H.R. 3639 — VET PFAS Act

This section establishes eligibility for hospital care and medical services under 38 U.S.C. §1710(e)(1)(J), beginning 90 days after enactment, for veterans who served on active duty (or specified reserve component service treated as active duty) at a covered military installation—defined as a military installation where individuals were exposed to perfluorooctanoic acid (PFOA) or other per- and polyfluoroalkyl substances (PFAS), including via contaminated drinking water wells—for the following presumptive conditions notwithstanding insufficient medical evidence of service connection: with respect to PFOA exposure, diagnosed high cholesterol, ulcerative colitis, thyroid disease, testicular cancer, kidney cancer, and pregnancy-induced hypertension; and with respect to other PFAS exposure, any disease, illness, or condition determined by the Secretary of Veterans Affairs, in consultation with the Agency for Toxic Substances and Disease Registry, to have a positive association based on the study under §316 of the National Defense Authorization Act for Fiscal Year 2018 (P.L. 115-91). This section further adds a new 38 U.S.C. §1787A to provide the same hospital care and medical services, beginning 90 days after enactment, to family members of such veterans (or those who would qualify but for discharge reason) who resided at a covered military installation or were in utero while the mother resided there, subject to limitations including availability of appropriations, guidelines excluding non-residence-related causes, and exhaustion of third-party claims prior to VA reimbursement. (Thus, these provisions expand VA's existing presumptive care authority under 38 U.S.C. §1710(e), which provides hospital care and medical services for certain toxic exposure-related conditions without requiring proof of service connection.) This section requires the Secretary of Veterans Affairs to submit annual reports to the Senate and House Committees on Veterans' Affairs, during the three-year period beginning in the year the NDAA FY2018 §316 study is submitted to Congress, detailing the number of veterans and family members provided care under the new provisions, the illnesses/conditions treated, and the number denied such care.

This section establishes a presumption of service connection for disability compensation under 38 U.S.C. §1110 for specified diseases and illnesses in veterans who served at a military installation where individuals were exposed to perfluorooctanoic acid (PFOA) or other per- and polyfluoroalkyl substances (PFAS), including through contaminated drinking water wells. (Thus, such diseases are deemed incurred or aggravated in the line of duty absent evidence to the contrary under 38 U.S.C. §1113, easing veterans' proof requirements for VA benefits.) For PFOA exposure, the presumption covers (1) diagnosed high cholesterol; (2) ulcerative colitis; (3) thyroid disease; (4) testicular cancer; (5) kidney cancer; and (6) pregnancy-induced hypertension. For other PFAS exposure, the presumption covers any disease, illness, or condition that the Secretary of Veterans Affairs, in consultation with the Agency for Toxic Substances and Disease Registry, determines has a positive association based on the study required by section 316 of the National Defense Authorization Act for Fiscal Year 2018 (Pub. L. No. 115-91). The section further treats reserve component service for a period specified by the Secretary at such an installation as active military, naval, or air service for these purposes.