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amended by subsection (a)(2), who, during such period, en-
rolled in the patient enrollment system of the Department 
of Veterans Affairs established and operated under section 
1705(a) of such title. 
(e) EFFECTIVE DATE.—This section and the amend-
ments made by this section shall take effect on October 1, 
2022. 
TITLE II—TOXIC EXPOSURE 
PRESUMPTION PROCESS 
SEC. 201. SHORT TITLE. 
This title may be cited as the ‘‘Toxic Exposure in the 
American Military Act of 2022’’ or the ‘‘TEAM Act of 
2022’’. 
SEC. 202. IMPROVEMENTS TO ABILITY OF DEPARTMENT OF 
VETERANS AFFAIRS TO ESTABLISH PRESUMP-
TIONS OF SERVICE CONNECTION BASED ON 
TOXIC EXPOSURE. 
(a) ADVISORY COMMITTEES, PANELS, AND BOARDS.— 
Chapter 11 is amended by adding at the end the following 
new subchapter:
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‘‘SUBCHAPTER VII—DETERMINATIONS RELATING 
TO PRESUMPTIONS OF SERVICE CONNEC-
TION BASED ON TOXIC EXPOSURE 
‘‘§ 1171. Procedures to determine presumptions of 
service connection based on toxic expo-
sure; definitions 
‘‘(a) PROCEDURES.—The Secretary shall determine 
whether to establish, or to remove, presumptions of service 
connection based on toxic exposure pursuant to this sub-
chapter, whereby— 
‘‘(1) under section 1172 of this title— 
‘‘(A) the Secretary provides— 
‘‘(i) public notice regarding what for-
mal evaluations the Secretary plans to con-
duct; and 
‘‘(ii) the public an opportunity to com-
ment on the proposed formal evaluations; 
‘‘(B) the working group established under 
subsection (b) of such section provides— 
‘‘(i) advice to the Secretary on toxic- 
exposed veterans and cases in which vet-
erans who, during active military, naval, 
air, or space service, may have experienced 
a toxic exposure or their dependents may 
have experienced a toxic exposure while the
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veterans were serving in the active military, 
naval, air, or space service; 
‘‘(ii) recommendations to the Secretary 
on corrections needed in the Individual 
Longitudinal Exposure Record to better re-
flect veterans and dependents described in 
clause (i); and 
‘‘(iii) recommendations to the Sec-
retary regarding which cases of possible 
toxic exposure should be reviewed; 
‘‘(2) the Secretary provides for formal evalua-
tions of such recommendations under section 1173 of 
this title and takes into account reports received by 
the Secretary from the National Academies of 
Sciences, Engineering, and Medicine under section 
1176 of this title; and 
‘‘(3) the Secretary issues regulations under sec-
tion 1174 of this title. 
‘‘(b) DEFINITIONS.—In this subchapter: 
‘‘(1) The term ‘illness’ includes a disease or other 
condition affecting the health of an individual, in-
cluding mental and physical health. 
‘‘(2) The term ‘Individual Longitudinal Expo-
sure Record’ includes— 
‘‘(A) service records;
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‘‘(B) any database maintained by the De-
partment of Defense and shared with the Depart-
ment of Veterans Affairs to serve as a central 
portal for exposure-related data that compiles, 
collates, presents, and provides available occupa-
tional and environmental exposure information 
to support the needs of the Department of De-
fense and the Department of Veterans Affairs; or 
‘‘(C) any successor system to a database de-
scribed in subparagraph (B). 
‘‘§ 1172. Annual notice and opportunity for public 
comment 
‘‘(a) NOTICE REQUIRED.—(1)(A) Not less frequently 
than once each year, the Secretary shall publish in the Fed-
eral Register notice of the formal evaluations that the Sec-
retary plans to conduct pursuant to section 1173 of this 
title. 
‘‘(B) Each notice published under subparagraph (A) 
shall include, for each formal evaluation referred to in the 
notice, an explanation as to why the military environ-
mental exposures and adverse health outcomes that are the 
subject of the formal evaluation were chosen by the Sec-
retary for formal evaluation under section 1173 of this title. 
‘‘(2)(A) With each notice published under paragraph 
(1), the Secretary shall seek public comment on the military
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environmental exposures and adverse health outcomes that 
are the subject of the formal evaluations referred to in the 
notice. 
‘‘(B) The Secretary shall— 
‘‘(i) consider all public comment received under 
subparagraph (A); and 
‘‘(ii) publish in the Federal Register a response 
to the comments received under subparagraph (A). 
‘‘(3)(A) For each notice published under paragraph 
(1), the Secretary shall hold an open meeting for members 
of the public to voice their comments in response to the no-
tice. 
‘‘(B) To help evaluate presumptions of service connec-
tion, the Secretary shall, not less frequently than quarterly, 
collaborate with, partner with, and give weight to the advice 
of veterans service organizations and such other stakeholders 
as the Secretary considers appropriate. 
‘‘(4) Failure to include a military environmental expo-
sure or adverse health effect in a Federal Register notice 
published pursuant to subsection (a) shall not preclude the 
Secretary from initiating a formal evaluation of such expo-
sure or health effect. 
‘‘(b) WORKING GROUP.—(1) The Secretary shall estab-
lish a working group within the Department (in this section 
referred to as the ‘Working Group’).
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‘‘(2) The Working Group shall include personnel of the 
Veterans Health Administration and the Veterans Benefits 
Administration. 
‘‘(3) The Secretary shall consult with, and seek the ad-
vice of, the Working Group with respect to cases in which— 
‘‘(A) a veteran may have, during active mili-
tary, naval, air, or space service, experienced a toxic 
exposure; or 
‘‘(B) a dependent of a veteran may have experi-
enced a toxic exposure during the active military, 
naval, air, or space service of the veteran. 
‘‘(c) ASSESSMENTS.—(1) The Working Group shall as-
sess cases of the toxic exposure of veterans and their depend-
ents that occurred during active military, naval, air, or 
space service, including by conducting ongoing surveillance 
and reviewing such exposure described in scientific lit-
erature, media reports, information from veterans, and in-
formation from Congress. 
‘‘(2) The assessments under paragraph (1) shall cover 
suspected and known toxic exposures occurring during ac-
tive military, naval, air, or space service, including by 
identifying and evaluating new and emerging toxic expo-
sures that are not recognized under existing presumptions 
of service connection.
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‘‘(1) Scientific evidence, based on the review of 
available scientific literature, including human, toxi-
cological, animal, and methodological studies, and 
other factors. 
‘‘(2) Claims data, based on the review of claim 
rate, grant rate, and service connection prevalence, 
and other factors. 
‘‘(3) Other factors the Secretary determines ap-
propriate, such as— 
‘‘(A) the level of disability and mortality 
caused by the health effects related to the case of 
toxic exposure being evaluated; 
‘‘(B) the quantity and quality of the infor-
mation available and reviewed; 
‘‘(C) the feasibility of and period for gener-
ating relevant information and evidence; 
‘‘(D) whether such health effects are combat- 
or deployment-related; 
‘‘(E) the ubiquity or rarity of the health ef-
fects; and 
‘‘(F) any time frame during which a health 
effect must become manifest. 
‘‘(c) CONDUCT OF EVALUATIONS.—(1) The Secretary 
shall ensure that each formal evaluation under subsection 
(a)—
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‘‘(A) reviews scientific evidence in a manner 
that— 
‘‘(i) conforms to principles of scientific and 
data integrity; 
‘‘(ii) is free from suppression or distortion 
of scientific or technological findings, data, in-
formation, conclusions, or technical results; and 
‘‘(B)(i) evaluates the likelihood that a positive 
association exists between an illness and a toxic expo-
sure while serving in the active military, naval, air, 
or space service; and 
‘‘(ii) assesses the toxic exposures and illnesses 
and determines whether the evidence supports a find-
ing of a positive association between the toxic expo-
sure and the illness. 
‘‘(2) In carrying out paragraph (1)(B)(ii), a formal 
evaluation under subsection (a) shall include reviewing all 
relevant data to determine the strength of evidence for a 
positive association based on the following four categories: 
‘‘(A) The ‘sufficient’ category, where the evidence 
is sufficient to conclude that a positive association ex-
ists. 
‘‘(B) The ‘equipoise and above’ category, where 
the evidence is sufficient to conclude that a positive
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association is at least as likely as not, but not suffi-
cient to conclude that a positive association exists. 
‘‘(C) The ‘below equipoise’ category, where the 
evidence is not sufficient to conclude that a positive 
association is at least as likely as not, or is not suffi-
cient to make a scientifically informed judgment. 
‘‘(D) The ‘against’ category, where the evidence 
suggests the lack of a positive association. 
‘‘(d) RECOMMENDATION FOR ESTABLISHING A PRE-
SUMPTION OF SERVICE CONNECTION.—Not later than 120 
days after the date on which a formal evaluation is com-
menced, the element of the Department that conducts the 
evaluation shall submit to the Secretary a recommendation 
with respect to establishing a presumption of service connec-
tion for the toxic exposure and illness, or modifying an ex-
isting presumption of service connection, covered by the 
evaluation. 
‘‘§ 1174. Regulations regarding presumptions of serv-
ice connection based on toxic exposure 
‘‘(a) ACTION UPON RECOMMENDATION.—Not later 
than 160 days after the date on which the Secretary receives 
a recommendation to establish or modify a presumption of 
service connection under section 1173 of this title—
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‘‘(1) if the Secretary determines, in the discre-
tion of the Secretary, that the presumption, or modi-
fication, is warranted, the Secretary shall— 
‘‘(A) commence issuing regulations in ac-
cordance with the provisions of subchapter II of 
chapter 5 of title 5 (commonly referred to as the 
Administrative Procedures Act) setting forth the 
presumption or commence revising regulations to 
carry out such modification; and 
‘‘(B) include in such regulations any time 
frame during which a health effect must become 
manifest; or 
‘‘(2) if the Secretary determines, in the discre-
tion of the Secretary, that the presumption, or modi-
fication, is not warranted, the Secretary shall publish 
in the Federal Register a notice of the determination, 
including the reasons supporting the determination. 
‘‘(b) REMOVAL OF PRESUMPTION.—(1)(A) The Sec-
retary may— 
‘‘(i) issue a regulation to remove an illness from 
a presumption of service connection previously estab-
lished pursuant to a regulation issued under sub-
section (a); and 
‘‘(ii) issue a regulation to remove a presumption 
of service connection established pursuant to title IV
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of the Sergeant First Class Heath Robinson Honoring 
our Promise to Address Comprehensive Toxics Act of 
2022 if the Secretary concludes that evidence suggests 
the lack of a positive association between the disease 
and the toxic exposure. 
‘‘(B) Under subparagraph (A)(ii), the Secretary shall 
not consider the lack of evidence as sufficient to support 
a decision for removal of a presumption. 
‘‘(2) Whenever an illness is removed from regulations 
pursuant to paragraph (1), or the periods and locations of 
exposure covered by a presumption of service connection are 
modified under subsection (a)— 
‘‘(A) a veteran who was awarded compensation 
under chapter 11 of this title for such illness on the 
basis of the presumption provided under such regula-
tions before the effective date of the removal or modi-
fication shall continue to be entitled to receive com-
pensation on that basis; 
‘‘(B) a survivor of a veteran who was awarded 
dependency and indemnity compensation under chap-
ter 13 of this title for the death of a veteran resulting 
from such illness on the basis of such presumption 
shall continue to be entitled to receive dependency and 
indemnity compensation on such basis; and
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‘‘(C) no veteran or survivor covered under sub-
paragraph (A) or (B) shall have their compensation 
reduced solely because of the removal of an illness 
pursuant to paragraph (1). 
‘‘§ 1175. Authority to modify process; congressional 
oversight 
‘‘(a) IN GENERAL.—The Secretary may modify the 
process under which the working group established under 
subsection (b) of section 1172 of this title conducts assess-
ments under such section, the Secretary conducts formal 
evaluations under section 1173 of this title, and issues regu-
lations under section 1174 of this title if— 
‘‘(1) such evaluations cover the evidence, data, 
and factors required by subsection (b) of such section 
1173; and 
‘‘(2) a period of 180 days has elapsed following 
the date on which the Secretary submits the notice 
under subsection (b) regarding the modification. 
‘‘(b) NOTICE.—If the Secretary proposes to modify the 
process under which the working group established under 
subsection (b) of section 1172 of this title conducts assess-
ments under such section, the process under which the Sec-
retary conducts formal evaluations under section 1173 of 
this title, or issues regulations under section 1174 of this 
title, the Secretary shall submit to the Committee on Vet-
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erans’ Affairs of the Senate and the Committee on Veterans’ 
Affairs of the House of Representatives a notice of the pro-
posed modifications containing the following: 
‘‘(1) A description of the proposed modifications. 
‘‘(2) A description of any exceptions to the re-
quirements of such sections that are proposed because 
of limited available scientific evidence, and a descrip-
tion of how such evaluations will be conducted. 
‘‘§ 1176. Agreement with National Academies of 
Sciences, Engineering, and Medicine con-
cerning toxic exposures 
‘‘(a) PURPOSE.—The purpose of this section is to pro-
vide for the National Academies of Sciences, Engineering, 
and Medicine (in this section referred to as the ‘Acad-
emies’), an independent nonprofit scientific organization 
with appropriate expertise that is not part of the Federal 
Government, to review and evaluate the available scientific 
evidence regarding associations between diseases and toxic 
exposures. 
‘‘(b) AGREEMENT.—(1) The Secretary shall seek to 
enter into a five-year agreement with the Academies to per-
form the services covered by this section. 
‘‘(2) The Secretary shall seek to enter into an agree-
ment described in paragraph (1) not later than 60 days 
after the date of the enactment of the Sergeant First Class
† HR 3967 EAS 
Heath Robinson Honoring our Promise to Address Com-
prehensive Toxics Act of 2022. 
‘‘(3) An agreement under this section may be extended 
in five-year increments. 
‘‘(c) REVIEW OF SCIENTIFIC EVIDENCE.—Under an 
agreement between the Secretary and the Academies under 
this section, the Academies shall review and summarize the 
scientific evidence, and assess the strength thereof, con-
cerning the association between toxic exposures during ac-
tive military, naval, air, or space service and each disease 
suspected to be associated with such exposure in the human 
population. 
‘‘(d) SCIENTIFIC DETERMINATIONS CONCERNING DIS-
EASES.—For each disease reviewed under subsection (c), the 
Academies shall determine, to the extent that available sci-
entific data permit meaningful determinations— 
‘‘(1) whether an association exists between toxic 
exposures and the occurrence of the disease, taking 
into account the strength of the scientific evidence and 
the appropriateness of the statistical and epidemiolog-
ical methods used to detect the association; 
‘‘(2) the increased risk of the disease among those 
reporting toxic exposures during active military, 
naval, air, or space service;
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‘‘(3) whether there exists a plausible biological 
mechanism or other evidence of a positive association 
between the toxic exposure and the occurrence of the 
disease; and 
‘‘(4) determine the strength of evidence for a 
positive association based on categories furnished 
under section 1173 of this title. 
‘‘(e) COOPERATION
OF FEDERAL AGENCIES.—The 
head of each relevant Federal agency, including the Sec-
retary of Defense, shall cooperate fully with the Academies 
in performing the services covered by this section. 
‘‘(f) RECOMMENDATIONS FOR ADDITIONAL SCIENTIFIC 
STUDIES.—(1) Under an agreement between the Secretary 
and the Academies under this section, the Academies shall 
make any recommendations for additional scientific studies 
to resolve areas of continuing scientific uncertainty relating 
to toxic exposures. 
‘‘(2) In making recommendations under paragraph 
(1), the Academies shall consider— 
‘‘(A) the scientific information that is available 
at the time of the recommendation; 
‘‘(B) the value and relevance of the information 
that could result from additional studies; and 
‘‘(C) the cost and feasibility of carrying out such 
additional studies.
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‘‘(g) REPORTS.—(1)(A) Under an agreement between 
the Secretary and the Academies under this section, not 
later than one year after the date of the enactment of the 
Sergeant First Class Heath Robinson Honoring our Prom-
ise to Address Comprehensive Toxics Act of 2022, the Acad-
emies shall submit to the Secretary, the Committee on Vet-
erans’ Affairs of the Senate, and the Committee on Veterans’ 
Affairs of the House of Representatives an initial report on 
the activities of the Academies under the agreement. 
‘‘(B) The report submitted under subparagraph (A) 
shall include the following: 
‘‘(i) The determinations described in subsection 
(d). 
‘‘(ii) A full explanation of the scientific evidence 
and reasoning that led to such determinations. 
‘‘(iii) Any recommendations of the Academies 
under subsection (f). 
‘‘(2) Under an agreement between the Secretary and 
the Academies under this section, not less frequently than 
once every two years after the date on which the initial re-
port is submitted under paragraph (1)(A), the Academies 
shall submit to the Secretary, the Committee on Veterans’ 
Affairs of the Senate, and the Committee on Veterans’ Af-
fairs of the House of Representatives an updated report on 
the activities of the Academies under the agreement.
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‘‘(h) ALTERNATIVE CONTRACT SCIENTIFIC ORGANIZA-
TION.—(1) If the Secretary is unable within the time period 
prescribed in subsection (b)(2) to enter into an agreement 
with the Academies for the purposes of this section on terms 
acceptable to the Secretary, the Secretary shall seek to enter 
into an agreement for the purposes of this section with an-
other appropriate scientific organization that— 
‘‘(A) is not part of the Federal Government; 
‘‘(B) operates as a not-for-profit entity; and 
‘‘(C) has expertise and objectivity comparable to 
that of the Academies. 
‘‘(2) If the Secretary enters into an agreement with 
another organization as described in paragraph (1), any 
reference in this subchapter to the Academies shall be treat-
ed as a reference to the other organization.’’. 
(b) REPORTS AND BRIEFINGS.— 
(1) REPORT.— 
(A) IN GENERAL.—Not later than two years 
after the date of the enactment of this Act, the 
Secretary of Veterans Affairs shall submit to the 
Committee on Veterans’ Affairs of the Senate 
and the Committee on Veterans’ Affairs of the 
House of Representatives a report on the imple-
mentation of, and recommendations for, sub-
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chapter VII of chapter 11 of title 38, United 
States Code, as added by subsection (a). 
(B) CONSULTATION.—The Secretary shall 
develop the report under subparagraph (A) in 
consultation with organizations recognized by 
the Secretary for the representation of veterans 
under section 5902 of such title and any other 
entity the Secretary determines appropriate. 
(2) BRIEFING.—On a quarterly basis during the 
two-year period beginning on the date of the enact-
ment of this Act, the Secretary shall provide to the 
Committee on Veterans’ Affairs of the Senate and the 
Committee on Veterans’ Affairs of the House of Rep-
resentatives a briefing on the implementation of sub-
chapter VII of chapter 11 of such title, as added by 
subsection (a). 
(c) INDEPENDENT ASSESSMENT.— 
(1) AGREEMENT.—The Secretary shall seek to 
enter into an agreement with the National Academies 
of Science, Engineering, and Medicine (in this sub-
section referred to as the ‘‘Academies’’) before the date 
that is 90 days after the date of the enactment of this 
Act to perform the services set forth under paragraph 
(2). 
(2) ASSESSMENT.—
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(A) IN GENERAL.—Under an agreement be-
tween the Secretary and the Academies under 
paragraph (1), the Academies shall conduct an 
assessment of the implementation by the Depart-
ment of Veterans Affairs of the process estab-
lished under subchapter VII of chapter 11 of title 
38, United States Code, as added by subsection 
(a). 
(B) ELEMENTS.—The assessment conducted 
under subparagraph (A) shall include the fol-
lowing: 
(i) An assessment of the Department’s 
implementation of the process established 
under subsection (a) to determine whether 
the process is in accordance with current 
scientific standards for assessing the link 
between exposure to environmental hazards 
and the development of health outcomes, 
(ii) assess whether the criteria is fair 
and consistent, and 
(iii) provide recommendations for im-
provements to the process. 
(3) REPORT.—Not later than one year after the 
date on which the Secretary enters into an agreement 
under paragraph (1), the Secretary shall submit to
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the Committee on Veterans’ Affairs of the Senate and 
the Committee on Veterans’ Affairs of the House of 
Representatives a report on the findings of the Acad-
emies pursuant to such agreement. 
(4) ALTERNATIVE CONTRACT SCIENTIFIC ORGANI-
ZATION.— 
(A) IN GENERAL.—If the Secretary is un-
able within the time period prescribed in para-
graph (1) to enter into an agreement with the 
Academies for the purposes of this subsection on 
terms acceptable to the Secretary, the Secretary 
shall seek to enter into an agreement for the pur-
poses of this subsection with another appropriate 
scientific organization that— 
(i) is not part of the Federal Govern-
ment; 
(ii) operates as a not-for-profit entity; 
and 
(iii) has expertise and objectivity com-
parable to that of the Academies. 
(B) TREATMENT.—If the Secretary enters 
into an agreement with another organization as 
described in subparagraph (A), any reference in 
this subsection to the Academies of Sciences, En-
† HR 3967 EAS 
gineering, and Medicine shall be treated as a ref-
erence to the other organization. 
(d) CONFORMING
AMENDMENTS.—Chapter 11 is 
amended— 
(1) in section 1116— 
(A) by striking subsections (b), (c), (d), and 
(e); 
(B) by inserting after subsection (a) the fol-
lowing new subsection (b): 
‘‘(b) The Secretary shall ensure that any determina-
tion made on or after the date of the enactment of the Ser-
geant First Class Heath Robinson Honoring our Promise 
to Address Comprehensive Toxics Act of 2022 regarding a 
presumption of service connection based on exposure to an 
herbicide agent under this section is made pursuant to sub-
chapter VII of this chapter, including with respect to assess-
ing reports received by the Secretary from the National 
Academy of Sciences under section 3 of the Agent Orange 
Act of 1991 (Public Law 102–4).’’; and 
(C) by redesignating subsection (f) as sub-
section (c); 
(2) in section 1116B(b)(2)(A), by inserting ‘‘pur-
suant to subchapter VII of this chapter,’’ before ‘‘the 
Secretary determines’’; and 
(3) in section 1118—
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(A) by striking subsections (b) through (e); 
and 
(B) by inserting after subsection (a) the fol-
lowing new subsection (b): 
‘‘(b) The Secretary shall ensure that any determina-
tion made on or after the date of the enactment of the Ser-
geant First Class Heath Robinson Honoring our Promise 
to Address Comprehensive Toxics Act of 2022 regarding a 
presumption of service connection based on a toxic exposure 
under this section is made pursuant to subchapter VII of 
this chapter.’’. 
SEC. 203. OUTREACH TO CLAIMANTS FOR DISABILITY COM-
PENSATION PURSUANT TO CHANGES IN PRE-
SUMPTIONS OF SERVICE CONNECTION. 
(a) IN GENERAL.—Subchapter VI of chapter 11 is 
amended by adding at the end the following new section: 
‘‘§ 1167. Outreach pursuant to changes in presump-
tions of service connection 
‘‘(a) IN
GENERAL.—Whenever a law, including 
through a regulation or Federal court decision or settlement, 
establishes or modifies a presumption of service connection, 
the Secretary shall— 
‘‘(1) identify all claims for compensation under 
this chapter that— 
‘‘(A) were submitted to the Secretary;
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‘‘(B) were evaluated and denied by the Sec-
retary before the date on which such provision of 
law went into effect; and 
‘‘(C) might have been evaluated differently 
had the establishment or modification been ap-
plicable to the claim; and 
‘‘(2) pursuant to subsection (b), conduct outreach 
to the claimants. 
‘‘(b) OUTREACH.—(1) The Secretary shall conduct out-
reach to inform claimants identified under subsection (a) 
that they may submit a supplemental claim in light of the 
establishment or modification of a presumption of service 
connection described in subsection (a). 
‘‘(2) Outreach under paragraph (1) shall include the 
following: 
‘‘(A) The Secretary shall publish on the internet 
website of the Department a notice that such veterans 
may elect to file a supplemental claim. 
‘‘(B) The Secretary shall notify, in writing or by 
electronic means, veterans service organizations of the 
ability of such veterans to file a supplemental claim. 
‘‘(C) The Secretary shall contact each claimant 
identified under subsection (a) in the same manner 
that the Department last provided notice of a deci-
sion.’’.
† HR 3967 EAS 
(b) APPLICATION.—Section 1167 of title 38, United 
States Code, as added by subsection (a), shall apply with 
respect to presumptions of service connection established or 
modified on or after the date of the enactment of this Act, 
including pursuant to amendments made by this Act. 
(c) RULE OF CONSTRUCTION.—Nothing in this section 
shall be construed as— 
(1) modifying the obligations of the Department 
of Veterans Affairs under Federal court decisions or 
settlements in effect as of the date of the enactment of 
this Act; or 
(2) requiring a retroactively applied effective 
date of a supplemental claim earlier than the date a 
presumption of service connection is established or 
modified. 
SEC. 204. REEVALUATION OF CLAIMS FOR DEPENDENCY 
AND INDEMNITY COMPENSATION INVOLVING 
PRESUMPTIONS OF SERVICE CONNECTION. 
(a) IN GENERAL.—Subchapter I of chapter 13 is 
amended by adding at the end the following new section:
† HR 3967 EAS 
‘‘§ 1305. Reevaluation of dependency and indemnity 
compensation determinations pursuant to 
changes in presumptions of service con-
nection 
‘‘(a) REEVALUATION.—Whenever a law, including 
through a regulation or Federal court decision or settlement, 
establishes or modifies a presumption of service connection, 
the Secretary shall— 
‘‘(1) identify all claims for dependency and in-
demnity compensation under this chapter that— 
‘‘(A) were submitted to the Secretary; 
‘‘(B) were evaluated and denied by the Sec-
retary before the date on which such provision of 
law went into effect; and 
‘‘(C) might have been evaluated differently 
had the establishment or modification been ap-
plicable to the claim; 
‘‘(2) allow for the reevaluation of such claims at 
the election of the claimant; and 
‘‘(3) notwithstanding section 5110 of this title, 
with respect to claims approved pursuant to such re-
evaluation, provide compensation under this chapter 
effective as if the establishment or modification of the 
presumption of service connection had been in effect 
on the date of the submission of the original claim de-
scribed in paragraph (1).
† HR 3967 EAS 
‘‘(b) OUTREACH.—(1) The Secretary shall conduct out-
reach to inform relevant claimants that they may elect to 
have a claim be reevaluated in light of the establishment 
or modification of a presumption of service connection de-
scribed in subsection (a). 
‘‘(2) Outreach under paragraph (1) shall include the 
following: 
‘‘(A) The Secretary shall publish on the internet 
website of the Department a notice that such claim-
ants may elect to have a claim so reevaluated. 
‘‘(B) The Secretary shall notify, in writing or by 
electronic means, veterans service organizations of the 
ability of such claimants to elect to have a claim so 
reevaluated. 
‘‘(C) The Secretary shall contact each claimant 
identified under subsection (a) in the same manner 
that the Department last provided notice of a deci-
sion.’’. 
(b) APPLICATION.—Section 1305 of title 38, United 
States Code, as added by subsection (a), shall apply with 
respect to presumptions of service connection established or 
modified on or after the date of the enactment of this Act, 
including pursuant to amendments made by this Act. 
(c) RULE OF CONSTRUCTION.—Nothing in this section 
shall be construed as modifying the obligations of the De-
† HR 3967 EAS 
partment of Veterans Affairs under Federal court decisions 
or settlements in effect as of the date of the enactment of 
this Act. 
TITLE III—IMPROVING THE ES-
TABLISHMENT 
OF 
SERVICE 
CONNECTION PROCESS FOR 
TOXIC-EXPOSED VETERANS 
SEC. 301. SHORT TITLE. 
This title may be cited as the ‘‘Veterans Burn Pits Ex-
posure Recognition Act of 2022’’. 
SEC. 302. PRESUMPTIONS OF TOXIC EXPOSURE. 
Subchapter II of chapter 11 is amended by adding at 
the end the following new section: 
‘‘§ 1119. Presumptions of toxic exposure 
‘‘(a) CONSIDERATION OF RECORDS.—If a veteran sub-
mits to the Secretary a claim for compensation for a serv-
ice-connected disability under section 1110 of this title with 
evidence of a disability and a toxic exposure that occurred 
during active military, naval, air, or space service, the Sec-
retary may, in adjudicating such claim, consider— 
‘‘(1) any record of the veteran in an exposure 
tracking record system; and 
‘‘(2) if no record of the veteran in an exposure 
tracking record system indicates that the veteran was 
subject to a toxic exposure during active military,
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naval, air, or space service, the totality of the cir-
cumstances of the service of the veteran. 
‘‘(b) PRESUMPTION OF SPECIFIC TOXIC EXPOSURE 
FOR MEMBERS WHO SERVED IN CERTAIN LOCATIONS.— 
(1) The Secretary shall, for purposes of section 1110 and 
chapter 17 of this title, presume that any covered veteran 
was exposed to the substances, chemicals, and airborne haz-
ards identified in the list under paragraph (2) during the 
service of the covered veteran specified in subsection (c)(1), 
unless there is affirmative evidence to establish that the cov-
ered veteran was not exposed to any such substances, chemi-
cals, or hazards in connection with such service. 
‘‘(2) The Secretary shall— 
‘‘(A) establish and maintain a list that contains 
an identification of one or more such substances, 
chemicals, and airborne hazards as the Secretary, in 
collaboration with the Secretary of Defense, may de-
termine appropriate for purposes of this section; and 
‘‘(B) determine, using procedures consistent with 
section 1172 of this title and through the conduct of 
a formal evaluation under section 1173 of this title, 
whether to establish an end date for a covered veteran 
to qualify for presumptions of exposure under this 
section, if appropriate, but in no case establish an
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end date earlier than the last day of the period speci-
fied in section 101(33) for the Persian Gulf War. 
‘‘(3) Beginning not later than two years after the date 
of the enactment of the Sergeant First Class Heath Robin-
son Honoring our Promise to Address Comprehensive 
Toxics Act of 2022, and not less frequently than once every 
two years thereafter, the Secretary shall submit to the Com-
mittee on Veterans’ Affairs of the Senate and the Committee 
on Veterans’ Affairs of the House of Representatives a report 
identifying any additions or removals to the list under 
paragraph (2) during the period covered by the report. 
‘‘(c) DEFINITIONS.—In this section: 
‘‘(1) The term ‘covered veteran’ means any vet-
eran who— 
‘‘(A) on or after August 2, 1990, performed 
active military, naval, air, or space service while 
assigned to a duty station in, including airspace 
above— 
‘‘(i) Bahrain; 
‘‘(ii) Iraq; 
‘‘(iii) Kuwait; 
‘‘(iv) Oman; 
‘‘(v) Qatar; 
‘‘(vi) Saudi Arabia; 
‘‘(vii) Somalia; or
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‘‘(viii) United Arab Emirates; or 
‘‘(B) on or after September 11, 2001, per-
formed active military, naval, air, or space serv-
ice while assigned to a duty station in, including 
airspace above— 
‘‘(i) Afghanistan; 
‘‘(ii) Djibouti; 
‘‘(iii) Egypt; 
‘‘(iv) Jordan; 
‘‘(v) Lebanon; 
‘‘(vi) Syria; 
‘‘(vii) Yemen; 
‘‘(viii) Uzbekistan; or 
‘‘(ix) any other country determined rel-
evant by the Secretary. 
‘‘(2) The term ‘exposure tracking record sys-
tem’— 
‘‘(A) means any system, program, or pilot 
program used by the Secretary of Veterans Af-
fairs or the Secretary of Defense to track how 
veterans or members of the Armed Forces have 
been exposed to various occupational or environ-
mental hazards; and 
‘‘(B) includes the Individual Longitudinal 
Exposure Record, or successor system.
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‘‘(3) The term ‘toxic exposure risk activity’ has 
the meaning given such term in section 1710(e)(4) of 
this title.’’. 
SEC. 303. MEDICAL NEXUS EXAMINATIONS FOR TOXIC EX-
POSURE RISK ACTIVITIES. 
Subchapter VI of chapter 11, as amended by section 
203, is further amended by adding at the end the following 
new section: 
‘‘§ 1168. Medical nexus examinations for toxic expo-
sure risk activities 
‘‘(a) MEDICAL EXAMINATIONS AND MEDICAL OPIN-
IONS.—(1) Except as provided in subsection (b), if a vet-
eran submits to the Secretary a claim for compensation for 
a service-connected disability under section 1110 of this 
title with evidence of a disability and evidence of participa-
tion in a toxic exposure risk activity during active mili-
tary, naval, air, or space service, and such evidence is not 
sufficient to establish a service connection for the disability, 
the Secretary shall— 
‘‘(A) provide the veteran with a medical exam-
ination under section 5103A(d) of this title; and 
‘‘(B) obtain a medical opinion (to be requested 
by the Secretary in connection with the medical ex-
amination under subparagraph (A)) as to whether it 
is at least as likely as not that there is a nexus be-
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tween the disability and the toxic exposure risk activ-
ity. 
‘‘(2) When providing the Secretary with a medical 
opinion under paragraph (1)(B) for a veteran, the health 
care provider shall consider— 
‘‘(A) the total potential exposure through all ap-
plicable military deployments of the veteran; and 
‘‘(B) the synergistic, combined effect of all toxic 
exposure risk activities of the veteran. 
‘‘(3) The requirement under paragraph (2)(B) shall 
not be construed as requiring a health care provider to con-
sider the synergistic, combined effect of each of the sub-
stances, chemicals, and airborne hazards identified in the 
list under section 1119(b)(2) of this title. 
‘‘(b) EXCEPTION.—Subsection (a) shall not apply if 
the Secretary determines there is no indication of an asso-
ciation between the disability claimed by the veteran and 
the toxic exposure risk activity for which the veteran sub-
mitted evidence. 
‘‘(c) TOXIC EXPOSURE RISK ACTIVITY DEFINED.—In 
this section, the term ‘toxic exposure risk activity’ has the 
meaning given that term in section 1710(e)(4) of this title.’’.
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TITLE IV—PRESUMPTIONS OF 
SERVICE CONNECTION 
SEC. 401. TREATMENT OF VETERANS WHO PARTICIPATED 
IN CLEANUP OF ENEWETAK ATOLL AS RADI-
ATION-EXPOSED VETERANS FOR PURPOSES 
OF PRESUMPTION OF SERVICE CONNECTION 
OF CERTAIN DISABILITIES BY DEPARTMENT 
OF VETERANS AFFAIRS. 
(a) SHORT TITLE.—This section may be cited as the 
‘‘Mark Takai Atomic Veterans Healthcare Parity Act of 
2022’’. 
(b) ENEWETAK
ATOLL.—Section 1112(c)(3)(B) is 
amended by adding at the end the following new clause: 
‘‘(v) Cleanup of Enewetak Atoll during the 
period beginning on January 1, 1977, and end-
ing on December 31, 1980.’’. 
SEC. 402. TREATMENT OF VETERANS WHO PARTICIPATED 
IN NUCLEAR RESPONSE NEAR PALOMARES, 
SPAIN, OR THULE, GREENLAND, AS RADI-
ATION-EXPOSED VETERANS FOR PURPOSES 
OF PRESUMPTION OF SERVICE CONNECTION 
OF CERTAIN DISABILITIES BY DEPARTMENT 
OF VETERANS AFFAIRS. 
(a) SHORT TITLE.—This section may be cited as the 
‘‘Palomares or Thule Veterans Act of 2022’’.
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(b) PALOMARES OR THULE.—Section 1112(c)(3)(B), 
as amended by section 401, is further amended by adding 
at the end the following new clauses: 
‘‘(vi) Onsite participation in the response 
effort following the collision of a United States 
Air Force B–52 bomber and refueling plane that 
caused the release of four thermonuclear weapons 
in the vicinity of Palomares, Spain, during the 
period beginning January 17, 1966, and ending 
March 31, 1967. 
‘‘(vii) Onsite participation in the response 
effort following the on-board fire and crash of a 
United States Air Force B–52 bomber that 
caused the release of four thermonuclear weapons 
in the vicinity of Thule Air Force Base, Green-
land, during the period beginning January 21, 
1968, and ending September 25, 1968.’’. 
SEC. 403. PRESUMPTIONS OF SERVICE CONNECTION FOR 
DISEASES ASSOCIATED WITH EXPOSURES TO 
CERTAIN HERBICIDE AGENTS FOR VETERANS 
WHO SERVED IN CERTAIN LOCATIONS. 
(a) SHORT TITLE.—This section may be cited as the 
‘‘Veterans Agent Orange Exposure Equity Act of 2022’’. 
(b) IN GENERAL.—Section 1116, as amended by sec-
tion 202, is further amended—
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(1) by striking ‘‘, during active military, naval, 
air, or space service, served in the Republic of Viet-
nam during the period beginning on January 9, 
1962, and ending on May 7, 1975’’ each place it ap-
pears and inserting ‘‘performed covered service’’; 
(2) by striking ‘‘performed active military, 
naval, air, or space service in the Republic of Viet-
nam during the period beginning on January 9, 
1962, and ending on May 7, 1975’’ each place it ap-
pears and inserting ‘‘performed covered service’’; and 
(3) by adding at the end the following new sub-
section: 
‘‘(d) In this section, the term ‘covered service’ means 
active military, naval, air, or space service— 
‘‘(1) performed in the Republic of Vietnam dur-
ing the period beginning on January 9, 1962, and 
ending on May 7, 1975; 
‘‘(2) performed in Thailand at any United 
States or Royal Thai base during the period begin-
ning on January 9, 1962, and ending on June 30, 
1976, without regard to where on the base the veteran 
was located or what military job specialty the veteran 
performed;
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‘‘(3) performed in Laos during the period begin-
ning on December 1, 1965, and ending on September 
30, 1969; 
‘‘(4) performed in Cambodia at Mimot or Krek, 
Kampong Cham Province during the period begin-
ning on April 16, 1969, and ending on April 30, 
1969; or 
‘‘(5) performed on Guam or American Samoa, or 
in the territorial waters thereof, during the period be-
ginning on January 9, 1962, and ending on July 31, 
1980, or served on Johnston Atoll or on a ship that 
called at Johnston Atoll during the period beginning 
on January 1, 1972, and ending on September 30, 
1977.’’. 
(c) ELIGIBILITY FOR HOSPITAL CARE AND MEDICAL 
SERVICES.—Section 1710(e)(4), as amended by section 
102(c), is further amended by striking subparagraph (A) 
and inserting the following new subparagraph: 
‘‘(A) The term ‘Vietnam-era herbicide-exposed 
veteran’ means a veteran who— 
‘‘(i) performed covered service, as defined in 
section 1116(d) of this title; or 
‘‘(ii) the Secretary finds may have been ex-
posed during active military, naval, air, or 
space service to dioxin during the Vietnam era,
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regardless of the geographic area of such service, 
or was exposed during such service to a toxic 
substance found in a herbicide or defoliant used 
for military purposes during such era, regardless 
of the geographic area of such service.’’. 
(d) CONFORMING AMENDMENT.—The heading for sec-
tion 1116 is amended by striking ‘‘the Republic of 
Vietnam’’ and inserting ‘‘certain locations’’. 
(e) EFFECTIVE
DATE
AND
APPLICABILITY.—The 
amendments made by this section shall take effect on the 
date of the enactment of this Act and shall apply as follows: 
(1) On the date of the enactment of this Act for 
claimants for dependency and indemnity compensa-
tion under chapter 13 of title 38, United States Code, 
and for veterans whom the Secretary of Veterans Af-
fairs determines are— 
(A) terminally ill; 
(B) homeless; 
(C) under extreme financial hardship; 
(D) more than 85 years old; or 
(E) capable of demonstrating other suffi-
cient cause. 
(2) On October 1, 2022, for everyone not de-
scribed in paragraph (1).
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SEC. 404. ADDITION OF ADDITIONAL DISEASES ASSOCIATED 
WITH EXPOSURE TO CERTAIN HERBICIDE 
AGENTS FOR WHICH THERE IS A PRESUMP-
TION OF SERVICE CONNECTION FOR VET-
ERANS WHO SERVED IN CERTAIN LOCATIONS. 
(a) SHORT TITLE.—This section may be cited as the 
‘‘Fair Care for Vietnam Veterans Act of 2022’’. 
(b) MONOCLONAL GAMMOPATHY OF UNDETERMINED 
SIGNIFICANCE.—Section 1116(a)(2) of title 38, United 
States Code, is amended by adding at the end the following 
new subparagraph: 
‘‘(L) Monoclonal gammopathy of undetermined 
significance.’’. 
(c) HYPERTENSION.—Such section, as amended by 
subsection (b), is further amended by adding at the end the 
following new subparagraph: 
‘‘(M) Hypertension.’’. 
(d) EFFECTIVE DATES AND APPLICABILITY.— 
(1) MONOCLONAL
GAMMOPATHY
OF
UNDETER-
MINED SIGNIFICANCE.— 
(A) IN
GENERAL.—The amendment made 
by subsection (b) shall take effect on the date of 
the enactment of this Act and shall apply as fol-
lows: 
(i) On the date of the enactment of this 
Act for claimants for dependency and in-
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demnity compensation under chapter 13 of 
title 38, United States Code, and for vet-
erans whom the Secretary of Veterans Af-
fairs determines are— 
(I) terminally ill; 
(II) homeless; 
(III) under extreme financial 
hardship; 
(IV) more than 85 years old; or 
(V) 
capable 
of 
demonstrating 
other sufficient cause. 
(ii) On October 1, 2022, for everyone 
not described in clause (i). 
(B) RETROACTIVE APPLICATION.—Notwith-
standing any Federal court decisions or settle-
ments in effect on the day before the date of the 
enactment of this Act, the Secretary of Veterans 
Affairs shall award retroactive claims for a con-
dition under section 1116(a)(2)(L) of title 38, 
United States Code, as added by subsection (b) 
of this section, only to claimants for dependency 
and indemnity compensation under chapter 13 
of such title described in subparagraph (A)(i) of 
this paragraph. 
(2) HYPERTENSION.—
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(A) IN
GENERAL.—The amendment made 
by subsection (c) shall take effect on the date of 
the enactment of this Act and shall apply as fol-
lows: 
(i) On the date of the enactment of this 
Act for claimants for dependency and in-
demnity compensation under chapter 13 of 
title 38, United States Code, and for vet-
erans whom the Secretary of Veterans Af-
fairs determines are— 
(I) terminally ill; 
(II) homeless; 
(III) under extreme financial 
hardship; 
(IV) more than 85 years old; or 
(V) 
capable 
of 
demonstrating 
other sufficient cause. 
(ii) On October 1, 2026, for everyone 
not described in subparagraph (A). 
(B) RETROACTIVE APPLICATION.—Notwith-
standing any Federal court decisions or settle-
ments in effect on the day before the date of the 
enactment of this Act, the Secretary of Veterans 
Affairs shall award retroactive claims for a con-
dition under section 1116(a)(2)(M) of title 38,
† HR 3967 EAS 
United States Code, as added by subsection (c) 
of this section, only to claimants for dependency 
and indemnity compensation under chapter 13 
of such title described in subparagraph (A)(i) of 
this paragraph. 
SEC. 405. IMPROVING COMPENSATION FOR DISABILITIES 
OCCURRING IN PERSIAN GULF WAR VET-
ERANS. 
(a) REDUCTION IN THRESHOLD OF ELIGIBILITY.— 
Subsection (a)(1) of section 1117 is amended by striking 
‘‘became manifest—’’ and all that follows through the pe-
riod at the end and inserting ‘‘became manifest to any de-
gree at any time.’’. 
(b) PERMANENT EXTENSION OF PERIOD OF ELIGI-
BILITY.—Such section is further amended— 
(1) by striking subsection (b); 
(2) by redesignating subsections (c) and (d) as 
subsections (b) and (c), respectively; and 
(3) in subsection (a)(2)(C), by striking ‘‘under 
subsection (d)’’ and inserting ‘‘under subsection (c)’’. 
(c) 
ESTABLISHING
SINGULAR
DISABILITY-BASED 
QUESTIONNAIRE.—Such section is further amended by in-
serting after subsection (c) (as redesignated by subsection 
(b)) the following new subsection (d):
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‘‘(d) If a Persian Gulf veteran at a medical facility 
of the Department presents with any one symptom associ-
ated with Gulf War Illness, the Secretary shall ensure that 
health care personnel of the Department use a disability 
benefits questionnaire, or successor questionnaire, designed 
to identify Gulf War Illness, in addition to any other diag-
nostic actions the personnel determine appropriate.’’. 
(d) EXPANSION OF DEFINITION OF PERSIAN GULF 
VETERAN.—Subsection (f) of such section is amended by in-
serting ‘‘, Afghanistan, Israel, Egypt, Turkey, Syria, or 
Jordan,’’ after ‘‘operations’’. 
(e) TRAINING.—Such section is further amended by 
adding at the end the following new subsection: 
‘‘(i)(1) The Secretary shall take such actions as may 
be necessary to ensure that health care personnel of the De-
partment are appropriately trained to effectively carry out 
this section. 
‘‘(2) Not less frequently than once each year, the Sec-
retary shall submit to Congress a report on the actions 
taken by the Secretary to carry out paragraph (1).’’.
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SEC. 406. PRESUMPTION OF SERVICE CONNECTION FOR 
CERTAIN DISEASES ASSOCIATED WITH EXPO-
SURE TO BURN PITS AND OTHER TOXINS. 
(a) SHORT TITLE.—This section may be cited as the 
‘‘Presumptive Benefits for War Fighters Exposed to Burn 
Pits and Other Toxins Act of 2022’’. 
(b) IN GENERAL.—Subchapter II of chapter 11, as 
amended by section 302, is further amended by inserting 
after section 1119 the following new section: 
‘‘§ 1120. Presumption of service connection for certain 
diseases associated with exposure to burn 
pits and other toxins 
‘‘(a) PRESUMPTION OF SERVICE CONNECTION.—For 
the purposes of section 1110 of this title, and subject to sec-
tion 1113 of this title, a disease specified in subsection (b) 
becoming manifest in a covered veteran shall be considered 
to have been incurred in or aggravated during active mili-
tary, naval, air, or space service, notwithstanding that 
there is no record of evidence of such disease during the 
period of such service. 
‘‘(b) DISEASES SPECIFIED.—The diseases specified in 
this subsection are the following: 
‘‘(1) Asthma that was diagnosed after service of 
the covered veteran as specified in subsection (c). 
‘‘(2) The following types of cancer: 
‘‘(A) Head cancer of any type.
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‘‘(B) Neck cancer of any type. 
‘‘(C) Respiratory cancer of any type. 
‘‘(D) Gastrointestinal cancer of any type. 
‘‘(E) Reproductive cancer of any type. 
‘‘(F) Lymphoma cancer of any type. 
‘‘(G) Lymphomatic cancer of any type. 
‘‘(H) Kidney cancer. 
‘‘(I) Brain cancer. 
‘‘(J) Melanoma. 
‘‘(K) Pancreatic cancer. 
‘‘(3) Chronic bronchitis. 
‘‘(4) Chronic obstructive pulmonary disease. 
‘‘(5) Constrictive bronchiolitis or obliterative 
bronchiolitis. 
‘‘(6) Emphysema. 
‘‘(7) Granulomatous disease. 
‘‘(8) Interstitial lung disease. 
‘‘(9) Pleuritis. 
‘‘(10) Pulmonary fibrosis. 
‘‘(11) Sarcoidosis. 
‘‘(12) Chronic sinusitis. 
‘‘(13) Chronic rhinitis. 
‘‘(14) Glioblastoma. 
‘‘(15) Any other disease for which the Secretary 
determines, pursuant to regulations prescribed under
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subchapter VII that a presumption of service connec-
tion is warranted based on a positive association with 
a substance, chemical, or airborne hazard identified 
in the list under section 1119(b)(2) of this title. 
‘‘(c) COVERED VETERAN DEFINED.—In this section, 
the term ‘covered veteran’ has the meaning given that term 
in section 1119(c) of this title.’’. 
(c) CONFORMING
AMENDMENT.—Section 1113 is 
amended by striking ‘‘or 1118’’ each place it appears and 
inserting ‘‘1118, or 1120’’. 
(d) EFFECTIVE
DATE
AND
APPLICABILITY.—The 
amendments made by this section shall take effect on the 
date of the enactment of this Act and shall apply as follows: 
(1) On the date of the enactment of this Act for 
claimants for dependency and indemnity compensa-
tion under chapter 13 of title 38, United States Code, 
and veterans whom the Secretary of Veterans Affairs 
determines are— 
(A) terminally ill; 
(B) homeless; 
(C) under extreme financial hardship; 
(D) more than 85 years old; or 
(E) capable of demonstrating other suffi-
cient cause.
† HR 3967 EAS 
(2) On the date of the enactment of this Act for 
everyone not described in paragraph (1), with respect 
to paragraphs (1), (2)(C), (2)(I), (5), (6), (7), (8), 
(9), (10), (11), (12), (13), and (14), of section 1120(b) 
of title 38, United States Code, as added by subsection 
(b). 
(3) On October 1, 2023, for everyone not de-
scribed in paragraph (1), with respect to paragraphs 
(3) and (4) of section 1120(b) of such title, as so 
added. 
(4) On October 1, 2024, for everyone not de-
scribed in paragraph (1), with respect to subpara-
graphs (A), (B), (D), (E), (F), (G), and (K) of section 
1120(b)(2) of such title, as so added. 
(5) On October 1, 2025, for everyone not de-
scribed in paragraph (1), with respect to subpara-
graphs (H) and (J) of section 1120(b)(2) of such title, 
as so added. 
SEC. 407. RULE OF CONSTRUCTION. 
(a) GENERALLY.—Nothing in this Act shall be con-
strued to prevent the Secretary of Veterans Affairs from 
processing claims for benefits under title 38, United States 
Code, for a condition or disease for which this Act estab-
lishes a presumption of service connection, as a claim for
† HR 3967 EAS 
benefits for a condition or disease with direct service con-
nection. 
(b) EFFECTIVE DATES AND APPLICABILITY.—The Sec-
retary shall not deny a claim for benefits under title 38, 
United States Code, for a condition or disease for which 
this Act establishes a presumption of service connection be-
cause the claimant filed the claim prior to the effective date 
or date of applicability for that particular condition or dis-
ease. 
TITLE V—RESEARCH MATTERS 
SEC. 501. INTERAGENCY WORKING GROUP ON TOXIC EXPO-
SURE RESEARCH. 
(a) ESTABLISHMENT.— 
(1) IN GENERAL.—Not later than one year after 
the date of the enactment of this Act, the Secretary of 
Veterans Affairs shall, in collaboration with the heads 
of the entities described in paragraph (2), establish 
the Toxic Exposure Research Working Group (in this 
section referred to as the ‘‘Working Group’’). 
(2) COMPOSITION.—The Working Group shall 
consist of employees, selected by the Secretary, of the 
following: 
(A) The Department of Veterans Affairs. 
(B) The Department of Defense.
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(C) The Department of Health and Human 
Services. 
(D) The Environmental Protection Agency. 
(E) Other entities of the Federal Govern-
ment involved in research activities regarding 
the health consequences of toxic exposures experi-
enced during active military, naval, air, or 
space service. 
(b) FUNCTIONS.—The Working Group shall perform 
the following functions: 
(1) Identify collaborative research activities and 
resources available among entities represented by 
members of the Working Group to conduct such col-
laborative research activities. 
(2) Develop a five-year strategic plan for such 
entities to carry out collaborative research activities. 
(c) REPORTING.—The Secretary shall submit to the 
Committee on Veterans’ Affairs of the Senate and the Com-
mittee on Veterans’ Affairs of the House of Representatives 
the following: 
(1) Not later than one year after the date of the 
enactment of this Act, a report on the establishment 
of the Working Group under subsection (a). 
(2) Not later than two years after the date of the 
enactment of this Act, a report containing the collabo-
† HR 3967 EAS 
rative research activities identified, and the strategic 
plan developed, by the Working Group under sub-
section (b). 
(3) Not less frequently than annually during the 
five-year period covered by the strategic plan under 
subsection (b), a progress report on implementation of 
the strategic plan. 
(d) TERMINATION.—The Working Group shall termi-
nate after submitting the final report under subsection (c). 
(e) DEFINITIONS.—In this section: 
(1) ACTIVE
MILITARY, NAVAL, AIR, OR
SPACE 
SERVICE.—The term ‘‘active military, naval, air, or 
space service’’ has the meaning given that term in 
section 101 of title 38, United States Code. 
(2) COLLABORATIVE RESEARCH ACTIVITY.—The 
term ‘‘collaborative research activity’’ means a re-
search activity— 
(A) agreed upon by the Working Group; 
(B) conducted by an entity represented by 
a member of the Working Group; 
(C) funded by the Federal Government; and 
(D) regarding the health consequences of 
toxic exposures experienced during active mili-
tary, naval, air, or space service.
† HR 3967 EAS 
(3) TOXIC EXPOSURE.—The term ‘‘toxic expo-
sure’’ has the meaning given such term in section 101 
of title 38, United States Code, as amended by section 
102(b). 
SEC. 502. ANALYSIS AND REPORT ON TREATMENT OF VET-
ERANS FOR MEDICAL CONDITIONS RELATED 
TO TOXIC EXPOSURE. 
(a) IN GENERAL.—The Secretary of Veterans Affairs 
shall analyze, on a continuous basis, all clinical data 
that— 
(1) is obtained by the Department of Veterans 
Affairs in connection with hospital care, medical serv-
ices, and nursing home care furnished under section 
1710(a)(2)(F) of title 38, United States Code; and 
(2) is likely to be scientifically useful in deter-
mining the association, if any, between the medical 
condition of a veteran and a toxic exposure. 
(b) ANNUAL REPORT.—Not later than one year after 
the date of the enactment of this Act, and annually there-
after, the Secretary shall submit to the Committee on Vet-
erans’ Affairs of the Senate and the Committee on Veterans’ 
Affairs of the House of Representatives a report containing 
the following: 
(1) The aggregate data compiled under sub-
section (a).
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(2) An analysis of such data. 
(3) A description of the types and incidences of 
medical conditions identified by the Department 
under such subsection. 
(4) The explanation of the Secretary for the inci-
dence of such medical conditions and other expla-
nations for the incidence of such conditions as the 
Secretary considers reasonable. 
(5) The views of the Secretary on the scientific 
validity of drawing conclusions from the incidence of 
such medical conditions, as evidenced by the data 
compiled under subsection (a), regarding any associa-
tion between such conditions and toxic exposures. 
(c) TOXIC EXPOSURE DEFINED.—In this section, the 
term ‘‘toxic exposure’’ has the meaning given such term in 
section 101 of title 38, United States Code, as amended by 
section 102(b). 
SEC. 503. ANALYSIS RELATING TO MORTALITY OF VET-
ERANS WHO SERVED IN SOUTHWEST ASIA. 
(a) ANALYSIS.— 
(1) IN GENERAL.—Not later than 270 days after 
the date of the enactment of this Act, the Secretary of 
Veterans Affairs, in coordination with the Secretary 
of Defense, shall conduct an updated analysis of total 
and respiratory disease mortality in covered veterans.
† HR 3967 EAS 
(2) ELEMENTS.—The analysis required by para-
graph (1) shall include, to the extent practicable, the 
following with respect to each covered veteran: 
(A) Metrics of airborne exposures. 
(B) The location and timing of deployments 
of the veteran. 
(C) The military occupational specialty of 
the veteran. 
(D) The Armed Force in which the veteran 
served. 
(E) Pre-existing health status of the veteran, 
including with respect to asthma. 
(F) Relevant personal information of the 
veteran, including cigarette and e-cigarette smok-
ing history, diet, sex, gender, age, race, and eth-
nicity. 
(b) COVERED VETERAN DEFINED.—In this section, the 
term ‘‘covered veteran’’ means any veteran who— 
(1) on or after August 2, 1990, served on active 
duty in— 
(A) Bahrain; 
(B) Iraq; 
(C) Kuwait; 
(D) Oman; 
(E) Qatar;
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(F) Saudi Arabia; 
(G) Somalia; or 
(H) the United Arab Emirates; or 
(2) on or after September 11, 2001, served on ac-
tive duty in— 
(A) Afghanistan; 
(B) Djibouti; 
(C) Egypt; 
(D) Jordan; 
(E) Lebanon; 
(F) Syria; or 
(G) Yemen. 
SEC. 504. STUDY ON HEALTH TRENDS OF POST–9/11 VET-
ERANS. 
The Secretary of Veterans Affairs shall conduct an epi-
demiological study on the health trends of veterans who 
served in the Armed Forces after September 11, 2001. 
SEC. 505. STUDY ON CANCER RATES AMONG VETERANS. 
(a) IN GENERAL.—The Secretary of Veterans Affairs 
shall conduct a study on the incidence of cancer in veterans 
to determine trends in the rates of the incidence of cancer 
in veterans. 
(b) ELEMENTS.—The study required by subsection (a) 
shall assess, with respect to each veteran included in the 
study, the following:
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(1) The age of the veteran. 
(2) The period of service and length of service of 
the veteran in the Armed Forces. 
(3) The military occupational specialty or spe-
cialties of the veteran. 
(4) The sex of the veteran. 
(5) The type or types of cancer that the veteran 
has. 
SEC. 506. STUDY ON HEALTH EFFECTS OF WASTE RELATED 
TO MANHATTAN PROJECT ON CERTAIN VET-
ERANS. 
(a) STUDY.—Not later than 180 days after the date 
of the enactment of this Act, the Secretary of Veterans Af-
fairs shall enter into an agreement with the National Acad-
emies of Sciences, Engineering, and Medicine for the con-
duct of a study on the health trends of veterans who, while 
serving in the active military, naval, air, or space service— 
(1) participated in activities relating to the 
Manhattan Project (including activities relating to 
covered waste) in connection with such service; or 
(2) resided at or near, as determined by the Sec-
retary, the locations described in subsection (b). 
(b) COVERED LOCATIONS.—The locations described in 
this subsection are the following locations:
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(1) In the county of St. Louis, Missouri, the fol-
lowing: 
(A) Coldwater Creek, Missouri. 
(B) The St. Louis Airport Site, Missouri. 
(C) The West Lake Landfill. 
(2) Oak Ridge, Tennessee. 
(3) Hanford, Washington. 
(4) Any other location that is proximate to cov-
ered waste, as determined by the Secretary. 
(c) ELEMENTS.—The study under subsection (a) shall 
assess, with respect to each veteran included in the study, 
the following: 
(1) The age, sex, and race of the veteran. 
(2) The period and location of exposure to cov-
ered waste. 
(3) Any type of cancer, or other illness associated 
with toxic exposure, that the veteran has. 
(4) A comparison of the overall health condition 
of the veteran, including any illness of the veteran 
identified pursuant to paragraph (3), with the overall 
health condition of past and present civilian popu-
lations residing at the same location of exposure, as 
determined by the Secretary. 
(d) REPORT.—Not later than three years after the date 
of the enactment of this Act, the Secretary shall submit to
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the Committee on Veterans’ Affairs of the Senate and the 
Committee on Veterans’ Affairs of the House of Representa-
tives a report on the study under subsection (a) and include 
in such report an analysis of the data available and data 
reliability. 
(e) DEFINITIONS.—In this section: 
(1) ACTIVE
MILITARY, NAVAL, AIR, OR
SPACE 
SERVICE; TOXIC EXPOSURE.—The terms ‘‘active mili-
tary, naval, air, or space service’’ and ‘‘toxic expo-
sure’’ have the meanings given those terms in section 
101 of title 38, United States Code, as added by sec-
tion 102(b). 
(2) COVERED WASTE.—The term ‘‘covered waste’’ 
means any waste arising from activities carried out 
in connection with the Manhattan Project. 
(3) ILLNESS.—The term ‘‘illness’’ has the mean-
ing given that term in section 1171 of title 38, United 
States Code, as added by section 202. 
(4) TOXIC EXPOSURE.—The term ‘‘toxic expo-
sure’’ has the meaning given such term in section 101 
of title 38, United States Code, as amended by section 
102(b).
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SEC. 507. STUDY ON TOXIC EXPOSURE AND MENTAL 
HEALTH OUTCOMES. 
(a) STUDY REQUIRED.—Not later than 180 days after 
the date of the enactment of this Act, the Secretary of Vet-
erans Affairs shall enter into an agreement with the Na-
tional Academies of Sciences, Engineering, and Medicine 
for the conduct of a study of veterans to assess possible rela-
tionships between toxic exposures experienced during service 
in the Armed Forces and mental health conditions, includ-
ing chronic multisymptom illness, traumatic brain injury, 
post-traumatic stress disorder, depression, episodes of psy-
chosis, schizophrenia, bipolar disorder, suicide attempts, 
and suicide deaths. 
(b) ELEMENTS.—For each veteran included in the 
study under subsection (a), the following information shall 
be collected and assessed: 
(1) Age. 
(2) Sex. 
(3) Race and ethnicity. 
(4) Period and length of service in the Armed 
Forces. 
(5) The military occupational specialty or spe-
cialties of the veteran. 
(6) History of toxic exposure during service in 
the Armed Forces.
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(7) Any diagnosis of chronic multisymptom ill-
ness. 
(8) Any diagnosis of a mental health or cognitive 
disorder. 
(9) Any history of suicide attempt or suicidality. 
(10) If the veteran died by suicide. 
(11) Any confounding traumatic experiences that 
could affect a veteran’s mental health. 
(c) REPORT.—Not later than three years after the date 
of the enactment of this Act, the Secretary shall submit to 
the Committee on Veterans’ Affairs of the Senate and the 
Committee on Veterans’ Affairs of the House of Representa-
tives a report containing the findings of the National Acad-
emies of Sciences, Engineering, and Medicine with respect 
to the study conducted under subsection (a). 
SEC. 508. STUDY ON VETERANS IN TERRITORIES OF THE 
UNITED STATES. 
(a) GAO STUDY.— 
(1) IN GENERAL.—The Comptroller General of 
the United States shall conduct a study on the state 
of access and barriers to benefits and services fur-
nished by the Veterans Benefits Administration and 
the Veterans Health Administration under laws ad-
ministered by the Secretary of Veterans Affairs to vet-
erans in Territories and Freely Associated States of
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the United States, including deficits in the avail-
ability and accessibility of such benefits and services 
compared to veterans elsewhere in the United States. 
(2) ELEMENTS.—The study under paragraph (1) 
shall include— 
(A) the number of veterans in each Terri-
tory and Freely Associated State of the United 
States; 
(B) the number of veterans in each Terri-
tory and Freely Associated State who are en-
rolled in the system of annual patient enrollment 
of the Department of Veterans Affairs under sec-
tion 1705(a) of title 38, United States Code; 
(C) a description of how the Department es-
timates the number of veterans in each Territory 
and Freely Associated State who are eligible for 
services under section 1710 of such title but who 
are not enrolled as described in subparagraph 
(B); 
(D) a detailed description of obstacles fac-
ing veterans in each Territory and Freely Asso-
ciated State in accessing health care services, in-
cluding those involving the availability of such 
services to veterans in the Territory or Freely 
Associated State in which the veterans reside,
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and any distance impediments to receiving serv-
ices at a regional medical center of the Veterans 
Health Administration, a community-based out-
patient clinic, another full-service medical facil-
ity of the Department, or a Vet Center, respec-
tively; 
(E) a detailed description of obstacles facing 
veterans in each Territory and Freely Associated 
State in accessing readjustment counseling serv-
ices, including those involving the availability of 
such services to veterans in the Territory in 
which the veterans reside, and any distance im-
pediments to receiving services at a readjustment 
counseling services center of the Department; 
(F) a detailed description of obstacles facing 
veterans in each Territory and Freely Associated 
State in accessing non-health care veterans bene-
fits, including those involving the availability of 
benefits and services to veterans in the Territory 
or Freely Associated State in which the veterans 
reside, and any distance impediments to access-
ing the nearest office of the Veterans Benefits Ad-
ministration; 
(G) an analysis of the staffing and quality 
of the offices of the Veterans Benefits Adminis-
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tration and Veterans Health Administration 
charged with serving veterans in the Territories 
and Freely Associated States, including the 
availability of the full- and part-time staff of 
each office to the veterans they are charged with 
serving; 
(H) an analysis of the availability of the 
Veterans Community Care Program established 
under section 1703 of title 38, United States 
Code, to veterans in each Territory and Freely 
Associated State; 
(I) an analysis of the economic and health 
outcomes for veterans in each Territory or Freely 
Associated State resulting from obstacles to ac-
cessing adequate assistance and health care at 
facilities of the Department; 
(J) an analysis of the access to benefit as-
sistance and health care provided to veterans in 
the aftermath of major disasters declared in each 
of the Territories and Freely Associated States 
since September 4, 2017; and 
(K) such recommendations as the Comp-
troller General considers appropriate for improv-
ing access of veterans in the Territories and 
Freely Associated States to benefits and health
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care services furnished by the Secretary, and re-
ducing barriers and deficits in the availability 
and accessibility of such benefits and services 
compared to veterans elsewhere in the United 
States. 
(b) BRIEFING.—Not later than one year after the date 
of the enactment of this Act, the Comptroller General shall 
provide to the Committee on Veterans’ Affairs of the Senate 
and the Committee on Veterans’ Affairs of the House of Rep-
resentatives a briefing setting forth the results of the study 
conducted under subsection (a), including any rec-
ommendations developed under paragraph (2)(K) of such 
subsection. 
(c) DEFINITIONS.—In this section: 
(1) FREELY
ASSOCIATED
STATE.—The term 
‘‘Freely Associated State’’ includes the Federated 
States of Micronesia, the Republic of the Marshall Is-
lands, and the Republic of Palau. 
(2) TERRITORY.—The term ‘‘Territory’’ includes 
American Samoa, the Commonwealth of the Northern 
Marianas Islands, Guam, Puerto Rico, and the Vir-
gin Islands. 
(3) VET CENTER.—The term ‘‘Vet Center’’ has 
the meaning given that term in section 1712A(h) of 
title 38, United States Code.
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SEC. 509. DEPARTMENT OF VETERANS AFFAIRS PUBLIC 
WEBSITE FOR TOXIC EXPOSURE RESEARCH. 
(a) WEBSITE.—Not later than one year after the date 
of the enactment of this Act, the Secretary of Veterans Af-
fairs shall establish, and maintain thereafter, a publicly ac-
cessible internet website of the Department of Veterans Af-
fairs that serves as a clearinghouse for the publication of 
all toxic exposure research carried out or funded by the exec-
utive branch of the Federal Government. 
(b) COORDINATION.—In carrying out subsection (a), 
the Secretary shall coordinate with— 
(1) the heads of each Federal agency carrying 
out or funding toxic exposure research; 
(2) the War Related Illness and Injury Study 
Center of the Department of Veterans Affairs, or suc-
cessor center; and 
(3) any working group of the Department of Vet-
erans Affairs or other similar entity responsible for 
coordinating toxic exposure research. 
(c) DEFINITIONS.—In this section: 
(1) TOXIC EXPOSURE.—The term ‘‘toxic expo-
sure’’ has the meaning given that term in section 101 
of title 38, United States Code, as added by section 
102(b). 
(2) TOXIC
EXPOSURE
RESEARCH.—The term 
‘‘toxic exposure research’’ means research on the
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health consequences of toxic exposures experienced 
during service in the Armed Forces. 
SEC. 510. REPORT ON HEALTH EFFECTS OF JET FUELS 
USED BY ARMED FORCES. 
(a) INITIAL REPORT.—Not later than one year after 
the date of the enactment of this Act, the Secretary of Vet-
erans Affairs shall submit to the Committee on Veterans’ 
Affairs of the Senate and the Committee on Veterans’ Af-
fairs of the House of Representatives, and make publicly 
available, a report on health effects of jet fuels used by the 
Armed Forces. 
(b) CONTENTS.—The report submitted under sub-
section (a) shall include the following: 
(1) A discussion of the effect of various different 
types of jet fuels used by the Armed Forces on the 
health of individuals by length of exposure. 
(2) An identification of the immediate symptoms 
of jet fuel exposure that may indicate future health 
risks. 
(3) A chronology of health safeguards imple-
mented by the Armed Forces intended to reduce the 
exposure of members of the Armed Forces to jet fuel. 
(4) An identification of any areas relating to jet 
fuel exposure about which new research needs to be 
conducted.
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(c) FOLLOW-UP REPORT.—Not later than five years 
after the date of the submittal of the report under subsection 
(a), the Secretary shall submit to the committees referred 
to in such subsection an update to such report. 
TITLE VI—IMPROVEMENT OF RE-
SOURCES AND TRAINING RE-
GARDING 
TOXIC-EXPOSED 
VETERANS 
SEC. 601. SHORT TITLE; DEFINITIONS. 
(a) SHORT TITLE.—This title may be cited as the 
‘‘Fairly Assessing Service-related Toxic Exposure Residuals 
Presumptions Act of 2022’’ or the ‘‘FASTER Presumption 
Act of 2022’’. 
(b) DEFINITIONS.—In this title, the terms ‘‘active mili-
tary, naval, air, or space service’’, ‘‘toxic exposure’’, and 
‘‘toxic-exposed veteran’’ have the meanings given those 
terms in section 101 of title 38, United States Code, as 
amended by section 102.
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SEC. 602. PUBLICATION OF LIST OF RESOURCES OF DE-
PARTMENT 
OF 
VETERANS 
AFFAIRS 
FOR 
TOXIC-EXPOSED VETERANS AND VETERANS 
WHO REPORT TOXIC EXPOSURES AND OUT-
REACH PROGRAM FOR SUCH VETERANS AND 
CAREGIVERS AND SURVIVORS OF SUCH VET-
ERANS. 
(a) PUBLICATION OF LIST OF RESOURCES.— 
(1) IN GENERAL.—Not later than one year after 
the date of the enactment of this Act, and annually 
thereafter, the Secretary of Veterans Affairs shall pub-
lish a list of resources of the Department of Veterans 
Affairs for— 
(A) toxic-exposed veterans and veterans who 
report toxic exposure; 
(B) families and caregivers of such veterans; 
and 
(C) survivors of such veterans who are re-
ceiving death benefits under the laws adminis-
tered by the Secretary. 
(2) UPDATE.—The Secretary shall periodically 
update the list published under paragraph (1). 
(b) OUTREACH.—The Secretary shall develop, with 
input from the community, an informative outreach pro-
gram for veterans on illnesses that may be related to toxic
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exposures, including outreach with respect to benefits and 
support programs. 
SEC. 603. INCORPORATION OF TOXIC EXPOSURE SCREEN-
ING FOR VETERANS. 
(a) IN GENERAL.—Beginning not later than 90 days 
after the date of the enactment of this Act, the Secretary 
of Veterans Affairs shall incorporate a screening to help de-
termine potential toxic exposures during active military, 
naval, air, or space service as part of a health care screen-
ing furnished by the Department of Veterans Affairs to vet-
erans enrolled in the system of annual patient enrollment 
of the Department established and operated under section 
1705 of title 38, United States Code, to improve under-
standing by the Department of toxic exposures while serving 
in the Armed Forces. 
(b) TIMING.—The Secretary shall ensure that a veteran 
described in subsection (a) completes the screening required 
under such subsection not less frequently than once every 
five years. 
(c) DETERMINATION OF QUESTIONS.— 
(1) IN GENERAL.—The questions included in the 
screening required under subsection (a) shall be deter-
mined by the Secretary with input from medical pro-
fessionals.
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(2) SPECIFIC QUESTIONS.—At a minimum, the 
screening required under subsection (a) shall, with re-
spect to a veteran, include— 
(A) a question about the potential exposure 
of the veteran to an open burn pit; and 
(B) a question regarding toxic exposures 
that are commonly associated with service in the 
Armed Forces. 
(3) OPEN
BURN
PIT
DEFINED.—In this sub-
section, the term ‘‘open burn pit’’ means an area of 
land that— 
(A) is designated by the Secretary of De-
fense to be used for disposing solid waste by 
burning in the outdoor air; and 
(B) does not contain a commercially manu-
factured incinerator or other equipment specifi-
cally designed and manufactured for the burning 
of solid waste. 
(d) PRINT MATERIAL.—In developing the screening es-
tablished under subsection (a), the Secretary shall ensure 
that print materials complementary to such screening that 
outline related resources for veterans are available at each 
medical center of the Department to veterans who may not 
have access to the internet.
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(e) SCREENING UPDATES.—The Secretary shall con-
sider updates to the content of the screening required under 
subsection (a) not less frequently than biennially to ensure 
the screening contains the most current information. 
SEC. 604. TRAINING FOR PERSONNEL OF THE DEPARTMENT 
OF VETERANS AFFAIRS WITH RESPECT TO 
VETERANS WHO REPORT TOXIC EXPOSURES. 
(a) HEALTH CARE PERSONNEL.—The Secretary of 
Veterans Affairs shall provide to health care personnel of 
the Department of Veterans Affairs education and training 
to identify, treat, and assess the impact on veterans of ill-
nesses related to toxic exposures and inform such personnel 
of how to ask for additional information from veterans re-
garding different toxic exposures. 
(b) BENEFITS PERSONNEL.— 
(1) IN
GENERAL.—The Secretary shall incor-
porate a training program for processors of claims 
under the laws administered by the Secretary who re-
view claims for disability benefits relating to service- 
connected disabilities based on toxic exposures. 
(2) ANNUAL
TRAINING.—Training provided to 
processors under paragraph (1) shall be provided not 
less frequently than annually.
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TITLE VII—RESOURCING 
SEC. 701. AUTHORITY TO USE APPROPRIATIONS TO EN-
HANCE CLAIMS PROCESSING CAPACITY AND 
AUTOMATION. 
(a) AUTHORITY.—The Secretary of Veterans Affairs 
may use, from amounts appropriated to the Cost of War 
Toxic Exposures Fund established by section 324 of title 
38, United States Code, as added by section 805 of this Act, 
such amounts as may be necessary to continue the mod-
ernization, development, and expansion of capabilities and 
capacity of information technology systems and infrastruc-
ture of the Veterans Benefits Administration, including for 
claims automation, to support expected increased claims 
processing for newly eligible veterans pursuant to this Act. 
(b) PLAN FOR MODERNIZATION OF VETERANS BENE-
FITS ADMINISTRATION INFORMATION TECHNOLOGY SYS-
TEMS.— 
(1) IN GENERAL.—Not later than 180 days after 
the date of the enactment of this Act, the Secretary of 
Veterans Affairs shall submit to the appropriate con-
gressional committees a plan for the modernization of 
the information technology systems of the Veterans 
Benefits Administration. The plan shall cover the 
first fiscal year that begins after the date of the enact-
† HR 3967 EAS 
ment of this Act and the subsequent four fiscal years 
and shall include each of the following: 
(A) An identification of any information 
system to be modernized or retired, if applicable, 
during the period covered by the plan. 
(B) A description of how the Secretary in-
tends to incorporate the following principles into 
the modernization of such information systems: 
(i) The purpose of automation should 
be to increase the speed and accuracy of 
claims processing decisions. 
(ii) Automation should be conducted in 
a manner that enhances the productivity of 
employees of the Department of Veterans Af-
fairs. 
(iii) Automation should be carried out 
in a manner that achieves greater consist-
ency in the processing and rating of claims 
by relying on patterns of similar evidence 
in claim files. 
(iv) To the greatest extent possible, au-
tomation should be carried out by drawing 
from information in the possession of the 
Department, other Government agencies, 
and applicants for benefits.
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(v) Automation of any claims analysis 
or determination process should not be end- 
to-end or lack intermediation. 
(vi) Employees of the Department 
should continue to make decisions with re-
spect to the approval of claims and the 
granting of benefits. 
(vii) Automation should not be carried 
out in a manner that reduces or infringes 
upon the due process rights of applicants for 
benefits under the laws administered by the 
Secretary; or the duties of the Secretary to 
assist and notify claimants. 
(viii) Automation should be carried 
out while taking all necessary measures to 
protect the privacy of claimants and their 
personally identifiable information. 
(ix) Automation of claims processing 
should not eliminate or reduce the workforce 
of the Veterans Benefits Administration. 
(C) An identification of targets, for each fis-
cal year, by which the Secretary intends to com-
plete the modernization of each information sys-
tem or major component or functionality of such 
system identified under subparagraph (A).
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(D) Cost estimates for the modernization of 
each information system identified under para-
graph (A) for each fiscal year covered by the 
plan and in total. 
(2) 
APPROPRIATE
CONGRESSIONAL
COMMIT-
TEES.—In this section, the term ‘‘appropriate con-
gressional committees’’ means— 
(A) the Committee on Veterans’ Affairs and 
the Subcommittee on Military Construction, Vet-
erans Affairs, and Related Agencies of the Com-
mittee on Appropriations of the Senate; and 
(B) the Committee on Veterans’ Affairs and 
the Subcommittee on Military Construction, Vet-
erans Affairs, and Related Agencies of the Com-
mittee on Appropriations of the House of Rep-
resentatives. 
SEC. 702. AUTHORIZATION OF MAJOR MEDICAL FACILITY 
LEASES OF DEPARTMENT OF VETERANS AF-
FAIRS FOR FISCAL YEAR 2023. 
(a) IN GENERAL.—The Secretary of Veterans Affairs 
may carry out the following major medical facility leases 
in fiscal year 2023: 
(1) Lease for an outpatient clinic in the vicinity 
of Allentown, Pennsylvania, in an estimated amount 
of $31,832,000.
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(2) Lease for a facility for member services for 
the Veterans Health Administration in the vicinity of 
Atlanta, Georgia, in an estimated amount of 
$27,134,000. 
(3) Lease for an outpatient clinic in the vicinity 
of Baltimore, Maryland, in an estimated amount of 
$43,041,000. 
(4) Lease for an outpatient clinic in the vicinity 
of Baton Rouge, Louisiana, in an estimated amount 
of $29,550,000. 
(5) Lease for an outpatient clinic in the vicinity 
of Beaufort, South Carolina, in an estimated amount 
of $24,254,000. 
(6) Lease for an outpatient clinic in the vicinity 
of Beaumont, Texas, in an estimated amount of 
$15,632,000. 
(7) Lease for an outpatient clinic in the vicinity 
of Brainerd, Minnesota, in an estimated amount of 
$14,669,000. 
(8) Lease for a facility for research in the vicin-
ity of Buffalo, New York, in an estimated amount of 
$11,106,000. 
(9) Lease for an outpatient clinic in the vicinity 
of Clarksville, Tennessee, in an estimated amount of 
$75,135,000.
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(10) Lease of a facility for research in the vicin-
ity of Columbia, Missouri, in an estimated amount of 
$20,726,000. 
(11) Lease for an outpatient clinic in the vicin-
ity of Cookeville, Tennessee, in an estimated amount 
of $10,958,000. 
(12) Lease for a residential treatment facility in 
the vicinity of Denver, Colorado, in an estimated 
amount of $9,133,000. 
(13) Lease for an outpatient clinic in the vicin-
ity of Elizabethtown, Kentucky, in an estimated 
amount of $16,671,000. 
(14) Lease for an outpatient clinic in the vicin-
ity of Farmington, Missouri, in an estimated amount 
of $17,940,000. 
(15) Lease for an outpatient clinic in the vicin-
ity of Hampton, Virginia, in an estimated amount of 
$63,085,000. 
(16) Lease for an outpatient clinic in the vicin-
ity of Jacksonville, North Carolina, in an estimated 
amount of $61,450,000. 
(17) Lease for an outpatient clinic in the vicin-
ity of Killeen, Texas, in an estimated amount of 
$61,030,000.
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(18) Lease for an outpatient clinic in the vicin-
ity of Lawrence, Indiana, in an estimated amount of 
$15,811,000. 
(19) Lease for an outpatient clinic in the vicin-
ity of Lecanto, Florida, in an estimated amount of 
$15,373,000. 
(20) Lease for an outpatient clinic in the vicin-
ity of Nashville, Tennessee, in an estimated amount 
of $58,038,000. 
(21) Lease for an outpatient clinic in the vicin-
ity of North Kansas City, Missouri, in an estimated 
amount of $40,027,000. 
(22) Lease for an outpatient clinic in the vicin-
ity of Pflugerville, Texas, in an estimated amount of 
$16,654,000. 
(23) Lease for an outpatient clinic in the vicin-
ity of Plano, Texas, in an estimated amount of 
$32,796,000. 
(24) Lease for an outpatient clinic in the vicin-
ity of Prince George’s County, Maryland, in an esti-
mated amount of $31,754,000. 
(25) Lease for an outpatient clinic in the vicin-
ity of Rolla, Missouri, in an estimated amount of 
$21,352,000.