provide legal notice to the public or judicial notice to the courts. This Executive Order requires that DoD conduct a study to assess the conditions at the K-2 Air Base, to identify any toxic substances that may have contaminated the Air Base, and to conduct an epidemiological study on potential health consequences for those deployed to K-2 Air Base. NOVA v. Sec'y of Veterans Affairs, 669 F.3d 1340, 1348 (Fed. In addition, the ISA included both children and adults and had a much broader scope. (This is not a toll-free telephone number. (ii) Afghanistan, Syria, Djibouti, or Uzbekistan on or after September 19, 2001 during the Persian Gulf War as defined in § 3.2(i). The practice per VA Directive 0215 is that the VA workgroup on NASEM reports reviews pertinent literature that has been published during the time following the NASEM literature review and writing/publication of the report. Found inside – Page 30Hearings Before the Committee United States. Congress. ... What I am calling your attention to is we are leaving out the diseases such as cancer, paralysis, ... documents in the last year, 40 In addition, new paragraph (a)(3) provides the presumption that a veteran with a qualifying period of service was exposed to fine, particulate matter in service. or you may also comment via Regulations.gov at, %PDF-1.5 %���� The Department of Veterans Affairs (VA) amends its adjudication regulations regarding presumptive service connection, adding certain diseases associated with contaminants present in the base water supply at U.S. Marine Corps Base Camp Lejeune (Camp Lejeune), North Carolina, from August 1, 1953, to December 31, 1987. For adults there is evidence of acceleration of lung function decline, but inconsistent evidence for asthma development. ... What VA doesn’t say is that their definition of the ‘Gulf War era’ includes every veteran who has served from 1990 to the present, not just 1990-1991 Gulf War veterans. Found inside – Page 114Reporting Every state , the District of Columbia , Puerto Rico , Guam , the U.S. Virgin Islands , and American Samoa have laws that require the reporting of ... 2006. Found inside – Page 1337Every member of the fire department who Refusal of shall , at the time of any fire ... the orders of the senior assistant engineer present , and every ... Inhalation Toxicology, 2020, VOL. Found inside – Page 783Every member of the fire department , while such member , shall be exempt from ... shall be presumptive evidence before all courts and officers , civil and ... Veterans exposed to harmful burn pit smoke while serving in certain overseas war zones will for the first time get presumptive disability benefits status under a new announcement by the Department of Veterans Affairs on Monday.. However, VA has not identified literature to support inclusion of sleep apnea as a presumption at this time. Lastly, new paragraph (b) provides the three circumstances under which presumptive service connection will not be granted. Federal Register issue. ... veterans, and military families. 13. To incorporate the full range of evidence, human and non-human studies were considered. Understanding the immediate needs and concerns of the Gulf War cohort and airborne exposures in service, VA reviewed the most commonly claimed chronic conditions related to airborne hazards for disability compensation benefits (as described further below) and found that asthma, sinusitis, and rhinitis were the most commonly claimed and granted respiratory conditions, and these conditions also most closely represented the symptomatology of chronic persistent cough, shortness of breath (dyspnea), and wheeze. Since chronic rhinosinusitis is also a disease that affects the nasal cavity and paranasal sinuses similar to chronic sinusitis and rhinitis, VA will adjudicate claims for chronic rhinosinusitis under the Diagnostic Code (DC) for sinusitis in 38 CFR 4.97, Schedule of ratings-respiratory system under DCs 6510-6514 as appropriate.Start Printed Page 42731, Moreover, these three diseases must not be seasonal or an acute allergic manifestation in nature, as pursuant to 38 CFR 3.380, “[s]easonal and other acute allergic manifestations subsiding on the absence of or removal of the allergen are generally to be regarded as acute diseases, healing without residuals.”. 11. “Human studies” refers to observational, case-control, cohort, and meta-analytic studies involving people. This interim final rule contains no provisions constituting a collection of information under the Paperwork Reduction Act of 1995 (44 U.S.C. 3501-3521). %PDF-1.5 %âãÏÓ VA will utilize a phased approach in reviewing these disabilities to explore additional studies and data. Agent Orange was a tactical herbicide the U.S. military used to clear leaves and vegetation for military operations mainly during the Vietnam War. 292 0 obj <> endobj In addition, this approach is also consistent with some other presumptions of service connection. [10] The Secretary's broad Start Printed Page 42729discretion weighs more strongly here than it would if the science related to the composition and duration of actual particulate matter and airborne hazard exposures of service members were more robust. In response to the 2020 NASEM report, VA analyzed respiratory claims data for veterans who were deployed to Southwest Asia theater of operations and other locations and compared this data to a similar cohort of veterans who served during the same period but who had never deployed. As previously noted, the VA Technical Working Group identified knowledge gaps from the 2020 NASEM report and felt additional review of the literature, of relevance to service members and veterans, was warranted. 2020;63:980-987. Document Drafting Handbook Expansion will be encouraged through periodic communications through the MyPay pay notifications with both active duty service members and veterans, and through press releases as well as through VA's Health Outcomes Military Exposures website (https://www.publichealth.va.gov/​exposures/​burnpits/​index.asp). In addition, there is no minimum time limit required for the length of military deployment. NASEM, Respiratory Health Effects of Airborne Hazards Exposures in the Southwest Asia Theater of Military Operations (2020), https://doi.org/​10.17226/​25837. . Gulf War Illness and VA Disability. The presumption of PM2.5 exposure will also include those deployed to Afghanistan, Syria, and Djibouti on or after September 19, 2001, the earliest date when service members were deployed in these locations. https://www.regulations.gov/commenton/VA-2021-VBA-0015-0001. The fact sheet concluded that there was inconclusive evidence that there is an increased risk of chronic respiratory conditions associated with military deployment to K-2 Air Base. Chairman Takano, Ranking Member Bost, and distinguished members of the full committee, on behalf of our National Commander, James W. “Bill” Oxford and our nearly 2 million members, we thank you for the opportunity to comment on the following pieces on pending legislation. - Determination of the cause of death is the medical responsibility of a physician. electronic version on GPO’s govinfo.gov. World Health Organization (WHO) authorized the publication of the International Classification of Diseases 10th Revision (ICD-10), which was implemented for mortality coding and classification from death certificates. documents in the last year, 433 The annual injury/illness rate among American workers has decreased by 65 percent since 1973. 553(b)(B) and (d)(3), VA has found that there is good cause to publish this rule without prior opportunity for comment and to publish this rule with an immediate effective date. There is no set guidance on deployment and this varies widely by service: some smaller units may deploy for two weeks or less for specialized missions (special operations, construction units), while larger units may deploy for three to six months in the case of the U.S. Air Force, while some Army units have deployed in extreme cases for up to 15 months. 4. This fact sheet referenced the results of three declassified assessments conducted by DoD, namely the Environmental Site Characterization and an Operational Health Risk Assessment completed in 2001 and follow-up Post-Deployment Occupational and Environmental Health Site Assessments completed in 2002 and 2004. The Secretary hereby certifies that this interim final rule will not have a significant economic impact on a substantial number of small entities as they are defined in the Regulatory Flexibility Act (5 U.S.C. Tuesday, May 25, 2021. 38, par. The U.S. developed a Clinical Modification (CM) (ICD-10-CM) for medical diagnoses based on WHO's ICD-10. Found inside – Page 184... maybe the present process in some States , certainly not every State , may impede the process of occupational disease claims . Some of the old laws that ... In that year the Congress enacted a powerful and far-reaching law - the Occupational Safety and Health Act of 1970 (OSH Act). (3) Presumption of exposure. This information is not part of the official Federal Register document. One of the VA Secretary's priorities is to address the needs of the Gulf War cohort and to address the imminent need for care, services, and benefits to these veterans that is long overdue. During the 1990s, the federal government and more than half the states enacted truth-in-sentencing and three strikes laws. NASEM, Long-Term Health Consequences of Exposure to Burn Pits in Iraq and Afghanistan (2011), https://doi.org/​10.17226/​13209. 808(2). Found inside – Page 44Yet when they present with work - related illnesses , Federal law denies them ... states have already enacted similar disability presumption laws for state ... (2) Chronic diseases associated with exposure to particulate matter. How to use presumptive in a sentence. The presumption holds that if a veteran served in the locations listed above between August 2, 1990 and December 31, 2021, and they experience certain signs or symptoms, VA will presume that the veteran’s Gulf War service caused their condition. Presumptive definition is - based on probability or presumption. Co., 463 U.S. 29, 43 (1983)). Found inside – Page 30I think all of those are embraced in the present terminology . Mr. PATTERSON . Even brain tumors . Every form of tumor is in here . 11 present specific evidence of the current disability, the occurrence 12 during service, and a link between the claimed condition and 13 military service; and 14 WHEREAS, United States Senate Bill No. VA adheres to established internal procedure requiring it to review and respond to the recommendations in NASEM reports as outlined in VA Directive 0215, Management of Reports Issued by the National Academies of Sciences, Engineering, and Medicine. Public Law … The presumption includes (1) MUCMIs; (2) undiagnosed illnesses; and (3) certain infectious diseases. [4] . It was also noted that a significant number of individuals with burns to the skin also have inhalational injury, and the presence of inhalational injury is a determinant of mortality. It is recognized that the source of fine particles and their resultant chemical composition are important considerations beyond particle size that should be considered yet there is a paucity of these data. In accordance with 5 U.S.C. The VA workgroup also considered the onset of asthma, rhinitis, and sinusitis after service members separated from military service in the Southwest Asia theater of operations as well as Afghanistan, Syria, Djibouti, and Uzbekistan. 3. VA is adding new § 3.320 to address presumptive service connection based on exposure to particulate matter for Gulf War veterans. Exposures and Military Bases in the United States. The VA Secretary has determined that, for the three most commonly claimed respiratory health conditions, waiting for the results of additional studies for more conclusive scientific evidence would unnecessarily delay the delivery of services and benefits to veterans who served in the Gulf War. These can be useful (a) This section applies to peace officers described in Sections 830.1 to 830.5, inclusive, of the Penal Code, and members of a fire department. More information and documentation can be found in our (a) Service connection based on presumed exposure to particulate matter—(1) General. Each reviewing SME was provided with instructions on the overall goals of the review, the PICOTS framework (below) as well as instructions on the scoring matrix with the GRADE structure. The term NASEM is used in this rule to refer to reports published by IOM and NAM. There is no average deployment time because of these extremes. A NASEM committee was formed to undertake this review, which completed its work in early summer 2020. The move comes after years of lobbying from veterans advocates and months of legislative pressure from Capitol Hill on the issue. Further complicating this interpretation are the paucity of exposure data from earlier conflicts, such as the first Gulf War, that limit understanding of potential chronic health effects. Stay up-to-date on the latest in local and national government and political topics with our newsletter. If confirmed, VA will schedule an examination (or medical opinion if/when necessary) to determine if the veteran has a diagnosis for any of the new presumptive diseases and will adjudicate the claim under new § 3.320 accordingly. documents to your comment. Found inside – Page 82S. 995 A bill to amend title 38 , United States Code , to modify the rule for the ... connection presumption for certain diseases caused by Amendment No. Found inside – Page 965In the original “ presumptive ” legislation , Congress had recognized the ... and illnesses of officers serving in the World War are well known to every ... documents in the last year, by the National Institutes of Health that agencies use to create their documents. NASEM, Gulf War and Health Series: Volume 3: Fuels and Products of Combustion (2005), https://doi.org/​10.17226/​11180 and Volume 11: Generational Health Effects of Serving in the Gulf War (2018), https://doi.org/​10.17226/​25162. alternative ways to comment This increased volume of claims and the sheer number of grants within the deployed cohorts for these conditions was critical in determining that more scientific review was necessary. Auto. 501(a) to “prescribe all rules and regulations which are necessary or appropriate to carry out the laws administered by the Department and are consistent with those laws, including—. With regard to inhalation injuries for special home adaptation grants and PM exposure, VA concludes that the majority of these sources of particulate matter would not immediately put veterans in danger of suffering severe burn injury as particulate matter is ubiquitous in the environment. This publication highlights key issues and principles to be considered in the drafting, adoption and implementation of mental health legislation and best practice in mental health services. Additional SMEs were recruited to critically evaluate the strengths and weakness of evidence using a semi-quantitative transparent approach that was based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE) structure. 99th Cong., 2d Sess.). legal research should verify their results against an official edition of See 38 CFR 3.311(g), 3.316(b), and 3.317(a)(ii)(7) and (c)(4). [13] VA determined that the levels of particulate matter were high in Southwest Asia and could present a health risk to service members. Cassandra Crosby, Claims Advocate Updated: February 2, 2021. These presumptions would apply to veterans with a qualifying period of service, i.e., who served on active military, naval, or air service in the Southwest Asia theater of operations during the Persian Gulf War (hereafter Gulf War), as well as in Afghanistan, Syria, Djibouti, or Uzbekistan, on or after September 19, 2001, during the Gulf War. Found insideEvery ( 2 ) who has not been convicted anywhere in the business of ... mental hygiene concerning previous or present mental illness of the applicant shall ... In March 2020, the Army Public Health Center issued, Environmental Conditions at Karshi Khanabad (K-2) Air Base, Uzbekistan, to provide information to service members and veterans on environmental exposures at the K-2 Air Base and the risk of potential long-term adverse health effects related to such deployment. Physical Signs of Death. See US EPA, Particulate Matter (PM) Basics, https://www.epa.gov/​pm-pollution/​particulate-matter-pm-basics. on The ISA uses a formal causal framework to classify the weight of the evidence for health effects. 08/31/2021, 227 Therefore, VA will not automatically presume that anyone who is permanently and totally disabled due to a respiratory illness as a result of exposure to particulate matter will automatically qualify for special home adaptation grant (per 38 CFR 3.809a) based on the eligibility criteria of inhalation injury. (RIN 2900-AN21) Particularly, VA proposed to add eligibility criteria of severe burn injuries to § 3.809a to be defined as (1) deep partial thickness burns that have resulted in contractures with limitation of motion of two or more extremities or of at least one extremity and the trunk, or (2) subdermal burns that have resulted in contracture(s) with limitation of motion of one or more extremities or the trunk. Starting August 2, 2021, veterans diagnosed with chronic asthma, rhinitis, and sinusitis within 10 years of a qualifying period of service in Southwest Asia and certain other areas will have their disability claims processed on a presumptive basis. The term "state" includes an Indian tribe or band recognized by federal law or formally acknowledged by a state. About the Federal Register 151 0 obj <>stream In consideration of the length of the military operations in the Gulf War and a large number of affected service members and veterans, the 10-year manifestation period more liberally provides these veterans with the healthcare, benefits, and services they have earned. Something led me to “Gulf War Syndrome,” and under it, on the VA website, it listed presumptive illnesses that don’t require service members to show it was service connected. In the event a claimant does not specifically claim one of the three presumptive diseases by name but references symptoms of a general medical condition such as “shortness of breath” or “respiratory issues” on claims forms or applications, VA will continue to process and adjudicate such claims to include on the basis of presumptive service connection due to exposure to particulate matter. Found inside – Page 31National Commission on State Workmen's Compensation Laws ... not because of any presumption that he was to blame for every individual tragedy , but because ... documents in the last year, 31 documents in the last year, 566 Document page views are updated periodically throughout the day and are cumulative counts for this document. h�b```�-�l�� ��ea�X�$��vA��w ��Þ P%��>�꾏x��2�=��S�����@U R ̖ ⌎d�����e��b���� � ��%�������A��%���V0�`�s@���\�jkl���#*6٦��8���e%#� � ��XV�a ��GL�� Y-��rbT�@� 7�7M 108 0 obj <> endobj Initial literature screening was performed by VA SMEs to ensure appropriateness for review as well as assignment to human and non-human categories. (4) Qualifying period of service. Open for Comment, Consolidated Rail Infrastructure and Safety Improvements, Economic Sanctions & Foreign Assets Control, Threatened Species Status for Bartram's Stonecrop, Honoring the Victims of the Attack in Kabul, Afghanistan, Blocking Property With Respect to Certain Russian Energy Export Pipelines, Blocking Property of Additional Persons Contributing to the Situation in Belarus, https://www.regulations.gov/commenton/VA-2021-VBA-0015-0001. The growth of incarceration in the United States during four decades has prompted numerous critiques and a growing body of scientific knowledge about what prompted the rise and what its consequences have been for the people imprisoned, ... 601-612). National Academies of Science, Engineering, and Medicine (NASEM), a. The intended effect of this amendment is to address the needs and concerns of Gulf War Veterans and service members who have served and continue to serve in these locations as military operations in the Southwest Asia theater of operations have been ongoing from August 1990 until the present time. Found inside – Page 3111proficiency of seventy - five per centum to entitle them to receive such ... by a two - thirds vote of the members present at any regular meeting . $ 273. Found inside – Page 31992In my ficient to overcome such presumption other occupational hazards . ... of multibank holding companies under the precious in every state , ” he said . should verify the contents of the documents against a final, official Neither Congress nor the President has established an end date for the Gulf War. corresponding official PDF file on govinfo.gov. Start Printed Page 42728“Non-human studies” refers to experimental research not performed on people but includes in-vivo and in-vitro studies in animal models, cell lines, and donated human tissue. VA determined that the Southwest Asia theater of operations, Afghanistan, Syria, and Djibouti had similar arid or semi-arid climates with periods of high winds to suspend geologic dusts and regional pollutants, adhered to or a part of these dusts, though the composition of the PM varies in different regions. daily Federal Register on FederalRegister.gov will remain an unofficial Agencies review all submissions and may choose to redact, or withhold, certain submissions (or portions thereof). Part 3 Adjudication Regulations Update, IV. 38 U.S.C. endstream endobj startxref For this reason, delay in implementation of this rule would be contrary to the public interest. on The Department of Veterans Affairs (VA) is issuing this interim final rule to amend its adjudication regulations to establish presumptive service connection for three chronic respiratory health conditions, i.e., asthma, rhinitis, and sinusitis, to include rhinosinusitis, in association with presumed exposures to fine, particulate matter. Whereas, A presumption of service connection occurs when the Department of Veterans Affairs presumes a disability is caused by military service in order for a veteran to receive disability compensation; and Possession - Rifles and Shotguns. Use the PDF linked in the document sidebar for the official electronic format. Their definition of a `likely to be causal relationship' is as follows, “Evidence is sufficient to conclude that a causal relationship is likely to exist with relevant pollutant exposures. To further address and investigate this service member exposures, VA requested that NASEMexamine the long-term health consequences of service members' exposure to open burn pits while serving in Iraq and Afghanistan. Veterans Affairs Department has reviewed them. However, VA believes this is a veteran-centric approach that will enhance its operational efficiencies by simplifying the work necessary for claims adjudication. Found inside – Page 3851Parenthetically , I want to state my opinion that if this portion of the law ... states that the presumptive periods for certain diseases now in the law are ... Applicability Date: The provisions of this interim final rule shall apply to all applications for service connection for asthma, rhinitis, and sinusitis based on service in the Southwest Asia theater of operations, as well as Afghanistan, Syria, Djibouti, or Uzbekistan, during the Persian Gulf War that are received by VA on or after August 5, 2021, or that were pending before VA, the United States Court of Appeals for Veterans Claims, or the United States Court of Appeals for the Federal Circuit on August 5, 2021. VA is not obligated by statute to provide Congress with VA's response to the 2020 NASEM report. Based on the weight of the evidence considered as described above, VA presumes exposure to PM2.5 for Gulf War veterans deployed in the Southwest Asia theater of operations, as defined in 38 CFR 3.317(e)(2) including Iraq, Kuwait, Saudi Arabia, the neutral zone between Iraq and Saudi Arabia, Bahrain, Qatar, the United Arab Emirates, Oman, the Gulf of Aden, the Gulf of Oman, the Persian Gulf, the Arabian Sea, and the Red Sea during the Persian Gulf War. An Assembly Resolution urging the United States Congress to pass the “Presumptive Benefits for War Fighters Exposed to Burn Pits and Other Toxins Act of 2021.”. Thank you for taking the time to create a comment. For example, VA does not require exposure dosage for Vietnam veterans who were presumed to have been exposed to a herbicide agent such as Agent Orange. The study also describes the challenges associated with conducting exposure-assessment/health surveillance studies, including related to: The need to have co-deployed medical/public health experts to conduct sampling; limitations in monitoring technologies in harsh environments for which they have not been validated and where they may overestimate concentrations due to bounce-off problems, limitations in DOD's health effects studies, difficulties in characterization of exposure of troops to multiple sources (dust storms, vehicle emissions, and emissions from burn pits), and potential confounding factors (such as smoking). endstream endobj startxref NY Penal Law § 270.00. Wash. lawmakers add diseases to presumption list. In 1998, Congress passed the Persian Gulf War Veterans Act of 1998 (Public Law 105-277. 131 0 obj <>/Filter/FlateDecode/ID[<475DA949E74C314CA857FD1EB36977B7>]/Index[108 44]/Info 107 0 R/Length 112/Prev 250878/Root 109 0 R/Size 152/Type/XRef/W[1 3 1]>>stream “Gulf War Illness” and “Gulf War Syndrome” refer to some of the conditions veterans have developed as a result of their service in the Persian Gulf War. Pursuant to 5 U.S.C. 553(d) also requires a 30-day delayed effective date following publication of a rule, except for “(1) a substantive rule which grants or recognizes an exemption or relieves a restriction; (2) interpretative rules and statements of policy; or (3) as otherwise provided by the agency for good cause found and published with the rule.” Pursuant to section 553(d)(3), the Secretary finds that there is good cause to make the rule effective upon publication, for the reasons discussed above. Review of Other Part 3 Adjudication Regulations, Subpart A—Pension, Compensation, and Dependency and Indemnity Compensation, Read the 13 public comments on this document, https://www.federalregister.gov/d/2021-16693, MODS: Government Publishing Office metadata, https://cfpub.epa.gov/​ncea/​isa/​recordisplay.cfm?​deid=​310244, https://www.publichealth.va.gov/​exposures/​burnpits/​index.asp, https://apps.dtic.mil/​sti/​pdfs/​ADA605600.pdf, https://yosemite.epa.gov/​sab/​sabproduct.nsf/​6CBCBBC3025E13B4852583D90047B352/​$File/​EPA-CASAC-19-002+​.pdf, https://www.epa.gov/​pm-pollution/​particulate-matter-pm-basics, https://doi.org/​10.1080/​08958378.2020.1766602, https://www.tandfonline.com/​doi/​full/​10.1080/​08958370802464273, https://www.tandfonline.com/​doi/​full/​10.1080/​08958370802464299, https://uneplive.unep.org/​redesign/​media/​docs/​assessments/​global_​assessment_​of_​sand_​and_​dust_​storms.pdf, https://phc.amedd.army.mil/​PHC%20Resource%20Library/​EnvironmentalConditionsatK-2AirBaseUzbekistan_​FS_​64-038-0617.pdf, https://www.federalregister.gov/​documents/​2021/​01/​25/​2021-01712/​care-of-veterans-with-service-in-uzbekistan, Chronic exposure to particulate matter (PM, No exposure (or fine PM levels < federal guidelines).
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