I 
116TH CONGRESS 
2D SESSION 
H. R. 5957 
To direct the Secretary of Defense to conduct a study regarding toxic expo-
sure by members of the Armed Forces deployed to Karshi Khanabad 
Air Base, Uzbekistan, to direct the Secretary of Veterans Affairs to 
establish a registry regarding such exposure, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 25, 2020 
Mr. GREEN of Tennessee (for himself and Mr. LYNCH) introduced the fol-
lowing bill; which was referred to the Committee on Veterans’ Affairs, 
and in addition to the Committee on Armed Services, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
of such provisions as fall within the jurisdiction of the committee con-
cerned 
A BILL 
To direct the Secretary of Defense to conduct a study regard-
ing toxic exposure by members of the Armed Forces 
deployed to Karshi Khanabad Air Base, Uzbekistan, to 
direct the Secretary of Veterans Affairs to establish a 
registry regarding such exposure, 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 ‘‘K2 Veterans Toxic 
Exposure Accountability Act of 2020’’. 
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SEC. 2. STUDY ON TOXIC EXPOSURE AT KARSHI KHANABAD 
AIR BASE, UZBEKISTAN. 
(a) STUDY.— 
(1) IN
GENERAL.—The Secretary of Defense 
shall conduct a study on toxic exposure by members 
of the Armed Forces deployed to Karshi Khanabad 
Air Base, Uzbekistan, at any time during the period 
beginning October 1, 2001, and ending December 
31, 2005. 
(2) MATTERS
INCLUDED.—The study under 
paragraph (1) shall include the following: 
(A) An assessment regarding the condi-
tions of Karshi Khanabad Air Base, Uzbek-
istan, during the period beginning October 1, 
2001, and ending December 31, 2005, includ-
ing an identification of toxic substances con-
taminating the Air Base during such period. 
(B) An epidemiological study of the health 
consequences of a member of the Armed Forces 
deployed to the Air Base during such period. 
(C) An assessment of any association be-
tween exposure to toxic substances identified 
under subparagraph (A) and the health con-
sequences studied under subparagraph (B). 
(b) REPORT.—Not later than 180 days after the date 
of the enactment of this Act, the Secretary of Defense and 
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the Secretary of Veterans Affairs shall jointly submit to 
the appropriate congressional committees a report con-
taining— 
(1) the study under subsection (a); and 
(2) a description of— 
(A) the benefits administered by the Sec-
retary of Veterans Affairs that a veteran may 
be eligible to receive by reason of being exposed 
to toxic substances at Karshi Khanabad Air 
Base, Uzbekistan, while serving in the Armed 
Forces; and 
(B) the outreach conducted by the Sec-
retary to inform such veterans of such benefits. 
SEC. 3. ESTABLISHMENT OF K2 TOXIC EXPOSURE REG-
ISTRY. 
(a) ESTABLISHMENT OF REGISTRY.— 
(1) IN
GENERAL.—Not later than one year 
after the date of the enactment of this Act, the Sec-
retary of Veterans Affairs shall— 
(A) establish and maintain a registry for 
eligible individuals who may have been exposed 
to toxic substances at Karshi Khanabad Air 
Base, Uzbekistan, at any time during the pe-
riod beginning October 1, 2001, and ending De-
cember 31, 2005; 
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(B) include any information in such reg-
istry that the Secretary of Veterans Affairs de-
termines necessary to ascertain and monitor the 
health effects of the exposure of members to 
such substances; 
(C) develop a public information campaign 
to inform eligible individuals about the registry, 
including how to register and the benefits of 
registering; and 
(D) periodically notify eligible individuals 
of significant developments in the study and 
treatment of conditions associated with such ex-
posure. 
(2) UPDATES.—The Secretary shall take ac-
tions necessary to ensure that the registry may be 
updated with the cause of death of a deceased reg-
istered individual by— 
(A) an individual designated by such de-
ceased registered individual; or 
(B) if no such individual is designated, an 
immediate family member of such deceased reg-
istered individual. 
(3) COORDINATION.—The Secretary of Vet-
erans Affairs shall coordinate with the Secretary of 
Defense in carrying out paragraph (1). 
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(b) REPORT TO CONGRESS.— 
(1) REPORTS BY INDEPENDENT SCIENTIFIC OR-
GANIZATION.—The Secretary of Veterans Affairs 
shall enter into an agreement with an independent 
scientific organization to prepare reports as follows: 
(A) Not later than two years after the date 
on which the registry under subsection (a) is es-
tablished, an initial report containing the fol-
lowing: 
(i) An assessment of the effectiveness 
of actions taken by the Secretaries to col-
lect and maintain information on the 
health effects of exposure to toxic sub-
stances at Karshi Khanabad Air Base, Uz-
bekistan. 
(ii) Recommendations to improve the 
collection and maintenance of such infor-
mation. 
(iii) Using established and previously 
published 
epidemiological 
studies, 
rec-
ommendations regarding the most effective 
and prudent means of addressing the med-
ical needs of eligible individuals with re-
spect to conditions that are likely to result 
from such exposure. 
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(B) Not later than five years after com-
pleting the initial report described in subpara-
graph (A), a follow-up report containing the fol-
lowing: 
(i) An update to the initial report de-
scribed in subparagraph (A). 
(ii) An assessment of whether and to 
what degree the content of the registry es-
tablished under subsection (a) is current 
and scientifically up-to-date. 
(2) SUBMITTAL TO CONGRESS.— 
(A) INITIAL REPORT.—Not later than two 
years after the date on which the registry under 
subsection (a) is established, the Secretary of 
Veterans Affairs shall submit to Congress the 
initial report prepared under paragraph (1)(A). 
(B) FOLLOW-UP REPORT.—Not later than 
five years after submitting the report under 
subparagraph (A), the Secretary of Veterans 
Affairs shall submit to Congress the follow-up 
report prepared under paragraph (1)(B). 
(c) DEFINITIONS.—In this section: 
(1) The term ‘‘eligible individual’’ means any 
individual who was deployed as a member of the 
Armed Forces to Karshi Khanabad Air Base, Uz-
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bekistan, at any time during the period beginning 
October 1, 2001, and ending December 31, 2005. 
(2) The term ‘‘immediate family member’’, with 
respect to a deceased individual, means— 
(A) the spouse, parent, brother, sister, or 
adult child of the individual; 
(B) an adult person to whom the indi-
vidual stands in loco parentis; or 
(C) any other adult person— 
(i) living in the household of the indi-
vidual at the time of the death of the indi-
vidual; and 
(ii) related to the individual by blood 
or marriage. 
(3) The term ‘‘registered individual’’ means an 
individual registered with the registry under sub-
section (a). 
SEC. 4. DETERMINATION OF PRESUMPTIONS OF SERVICE 
CONNECTION FOR ILLNESSES ASSOCIATED 
WITH K2 EXPOSURE. 
(a) IN GENERAL.— 
(1) DETERMINATION
REQUIRED.—Not later 
than 60 days after the date on which the Secretary 
of Veterans Affairs receives the results of a covered 
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study, the Secretary shall make a determination 
whether a positive association exists between— 
(A) the exposure of humans to toxic sub-
stances at Karshi Khanabad Air Base, Uzbek-
istan, at any time during the period beginning 
October 1, 2001, and ending December 31, 
2005; and 
(B) the occurrence of a diagnosed illness in 
humans. 
(2) BASES OF DETERMINATION.—In making a 
determination under paragraph (1), the Secretary 
shall consider— 
(A) whether the evidence is statistically 
significant, capable of replication, and able to 
withstand peer review demonstrating that there 
is positive association between the exposure and 
the occurrence of a diagnosed illness; 
(B) the results of a covered study; and 
(C) all other sound medical and scientific 
evidence available to the Secretary. 
(3) PRESUMPTION.—If the Secretary deter-
mines that a positive association exists between ex-
posure and a diagnosed illness pursuant to para-
graph (1), the Secretary shall prescribe regulations 
providing that— 
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(A) a presumption of service connection is 
warranted for the illness covered by that deter-
mination if the illness first becomes manifest 
within the period, if any, prescribed in such 
regulations in a covered veteran; and 
(B) such covered veteran shall be pre-
sumed to have been exposed to toxic substances 
at Karshi Khanabad Air Base, Uzbekistan, at 
any time during the period beginning October 
1, 2001, and ending December 31, 2005, unless 
there is conclusive evidence to establish that— 
(i) the covered veteran was not ex-
posed to toxic substances in the course of 
such service in the Armed Forces; or 
(ii) the illness first became manifest 
prior to the covered veteran’s exposure. 
(4) SUBMISSION.—Upon the date on which the 
Secretary makes the determination under paragraph 
(1), the Secretary shall submit to the Committees on 
Veterans’ Affairs of the House of Representatives 
and the Senate an explanation of such determina-
tion. 
(b) REGULATIONS.— 
(1) PROPOSED REGULATIONS.— 
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(A) TIMING.—If the Secretary determines 
under subsection (a)(1) that a presumption of 
service connection is warranted for an illness, 
the Secretary shall, not later than 180 days 
after making such determination— 
(i) issue proposed regulations setting 
forth the determination; or 
(ii) submit the initial report under 
subparagraph (B). 
(B) REPORTS.—If the Secretary does not 
issue proposed regulations by the deadline es-
tablished in subparagraph (A), the Secretary 
shall submit to the Committees on Veterans’ 
Affairs of the House of Representatives and the 
Senate a report on the status of such proposed 
regulations. On a quarterly basis thereafter 
until the date on which the Secretary issues 
such proposed regulations, the Secretary shall 
submit to such committees an update on such 
status. 
(2) FINAL REGULATIONS.—Not later than 180 
days after the date on which the Secretary issues 
any proposed regulations under this subsection, the 
Secretary shall prescribe final regulations. Such reg-
ulations shall be effective on the date of issuance. 
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(3) PRESUMPTION NOT WARRANTED.— 
(A) PUBLICATION.—If the Secretary deter-
mines under subsection (a) that a presumption 
of service connection is not warranted for an ill-
ness, or proposes to remove a previously estab-
lished presumption, the Secretary shall publish 
in the Federal Register a notice of that deter-
mination not later than 180 days after making 
the determination. The notice shall include an 
explanation of the evidence and scientific basis 
for that determination. 
(B) REMOVAL
OF
PREVIOUS
PRESUMP-
TION.—If an illness already presumed to be 
service connected under this section is subject 
to a notice published under subparagraph (A), 
the Secretary shall issue proposed regulations 
removing the presumption for the illness not 
later than 180 days after publication of such 
notice. 
(4) EFFECT OF REMOVAL.—Whenever the pre-
sumption of service connection for an illness under 
this section is removed under this subsection— 
(A) a veteran who was awarded compensa-
tion for the illness on the basis of the presump-
tion before the effective date of the removal of 
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the presumption shall continue to be entitled to 
receive compensation on that basis; and 
(B) a survivor of a veteran who was 
awarded dependency and indemnity compensa-
tion for the death of a veteran resulting from 
the illness on the basis of the presumption be-
fore that date shall continue to be entitled to 
receive dependency and indemnity compensation 
on that basis. 
(c) EFFECTIVE DATE OF BENEFIT AWARDS.—The 
effective date of any benefit awarded by reason of this sec-
tion shall be determined in accordance with section 5110 
of title 38, United States Code, but shall in no case be 
earlier than the effective date of the final regulations pre-
scribed pursuant to subsection (b)(2). 
(d) DEFINITIONS.—In this section: 
(1) The term ‘‘covered study’’ includes— 
(A) the study conducted under section 2; 
and 
(B) any subsequent study or any study 
conducted by the National Academies of 
Sciences, Engineering, and Medicine regarding 
the effects of exposure of humans to toxic sub-
stances at Karshi Khanabad Air Base, Uzbek-
istan, at any time during the period beginning 
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October 1, 2001, and ending December 31, 
2005. 
(2) The term ‘‘covered veteran’’ means a vet-
eran who was deployed as a member of the Armed 
Forces to Karshi Khanabad Air Base, Uzbekistan, 
at any time during the period beginning October 1, 
2001, and ending December 31, 2005. 
SEC. 
5. 
ACCESS 
OF 
THE 
NATIONAL 
ACADEMIES 
OF 
SCIENCES, ENGINEERING, AND MEDICINE TO 
INFORMATION FROM THE DEPARTMENT OF 
DEFENSE. 
Upon request by the National Academies of Sciences, 
Engineering, and Medicine (in this section referred to as 
the ‘‘Academies’’), the Secretary of Defense shall provide 
to the Academies information in the possession of the De-
partment of Defense that the Academies determine useful 
in performing a covered study, as that term is defined in 
section 4(d). Such information includes, at a minimum, 
all environmental sampling data relative to any location 
included in the study. 
Æ 
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