program; 
(2) 102 percent of the current workload of the 
Department; and 
(3) 110 percent of the current workload of the 
Department.
SEC. 502. ADDITIONAL DEPARTMENT OF VETERANS AF-
FAIRS RESOURCES. 
In order to improve access to mental health services, 
the Secretary of Veterans Affairs shall provide the fol-
lowing: 
(1) 100 additional full-time equivalent employ-
ees to Readjustment Counseling Service outstations. 
(2) A PTSD clinical team at every medical cen-
ter of the Veterans Health Administration. 
(3) A family therapist at each Vet Center under 
section 1712A of title 38, United States Code. 
(4) A PTSD coordinator in each regional net-
work referred to as a Veterans Integrated Service 
Network (VISN ) whose duties shall include— 
(A) development of plans for meeting 
PTSD and other post-deployment mental health 
treatment needs consistent with the report 
under section 402(b); 
(B) assurance of implementation of clinical 
practice guidelines throughout the VISN; 
(C) liaison among all health-care sites in 
the VISN and the Department Central Office 
on matters relating to PTSD. 
(5) A PTSD coordinator in each regional office 
of the Readjustment Counseling Service whose du-
ties shall include liaison with regional office staff
and medical centers for veterans seeking service-con-
nection for PTSD. 
TITLE VI—FAMILY THERAPY 
SEC. 601. ELIGIBILITY FOR FAMILY COUNSELING AND BE-
REAVEMENT COUNSELING. 
(a) COUNSELING FOR FAMILY MEMBERS OF VET-
ERANS BEING TREATED FOR SERVICE-CONNECTED DIS-
ABILITIES.—Section 1782(a) of title 38, United States 
Code, is amended by adding at the end the following new 
sentence: ‘‘In addition, the Secretary shall provide to an 
individual described in subsection (c) such professional 
counseling and mental health services as are necessary as 
a consequence of a disability of a veteran described in the 
preceding sentence. Counseling and mental health services 
under the preceding sentence shall be provided (if so re-
quested by the individual) for a period of two years from 
the date on which the individual first receives such coun-
seling or mental health services under the preceding sen-
tence.’’. 
(b) BEREAVEMENT COUNSELING.—Section 1783 of 
such title is amended— 
(1) by striking ‘‘may provide’’ in subsections (a) 
and (b) and inserting ‘‘shall, upon request, provide’’; 
and
(2) by adding at the end the following new sub-
section: 
‘‘(d) DURATION OF COUNSELING.—Counseling under 
subsection (a) or with respect to the death of a veteran 
or under subsection (b) with respect to the death of a 
member who dies in the active military, naval, or air serv-
ice shall be provided to an individual eligible for such 
counseling (if so requested by that individual) for a period 
of two years from the date on which the individual first 
receives counseling under this section with respect to that 
death.’’. 
TITLE VII—EDUCATIONAL 
INITIATIVES 
SEC. 701. TRAINING PROGRAM FOR HEALTH-CARE PRO-
VIDERS. 
The Secretary of Veterans Affairs and the Secretary 
of Defense shall jointly develop a broad training program 
for all health-care providers in the Department of Vet-
erans Affairs and the Department of Defense to famil-
iarize those providers with mental health-care issues that 
are likely to arise among persons deployed to combat thea-
ters during the five years after such a deployment.
SEC. 702. CURRICULUM AND PROTOCOLS FOR CROSS- 
TRAINING OF DEPARTMENT OF VETERANS 
AFFAIRS CLINICIANS. 
The Secretary of Veterans Affairs shall develop a cur-
riculum and required protocols for cross-training to allow 
the following clinicians of the Department of Veterans Af-
fairs to screen for post-deployment mental health prob-
lems, including PTSD, and, as appropriate, provide infor-
mation and appropriate referral to— 
(1) primary care providers; 
(2) practitioners assigned as Gulf War points- 
of-contact; and 
(3) clinicians assigned as case managers. 
SEC. 703. PUBLICATION OF STATE-OF-THE-ART POST-DE-
PLOYMENT MENTAL HEALTH PROBLEMS DI-
AGNOSIS AND TREATMENT. 
The Secretary of Veterans Affairs and the Secretary 
of Defense shall jointly develop a plan for the production 
and dissemination of publications to advise clinicians on 
state-of-the-art diagnosis and treatment of PTSD and 
other mental health disorders experienced after deploy-
ment, including any medical conditions associated with 
such disorders.
SEC. 704. PROTOCOLS FOR PAIN MANAGEMENT FOR PTSD 
AND WAR-RELATED PAIN. 
The Secretary of Veterans Affairs and the Secretary 
of Defense shall jointly develop protocols for pain manage-
ment for PTSD and war-related pain. 
SEC. 705. PROTOCOLS FOR TREATMENT OF SUBSTANCE 
USE DISORDERS. 
The Secretary of Defense shall develop appropriate 
substance use disorder treatment protocols for assistance 
in combat areas of operations and on return to the United 
States. 
SEC. 706. PROTOCOLS FOR DIAGNOSIS OF POST-TRAU-
MATIC STRESS DISORDER. 
(a) FINDINGS.—The Congress finds as follows: 
(1) The symptoms of post-traumatic stress dis-
order are often similar to those of traumatic brain 
injury and some neurological disorders. 
(2) Some veterans with PTSD have co- 
morbidities that may mask or compound the symp-
toms associated with PTSD. 
(3) Correct diagnosis of PTSD and other dis-
orders is critical to effective treatment of those dis-
orders. 
(b) CLINICAL PRACTICE GUIDELINES.—The Sec-
retary of Veterans Affairs shall develop clinical practice 
guidelines to ensure that clinicians are able to effectively
distinguish between diagnoses with similar symptoms that 
may manifest as post-traumatic stress disorder. 
TITLE 
VIII—NATIONAL 
STEER-
ING 
COMMITTEE 
ON 
PTSD 
EDUCATION 
SEC. 801. NATIONAL STEERING COMMITTEE. 
(a) ESTABLISHMENT.—There is a National Steering 
Committee on PTSD Education, to be appointed by the 
joint council established under section 401. The committee 
shall be comprised of mental health and other health pro-
fessionals and health educators involved in the care of vet-
erans of a deployment to a theater of combat on or after 
the date of the enactment of this Act. 
(b) PURPOSE.—The committee shall review training 
protocols for health-care providers and plans for dissemi-
nation of educational materials to veterans, their families, 
and other relevant parties and shall identify the resources 
available to provide for those purposes. 
(c) MEETINGS.—The committee shall meet at least 
once annually. 
SEC. 802. FUNDING SUPPORT FOR NATIONAL CENTER FOR 
PTSD. 
There is authorized to be appropriated to the Sec-
retary of Veterans Affairs for the National Center for 
PTSD to assist in carrying out a joint educational initia-
tive with the Uniformed Services University of the Health 
Sciences the amount of $5,000,000 for each of fiscal years 
2005 through 2014. 
SEC. 803. CONTINUING EDUCATION TO MENTAL HEALTH 
PROVIDERS. 
The National Steering Committee established under 
section 801 shall provide continuing education to mental 
health providers in the Department of Veterans Affairs 
and the Department of Defense. 
SEC. 804. WEB-BASED CURRICULUM TO SPONSOR CLINI-
CIAN TRAINING INITIATIVES. 
The National Steering Committee established under 
section 801 shall develop a Web-based curriculum to spon-
sor clinician training initiatives. 
TITLE IX—BENEFITS 
SEC. 901. IDENTIFICATION OF DEFICIENCIES IN PTSD DIS-
ABILITY EXAMINATIONS. 
(a) EVALUATION OF ADJUDICATION OF CLAIMS.— 
The Secretary of Veterans Affairs, in consultation with the 
National Center for PTSD, shall obtain an evaluation of 
the quality and consistency of adjudication of claims for 
PTSD, including the adequacy of service-connected com-
pensation examinations for rating purposes and the extent 
to which veterans who are service-connected for PTSD are 
actually employed and employable.
(b) REPORT.—Not later than 12 months after the 
date of the enactment of this Act, the Secretary shall sub-
mit to the Committees on Veterans Affairs of the Senate 
and House of Representatives a report that includes the 
following information and recommendations: 
(1) The types of evidence sufficient to confirm 
combat experience for veterans filing claims for 
PTSD based on combat. 
(2) The policies and procedures used to obtain 
confirmation of a stressor, including documentation 
of service in combat for claims based on PTSD. 
(3) Based on a representative national sample, 
the number and percentage of veterans for each pe-
riod of war whose claims for PTSD have been de-
nied based upon the lack of a credible stressor. 
(4) Based on a representative national sample, 
the number and percentage of veterans for each pe-
riod of war whose claims for PTSD have been de-
nied based upon the lack of a diagnosis of PTSD. 
(5) Based on a representative national sample, 
the number and percentage of veterans for each pe-
riod of war whose claims for PTSD have been grant-
ed and the rating which was initially awarded for 
that claim.
(6) The number of initial and subsequent 
claims and average time to process claims for PTSD 
which have been granted (including the rating as-
signed and any determination as to employability) 
and denied for each regional office for a consecutive 
six month period. 
(7) The number and percentage of initial claims 
for PTSD selected from a representative national 
sample during a consecutive six month period which 
had a compensation and pension examination con-
ducted in compliance with best practices for PTSD 
examinations. 
(8) The number and percentage of examina-
tions selected from a representative national sample 
during a consecutive six month period in which the 
compensation and pension examinations for PTSD 
were judged to be inadequate. 
(9) The number and percentage of claims for 
PTSD selected from a representative national sam-
ple during that consecutive six month period for 
which the examination was returned as inadequate. 
(10) The maximum, minimum and average time 
based upon a representative national sample allo-
cated for completion of an initial compensation and 
pension examination for PTSD.
(11) An assessment comparing the employment 
of veterans rated for psychiatric impairments with 
similar ratings based upon physical impairments in-
cluding, the number of veterans in each sample who 
are employed on a full time or part time basis, the 
average time such veterans have been unemployed 
and a comparison of the amount of work lost from 
employment due to disability and the average earn-
ings of veterans in each group. 
(12) Taking into account criteria such as the 
information in the Dictionary of Occupational Titles 
(DOT), including its companion publication, the Se-
lected Characteristics of Occupations Defined in the 
Revised Dictionary of Occupational Titles (SCO), 
published by the Department of Labor, examples of 
the types of employment that an average veteran 
rated at 30 percent, at 50 percent, and at 70 per-
cent disabled for PTSD can be expected to obtain 
and retain. 
(13) The number of claims for PTSD appealed 
to the Board of Veterans Appeals during fiscal year 
2005, including the specific issue appealed (service- 
connection, effective date, rating) and the results of 
such appeals (affirmed, denied, remanded, other dis-
position).
(14) Recommendations for improving the accu-
racy and consistency of PTSD examinations, claim 
development and decisions. 
(15) Barriers to successful employment for vet-
erans who have been service-connected for PTSD. 
(16) Recommendations for removing barriers to 
employment for veterans who have been service-con-
nected for PTSD. 
(17) Recommendations for legislative changes 
which could improve the potential for vocational re-
habilitation and employment of persons service-con-
nected for PTSD. 
SEC. 902. CRITERIA FOR DETERMINING MEDICAL CONDI-
TIONS ASSOCIATED WITH PTSD. 
The Secretary of Veterans Affairs shall develop— 
(1) criteria for determining those medical condi-
tions that are as likely as not to be associated with 
PTSD; and 
(2) standards for determining when secondary 
service-connection should be granted for those condi-
tions. 
TITLE X—PUBLIC AWARENESS 
SEC. 1001. PUBLIC AWARENESS PROGRAM. 
The Secretary of Veterans Affairs shall conduct an 
aggressive, comprehensive outreach program to enhance
the awareness of veterans, and the public in general, of 
the symptoms of PTSD and of the services available for 
veterans with those symptoms. The Secretary of Defense 
shall provide the Secretary of Veterans Affairs with such 
assistance as may be required for the purposes of such 
program. To the extent practicable, the program shall be 
conducted through the joint council established under sec-
tion 401. 
SEC. 1002. WEB SITE AND MATERIALS FOR GENERAL CAM-
PAIGN OF AWARENESS OF PTSD. 
As part of the program under this title, the Secretary 
of Veterans Affairs shall develop and continually update 
a Web site and materials, including pamphlets, news re-
leases, fact sheets, and other materials, for the purposes 
of a general campaign of awareness of post-traumatic 
stress disorder. 
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