I 
117TH CONGRESS 
1ST SESSION H. R. 5666 
To amend title 38, United States Code, to expand health care and benefits 
from the Department of Veterans Affairs for military sexual trauma, 
and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 21, 2021 
Ms. PINGREE (for herself, Ms. BROWNLEY, Ms. DELBENE, Ms. NORTON, Ms. 
KUSTER, Ms. TITUS, Mrs. DINGELL, Mr. MCGOVERN, Mr. RUSH, and 
Mr. KILMER) 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 subsequently determined by the Speak-
er, in each case for consideration of such provisions as fall within the ju-
risdiction of the committee concerned 
A BILL 
To amend title 38, United States Code, to expand health 
care and benefits from the Department of Veterans Af-
fairs for military sexual trauma, 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 
‘‘Servicemembers and Veterans Empowerment and Sup-
port Act of 2021’’. 
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(b) TABLE OF CONTENTS.—The table of contents for 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
TITLE I—DEFINING MILITARY SEXUAL TRAUMA 
Sec. 101. Military sexual trauma defined for the digital age. 
TITLE II—DISABILITY COMPENSATION AND CLAIMS PROCESSING 
Sec. 201. Definition of military sexual trauma. 
Sec. 202. Conforming changes relating to specialized teams to evaluate claims 
involving military sexual trauma. 
Sec. 203. Standard of proof for service-connection of mental health conditions 
relating to military sexual trauma. 
Sec. 204. Choice of location of Department of Veterans Affairs medical exam-
ination for assessment of claims for compensation relating to 
disability resulting from military sexual trauma. 
Sec. 205. Communications from the Department of Veterans Affairs to military 
sexual trauma survivors. 
Sec. 206. Study on training and processing relating to claims for disability 
compensation relating to military sexual trauma. 
Sec. 207. Annual special focus review of claims for disability compensation for 
disabilities relating to military sexual trauma. 
TITLE III—ACCESS TO HEALTH CARE 
Sec. 301. Expansion of eligibility for counseling and treatment for military sex-
ual trauma to include all former members of the reserve com-
ponents of the Armed Forces. 
Sec. 302. Connection to Veterans Health Administration when a disability 
claim related to military sexual trauma is submitted to Vet-
erans Benefits Administration. 
Sec. 303. Study on access to inpatient mental health care for survivors of mili-
tary sexual trauma. 
Sec. 304. Pilot program for interim access to mental health care for survivors 
of military sexual trauma. 
Sec. 305. Comptroller General study on access to care for survivors of military 
sexual trauma at the Department of Veterans Affairs. 
TITLE I—DEFINING MILITARY 
SEXUAL TRAUMA 
SEC. 101. MILITARY SEXUAL TRAUMA DEFINED FOR THE 
DIGITAL AGE. 
(a) REVISION
TO REGULATIONS REQUIRED.—The 
Secretary of Veterans Affairs shall, in accordance with 
subsection (b), revise regulations for the definition of 
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‘‘military sexual trauma’’ for the purposes of access to 
health care under chapter 17 of title 38, United States 
Code, and compensation under chapter 11 of such title. 
(b) REQUIREMENTS.— 
(1) TECHNOLOGICAL ABUSE.— 
(A) IN GENERAL.—The Secretary shall en-
sure that all regulations revised under sub-
section (a) include matters relating to techno-
logical abuse to reflect sexual harassment in the 
digital age. 
(B) INCLUSION
OF
CERTAIN
BEHAVIOR 
AND
ACTIVITIES.—For purposes of subpara-
graph (A), the term ‘‘technological abuse’’ may 
include— 
(i) behavior intended to harm, threat-
en, intimidate, control, stalk, harass, im-
personate, or monitor another person, ex-
cept as otherwise permitted by law, that 
occurs via the internet, social networking 
sites, computers, mobile devices, mobile 
telephones, apps, location tracking devices, 
instant messages, text messages, or other 
forms of technology; and 
(ii) specific activities, including— 
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(I) unwanted, repeated telephone 
calls, text messages, instant messages, 
or social media posts; 
(II) 
nonconsensual 
access 
of 
email accounts, texts or instant mes-
saging accounts, social networking ac-
counts, or mobile telephone logs; 
(III) attempting to control or re-
strict a person’s ability to access tech-
nology with the intent to isolate the 
person from support and social con-
nection; 
(IV) using tracking devices or lo-
cation tracking software for the pur-
pose of monitoring or stalking another 
person’s location; 
(V) impersonation of a person 
with the intent to deceive or cause 
harm through the use of spoofing 
technology or the creation of fake 
email or social media accounts; or 
(VI) pressuring for or sharing of 
another person’s private information, 
photographs, or videos without the 
person’s consent. 
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(2) COLLABORATION.—In carrying out sub-
section (a), the Secretary of Veterans Affairs shall 
collaborate with the Secretary of Defense. 
(3) CONSULTATION.—In carrying out sub-
section (a), the Secretary of Veterans Affairs shall 
consult with veterans service organizations, military 
service organizations, and other stakeholders. 
(c) COMMENCEMENT OF EFFORTS.—Not later than 
one year after the date of the enactment of this Act, the 
Secretary shall commence efforts to carry out subsection 
(a). 
(d) PROGRESS REPORT.—Not later than one year 
after the date of the enactment of this Act, the Secretary 
of Veterans Affairs shall submit to the Committee on Vet-
erans’ Affairs of the Senate and the Committee on Vet-
erans’ Affairs of the House of Representatives a report 
on the progress of the Secretary in carrying out subsection 
(a). 
(e) FINAL REGULATIONS.—Not later than two years 
after the date of the enactment of this Act, the Secretary 
shall— 
(1) issue the revised regulations required by 
subsection (a); and 
(2) update training aids, manuals, and informa-
tional materials for staff, veterans, members of the 
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Armed Forces, and stakeholders to reflect the re-
vised regulations. 
TITLE 
II—DISABILITY 
COM-
PENSATION 
AND 
CLAIMS 
PROCESSING 
SEC. 201. DEFINITION OF MILITARY SEXUAL TRAUMA. 
In this title, the term ‘‘military sexual trauma’’ has 
the meaning given such term in section 1167(j) of title 
38, United States Code, as added by section 203(a). 
SEC. 202. CONFORMING CHANGES RELATING TO SPECIAL-
IZED TEAMS TO EVALUATE CLAIMS INVOLV-
ING MILITARY SEXUAL TRAUMA. 
Section 1166(c) of title 38, United States Code, as 
redesignated by section 7(a) of the Training in High-de-
mand Roles to Improve Veteran Employment Act (Public 
Law 117–16), is amended by striking ‘‘In this section’’ 
and all that follows and inserting the following: ‘‘In this 
section, the terms ‘covered mental health condition’ and 
‘military sexual trauma’ have the meanings given those 
terms in section 1167(j) of this title.’’. 
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SEC. 203. STANDARD OF PROOF FOR SERVICE-CONNECTION 
OF MENTAL HEALTH CONDITIONS RELATING 
TO MILITARY SEXUAL TRAUMA. 
(a) IN GENERAL.—Subchapter VI of chapter 11 of 
such title is amended by adding at the end the following 
new section: 
‘‘§ 1167. Evaluation of claims involving military sex-
ual trauma 
‘‘(a) STANDARD OF PROOF.—(1) In the case of any 
veteran who claims that a covered mental health condition 
based on military sexual trauma was incurred in or aggra-
vated by active military, naval, or air service, the Sec-
retary shall accept as sufficient proof of service-connection 
a diagnosis of such mental health condition by a mental 
health professional together with satisfactory lay or other 
evidence, in accordance with subsections (b) and (c), of 
such trauma and an opinion by the mental health profes-
sional that such covered mental health condition is related 
to such military sexual trauma, as specified in subsection 
(f), notwithstanding the fact that there is no official record 
of such incurrence or aggravation in such service, and, to 
that end, shall resolve every reasonable doubt in favor of 
the veteran. 
‘‘(2) Service-connection of such covered mental health 
condition may be rebutted by clear and convincing evi-
dence to the contrary. 
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‘‘(3) The reasons for granting or denying service-con-
nection in each case shall be recorded in full. 
‘‘(b) NONMILITARY SOURCES OF EVIDENCE.—(1) In 
carrying out subsection (a), the Secretary shall ensure 
that if a claim for compensation under this chapter is re-
ceived by the Secretary for a covered mental health condi-
tion based on military sexual trauma, evidence from 
sources other than official records of the Department of 
Defense regarding the veteran’s service may corroborate 
the veteran’s account of the trauma. 
‘‘(2) Examples of evidence described in paragraph (1) 
include the following: 
‘‘(A) Records from law enforcement authorities, 
rape crisis centers, mental health counseling centers, 
hospitals, and physicians. 
‘‘(B) Pregnancy tests and tests for sexually 
transmitted diseases. 
‘‘(C) Statements from family members, room-
mates, other members of the Armed Forces or vet-
erans, and clergy. 
‘‘(c) EVIDENCE
OF BEHAVIOR CHANGES.—(1) In 
carrying out subsection (a), the Secretary shall ensure 
that evidence of a behavior change following military sex-
ual trauma is one type of relevant evidence that may be 
found in sources described in such subsection. 
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‘‘(2) Examples of behavior changes that may be rel-
evant evidence of military sexual trauma include the fol-
lowing: 
‘‘(A) A request for a transfer to another mili-
tary duty assignment. 
‘‘(B) Deterioration in work performance. 
‘‘(C) Substance abuse or substance use dis-
order. 
‘‘(D) Episodes of depression, panic attacks, or 
anxiety without an identifiable cause. 
‘‘(E) Unexplained economic or social behavior 
changes. 
‘‘(d) NOTICE AND OPPORTUNITY TO SUPPLY EVI-
DENCE.—The Secretary may not deny a claim of a veteran 
for compensation under this chapter for a covered mental 
health condition that is based on military sexual trauma 
without first— 
‘‘(1) advising the veteran that evidence de-
scribed in subsections (b) and (c) may constitute 
credible corroborating evidence of the military sexual 
trauma; and 
‘‘(2) allowing the veteran an opportunity to fur-
nish such corroborating evidence or advise the Sec-
retary of potential sources of such evidence. 
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‘‘(e) ROLE OF LAY STATEMENTS.—In a case where 
evidence described in subsection (b) or (c) is unavailable, 
and the only evidence of the occurrence of the military 
sexual trauma is the veteran’s own lay statement, the Sec-
retary shall accept such lay statement as credible evidence 
the event occurred, unless such statement is inconsistent 
with the places, types, and circumstances of the service 
of the veteran, including evidence of the veteran’s unit as-
signments, military specialty, or dates and locations of 
service, or unless there is clear and convincing evidence 
to the contrary. 
‘‘(f) REVIEW
OF EVIDENCE.—(1) In reviewing a 
claim for compensation described in subsection (a)(1), for 
any evidence identified as part of such claim that is de-
scribed in subsection (b) or (c), or if subsection (e) applies, 
the Secretary shall submit such evidence to such medical 
or mental health professional as the Secretary considers 
appropriate, including clinical and counseling experts em-
ployed by the Department, to obtain an opinion as to 
whether it is at least as likely as not that there is a nexus 
between the military sexual trauma and any diagnosed 
covered mental health condition. 
‘‘(2) In the case of any veteran who submits with the 
claim for a covered mental health condition a lay state-
ment describing the military sexual trauma, such veteran 
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shall be provided with a medical examination and opinion 
as described in paragraph (1) without delay for request 
of records specified in subsections (b) and (c) from the 
veteran. 
‘‘(3) For any veteran described in paragraph (2), if 
the medical examination and opinion do not result in a 
diagnosis of a covered mental health condition and a posi-
tive opinion that the military sexual trauma is related to 
such diagnosis, the Secretary shall request the records 
specified in subsections (b) and (c) and, if such evidence 
is received, paragraph (1) shall again apply and a subse-
quent medical examination and opinion shall be requested. 
‘‘(g) POINT OF CONTACT.—The Secretary shall en-
sure that each document provided to a veteran relating 
to a claim for compensation described in subsection (a) 
includes contact information for an appropriate point of 
contact with the Department. 
‘‘(h) SPECIALIZED TEAMS.—The Secretary shall en-
sure that all claims for compensation described in sub-
section (a) are reviewed and processed by a specialized 
team established under section 1166 of this title. 
‘‘(i) RULE OF CONSTRUCTION REGARDING APPLICA-
TION TO NONSEXUAL PERSONAL ASSAULT.—The Sec-
retary shall not construe this section as supplanting the 
standard of proof or evidence required for claims for 
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posttraumatic stress disorder based on non-sexual per-
sonal assault, which the Secretary shall continue to define 
in regulation. 
‘‘(j) DEFINITIONS.—In this section: 
‘‘(1) The term ‘covered mental health condition’ 
means post-traumatic stress disorder, anxiety, de-
pression, or other mental health diagnosis described 
in the current version of the Diagnostic and Statis-
tical Manual of Mental Disorders published by the 
American Psychiatric Association that the Secretary 
determines to be related to military sexual trauma 
and which may be service-connected. 
‘‘(2) The term ‘military sexual trauma’ means, 
with respect to a veteran, a physical assault of a sex-
ual nature, battery of a sexual nature, or sexual har-
assment that occurred while the veteran was serving 
in the active military, naval, or air service.’’. 
(b) OUTREACH.—Not later than 180 days after the 
date of the enactment of this Act, the Secretary of Vet-
erans Affairs shall implement, with input from the veteran 
community, an informative outreach program for veterans 
regarding the standard of proof for evaluation of claims 
related to military sexual trauma, including consideration 
of lay statements and requirements for a medical examina-
tion and opinion. 
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(c) CLERICAL AMENDMENT.—The table of sections 
at the beginning of such chapter is amended by adding 
at the end the following new item: 
‘‘1167. Evaluation of claims involving military sexual trauma.’’. 
SEC. 204. CHOICE OF LOCATION OF DEPARTMENT OF VET-
ERANS AFFAIRS MEDICAL EXAMINATION FOR 
ASSESSMENT OF CLAIMS FOR COMPENSA-
TION RELATING TO DISABILITY RESULTING 
FROM MILITARY SEXUAL TRAUMA. 
(a) IN GENERAL.—Section 1165 of title 38, United 
States Code, is amended— 
(1) in the section heading, by inserting ‘‘and 
location of medical examination’’ after ‘‘ex-
aminer’’; 
(2) in subsection (a), by striking ‘‘a physical as-
sault of a sexual nature, battery of a sexual nature, 
or sexual harassment’’ and inserting ‘‘military sexual 
trauma (as defined in section 1167(j) of this title)’’; 
(3) by redesignating subsection (c) as sub-
section (d); and 
(4) by inserting after subsection (b) the fol-
lowing new subsection (c): 
‘‘(c) CHOICE OF EXAMINATION LOCATION.—(1) The 
Secretary shall ensure that a veteran who requires a med-
ical examination in support of a claim described in sub-
section (a) may request that the medical examination take 
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place at a facility of the Department by a qualified em-
ployee of the Department. 
‘‘(2) The Secretary— 
‘‘(A) shall grant any request under paragraph 
(1); and 
‘‘(B) may not issue a decision on a claim de-
scribed in such paragraph before the requested ex-
amination is completed.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of chapter 11 of such title is amended 
by striking the item relating to section 1165 and inserting 
the following new item: 
‘‘1165. Choice of sex of medical examiner and location of medical examination 
for certain disabilities.’’. 
SEC. 205. COMMUNICATIONS FROM THE DEPARTMENT OF 
VETERANS AFFAIRS TO MILITARY SEXUAL 
TRAUMA SURVIVORS. 
(a) REVIEW BOARD.— 
(1) IN GENERAL.—The Secretary of Veterans 
Affairs shall establish a board to review correspond-
ence relating to military sexual trauma. 
(2) MEMBERSHIP.—The Secretary shall appoint 
members of the board from among experts in mili-
tary sexual trauma and mental health, including— 
(A) mental health providers of the Depart-
ment; 
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(B) experts on sexual assault and sexual 
harassment; and 
(C) members from both the Veterans 
Health Administration and Veterans Benefits 
Administration. 
(3) DUTIES.—The board established under 
paragraph (1) shall— 
(A) review all standard correspondence and 
other materials, which may include templates 
for notices under sections 5103 and 5104B of 
title 38, United States Code, as well as out-
reach materials and veteran-facing website con-
tent, from the Department of Veterans Affairs 
to survivors of military sexual trauma for sensi-
tivity; and 
(B) ensure that the communications— 
(i) treat survivors with dignity and re-
spect; and 
(ii) do not re-traumatize survivors. 
(b) CONTENTS OF WRITTEN COMMUNICATIONS TO 
MILITARY SEXUAL TRAUMA SURVIVORS.—The Secretary 
shall ensure that any written communication from the De-
partment of Veterans Affairs to a military sexual trauma 
survivor shall include contact information for the fol-
lowing: 
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(e) PARTICIPATION.— 
(1) CLARIFICATION ON PARTICIPATION.—Par-
ticipation by a survivor in the pilot program under 
subsection (a) shall be during the period in which 
the survivor is waiting for an inpatient bed opening 
and shall not disqualify the survivor from receiving 
inpatient mental health care following their partici-
pation in the pilot program. 
(2) DECISIONS ON PARTICIPATION.—Decisions 
about the participation of a survivor in the pilot pro-
gram and the transition of the survivor to inpatient 
mental health care shall be made by the survivor and 
their health care provider. 
(f) REPORT.—Not later than 180 days after the con-
clusion of the pilot program under subsection (a), the Sec-
retary shall submit to Congress a report on— 
(1) participation in the pilot program; 
(2) clinical outcomes under the pilot program; 
and 
(3) such recommendations for continuation or 
termination of the program as the Secretary may 
have, including recommendations for legislative or 
administrative action. 
(g) DEFINITION OF MILITARY SEXUAL TRAUMA.— 
In this section, the term ‘‘military sexual trauma’’ has the 
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