From: "\"Doc\" Bruce K. Melson" <docmelson@docmelson.com>

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VETERANS BENEFITS ACT OF 2001



TITLE II-COMPENSATION PROVISIONS
1. Add Diabetes Mellitus (Type 2) to the list of diseases presumed to be
service-connected in Vietnam veterans exposed to herbicide agents.

2. Expand, effective April 1, 2002, the definition of undiagnosed illnesses
for Persian Gulf War veterans to include fibromyalgia, chronic fatigue
syndrome, and chronic multisymptom illness and any other illness that cannot
be clearly defined; signs or symptoms that may be a manifestation of
undiagnosed illness include fatigue, unexplained rashes or other
dermatological signs or symptoms, headache, muscle pain, joint pain,
neurologic signs or symptoms, neuropsychological signs or symptoms, signs or
symptoms involving the respiratory system (upper or lower), sleep
disturbances, gastrointestinal signs or symptoms, cardiovascular signs or
symptoms, abnormal weight loss, and/or menstrual disorders.

3. Authorize the Secretary of Veterans Affairs to protect the grant of
service connection of a Persian Gulf War veteran who participates in a
Department of Veterans Affairs (VA)-sponsored medical research project.


TITLE III-ADMINISTRATION OF U.S. COURT OF APPEALS FOR VETERANS CLAIMS
1. Allow the Court to impose registration fees on persons participating in
Court-sponsored activities, including judicial conferences.

2. Provide the Court with the authority to use practice and registration
fees for the purposes of disciplinary matters, and for defraying the expenses
of judicial conferences and other activities to support and foster
bench-and-bar relationships, veterans law or the work of the Court.


TITLE IV-OTHER MATTERS
1. Authorize the Secretary to pay unclaimed National Service Life Insurance
and United States Government Life Insurance proceeds to an alternate
beneficiary when the first beneficiary cannot be located within three years
of the death of the insured.

2. Extend to September 30, 2006, the copayment requirement for outpatient
prescription medications.

3. Make the availability of funds from the Department of Veterans Affairs
Health Services Improvement Fund subject to appropriations effective October
1, 2002.

4. Extend to December 31, 2005, VA's direct home loan program for Native
American veterans living on trust lands, and eliminate the requirement for VA
to have a separate memorandum of understanding (MOUE) with tribal authorities
if another federal agency has a MOUE which substantially complies with VA's
requirement.

5. Modify the requirement for loan assumption language in home loan
documents.

6. Eliminate the requirement for veterans to furnish the Secretary of
Veterans Affairs with a copy of the notice of appeal filed with the US
Court of Appeals for Veterans Claims.

7. Require the Secretary to establish a two-year nationwide pilot program to
expand the available hours of VA's 1-800 toll-free information service, and
to assess the extent to which a demand for such service exists.

8. Make technical and clerical amendments to title 38, United States Code.

9. Codify recurring provisions in annual Department of Veterans Affairs
Appropriations Acts.


BACKGROUND AND DISCUSSION

TITLE I-ANNUAL COST-OF-LIVING ADJUSTMENT IN COMPENSATION AND DIC RATES
Increase in rates of disability compensation and dependency and indemnity
compensation- Section 101 of the bill would increase, effective December 1,
2001, the rates of compensation for service-connected disabilities and the
rates of dependency and indemnity compensation (DIC) for surviving spouses
and children of veterans who die of service-connected causes, as well as the
additional amounts for dependents and survivors, and clothing allowances for
certain veterans. The percentage of increase would be the same as that
automatically received by Social Security recipients.

The Committee annually reviews the service-connected disability compensation
and DIC programs to ensure that the benefits provide reasonable and adequate
compensation for disabled veterans and their families. Based on this review,
the Congress acts annually to provide a cost-of-living adjustment (COLA) in
compensation and DIC benefits. The Congress has provided annual increases in
these rates for every fiscal year since 1976.


TITLE II-COMPENSATION PROVISIONS
Presumption that Diabetes Mellitus (Type 2) is service-connected-Section 201
would codify VA's July 9, 2001, regulation providing benefits for Vietnam
veterans with Type 2 diabetes. In adding Type 2 diabetes to the list of
diseases presumed to be service-connected for veterans exposed to herbicides
in Vietnam, veterans will receive priority VA health care and depending on
the severity of their illness, disability compensation. VA estimates that
about nine percent of the 2.3 million Vietnam veterans still alive have Type
2 diabetes. Approximately 16 percent of veterans currently receiving care in
VA medical facilities have been diagnosed with diabetes.

The Agent Orange Act of 1991, Public Law 102-4, directed VA to seek to enter
into an agreement with the National Academy of Sciences (AS) to review,
summarize and evaluate the scientific evidence concerning the association
between exposure to herbicides and each disease suspected to be associated
with such exposure. AS conducted comprehensive reviews and evaluations of
available literature. AS published its initial report in 1993, with updates
published approximately every two years. In November 2000, the NAS' Institute
of Medicine found a `limited/suggestive' association between adult onset, or
Type 2, diabetes and exposure to Agent Orange and other herbicides used in
Vietnam. The Committee believes the presumption established in regulation
should be made permanent by statute.

Inclusion of illnesses that cannot be clearly defined in presumption of
service connection for Gulf War veterans-Section 202 expands the definition
of `undiagnosed illness' for Persian Gulf War veterans to include
fibromyalgia, chronic fatigue syndrome, and chronic multisymptom illness, as
well as any other illness that cannot be clearly defined.

Public Law 103-446 gave the Secretary the authority to compensate a Persian
Gulf War veteran who suffers from disabilities that cannot be diagnosed or
clearly defined, when other causes cannot be identified. In interpreting this
law, VA issued General Counsel Opinion 8-98 holding that only disabilities
that cannot be attributed to `any known clinical diagnosis' could be
compensated. Many Gulf War veterans, however, report disabilities related to
poorly understood multisymptom disabilities that one physician may classify
as `undiagnosed', and that another physician may diagnose as fibromyalgia or
chronic fatigue syndrome. VA data indicates that approximately 2,000 Gulf War
veterans diagnosed with chronic fatigue syndrome, 1,000 diagnosed with
irritable bowel syndrome and 400 diagnosed with fibromyalgia have been denied
service-connected compensation benefits for undiagnosed conditions.

This provision would also apply to disabilities resulting from a chronic
multisymptom illness, such as those described by Fukada et al in `Chronic
Multisymptom Illness Affecting Air Force Veterans of the Gulf War', JAMA
1998; 280:981-988, and Reid et al in `Multiple Chemical Sensitivity and
Chronic Fatigue Syndrome in British Gulf War Veterans', American Journal of
Epidemiology 2001; 153:604-609. The Committee notes that chronic multisymptom
illness may include symptoms attributed by some researchers to `multiple
chemical sensitivity.' While the Committee recognizes there is not a
generally accepted medical definition for multiple chemical sensitivity, the
Committee bill explicitly includes such signs and symptoms.

This section would allow a more consistent interpretation of `undiagnosed
illness' in keeping with Congressional intent, and would take effect for
benefits payable on April 1, 2002. The bill also lists a number of symptoms
that have been associated with undiagnosed or poorly defined illnesses in
Gulf War veterans, to include fatigue, unexplained rashes or other
dermatological signs or symptoms, headache, muscle pain, joint pain,
neurologic signs or symptoms, neuropsychological signs or symptoms, signs or
symptoms involving the respiratory system (upper or lower), sleep
disturbances, gastrointestinal signs or symptoms, cardiovascular signs or
symptoms, abnormal weight loss, and/or menstrual disorders.

The Committee directs the Secretary to submit a report on October 1, 2002, on
the Department's implementation of this section of the bill. The report would
include the number of claims filed pertaining to this section, disposition of
such claims, and other appropriate data.

Current law provides that both diagnosed and undiagnosed disabilities be
evaluated under the relevant medical criteria appropriate to each. This bill
would not change that requirement.

Preservation of service connection for undiagnosed illnesses to provide for
participation in research projects by Gulf War veterans-Section 203 would
authorize the Secretary to protect the grant of service connection for a
Persian Gulf War veteran who participates in a VA-sponsored medical research
project. In the case of a Gulf War veteran being compensated for an
undiagnosed illness, VA has taken the position that current law prevents them
from acting to protect the individual's service-connected grant if, as a
result of participating in a medical research study, the condition is
diagnosed. Medical research studies are designed to increase knowledge of
human disease and appropriate treatment. They often provide no direct benefit
to individual research subjects, but serve a broader humanitarian goal.

The Committee intends that this section would give the Secretary the
authority to protect the service-connected character of benefits received by
veterans participating in such studies in order to broaden participation by
veterans in medical research studies of rare or ill-defined conditions, such
as Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig's Disease). The Committee
intends by preserving the service-connected character of the veteran's
disabilities, that in the event of their death from such illnesses, survivors
would qualify for survivor's benefits.

 

 

 

"When the way comes to an end, then change - having changed, you pass through."

      I. Ching

 

 Bruce "Doc". Melson

http://www.docmelson.com/

http://www.docmelson.com/MedicsPlace/index.htm