I 
114TH CONGRESS 
1ST SESSION H. R. 3989 
To amend title 38, United States Code, to improve the process for determining 
the eligibility of caregivers of veterans to certain benefits administered 
by the Secretary of Veterans Affairs. 
IN THE HOUSE OF REPRESENTATIVES 
NOVEMBER 5, 2015 
Ms. STEFANIK introduced the following bill; which was referred to the 
Committee on Veterans’ Affairs 
A BILL 
To amend title 38, United States Code, to improve the 
process for determining the eligibility of caregivers of 
veterans to certain benefits administered by the Sec-
retary of Veterans Affairs. 
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 ‘‘Support Our Military 
Caregivers Act’’. 
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SEC. 2. EXTERNAL CLINICAL REVIEW OF DENIED APPLICA-
TIONS BY CAREGIVERS OF VETERANS. 
(a) IN GENERAL.—Section 1720G of title 38, United 
States Code, is amended— 
(1) by redesignating subsections (d) and (e) as 
subsections (e) and (f), respectively; and 
(2) by inserting after subsection (c) the fol-
lowing new subsection (d): 
‘‘(d) EXTERNAL CLINICAL REVIEW
OF APPLICA-
TIONS.—(1) Using amounts otherwise appropriated to 
carry out this section, an individual may elect to have an 
independent contractor described in paragraph (2) per-
form an external clinical review of any of the following: 
‘‘(A) The denial by the Secretary of an applica-
tion by an individual to be a caregiver or family 
caregiver eligible for benefits administered by the 
Secretary pursuant to this section. 
‘‘(B) With respect to such an application that 
the Secretary has granted, a determination by the 
Secretary of the level or amount of personal care 
services that a veteran requires. 
‘‘(C) A request by a caregiver or family care-
giver for a reconsideration of the level or amount of 
personal care services that a veteran requires based 
on changes to the health or abilities of the veteran 
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occurring since the Secretary granted such an appli-
cation. 
‘‘(D) The revocation by the Secretary of bene-
fits administered by the Secretary pursuant to this 
section. 
‘‘(2) An independent contractor described in this 
paragraph is an independent contractor that— 
‘‘(A) is awarded a contract by the Secretary to 
carry out this section pursuant to full and open com-
petition under the Federal Acquisition Regulation; 
‘‘(B) has no direct or indirect financial relation-
ship with any non-Department provider of services 
to caregivers and family caregivers pursuant to this 
title; 
‘‘(C) has not otherwise conducted an external 
clinical review of benefits administered by the Sec-
retary pursuant to this title other than this section; 
‘‘(D) has sufficient training and expertise in 
medical science and other appropriate health, edu-
cational, and vocational training and legal matters 
to perform the reviews described in paragraph (1); 
and 
‘‘(E) employs a panel of physicians or other ap-
propriate health care professionals who do not pro-
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vide health care to the individual who makes an elec-
tion under paragraph (1). 
‘‘(3) Each external clinical review conducted pursu-
ant to paragraph (1) shall— 
‘‘(A) be based on applicable information in-
cluded in the application for benefits described in 
such paragraph, including clinical expertise, medical, 
technical, and scientific evidence; 
‘‘(B) include an opportunity for the individual 
who elects for such review to provide the opinions of 
the individual and the veteran for whom care is pro-
vided; and 
‘‘(C) include a review of the initial clinical re-
view of such veteran and any other review made by 
the Secretary. 
‘‘(4) In carrying out the external clinical reviews pur-
suant to paragraph (1), the independent contractor shall, 
as determined appropriate by the Secretary— 
‘‘(A) collect and maintain information required; 
and 
‘‘(B) share such information with the Secretary. 
‘‘(5) The determination made by the independent 
contractor pursuant to paragraph (1) shall be final. 
‘‘(6) The Secretary shall ensure that each external 
clinical review conducted by the independent contractor 
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pursuant to paragraph (1) is completed and the individual 
is notified in writing of the results of the review by not 
later than 120 days after the date on which the individual 
makes the election under such paragraph. Such notifica-
tion shall include an explanation of the decision, a discus-
sion of the facts and applicable regulations, and an expla-
nation of the clinical rationale for the decision. 
‘‘(7) The Secretary shall notify individuals who sub-
mit an application to be a caregiver or family caregiver 
eligible for benefits administered by the Secretary pursu-
ant to this section of the ability of the individual to make 
an election under paragraph (1). 
‘‘(8) Nothing in this subsection may be construed to 
affect claims made by veterans for disability compensation 
under chapter 11 of this title.’’. 
(b) APPLICATION.— 
(1) IN GENERAL.—Except as provided by para-
graph (2), the amendments made by subsection (a) 
shall apply with respect to elections under subsection 
(d) of section 1720G of title 38, United States Code, 
as added by subsection (a)(2), that are for applica-
tions or revocations for benefits by caregivers and 
family caregivers pursuant to such section for which 
the Secretary of Veterans Affairs has not made a 
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final decision as of the date of the enactment of this 
Act. 
(2) SPECIAL RULE.—A caregiver or family care-
giver may make an election for an external clinical 
review under subsection (d)(1)(C) of section 1720G 
of title 38, United States Code, as added by sub-
section (a)(2), regardless of whether the Secretary of 
Veterans Affairs made the final decision with respect 
to the application for benefits by the caregiver or 
family caregiver before the date of the enactment of 
this Act. 
Æ 
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