Lawmakers relaunch landmark bill to create path to VA care for veterans ill from toxic exposure

U.S. Army Staff Sgt. Alexis Castillo watches as unused mortar ‘cheese’ charges are disposed by fire during a mortar training exercise with Iraqi soldiers.
U.S. Army Staff Sgt. Alexis Castillo watches
as unused mortar ‘cheese’ charges are
disposed of by fire during a mortar training
exercise with Iraqi soldiers.
Photo credit Sgt. Gustavo Olgiati, U.S. Army

Veterans exposed to toxic substances during their military service could qualify for additional care and benefits from the Department of Veterans Affairs under landmark legislation reintroduced in Congress this week.

The Toxic Exposure in the American Military (TEAM) Act creates sweeping mandates for VA to further research, track and care for eligible veterans who fall ill because of exposure to toxic substances during service -- perhaps the most comprehensive legislation on military toxic exposures ever introduced in Congress.

The TEAM Act was introduced by Sen. Thom Tillis, R-N.C., who represents one of the largest populations of troops and veterans in the country, including the largest Army base in the world, Fort Bragg. Sen. Maggie Hassan, D-N.H., who represents Pease Air Force Base where troops and their families have been exposed to high levels of "forever chemicals" including PFAS, cosponsored the bill at its introduction.

Last year, the bill passed out of the Senate Veterans Affairs Committee, a key endorsement, but did not receive a vote on the Senate floor before the end of the year, meaning it had to be reintroduced in 2021. Tillis said in a press conference on Tuesday he believed the reason the bill didn't pass last year was because of its late introduction, and now he and Hassan are working to partner with House members on a companion bill, and that additional amendments and provisions are on the table.

"We're trying to put a framework in place that lets us end mistakes we made dating back to Agent Orange," Tillis said. "When a veteran is experiencing an illness, they've got so many other distractions on their mind, we should not make it difficult for them to get the care they deserve."

The bill aims to allow VA to potentially expand benefits and health care to thousands of veterans by allowing VA to more efficiently add presumptive conditions for troops exposed to toxic substances, such as herbicides and burn pits, and provide consultations, testing and treatment, among other major mandates. Toxic exposures have increasingly gained attention as veterans and troops sicken with rare cancers, respiratory and fertility issues, especially those who served in Afghanistan and Iraq.

"Burn pits are the issue on top of mind, but we really want to get to a point where it's on the independent commission (established under the bill) and a relationship with the National Academies to very quickly have a science-based approach to providing presumptions for veterans," Tillis said Tuesday. "We're providing a presumption framework that favors the veteran."

Millions of veterans have been exposed to toxic hazards just since 2001, along with generations of troops who came before. But after nearly two decades of war, the Department of Veterans Affairs still denies the majority of claims for burn pits, one of the most common exposures troops experience.

As of March 10, 233,406 veterans and service members have added themselves to the VA Airborne Hazards and Open Burn Pit Registry, open to those who have served since 1990. VA has previously estimated as many as 3.5 million veterans and troops have been affected by burn pits alone.

Surveys from veteran service organizations including Iraq and Afghanistan Veterans of America and Wounded Warrior Project show a majority of respondents report toxic exposures of some kind, and most said they were not receiving care for those exposures at VA. Veteran service organizations have made multiple presentations to Congress in recent years arguing that toxic exposures should be a top legislative priority. Veterans have testified before lawmakers again and again about the rare cancers and other severe, and often fatal, conditions they believe have been caused by toxic exposures they suffered, or lost friends to.

But progress remains slow, despite lawmakers continually saying they don't want to repeat the mistakes of Agent Orange exposures, forcing veterans to wait decades for care and benefits. Meanwhile, VA continues to deny thousands of claims.

"We don't want to repeat the mistakes of Agent Orange," Tillis said again Tuesday. "If we don't get it right (burn pits) could be our next Agent Orange."

VA has received 15,513 claims from veterans of conditions specifically related to burn pits. The most common issues claimed are respiratory conditions. VA has denied 11,964 burn pit-related claims, or about 77%, approving 3,549, or about 29%, according to data provided to Connecting Vets.

"Unfortunately toxic exposure has become synonymous with military service,” said Kristina Keenan of the Veterans of Foreign Wars.

Establishing a firm link between toxic exposures and the illnesses they cause has proved difficult over the years, as Pentagon records of exposures are notoriously incomplete or nonexistent -- including the locations of burn pits and other hazards -- leaving veterans waiting as they grow more ill or die. Both VA and the Defense Department -- the two largest federal agencies -- place the burden on veterans and their families to prove they were exposed, when and where with documents that often don't exist.

"We often place a huge onus on our veterans and service members, especially those who have been exposed to toxic environments," Hassan said Tuesday. "We have to make sure we're addressing the health challenges that occurred as a result of their service."

"We need to start thinking, even before they reach veteran status, about ... potential exposures that we should be mindful of," Tillis said.

The TEAM Act is the culmination of years of effort from the TEAM Coalition of more than 30 veteran service organizations, along with researchers, advocates and others working to codify care for veterans afflicted by their toxic exposures.

"The TEAM Coalition has been working hard to ensure that toxic exposures are not something we're going to be fighting to address a generation from now," said Aleksander Morosky, Wounded Warrior Project government affairs specialist.

Veterans eligible for consultations, testing and treatment under the bill would include those who received hazardous duty pay for more than one day, or who have been identified by the Pentagon as possibly exposed inside or outside the U.S. to burn pits or other toxic substances or visited a location where service members were potentially exposed.

The authority to decide which illnesses qualify as service-connected resides with the Department of Veterans Affairs secretary.

The bill would:

- Require VA provide consultation, testing and treatment for eligible veterans who received hazardous duty pay, or were exposed to toxic substances with no copays;
- Permanently reauthorize VA's authority to establish presumptive service connection for diseases associated with herbicide exposure;
- Allow the VA Secretary to establish additional presumptives for illnesses linked to certain toxic substances;
- Establish a Toxic Exposure Review Commission to authorize further research on exposures;
- Formalize an agreement with the National Academies of Sciences, Engineering and Medicine to report on scientific evidence for illnesses linked to exposures;
- Require analysis of veterans exposed to toxic substances to help identify those most at risk and provide regular reports to Congress;
- Require VA create a list of resources to be published for veterans exposed to toxicants, and an outreach program for those veterans, their caregivers and survivors;
- Incorporate toxic exposure questionnaires during primary care appointments;
- Create a portal for veterans to access their Individual Longitudinal Exposure Record;
- Require VA establish training for its staff on illnesses linked to toxic exposure.

The bill gives authority to VA leadership to determine illnesses that qualify for service-connected benefits, as has been the case in the past. But to avoid delays Agent Orange-exposed veterans and others have faced as VA weighs whether to expand benefits, the bill requires VA to make a decision within 60 days of a National Academies of Sciences report linking illnesses to exposures.

For information on how to add yourself to VA's burn pit and airborne hazard registry, click here.

Need help with toxic exposure? Click here for a list of resources and information on VA and Defense Department registries.

Featured Image Photo Credit: Sgt. Gustavo Olgiati, U.S. Army