§1117. Compensation for disabilities occurring in Persian Gulf War veterans
(a)(1) The Secretary may pay compensation under this subchapter to a Persian Gulf veteran with a qualifying chronic disability that became manifest to any degree at any time.
(2) For purposes of this subsection, the term "qualifying chronic disability" means a chronic disability resulting from any of the following (or any combination of any of the following):
(A) An undiagnosed illness.
(B) A medically unexplained chronic multisymptom illness (such as chronic fatigue syndrome, fibromyalgia, and irritable bowel syndrome) that is defined by a cluster of signs or symptoms.
(C) Any diagnosed illness that the Secretary determines in regulations prescribed under subsection (c) warrants a presumption of service-connection.
(b)(1) Whenever the Secretary determines under section 1118(c) 1 of this title that a presumption of service connection previously established under this section is no longer warranted-
(A) a veteran who was awarded compensation under this section 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 on September 30, 2011.
(c)(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.
(d) If a Persian Gulf veteran at a medical facility of the Department presents with any one symptom associated 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 diagnostic actions the personnel determine appropriate.
(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, Afghanistan, Israel, Egypt, Turkey, Syria, or Jordan, during the Persian Gulf War.
(g) For purposes of this section, signs or symptoms that may be a manifestation of an undiagnosed illness or a chronic multisymptom illness include the following:
(1) Fatigue.
(2) Unexplained rashes or other dermatological signs or symptoms.
(3) Headache.
(4) Muscle pain.
(5) Joint pain.
(6) Neurological signs and symptoms.
(7) Neuropsychological signs or symptoms.
(8) Signs or symptoms involving the upper or lower respiratory system.
(9) Sleep disturbances.
(10) Gastrointestinal signs or symptoms.
(11) Cardiovascular signs or symptoms.
(12) Abnormal weight loss.
(13) Menstrual disorders.
(h)(1) If the Secretary determines with respect to a medical research project sponsored by the Department that it is necessary for the conduct of the project that Persian Gulf veterans in receipt of compensation under this section or section 1118 of this title participate in the project without the possibility of loss of service connection under either such section, the Secretary shall provide that service connection granted under either such section for disability of a veteran who participated in the research project may not be terminated. Except as provided in paragraph (2), notwithstanding any other provision of law any grant of service-connection protected under this subsection shall remain service-connected for purposes of all provisions of law under this title.
(2) Paragraph (1) does not apply in a case in which-
(A) the original award of compensation or service connection was based on fraud; or
(B) it is clearly shown from military records that the person concerned did not have the requisite service or character of discharge.
(3) The Secretary shall publish in the Federal Register a list of medical research projects sponsored by the Department for which service connection granted under this section or section 1118 of this title may not be terminated pursuant to paragraph (1).
(i)(1) The Secretary shall take such actions as may be necessary to ensure that health care personnel of the Department are appropriately trained to effectively carry out this section.
(2) Not less frequently than once each year, the Secretary shall submit to Congress a report on the actions taken by the Secretary to carry out paragraph (1).
(Added
Editorial Notes
References in Text
Section 1118(c) of this title, referred to in subsec. (b)(1), was repealed by
Amendments
2022-Subsec. (a)(1).
"(A) during service on active duty in the Armed Forces in the Southwest Asia theater of operations during the Persian Gulf War; or
"(B) to a degree of 10 percent or more during the presumptive period prescribed under subsection (b)."
Subsec. (a)(2)(C).
Subsecs. (b), (c).
Subsec. (d).
Subsec. (f).
Subsec. (i).
2006-Subsec. (h)(1).
2001-Subsec. (a).
"(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)."
Subsec. (c)(1).
Subsec. (c)(1)(A).
Subsec. (c)(2).
Subsec. (g).
Subsec. (h).
1998-Subsecs. (c) to (f).
Statutory Notes and Related Subsidiaries
Effective Date of 2001 Amendment
Regulations
Agreement With National Academy of Sciences Regarding Evaluation of Health Consequences of Service in Southwest Asia During the Persian Gulf War
Improving Effectiveness of Care of Persian Gulf War Veterans
"(a)
"(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)
"(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
"SEC. 1603. AGREEMENT WITH NATIONAL ACADEMY OF SCIENCES.
"(a)
"(b)
"(c)
"(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 may have been exposed by reason of service in the Southwest Asia theater of operations during the Persian Gulf War or, after September 11, 2001, in another Post-9/11 Global Theater of Operations; 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)
"(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)
"(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)
"(g)
"(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)
"(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)
"(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) In each report under this subsection submitted after the date of the enactment of this paragraph [Oct. 13, 2010], any determinations, results, and recommendations as described in paragraph (2) shall be submitted separately as follows:
"(A) For the Southwest Asia theater of operations for the period of the Persian Gulf War ending on September 11, 2001.
"(B) For the Post-9/11 Global Theaters of Operations for the period of the Persian Gulf War beginning on September 11, 2001.
"(6) 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)
"(k)
"(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.
"(l)
"(1) The term 'Persian Gulf War' has the meaning given that term in section 101(33) of title 38, United States Code.
"(2) The term 'Post-9/11 Global Theater of Operations' means Afghanistan, Iraq, and any other theater of operations for which the Global War on Terrorism Expeditionary Medal is awarded for service.
"[SEC. 1604. Repealed.
Pub. L. 111–275, title VIII, §806(b)(3), Oct. 13, 2010, 124 Stat. 2893
.]
"SEC. 1605. DEFINITIONS.
"In this title [enacting section 1118 of this title, amending this section and section 1113 of this title, and enacting this note and provisions set out as a note under section 101 of 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."
Persian Gulf War Veterans' Benefits
"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
"(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 [
"(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)
"(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 sections 1703A, 8111, and 8153 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)
"(c)
"SEC. 105. OUTREACH TO PERSIAN GULF VETERANS.
"(a)
"(b)
"(2) The requirement under this subsection for the distribution of the newsletter shall terminate on December 31, 2003.
"(c)
"SEC. 107. EVALUATION OF HEALTH STATUS OF SPOUSES AND CHILDREN OF PERSIAN GULF WAR VETERANS.
"(a)
"(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
"(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)
"(c)
"(d)
"(e)
"(f)
"(g)
"(h)
"(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)
"(j)
"SEC. 109. SURVEY OF PERSIAN GULF VETERANS.
"(a)
"(b)
"(c)
"SEC. 110. AUTHORIZATION FOR EPIDEMIOLOGICAL STUDIES.
"(a)
"(b)
"(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)
"(d)
[
Report to Congress on Intention To Pay Compensation
Section 106(c) of
Executive Documents
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, §3(g), Sept. 30, 1999, 64 F.R. 53880, formerly set out as a note under section 1013 of 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:
(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.
(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.