II
103D CONGRESS
2D SESSION
H. R. 4386
IN THE SENATE OF THE UNITED STATES
AUGUST 9 (legislative day, AUGUST 8), 1994
Received; read twice and referred to the Committee on Veterans’ Affairs
OCTOBER 7 (legislative day, SEPTEMBER 12), 1994
Committee discharged
AN ACT
To amend title 38, United States Code, authorizing the Sec-
retary of Veterans Affairs to provide compensation to
veterans suffering from disabilities resulting from ill-
nesses attributed to service in the Persian Gulf theater
of operations during the Persian Gulf War, to provide
for increased research into illnesses reported by Persian
Gulf War veterans, 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 ‘‘Veterans’ Persian Gulf
War Benefits Act’’.
SEC. 2. CONGRESSIONAL FINDINGS.
The Congress makes the following findings:
(1) During the Persian Gulf War, members of
the Armed Forces were exposed to numerous poten-
tially toxic substances, including fumes and smoke
from military operations, oil well fires, diesel ex-
haust, paints, pesticides, depleted uranium, infec-
tious agents, chemoprophylactic agents, and indige-
nous diseases, and were also given multiple immuni-
zations. 
It 
is 
not 
known 
whether 
these
servicemembers were exposed to chemical or biologi-
cal warfare agents. However, threats of enemy use
of chemical and biological warfare heightened the
psychological stress associated with the military op-
eration.
(2) Significant numbers of veterans of the Per-
sian Gulf War are suffering from illnesses, or are ex-
hibiting symptoms of illness, that cannot now be di-
agnosed or clearly defined. As a result, many of
these conditions or illnesses are not considered to be
service connected under current law for purposes of
benefits administered by the Department of Veter-
ans Affairs.
(3) The Technology Assessment Workshop on
the Persian Gulf Experience and Health conducted
by the National Institutes of Health concluded that
the complex biological, chemical, physical, and psy-
chological environment of the Southwest Asia thea-
ter of operations produced complex adverse health
effects in Persian Gulf War veterans and that it ap-
pears that no single disease entity or syndrome ex-
ists. Rather, it appears that the illnesses suffered by
those veterans result from multiple illnesses with
overlapping symptoms and causes that have yet to
be defined.
(4) That workshop concluded that the data con-
cerning the range and intensity of exposure to toxic
substances by military personnel in the Southwest
Asia theater of operations are very limited and that
such data were collected only after a considerable
delay.
(5) In response to concerns regarding the
health-care needs of Persian Gulf War veterans, par-
ticularly those who suffer from illnesses or condi-
tions for which no diagnosis has been made, the
Congress, in Public Law 102–585, directed the es-
tablishment of a Persian Gulf War Veterans Health
Registry, authorized health examinations for veter-
ans of the Persian Gulf War, and provided for the
National Academy of Sciences to conduct a com-
prehensive review and assessment of information re-
garding the health consequences of military service
in the Persian Gulf theater of operations and to de-
velop recommendations on avenues for research re-
garding such health consequences. In Public Law
103–210, the Congress authorized the Department
of Veterans Affairs to provide health care services on
a priority basis to Persian Gulf War veterans. The
Congress also provided in Public Law 103–160 (the
National Defense Authorization Act for Fiscal Year
1994) for the establishment of a specialized environ-
mental medical facility for the conduct of research
into the possible health effects of exposure to low
levels of hazardous chemicals, especially among Per-
sian Gulf veterans, and for research into the possible
health effects of battlefield exposure in such veterans
to depleted uranium.
(6) Further research and studies must be un-
dertaken to determine the underlying causes of the
illnesses suffered by Persian Gulf War veterans and,
pending the outcome of such research, veterans who
are seriously ill as the result of such illnesses should
be given the benefit of the doubt and be provided
compensation benefits to offset the impairment in
earnings capacities they may be experiencing.
SEC. 3. PURPOSES.
The purposes of this Act are—
(1) to provide compensation to Persian Gulf
War veterans who suffer disabilities resulting from
illnesses that cannot now be diagnosed or defined,
and for which other causes cannot be identified,
(2) to require the Secretary of Veterans Affairs
to develop at the earliest possible date case assess-
ment strategies and definitions or diagnoses of such
illnesses,
(3) to promote greater outreach to Persian Gulf
War veterans and their families to inform them of
ongoing research activities, as well as the services
and benefits to which they are currently entitled,
and
(4) to ensure that research activities and ac-
companying surveys of Persian Gulf War veterans
are appropriately funded and undertaken by the De-
partment of Veterans Affairs.
SEC. 4. DEVELOPMENT OF CASE ASSESSMENT PROTOCOL
AND CASE DEFINITIONS.
(a) IN GENERAL.—The Secretary of Veterans Affairs
shall—
(1) develop and implement at the earliest pos-
sible date a uniform case assessment protocol that
will ensure thorough assessment, diagnosis, and
treatment of all Persian Gulf War veterans suffering
from illness attributed to service in the Southwest
Asia theater of operations during the Persian Gulf
War; and
(2) develop at the earliest possible date case
definitions or diagnoses for illnesses associated with
such service.
(b) CONSULTATION.—Development of a uniform case
assessment protocol under subsection (a)(1) and develop-
ment of case definitions or diagnoses under subsection
(a)(2) shall be carried out by the Secretary of Veterans
Affairs in consultation with the Secretary of Defense and
the Secretary of Health and Human Services.
(c) REPORTS.—The Secretary shall submit to the
Committees on Veterans’ Affairs of the Senate and House
of Representatives an annual report on the status of the
activities required by this section. The first such report
shall be submitted not later than six months after the date
of the enactment of this Act.
SEC. 5. PROVISION OF INFORMATION TO VETERANS OF
THE PERSIAN GULF WAR.
(a) OUTREACH PROGRAM.—The Secretary of Veter-
ans Affairs shall develop and implement a comprehensive
outreach program and information system to provide Per-
sian Gulf War veterans and their families with information
regarding the following:
(1) The Persian Gulf War Veterans Health
Registry established by the Persian Gulf War Veter-
ans’ Health Status Act (38 U.S.C. 527 note).
(2) Access to health services and health-related
benefits provided by or under the auspices of the
Department of Veterans Affairs, including—
(A) marriage and family counseling avail-
able under section 121 of the Veterans’ Medical
Programs Amendments of 1992 (38 U.S.C.
1712A note);
(B) health care available under section
1710(e)(1)(C) of title 38, United States Code;
and
(C) health examinations, consultation, and
counseling available under section 703 of the
Persian Gulf War Veterans’ Health Status Act
(38 U.S.C. 527 note).
(3) Compensation and benefits related to dis-
abilities resulting from service in the Persian Gulf
War, including disabilities resulting from illness that
resulted from such service.
(4) Significant developments in research relat-
ing to the health consequences of service in the Per-
sian Gulf War.
(5) Any other information that the Secretary
determines to be appropriate.
(b) TOLL-FREE TELEPHONE NUMBER.—The infor-
mation system required by subsection (a) shall include the
establishment and staffing of a toll-free telephone number
for the use of such veterans and their families.
(c) FURTHER INFORMATION.—Section 702(f) of the
Persian Gulf War Veterans’ Health Status Act (38 U.S.C.
527 note) is amended to read as follows:
‘‘(f) ONGOING OUTREACH TO INDIVIDUALS LISTED
IN REGISTRY.—(1) The Secretary of Veterans Affairs
shall notify each individual listed in the Registry or, in
the case of such an individual who is deceased, the surviv-
ing spouse, children, or parents of such individual, at least
quarterly, by newsletter or by other means that the Sec-
retary determines to be appropriate, of—
‘‘(A) the status and findings of federally spon-
sored research relating to the illnesses of individuals
who served as members of the Armed Forces in the
Persian Gulf theater of operations during the Per-
sian Gulf War or to the illnesses of the family mem-
bers of such individuals;
‘‘(B) compensation and benefits, including
health care and other health-related benefits, that
may be provided by the Department of Veterans Af-
fairs or the Department of Defense to an individual
who served as a member of the Armed Forces in the
Persian Gulf theater of operations during the Per-
sian Gulf War or, in the case of such an individual
who is deceased, to the surviving spouse, children, or
parents of such an individual; and
‘‘(C) any other information that the Secretary
determines to be appropriate.
‘‘(2) In preparing the newsletter or other means used
to provide information as required by paragraph (1), the
Secretary shall consult with veterans’ service organiza-
tions.
‘‘(3) The requirement of paragraph (1) shall not
apply regarding notification of any individual if that indi-
vidual makes a written request to the Secretary of Veter-
ans Affairs that the notification not be provided.’’.
SEC. 6. COMPENSATION BENEFITS FOR DISABILITY RE-
SULTING FROM ILLNESS ATTRIBUTED TO
SERVICE DURING THE PERSIAN GULF WAR.
(a) IN GENERAL.—(1) Chapter 11 of title 38, United
States Code, is amended by adding at the end of sub-
chapter II the following new section:
‘‘§ 1117. Compensation for disabilities associated with
Persian Gulf War
‘‘(a) The Secretary shall pay compensation under this
subchapter to a Persian Gulf veteran suffering from a
chronic disability resulting from an undiagnosed illness (or
combination of undiagnosed illnesses) that became mani-
fest to a degree of 10 percent or more before the later
of (1) October 1, 1996, or (2) the end of the two-year
period beginning on the last date on which the veteran
performed active military, naval, or air service in the
Southwest Asia theater of operations while on active duty.
‘‘(b) A disability for which compensation under this
subchapter is payable shall be considered to be service con-
nected for purposes of all other laws of the United States.
‘‘(c) Compensation may not be paid under this sec-
tion with respect to a disability occurring in a veteran—
‘‘(1) where there is affirmative evidence that
the disability was not incurred by the veteran during
service in the Persian Gulf theater of operations
during the Persian Gulf War; or
‘‘(2) where there is affirmative evidence to es-
tablish that an intercurrent injury or illness which is
a recognized cause of the disability was suffered by
the veteran between the date of the veteran’s most
recent departure from that theater of operations
while on active duty and the onset of the disability.
‘‘(d) The Secretary may not make payments under
this section with respect to a disability for which com-
pensation is paid under this section for any month after
the month during which the Secretary determines that
such disability was not incurred as the result of service
in the Southwest Asia theater of operations during the
Persian Gulf War.
‘‘(e) For purposes of this section, the term ‘Persian
Gulf veteran’ means a veteran who served on active duty
in the Armed Forces in the Southwest Asia theater of op-
erations during the Persian Gulf War.
‘‘(f)(1) No payment may be made under this section
for any month that begins after the end of the three-year
period beginning on the date of the enactment of this sec-
tion.
‘‘(2) If, before the end of such three-year period, the
Secretary submits to the Committees on Veterans’ Affairs
of the Senate and House of Representatives a report stat-
ing that, as of the date of the report, no diagnoses for
the illnesses referred to in subsection (a) can be made
based on current medical knowledge, such three-year pe-
riod shall continue for an additional three years.
‘‘(3) The Secretary shall submit to those committees
a report addressing the issue of diagnoses of such illnesses
not later than April 1, 1997.’’.
(2) The table of sections at the beginning of such
chapter is amended by inserting after the item relating
to section 1116 the following new item:
‘‘1117. Compensation for disabilities associated with Persian Gulf War.’’.
(b) EFFECTIVE DATE.—Section 1117 of title 38,
United States Code, as added by subsection (a), shall take
effect on October 1, 1994.
SEC. 7. AUTHORIZATION OF APPROPRIATIONS FOR PER-
SIAN GULF ILLNESS RESEARCH.
There is authorized to be appropriated to the Depart-
ment of Veterans Affairs $5,000,000 for each of fiscal
years 1995 through 1997 for the conduct of research,
which the Secretary of Veterans Affairs, in consultation
with the Secretary of Defense and the Secretary of Health
and Human Services, determines would advance under-
standing of health risks and effects of service during the
Persian Gulf War and effective means of treating such
health effects.
SEC. 8. SURVEY OF PERSIAN GULF VETERANS.
(a) IN GENERAL.—There is authorized to be appro-
priated to the Department of Veterans Affairs such sums
as are needed for fiscal year 1995 for the conduct of a
survey of Persian Gulf veterans to gather information on
the incidence and nature of health problems occurring in
Persian Gulf veterans and their families.
(b) COORDINATION WITH DEPARTMENT
OF DE-
FENSE.—The survey under subsection (a) shall be carried
out in coordination with the Secretary of Defense.
(c) PERSIAN GULF VETERAN.—For purposes of this
section, a Persian Gulf veteran is an individual who served
on active duty in the Armed Forces in the Southwest Asia
theater of operations during the Persian Gulf War as de-
fined in section 101(33) of title 38, United States Code.
SEC. 9. AUTHORIZATION FOR EPIDEMIOLOGICAL STUDIES.
(a) STUDY OF HEALTH CONSEQUENCES OF PERSIAN
GULF SERVICE.—If the National Academy of Sciences in-
cludes in the report required by section 706(b) of the Vet-
erans Health Care Act of 1992 (Public Law 102–585) a
finding that there is a sound basis for an epidemiological
study or studies on the health consequences of service in
the Persian Gulf theater of operations during the Persian
Gulf War and recommends the conduct of such a study
or studies, the Secretary of Veterans Affairs is authorized
to carry out such study.
(b) OVERSIGHT.—(1) The Secretary shall seek to
enter into an agreement with the Medical Follow-Up
Agency (MFUA) of the Institute of Medicine of the Na-
tional Academy of Sciences for (A) the review of proposals
to conduct the research referred to in subsection (a), (B)
SEC. 10. EXTENSION OF MARRIAGE AND FAMILY COUNSEL-
ING AVAILABILITY FOR PERSIAN GULF WAR
VETERANS.
(a) IN GENERAL.—Section 121(a) of the Veterans’
Medical Programs Amendments of 1992 (38 U.S.C.
1712A note) is amended by striking out ‘‘September 30,
1994’’ and inserting in lieu thereof ‘‘December 31, 1998’’.
(b) AUTHORIZATION OF APPROPRIATIONS.—Section
121(g) of the Veterans’ Medical Programs Amendments
of 1992 (38 U.S.C. 1712A note) is amended by striking
out ‘‘and 1994’’ and inserting in lieu thereof ‘‘through
1999’’.
SEC. 11. COST-SAVINGS PROVISIONS.
(a) ELECTION OF DEATH PENSION BY SURVIVING
SPOUSE.—Section 1317 of title 38, United States Code,
is amended—
(1) by striking out ‘‘No person’’ and inserting
in lieu thereof ‘‘(a) Except as provided in subsection
(b), no person’’; and
(2) by adding at the end the following:
‘‘(b) A surviving spouse who is eligible for dependency
and indemnity compensation by reason of any death occur-
ring after December 31, 1956, may elect to receive death
pension instead of such compensation.’’.
(b) POLICY REGARDING COST-OF-LIVING ADJUST-
MENT
IN COMPENSATION RATES
FOR FISCAL YEAR
1995.—The fiscal year 1995 cost-of-living adjustments in
the rates of and limitations for compensation payable
under chapter 11 of title 38, United States Code, and of
dependency and indemnity compensation payable under
chapter 13 of such title will be no more than a percentage
equal to the percentage by which benefit amounts payable
under title II of the Social Security Act (42 U.S.C. 401
et seq.) are increased effective December 1, 1994, as a
result of a determination under section 215(i) of such Act
(42 U.S.C. 415(i)), with all increased monthly rates and
limitations (other than increased rates or limitations equal
to a whole dollar amount) rounded down to the next lower
dollar.
Passed the House of Representatives August 8,
1994.
Attest:
DONNALD K. ANDERSON,
Clerk.
HR 4386 CDS——2