
From the U.S. Code Online via GPO Access
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[Laws in effect as of January 23, 2000]
[Document affected by Public Law 107-103 Section 202(a),]
[Document affected by Public Law 107-103 Section 202(d)(1)]
[Document affected by Public Law 107-103 Section 203(a)]
[Document affected by Public Law 107-103 Section 202(d)(2)]
[Document affected by Public Law 107-103 Section 202(c)]
[Document affected by Public Law 107-103 Section 203(b)]
[CITE: 38USC1117]

 
                      TITLE 38--VETERANS' BENEFITS
 
                        PART II--GENERAL BENEFITS
 
   CHAPTER 11--COMPENSATION FOR SERVICE-CONNECTED DISABILITY OR DEATH
 
             SUBCHAPTER II--WARTIME DISABILITY COMPENSATION
 
Sec. 1117. Compensation for disabilities occurring in Persian 
        Gulf War veterans
        
    (a) The Secretary may pay compensation under this subchapter to any 
Persian Gulf veteran suffering from a chronic disability resulting from 
an undiagnosed illness (or combination of undiagnosed illnesses) that--
        (1) became manifest during service on active duty in the Armed 
    Forces in the Southwest Asia theater of operations during the 
    Persian Gulf War; or
        (2) became manifest to a degree of 10 percent or more within the 
    presumptive period prescribed under subsection (b).

    (b) The Secretary shall prescribe by regulation the period of time 
following service in the Southwest Asia theater of operations during the 
Persian Gulf War that the Secretary determines is appropriate for 
presumption of service connection for purposes of this section. The 
Secretary's determination of such period of time shall be made following 
a review of any available credible medical or scientific evidence and 
the historical treatment afforded disabilities for which manifestation 
periods have been established and shall take into account other 
pertinent circumstances regarding the experiences of veterans of the 
Persian Gulf War.
    (c)(1) Whenever the Secretary determines under section 1118(c) of 
this title that a presumption of service connection for an undiagnosed 
illness (or combination of undiagnosed illnesses) previously established 
under this section is no longer warranted--
        (A) a veteran who was awarded compensation under this section 
    for such illness (or combination of illnesses) on the basis of the 
    presumption shall continue to be entitled to receive compensation 
    under this section on that basis; and
        (B) a survivor of a veteran who was awarded dependency and 
    indemnity compensation for the death of a veteran resulting from the 
    disease on the basis of the presumption before that date shall 
    continue to be entitled to receive dependency and indemnity 
    compensation on that basis.

    (2) This subsection shall cease to be effective 10 years after the 
first day of the fiscal year in which the National Academy of Sciences 
submits to the Secretary the first report under section 1603 of the 
Persian Gulf War Veterans Act of 1998.
    (d)(1) The Secretary shall prescribe regulations to carry out this 
section.
    (2) Those regulations shall include the following:
        (A) A description of the period and geographical area or areas 
    of military service in connection with which compensation under this 
    section may be paid.
        (B) A description of the illnesses for which compensation under 
    this section may be paid.
        (C) A description of any relevant medical characteristic (such 
    as a latency period) associated with each such illness.

    (e) A disability for which compensation under this subchapter is 
payable shall be considered to be service connected for purposes of all 
other laws of the United States.
    (f) 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 operations during the Persian Gulf War.

(Added Pub. L. 103-446, title I, Sec. 106(a)(1), Nov. 2, 1994, 108 Stat. 
4650; amended Pub. L. 105-277, div. C, title XVI, Sec. 1602(c), Oct. 21, 
1998, 112 Stat. 2681-744.)

                       References in Text

    Section 1603 of the Persian Gulf War Veterans Act of 1998, referred 
to in subsec. (c)(2), is section 1603 of Pub. L. 105-277, which is set 
out in a note below.


                               Amendments

    1998--Subsecs. (c) to (f). Pub. L. 105-277 added subsec. (c) and 
redesignated former subsecs. (c) to (e) as (d) to (f), respectively.


                               Regulations

    Section 106(d) of Pub. L. 103-446 provided that: ``If the Secretary 
states in the report under subsection (c) [set out below] that the 
Secretary intends to pay compensation as provided in section 1117 of 
title 38, United States Code, as added by subsection (a), the Secretary 
shall, not later than 30 days after the date on which such report is 
submitted, publish in the Federal Register proposed regulations under 
subsections (b) and (c) of that section.''


      Improving Effectiveness of Care of Persian Gulf War Veterans

    Pub. L. 105-368, title I, Sec. 105, Nov. 11, 1998, 112 Stat. 3324, 
provided that:
    ``(a) Assessment by National Academy of Sciences.--Not later than 
April 1, 1999, the Secretary of Veterans Affairs shall enter into a 
contract with the National Academy of Sciences to review the available 
scientific data in order to--
        ``(1) assess whether a methodology could be used by the 
    Department of Veterans Affairs for determining the efficacy of 
    treatments furnished to, and health outcomes (including functional 
    status) of, Persian Gulf War veterans who have been treated for 
    illnesses which may be associated with their service in the Persian 
    Gulf War; and
        ``(2) identify, to the extent feasible, with respect to each 
    undiagnosed illness prevalent among such veterans and for any other 
    chronic illness that the Academy determines to warrant such review, 
    empirically valid models of treatment for such illness which employ 
    successful treatment modalities for populations with similar 
    symptoms.
    ``(b) Action on Report.--(1) After receiving the final report of the 
National Academy of Sciences under subsection (a), the Secretary shall, 
if a reasonable and scientifically feasible methodology is identified by 
the Academy, develop an appropriate mechanism to monitor and study the 
effectiveness of treatments furnished to, and health outcomes of, 
Persian Gulf War veterans who suffer from diagnosed and undiagnosed 
illnesses which may be associated with their service in the Persian Gulf 
War.
    ``(2) The Secretary shall submit to the Committees on Veterans' 
Affairs of the Senate and House of Representatives a report on the 
implementation of paragraph (1).
    ``(3) The Secretary shall carry out paragraphs (1) and (2) not later 
than 180 days after receiving the final report of the National Academy 
of Sciences under subsection (a).''


 Agreement With National Academy of Sciences Regarding Toxic Drugs and 
                   Illnesses Associated With Gulf War

    Pub. L. 105-277, div. C, title XVI, Sec. 1603-1605, Oct. 21, 1998, 
112 Stat. 2681-745 to 2681-748, provided that:
``SEC. 1603. AGREEMENT WITH NATIONAL ACADEMY OF SCIENCES.
    ``(a) Purpose.--The purpose of this section is to provide for the 
National Academy of Sciences, an independent nonprofit scientific 
organization with appropriate expertise, to review and evaluate the 
available scientific evidence regarding associations between illnesses 
and exposure to toxic agents, environmental or wartime hazards, or 
preventive medicines or vaccines associated with Gulf War service.
    ``(b) Agreement.--The Secretary of Veterans Affairs shall seek to 
enter into an agreement with the National Academy of Sciences for the 
Academy to perform the activities covered by this section. The Secretary 
shall seek to enter into the agreement not later than two months after 
the date of enactment of this Act [Oct. 21, 1998].
    ``(c) Identification of Agents and Illnesses.--(1) Under the 
agreement under subsection (b), the National Academy of Sciences shall--
        ``(A) identify the biological, chemical, or other toxic agents, 
    environmental or wartime hazards, or preventive medicines or 
    vaccines to which members of the Armed Forces who served in the 
    Southwest Asia theater of operations during the Persian Gulf War may 
    have been exposed by reason of such service; and
        ``(B) identify the illnesses (including diagnosed illnesses and 
    undiagnosed illnesses) that are manifest in such members.
    ``(2) In identifying illnesses under paragraph (1)(B), the Academy 
shall review and summarize the relevant scientific evidence regarding 
illnesses among the members described in paragraph (1)(A) and among 
other appropriate populations of individuals, including mortality, 
symptoms, and adverse reproductive health outcomes among such members 
and individuals.
    ``(d) Initial Consideration of Specific Agents.--(1) In identifying 
under subsection (c) the agents, hazards, or preventive medicines or 
vaccines to which members of the Armed Forces may have been exposed for 
purposes of the first report under subsection (i), the National Academy 
of Sciences shall consider, within the first six months after the date 
of enactment of this Act [Oct. 21, 1998], the following:
        ``(A) The following organophosphorous pesticides:
            ``(i) Chlorpyrifos.
            ``(ii) Diazinon.
            ``(iii) Dichlorvos.
            ``(iv) Malathion.
        ``(B) The following carbamate pesticides:
            ``(i) Proxpur.
            ``(ii) Carbaryl.
            ``(iii) Methomyl.
        ``(C) The carbamate pyridostigmine bromide used as nerve agent 
    prophylaxis.
        ``(D) The following chlorinated hydrocarbon and other pesticides 
    and repellents:
            ``(i) Lindane.
            ``(ii) Pyrethrins.
            ``(iii) Permethrins.
            ``(iv) Rodenticides (bait).
            ``(v) Repellent (DEET).
        ``(E) The following low-level nerve agents and precursor 
    compounds at exposure levels below those which produce immediately 
    apparent incapacitating symptoms:
            ``(i) Sarin.
            ``(ii) Tabun.
        ``(F) The following synthetic chemical compounds:
            ``(i) Mustard agents at levels below those which cause 
        immediate blistering.
            ``(ii) Volatile organic compounds.
            ``(iii) Hydrazine.
            ``(iv) Red fuming nitric acid.
            ``(v) Solvents.
            ``(vi) Uranium.
        ``(G) The following ionizing radiation:
            ``(i) Depleted uranium.
            ``(ii) Microwave radiation.
            ``(iii) Radio frequency radiation.
        ``(H) The following environmental particulates and pollutants:
            ``(i) Hydrogen sulfide.
            ``(ii) Oil fire byproducts.
            ``(iii) Diesel heater fumes.
            ``(iv) Sand micro-particles.
        ``(I) Diseases endemic to the region (including the following):
            ``(i) Leishmaniasis.
            ``(ii) Sandfly fever.
            ``(iii) Pathogenic escherechia coli.
            ``(iv) Shigellosis.
        ``(J) Time compressed administration of multiple live, 
    `attenuated', and toxoid vaccines.
    ``(2) The consideration of agents, hazards, and medicines and 
vaccines under paragraph (1) shall not preclude the Academy from 
identifying other agents, hazards, or medicines or vaccines to which 
members of the Armed Forces may have been exposed for purposes of any 
report under subsection (i).
    ``(3) Not later than six months after the date of enactment of this 
Act [Oct. 21, 1998], the Academy shall submit to the designated 
congressional committees a report specifying the agents, hazards, and 
medicines and vaccines considered under paragraph (1).
    ``(e) Determinations of Associations Between Agents and Illnesses.--
(1) For each agent, hazard, or medicine or vaccine and illness 
identified under subsection (c), the National Academy of Sciences shall 
determine, to the extent that available scientific data permit 
meaningful determinations--
        ``(A) whether a statistical association exists between exposure 
    to the agent, hazard, or medicine or vaccine and the illness, taking 
    into account the strength of the scientific evidence and the 
    appropriateness of the scientific methodology used to detect the 
    association;
        ``(B) the increased risk of the illness among human or animal 
    populations exposed to the agent, hazard, or medicine or vaccine; 
    and
        ``(C) whether a plausible biological mechanism or other evidence 
    of a causal relationship exists between exposure to the agent, 
    hazard, or medicine or vaccine and the illness.
    ``(2) The Academy shall include in its reports under subsection (i) 
a full discussion of the scientific evidence and reasoning that led to 
its conclusions under this subsection.
    ``(f) Review of Potential Treatment Models for Certain Illnesses.--
Under the agreement under subsection (b), the National Academy of 
Sciences shall separately review, for each chronic undiagnosed illness 
identified under subsection (c)(1)(B) and for any other chronic illness 
that the Academy determines to warrant such review, the available 
scientific data in order to identify empirically valid models of 
treatment for such illnesses which employ successful treatment 
modalities for populations with similar symptoms.
    ``(g) Recommendations for Additional Scientific Studies.--(1) Under 
the agreement under subsection (b), the National Academy of Sciences 
shall make any recommendations that it considers appropriate for 
additional scientific studies (including studies relating to treatment 
models) to resolve areas of continuing scientific uncertainty relating 
to the health consequences of exposure to toxic agents, environmental or 
wartime hazards, or preventive medicines or vaccines associated with 
Gulf War service.
    ``(2) In making recommendations for additional studies, the Academy 
shall consider the available scientific data, the value and relevance of 
the information that could result from such studies, and the cost and 
feasibility of carrying out such studies.
    ``(h) Subsequent Reviews.--(1) Under the agreement under subsection 
(b), the National Academy of Sciences shall conduct on a periodic and 
ongoing basis additional reviews of the evidence and data relating to 
its activities under this section.
    ``(2) As part of each review under this subsection, the Academy 
shall--
        ``(A) conduct as comprehensive a review as is practicable of the 
    evidence referred to in subsection (c) and the data referred to in 
    subsections (e), (f), and (g) that became available since the last 
    review of such evidence and data under this section; and
        ``(B) make determinations under the subsections referred to in 
    subparagraph (A) on the basis of the results of such review and all 
    other reviews previously conducted for purposes of this section.
    ``(i) Reports.--(1) Under the agreement under subsection (b), the 
National Academy of Sciences shall submit to the committees and 
officials referred to in paragraph (5) periodic written reports 
regarding the Academy's activities under the agreement.
    ``(2) The first report under paragraph (1) shall be submitted not 
later than 18 months after the date of enactment of this Act [Oct. 21, 
1998]. That report shall include--
        ``(A) the determinations and discussion referred to in 
    subsection (e);
        ``(B) the results of the review of models of treatment under 
    subsection (f); and
        ``(C) any recommendations of the Academy under subsection (g).
    ``(3) Reports shall be submitted under this subsection at least once 
every two years, as measured from the date of the report under paragraph 
(2).
    ``(4) In any report under this subsection (other than the report 
under paragraph (2)), the Academy may specify an absence of meaningful 
developments in the scientific or medical community with respect to the 
activities of the Academy under this section during the 2-year period 
ending on the date of such report.
    ``(5) Reports under this subsection shall be submitted to the 
following:
        ``(A) The designated congressional committees.
        ``(B) The Secretary of Veterans Affairs.
        ``(C) The Secretary of Defense.
    ``(j) Sunset.--This section shall cease to be effective 10 years 
after the last day of the fiscal year in which the National Academy of 
Sciences submits the first report under subsection (i).
    ``(k) Alternative Contract Scientific Organization.--(1) If the 
Secretary is unable within the time period set forth in subsection (b) 
to enter into an agreement with the National Academy of Sciences for the 
purposes of this section on terms acceptable to the Secretary, the 
Secretary shall seek to enter into an agreement for purposes of this 
section with another appropriate scientific organization that is not 
part of the Government, operates as a not-for-profit entity, and has 
expertise and objectivity comparable to that of the National Academy of 
Sciences.
    ``(2) If the Secretary enters into an agreement with another 
organization under this subsection, any reference in this section and 
section 1118 of title 38, United States Code (as added by section 
1602(a)), to the National Academy of Sciences shall be treated as a 
reference to such other organization.
``SEC. 1604. REPEAL OF INCONSISTENT PROVISIONS OF LAW.
    ``In the event of the enactment, before, on, or after the date of 
the enactment of this Act [Oct. 21, 1998], of section 101 of the 
Veterans Programs Enhancement Act of 1998 [Pub. L. 105-368, 112 Stat. 
3317], or any similar provision of law enacted during the second session 
of the 105th Congress requiring an agreement with the National Academy 
of Sciences regarding an evaluation of health consequences of service in 
Southwest Asia during the Persian Gulf War, such section 101 (or other 
provision of law) shall be treated as if never enacted, and shall have 
no force or effect.
``SEC. 1605. DEFINITIONS.
    ``In this title:
        ``(1) The term `toxic agent, environmental or wartime hazard, or 
    preventive medicine or vaccine associated with Gulf War service' 
    means a biological, chemical, or other toxic agent, environmental or 
    wartime hazard, or preventive medicine or vaccine that is known or 
    presumed to be associated with service in the Armed Forces in the 
    Southwest Asia theater of operations during the Persian Gulf War, 
    whether such association arises as a result of single, repeated, or 
    sustained exposure and whether such association arises through 
    exposure singularly or in combination.
        ``(2) The term `designated congressional committees' means the 
    following:
            ``(A) The Committees on Veterans' Affairs and Armed Services 
        of the Senate.
            ``(B) The Committees on Veterans' Affairs and National 
        Security [now Armed Services] of the House of Representatives.
        ``(3) The term `Persian Gulf War' has the meaning given that 
    term in section 101(33) of title 38, United States Code.''
    [Pub. L. 105-368, title I, Sec. 101, Nov. 11, 1998, 112 Stat. 3317, 
enacted provisions similar to those in sections 1603 and 1605 of Pub. L. 
105-277, set out above. See section 1604 of Pub. L. 105-277, set out 
above.]


                   Persian Gulf War Veterans' Benefits

    Sections 102 to 105, 107, 109, and 110 of title I of Pub. L. 103-
446, as amended by Pub. L. 104-262, title III, Sec. 352(a), Oct. 9, 
1996, 110 Stat. 3210; Pub. L. 105-368, title I, Sec. 107, Nov. 11, 1998, 
112 Stat. 3325; Pub. L. 106-117, title II, Sec. 205(b), (c), Nov. 30, 
1999, 113 Stat. 1563, provided that:
``SEC. 102. FINDINGS.
    ``The Congress makes the following findings:
        ``(1) During the Persian Gulf War, members of the Armed Forces 
    were exposed to numerous potentially toxic substances, including 
    fumes and smoke from military operations, oil well fires, diesel 
    exhaust, paints, pesticides, depleted uranium, infectious agents, 
    investigational drugs and vaccines, and indigenous diseases, and 
    were also given multiple immunizations. It is not known whether 
    these servicemembers were exposed to chemical or biological warfare 
    agents. However, 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 Persian Gulf War 
    are suffering from illnesses, or are exhibiting symptoms of illness, 
    that cannot now be diagnosed 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 National Institutes of Health Technology Assessment 
    Workshop on the Persian Gulf Experience and Health, held in April 
    1994, concluded that the complex biological, chemical, physical, and 
    psychological environment of the Southwest Asia theater of 
    operations produced complex adverse health effects in Persian Gulf 
    War veterans and that no single disease entity or syndrome is 
    apparent. Rather, it may be that the illnesses suffered by those 
    veterans result from multiple illnesses with overlapping symptoms 
    and causes that have yet to be defined.
        ``(4) That workshop concluded that the information concerning 
    the range and intensity of exposure to toxic substances by military 
    personnel in the Southwest Asia theater of operations is very 
    limited and that such information was 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 [see Short Title of 1992 Amendments 
    note under section 101 of this title], 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 information regarding the health consequences of 
    military service in the Persian Gulf theater of operations and to 
    develop recommendations on avenues for research regarding such 
    health consequences. In Public Law 103-210 [see Tables for 
    classification], the Congress authorized the Department of Veterans 
    Affairs to provide health care services on a priority basis to 
    Persian Gulf War veterans. The Congress also provided in Public Law 
    103-160 (the National Defense Authorization Act for Fiscal Year 
    1994) [see Tables for classification] for the establishment of a 
    specialized environmental 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 depleted uranium.
        ``(6) In response to concerns about the lack of objective 
    research on Gulf War illnesses, Congress included research 
    provisions in the National Defense Authorization Act for Fiscal Year 
    1995 [Pub. L. 103-337, see Tables for classification], which was 
    passed by the House and Senate in September 1994. This legislation 
    requires the Secretary of Defense to provide research grants to non-
    Federal researchers to support three types of studies of the Gulf 
    War syndrome. The first type of study will be an epidemiological 
    study or studies of the incidence, prevalence, and nature of the 
    illness and symptoms and the risk factors associated with symptoms 
    or illnesses. This will include illnesses among spouses and birth 
    defects and illnesses among offspring born before and after the Gulf 
    War. The second group of studies shall be conducted to determine the 
    health consequences of the use of pyridostigmine bromide as a 
    pretreatment antidote enhancer during the Persian Gulf War, alone or 
    in combination with exposure to pesticides, environmental toxins, 
    and other hazardous substances. The final group of studies shall 
    include clinical research and other studies on the causes, possible 
    transmission, and treatment of Gulf War syndrome, and will include 
    studies of veterans and their spouses and children.
        ``(7) Further research and studies must be undertaken to 
    determine the underlying causes of the illnesses suffered by Persian 
    Gulf War veterans and, pending the outcome of such research, 
    veterans who are seriously ill as the result of such illnesses 
    should be given the benefit of the doubt and be provided 
    compensation benefits to offset the impairment in earnings 
    capacities they may be experiencing.
``SEC. 103. PURPOSES.
    ``The purposes of this title [see Short Title of 1994 Amendments 
note under section 101 of this title] 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 illnesses;
        ``(3) to promote greater outreach to Persian Gulf War veterans 
    and their families to inform them of ongoing research activities, as 
    well as the services and benefits to which they are currently 
    entitled; and
        ``(4) to ensure that research activities and accompanying 
    surveys of Persian Gulf War veterans are appropriately funded and 
    undertaken by the Department of Veterans Affairs.
``SEC. 104. DEVELOPMENT OF MEDICAL EVALUATION PROTOCOL.
    ``(a) Uniform Medical Evaluation Protocol.--(1) The Secretary of 
Veterans Affairs shall develop and implement a uniform and comprehensive 
medical evaluation protocol that will ensure appropriate medical 
assessment, diagnosis, and treatment of Persian Gulf War veterans who 
are suffering from illnesses the origins of which are (as of the date of 
the enactment of this Act [Nov. 2, 1994]) unknown and that may be 
attributable to service in the Southwest Asia theater of operations 
during the Persian Gulf War. The protocol shall include an evaluation of 
complaints relating to illnesses involving the reproductive system.
    ``(2) If such a protocol is not implemented before the end of the 
120-day period beginning on the date of the enactment of this Act [Nov. 
2, 1994], the Secretary shall, before the end of such period, submit to 
the Committees on Veterans' Affairs of the Senate and House of 
Representatives a report as to why such a protocol has not yet been 
developed.
    ``(3)(A) The Secretary shall ensure that the evaluation under the 
protocol developed under this section is available at all Department 
medical centers that have the capability of providing the medical 
assessment, diagnosis, and treatment required under the protocol.
    ``(B) The Secretary may enter into contracts with non-Department 
medical facilities for the provision of the evaluation under the 
protocol.
    ``(C) In the case of a veteran whose residence is distant from a 
medical center described in subparagraph (A), the Secretary may provide 
the evaluation through a Department medical center described in that 
subparagraph and, in such a case, may provide the veteran the travel and 
incidental expenses therefor pursuant to the provisions of section 111 
of title 38, United States Code.
    ``(4)(A) If the Secretary is unable to diagnose the symptoms or 
illness of a veteran provided an evaluation, or if the symptoms or 
illness of a veteran do not respond to treatment provided by the 
Secretary, the Secretary may use the authority in section 1703 of title 
38, United States Code, in order to provide for the veteran to receive 
diagnostic tests or treatment at a non-Department medical facility that 
may have the capability of diagnosing or treating the symptoms or 
illness of the veteran. The Secretary may provide the veteran the travel 
and incidental expenses therefor pursuant to the provisions of section 
111 of title 38, United States Code.
    ``(B) The Secretary shall request from each non-Department medical 
facility that examines or treats a veteran under this paragraph such 
information relating to the diagnosis or treatment as the Secretary 
considers appropriate.
    ``(5) In each year after the implementation of the protocol, the 
Secretary shall enter into an agreement with the National Academy of 
Sciences under which agreement appropriate experts shall review the 
adequacy of the protocol and its implementation by the Department of 
Veterans Affairs.
    ``(b) Relationship to Other Comprehensive Clinical Evaluation 
Protocols.--The Secretary, in consultation with the Secretary of 
Defense, shall ensure that the information collected through the 
protocol described in this section is collected and maintained in a 
manner that permits the effective and efficient cross-reference of that 
information with information collected and maintained through the 
comprehensive clinical protocols of the Department of Defense for 
Persian Gulf War veterans.
    ``(c) Case Definitions and Diagnoses.--The Secretary shall develop 
case definitions or diagnoses for illnesses associated with the service 
described in subsection (a)(1). The Secretary shall develop such 
definitions or diagnoses at the earliest possible date.
``SEC. 105. OUTREACH TO PERSIAN GULF VETERANS.
    ``(a) In General.--The Secretary of Veterans Affairs shall implement 
a comprehensive outreach program to inform Persian Gulf War veterans and 
their families of the medical care and other benefits that may be 
provided by the Department of Veterans Affairs and the Department of 
Defense arising from service in the Persian Gulf War.
    ``(b) Newsletter.--(1) The outreach program shall include a 
newsletter which shall be updated and distributed at least semi-annually 
and shall be distributed to the veterans listed on the Persian Gulf War 
Veterans Health Registry. The newsletter shall include summaries of the 
status and findings of Government sponsored research on illnesses of 
Persian Gulf War veterans and their families, as well as on benefits 
available to such individuals through the Department of Veterans 
Affairs. The newsletter shall be prepared in consultation with veterans 
service organizations.
    ``(2) The requirement under this subsection for the distribution of 
the newsletter shall terminate on December 31, 2003.
    ``(c) Toll-Free Number.--The outreach program shall include 
establishment of a toll-free telephone number to provide Persian Gulf 
War veterans and their families information on the Persian Gulf War 
Veterans Health Registry, health care and other benefits provided by the 
Department of Veterans Affairs, and such other information as the 
Secretary considers appropriate. Such toll-free telephone number shall 
be established not later than 90 days after the date of the enactment of 
this Act [Nov. 2, 1994].
``SEC. 107. EVALUATION OF HEALTH STATUS OF SPOUSES AND CHILDREN OF 
        PERSIAN GULF WAR VETERANS.
    ``(a) Evaluation Program.--Subject to subsection (c), the Secretary 
of Veterans Affairs shall conduct a program to evaluate the health 
status of spouses and children of Persian Gulf War veterans. Under the 
program, the Secretary shall provide for the conduct of diagnostic 
testing and appropriate medical examinations of any individual--
        ``(1) who is the spouse or child of a veteran who--
            ``(A) is listed in the Persian Gulf War Veterans Registry 
        established under section 702 of Public Law 102-585 [set out in 
        a note under section 527 of this title]; and
            ``(B) is suffering from an illness or disorder;
        ``(2) who is apparently suffering from, or may have suffered 
    from, an illness or disorder (including a birth defect, miscarriage, 
    or stillbirth) which cannot be disassociated from the veteran's 
    service in the Southwest Asia theater of operations; and
        ``(3) who, in the case of a spouse, has granted the Secretary 
    permission to include in the Registry relevant medical data 
    (including a medical history and the results of diagnostic testing 
    and medical examinations) and such other information as the 
    Secretary considers relevant and appropriate with respect to such 
    individual.
    ``(b) Duration of Program.--The program shall be carried out during 
the period beginning on November 1, 1994, and ending on December 31, 
2003.
    ``(c) Funding Limitation.--The amount spent for the program under 
subsection (a) may not exceed $2,000,000.
    ``(d) Contracting.--The Secretary may provide for the conduct of 
testing and examinations under subsection (a) through appropriate 
contract arrangements, including fee arrangements described in section 
1703 of title 38, United States Code.
    ``(e) Standard Protocols and Guidelines.--The Secretary shall seek 
to ensure uniform development of medical data through the development of 
standard protocols and guidelines for such testing and examinations. If 
such protocols and guidelines have not been adopted before the end of 
the 120-day period beginning on the date of the enactment of this Act 
[Nov. 2, 1994], the Secretary shall, before the end of such period, 
submit to the Committees on Veterans' Affairs of the Senate and House of 
Representatives a report as to why such protocols and guidelines have 
not yet been developed.
    ``(f) Entry of Results in Registry.--The results of diagnostic 
tests, medical histories, and medical examinations conducted under 
subsection (a) shall be entered into the Persian Gulf War Veterans 
Health Registry.
    ``(g) Outreach.--The Secretary shall conduct such outreach 
activities as the Secretary determines necessary for the purposes of the 
program. In conducting such outreach activities, the Secretary shall 
advise that medical treatment is not available under the program.
    ``(h) Use Outside Department of Standard Protocols and Guidelines.--
The Secretary shall--
        ``(1) make the standard protocols and guidelines developed under 
    this section available to any entity which requests a copy of such 
    protocols and guidelines; and
        ``(2) enter into the registry the results of any examination of 
    the spouse or child of a veteran who served in the Persian Gulf 
    theater which a licensed physician certifies was conducted using 
    those standard protocols and guidelines.
    ``(i) Report to Congress.--Not later than July 31, 1999, the 
Secretary shall submit to the Committees on Veterans' Affairs of the 
Senate and House of Representatives a report on activities with respect 
to the program, including the provision of services under subsection 
(d).
    ``(j) Definitions.--For purposes of this section, the terms `child' 
and `spouse' have the meanings given those terms in paragraphs (4) and 
(31), respectively, of section 101 of title 38, United States Code.
``SEC. 109. SURVEY OF PERSIAN GULF VETERANS.
    ``(a) In General.--The Secretary of Veterans Affairs may carry out a 
survey of Persian Gulf veterans to gather information on the incidence 
and nature of health problems occurring in Persian Gulf veterans and 
their families.
    ``(b) Coordination With Department of Defense.--Any 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 defined in section 101(33) of title 38, United States Code.
``SEC. 110. AUTHORIZATION FOR EPIDEMIOLOGICAL STUDIES.
    ``(a) Study of Health Consequences of Persian Gulf Service.--If the 
National Academy of Sciences includes in the report required by section 
706(b) of the Veterans Health Care Act of 1992 (Public Law 102-585) [set 
out in a note under section 527 of this title] a finding that there is a 
sound basis for an epidemiological study or studies on the health 
consequences of service in the Persian Gulf theater of operations during 
the Persian Gulf War and recommends the conduct of such a study or 
studies, the Secretary of Veterans Affairs is authorized to carry out 
such study.
    ``(b) Oversight.--(1) The Secretary shall seek to enter into an 
agreement with the Medical Follow-Up Agency (MFUA) of the Institute of 
Medicine of the National Academy 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 agreement under 
paragraph (1) with the entity specified in that paragraph, the Secretary 
shall enter into an agreement described in that paragraph with another 
appropriate scientific organization which does not have a connection to 
the Department of Veterans Affairs. In such a case, the Secretary 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, notice 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 Academy of Sciences and the contractor for the study, considers 
relevant to the study.
    ``(d) Authorization.--There are authorized to be appropriated to the 
Department such sums as are necessary for the conduct of studies 
described in subsection (a).''
    [Pub. L. 104-262, title III, Sec. 352(b), Oct. 9, 1996, 110 Stat. 
3211, provided that: ``Any diagnostic testing and medical examinations 
undertaken by the Secretary of Veterans Affairs for the purpose of the 
study required by subsection (a) of such section [section 107(a) of Pub. 
L. 103-446, set out above] during the period beginning on October 1, 
1996, and ending on the date of the enactment of this Act [Oct. 9, 1996] 
is hereby ratified.'']


           Report to Congress on Intention To Pay Compensation

    Section 106(c) of Pub. L. 103-446 directed Secretary of Veterans 
Affairs, not later than 60 days after Nov. 2, 1994, to submit to 
Congress a report stating whether or not the Secretary intended to pay 
compensation as provided in this section.

                        Executive Order No. 12961

    Ex. Ord. No. 12961, May 26, 1995, 60 F.R. 28507, which established 
the Presidential Advisory Committee on Gulf War Veterans' Illnesses, was 
revoked by Ex. Ord. No. 13138, Sec. 3(g), Sept. 30, 1999, 64 F.R. 53880, 
set out as a note under section 14 of the Appendix to Title 5, 
Government Organization and Employees.

Ex. Ord. No. 13034. Extension of Presidential Advisory Committee on Gulf 
                         War Veterans' Illnesses

    Ex. Ord. No. 13034, Jan. 30, 1997, 62 F.R. 5137, provided:
    By the authority vested in me as President by the Constitution and 
the laws of the United States of America, it is hereby ordered as 
follows:
    Section 1. Extension. The Presidential Advisory Committee on Gulf 
War Veterans' Illnesses (the ``Committee''), established pursuant to 
Executive Order 12961 [set out above] of May 26, 1995, is hereby 
extended for the purposes set forth herein. All provisions of that order 
relating to membership and administration shall remain in effect. All 
Committee appointments, as well as the President's designation of a 
Chairperson, shall remain in effect. The limitations set forth in 
section 2(c)-(e) and section 4(a) of Executive Order 12961 shall also 
remain in effect. The Committee shall remain subject to the Federal 
Advisory Committee Act, as amended, 5 U.S.C. App.
    Sec. 2. Functions. (a) The Committee shall report to the President 
through the Secretary of Defense, the Secretary of Veterans Affairs, and 
the Secretary of Health and Human Services.
    (b) The Committee shall have two principal roles:
    (1) Oversight of the ongoing investigation being conducted by the 
Department of Defense with the assistance, as appropriate, of other 
executive departments and agencies into possible chemical or biological 
warfare agent exposures during the Gulf War; and
    (2) Evaluation of the Federal Government's plan for and progress 
towards the implementation of the Committee's recommendations contained 
in its Final Report submitted on December 31, 1996.
    (c) The Committee shall provide advice and recommendations related 
to its oversight and evaluation responsibilities.
    (d) The Committee may also provide additional advice and 
recommendations prompted by any new developments related to its original 
functions as set forth in section 2(b) of Executive Order 12961.
    (e) The Committee shall submit by letter a status report by April 
30, 1997, and a final supplemental report by October 31, 1997, unless 
otherwise directed by the President.
    Sec. 3. General Provisions. (a) The Committee shall terminate 30 
days after submitting its final supplemental report.
    (b) This order is intended only to improve the internal management 
of the executive branch and it is not intended to create any right, 
benefit or trust responsibility, substantive or procedural, enforceable 
at law or equity by a party against the United States, its agencies, its 
officers, or any person.
                                                     William J. Clinton.

                  Section Referred to in Other Sections

    This section is referred to in section 1113 of this title.
