Union Calendar No. 364
103D CONGRESS
2D SESSION
H. R. 4386
[Report No. 103–669]
A BILL
To amend title 38, United States Code, authorizing
the Secretary of Veterans Affairs to provide com-
pensation to veterans suffering from disabilities
resulting from illnesses attributed to service in
the Persian Gulf theater of operations during the
Persian Gulf War, to provide for increased re-
search into illnesses reported by Persian Gulf
War veterans, and for other purposes.
AUGUST 4, 1994
Reported with an amendment, committed to the Commit-
tee of the Whole House on the State of the Union, and
ordered to be printed
IB
Union Calendar No. 364
103D CONGRESS
2D SESSION
H. R. 4386
[Report No. 103–669]
To amend title 38, United States Code, authorizing the Secretary of Veterans
Affairs to provide compensation to veterans suffering from disabilities
resulting from illnesses 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.
IN THE HOUSE OF REPRESENTATIVES
MAY 11, 1994
Mr. MONTGOMERY (for himself, Mr. SLATTERY, Mr. ROWLAND, Mr. BILI-
RAKIS, Mr. KENNEDY, Mr. CLEMENT, Mr. STEARNS, Mr. BISHOP, Mr.
PARKER, Mr. KREIDLER, Mr. HALL of Ohio, Mr. TEJEDA, Mr. STUMP,
Mr. APPLEGATE, Mr. BACHUS of Alabama, Mr. SANGMEISTER, Mr. JA-
COBS, Mr. GONZALEZ, Mr. COOPER, Mr. EDWARDS of Texas, Mr. KYL,
Mr. TAYLOR of Mississippi, Mr. BROWN of Ohio, Ms. BROWN of Florida,
Mr. SWETT, Mr. SMITH of New Jersey, Mr. QUINN, Mr. BEVILL, Mr.
CANADY, Mr. COLLINS of Georgia, Mr. MCHALE, Mr. HEFNER, Mr.
MACHTLEY, Mr. COYNE, Mrs. JOHNSON of Connecticut, Mr. GORDON,
Mr. SKELTON, Mr. WALSH, Mr. RAHALL, Mrs. MEEK of Florida, Mr.
BOEHLERT, Mr. CALLAHAN, Mr. MYERS of Indiana, Mr. MCCURDY, Mr.
ORTON, Mrs. LLOYD, Mr. ACKERMAN, Mr. ORTIZ, Mr. BATEMAN, Mr.
DELLUMS, Mr. CAMP, Mr. HOCHBRUECKNER, Mr. WELDON, Mr. LIPIN-
SKI, Mr. PETE GEREN of Texas, Mr. PRICE of North Carolina, Mr. GENE
GREEN of Texas, Mr. FILNER, Mr. FROST, Mr. BURTON of Indiana, Mr.
HANCOCK, Mr. RIDGE, Mr. KINGSTON, Mr. LANCASTER, Mr. BROWDER,
Mr. HUTCHINSON, Mr. BUYER, Mr. SHAW, Mr. CRAMER, Mr.
FINGERHUT, Mr. WILSON, Mr. LEWIS of Florida, Mrs. VUCANOVICH, Mr.
PICKETT, Mr. FARR, Mr. JOHNSON of Georgia, Mr. TRAFICANT, Mr.
CARR of Michigan, Mr. FRANK of Massachusetts, Mr. COLEMAN, Mr.
DEAL, Mrs. SCHROEDER, Mr. RICHARDSON, Mr. EVERETT, Mr. SOLO-
MON, Mr. CUNNINGHAM, Mr. BROWN of California, Mr. SAXTON, Mr.
LEWIS of California, Mr. LAUGHLIN, Mr. MINGE, Mr. TORKILDSEN, Mr.
HUNTER, Mr. BARLOW, Mr. WILLIAMS, Mr. KLEIN, Mr. GREENWOOD,
Mr. BARCA of Wisconsin, Mr. WHITTEN, Mr. SCHIFF, Mr. BARCIA of
Michigan, Mr. DOOLEY, Mr. ROSE, Mr. PALLONE, Mr. DEFAZIO, Mr.
BACCHUS of Florida, Mr. DE LA GARZA, Mrs. MORELLA, Mr. CLAY, Mr.
OBERSTAR, Ms. EDDIE BERNICE JOHNSON of Texas, Mr. DURBIN, Mr.
DE LUGO, Mr. MICHEL, Mr. QUILLEN, Mr. HANSEN, Mr. MILLER of
California, Mr. BAKER of Louisiana, Mr. BONILLA, Mr. MANN, Mr. PE-
TERSON of Florida, Mr. ENGEL, Mr. LAFALCE, Mr. INGLIS of South
Carolina, Mr. MOAKLEY, Mr. SYNAR, Mr. NEAL of North Carolina, Mr.
DIAZ-BALART, Mr. BARRETT of Wisconsin, Mr. LEVY, Mr. GILMAN, Mr.
STUPAK, Mr. SHAYS, Mr. SPENCE, Ms. KAPTUR, Mrs. MALONEY, Mr.
WASHINGTON, Mr. MINETA, Mr. GUNDERSON, Mr. THORNTON, Mr.
DUNCAN, Mr. KING, Mr. TUCKER, Mr. FALEOMAVAEGA, Mr. TORRES,
Mr. GINGRICH, Mr. PASTOR, Mr. NEAL of Massachusetts, Mr. JOHNSON
of South Dakota, Mr. HOAGLAND, Mr. DIXON, Mr. ROMERO BARCELO´,
Mr. THOMPSON
of Mississippi, Mr. EMERSON, Mr. LINDER, Mr.
TORRICELLI, Mr. CALVERT, Ms. FURSE, Ms. ENGLISH of Arizona, Mr.
JEFFERSON, Mr. STRICKLAND, Mr. STENHOLM, Mr. PAYNE of Virginia,
Mr. CHAPMAN, Mr. MCNULTY, Mrs. CLAYTON, Mr. HALL of Texas, Mrs.
BYRNE, Ms. PRYCE of Ohio, and Mr. EVANS) introduced the following
bill; which was referred to the Committee on Veterans’ Affairs
AUGUST 4, 1994
Reported with an amendment, committed to the Committee of the Whole
House on the State of the Union, and ordered to be printed
[Strike out all after the enacting clause and insert the part printed in italic]
[For text of introduced bill, see copy of bill as introduced on May 11, 1994]
A BILL
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 exhaust,
paints, 
pesticides, 
depleted 
uranium, 
infectious
agents, chemoprophylactic agents, and indigenous dis-
eases, and were also given multiple immunizations. It
is not known whether these servicemembers were ex-
posed to chemical or biological warfare agents. How-
ever, threats of enemy use of chemical and biological
warfare heightened the psychological stress associated
with the military operation.
(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 Veterans Affairs.
(3) The Technology Assessment Workshop on the
Persian Gulf Experience and Health conducted by the
National Institutes of Health concluded that the com-
plex biological, chemical, physical, and psychological
environment of the Southwest Asia theater of oper-
ations produced complex adverse health effects in Per-
sian Gulf War veterans and that it appears that no
single disease entity or syndrome exists. Rather, it
appears that the illnesses suffered by those veterans
result from multiple illnesses with overlapping symp-
toms 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, particularly
those who suffer from illnesses or conditions for which
no diagnosis has been made, the Congress, in Public
Law 102–585, directed the establishment of a Persian
Gulf War Veterans Health Registry, authorized health
examinations for veterans of the Persian Gulf War,
and provided for the National Academy of Sciences to
conduct a comprehensive review and assessment of in-
formation regarding the health consequences of mili-
tary service in the Persian Gulf theater of operations
and to develop recommendations on avenues for re-
search regarding such health consequences. In Public
Law 103–210, the Congress authorized the Depart-
ment of Veterans Affairs to provide health care serv-
ices 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 envi-
ronmental medical facility for the conduct of research
into the possible health effects of exposure to low levels
of hazardous chemicals, especially among Persian
Gulf veterans, and for research into the possible health
effects of battlefield exposure in such veterans to de-
pleted uranium.
(6) Further research and studies must be under-
taken to determine the underlying causes of the ill-
nesses 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 com-
pensation benefits to offset the impairment in earn-
ings 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 assessment
strategies and definitions or diagnoses of such ill-
nesses,
(3) to promote greater outreach to Persian Gulf
War veterans and their families to inform them of on-
going research activities, as well as the services and
benefits to which they are currently entitled, and
(4) to ensure that research activities and accom-
panying surveys of Persian Gulf War veterans are
appropriately funded and undertaken by the Depart-
ment 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 ill-
ness attributed to service in the Southwest Asia thea-
ter of operations during the Persian Gulf War; and
(2) develop at the earliest possible date case defi-
nitions 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 Af-
fairs in consultation with the Secretary of Defense and the
Secretary of Health and Human Services.
(c) REPORTS.—The Secretary shall submit to the Com-
mittees on Veterans’ Affairs of the Senate and House of
Representatives an annual report on the status of the activi-
ties 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 Veterans
Affairs shall develop and implement a comprehensive out-
reach program and information system to provide Persian
Gulf War veterans and their families with information re-
garding the following:
(1) The Persian Gulf War Veterans Health Reg-
istry established by the Persian Gulf War Veterans’
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 De-
partment 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 disabil-
ities resulting from service in the Persian Gulf War,
including disabilities resulting from illness that re-
sulted from such service.
(4) Significant developments in research relating
to the health consequences of service in the Persian
Gulf War.
(5) Any other information that the Secretary de-
termines to be appropriate.
(b) TOLL-FREE TELEPHONE NUMBER.—The informa-
tion system required by subsection (a) shall include the es-
tablishment 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 no-
tify each individual listed in the Registry or, in the case
of such an individual who is deceased, the surviving spouse,
children, or parents of such individual, at least quarterly,
by newsletter or by other means that the Secretary deter-
mines 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 Persian
Gulf War or to the illnesses of the family members of
such individuals;
‘‘(B) compensation and benefits, including health
care and other health-related benefits, that may be
provided by the Department of Veterans Affairs 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 Persian 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 organizations.
‘‘(3) The requirement of paragraph (1) shall not apply
regarding notification of any individual if that individual
makes a written request to the Secretary of Veterans 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 subchapter
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 manifest
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 begin-
ning 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 section
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 dur-
ing the Persian Gulf War; or
‘‘(2) where there is affirmative evidence to estab-
lish 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 ac-
tive duty and the onset of the disability.
‘‘(d) The Secretary may not make payments under this
section with respect to a disability for which compensation
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 oper-
ations 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 stating
that, as of the date of the report, no diagnoses for the ill-
nesses referred to in subsection (a) can be made based on
current medical knowledge, such three-year period shall con-
tinue 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 chap-
ter 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, Unit-
ed 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 Sec-
retary of Defense and the Secretary of Health and Human
Services, determines would advance understanding 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 sur-
vey of Persian Gulf veterans to gather information on the
incidence and nature of health problems occurring in Per-
sian 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 Veter-
ans Health Care Act of 1992 (Public Law 102–585) a find-
ing that there is a sound basis for an epidemiological study
or studies on the health consequences of service in the Per-
sian 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 National Acad-
emy of Sciences for (A) the review of proposals to conduct
the research referred to in subsection (a), (B) oversight of
such research, and (C) review of the research findings.
(2) If the Secretary is unable to enter into an agree-
ment under paragraph (1) with the entity specified in that
paragraph, the Secretary shall enter into an agreement de-
scribed in that paragraph with another appropriate sci-
entific organization which does not have a connection to
the Department of Veterans Affairs. In such a case, the Sec-
retary shall submit to the Committees on Veterans’ Affairs
of the Senate and House of Representatives, at least 90 days
before the date on which the agreement is entered into, no-
tice in writing identifying the organization with which the
Secretary intends to enter into the agreement.
(c) ACCESS TO DATA.—The Secretary shall enter into
agreements with the Secretary of Defense and the Secretary
of Health and Human Services to make available for the
purposes of any study described in subsection (a) all data
that the Secretary, in consultation with the National Acad-
emy of Sciences and the contractor, considers relevant to
the study.
(d) AUTHORIZATION.—There are authorized to be ap-
propriated to the Department such sums as are necessary
for the conduct of studies described in subsection (a).
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 ADJUSTMENT
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 in-
demnity compensation payable under chapter 13 of such
title will be no more than a percentage equal to the percent-
age 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 in-
creased rates or limitations equal to a whole dollar amount)
rounded down to the next lower dollar.
HR 4386 RH——2