(a)
(b)
(i) accurately record the health status of members before their deployment;
(ii) accurately record any changes in their health status during the course of their deployment;
(iii) identify health concerns, including mental health concerns, that may become manifest several months following their deployment; and
(iv) accurately record any exposure to occupational and environmental health risks during the course of their deployment.
(B) The postdeployment medical examination shall be conducted when the member is redeployed or otherwise leaves an area in which the system is in operation (or as soon as possible thereafter).
(C) The postdeployment health reassessment shall be conducted at an appropriate time during the period beginning 90 days after the member is redeployed and ending 180 days after the member is redeployed.
(2) The predeployment medical examination, postdeployment medical examination, and postdeployment health reassessment of a member of the armed forces required under paragraph (1) shall include the following:
(A) An assessment of the current treatment of the member and any use of psychotropic medications by the member for a mental health condition or disorder.
(B) An assessment of traumatic brain injury.
(C) An assessment of post-traumatic stress disorder.
(D) An assessment of whether the member was—
(i) based or stationed at a location where an open burn pit, as defined in subsection (c) of section 201 of the Dignified Burial and Other Veterans' Benefits Improvement Act of 2012 (Public Law 112–260; 38 U.S.C. 527 note), was used; or
(ii) exposed to toxic airborne chemicals or other airborne contaminants, including any information recorded as part of the registry established by the Secretary of Veterans Affairs under such section 201.
(3)
(A) The Secretary shall establish for purposes of subparagraphs (B) and (C) of paragraph (2) a protocol for the predeployment assessment and documentation of the cognitive (including memory) functioning of a member who is deployed outside the United States in order to facilitate the assessment of the postdeployment cognitive (including memory) functioning of the member.
(B) The protocol under subparagraph (A) shall include appropriate mechanisms to permit the differential diagnosis of traumatic brain injury in members returning from deployment in a combat zone.
(c)
(d)
(2) The quality assurance program established under paragraph (1) shall also include the following elements:
(A) The types of healthcare providers conducting postdeployment health assessments and reassessments.
(B) The training received by such providers applicable to the conduct of such assessments and reassessments, including training on assessments and referrals relating to mental health.
(C) The guidance available to such providers on how to apply the clinical practice guidelines developed under subsection (e)(1) in determining whether to make a referral for further evaluation of a member of the armed forces relating to mental health.
(D) The effectiveness of the tracking mechanisms required under this section in ensuring that members who receive referrals for further evaluations relating to mental health receive such evaluations and obtain such care and services as are warranted.
(E) Programs established for monitoring the mental health of each member who, after deployment to a combat operation or contingency operations, is known—
(i) to have a mental health condition or disorder; or
(ii) to be receiving treatment, including psychotropic medications, for a mental health condition or disorder.
(F) The diagnosis and treatment of traumatic brain injury and post-traumatic stress disorder.
(e)
(1) development of clinical practice guidelines to be utilized by healthcare providers in determining whether to refer a member of the armed forces for further evaluation relating to mental health (including traumatic brain injury);
(2) mechanisms to ensure that healthcare providers are trained in the application of such clinical practice guidelines; and
(3) mechanisms for oversight to ensure that healthcare providers apply such guidelines consistently.
(f)
(2) The standards required by paragraph (1) shall include the following:
(A) A specification of the mental health conditions, treatment for such conditions, and receipt of psychotropic medications for such conditions that preclude deployment of a member of the armed forces to a combat operation or contingency operation, or to a specified type of such operation.
(B) Guidelines for the deployability and treatment of members of the armed forces diagnosed with a severe mental illness, traumatic brain injury, or post traumatic stress disorder.
(3) The Secretary shall take appropriate actions to ensure the utilization of the standards prescribed under paragraph (1) in the making of determinations regarding the deployability of members of the armed forces to a combat operation or contingency operation.
(g)
(2) The Secretary, to the extent practicable, shall ensure that the medical record of a member includes information on the external cause relating to a diagnosis of the member, including by associating an external cause code (as issued under the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (or any successor revision)).
Amendments
2019—Subsec. (b)(1)(A)(iv). Pub. L. 116–92, §705(a)(1), added cl. (iv).
Subsec. (b)(2)(D). Pub. L. 116–92, §704(c), added subpar. (D).
Subsec. (c). Pub. L. 116–92, §705(a)(2), inserted "(including the results of any assessment performed by the Secretary of occupational and environmental health risks for such area)" after "deployment area".
Subsec. (g). Pub. L. 116–92, §705(b), added subsec. (g).
2011—Subsec. (b)(1). Pub. L. 111–383, §712(a), amended par. (1) generally. Prior to amendment, par. (1) read as follows: "The system described in subsection (a) shall include the use of predeployment medical examinations and postdeployment medical examinations (including an assessment of mental health and the drawing of blood samples) to accurately record the medical condition of members before their deployment and any changes in their medical condition during the course of their deployment. The postdeployment examination shall be conducted when the member is redeployed or otherwise leaves an area in which the system is in operation (or as soon as possible thereafter)."
Subsec. (b)(2). Pub. L. 111–383, §712(b), substituted "medical examination, postdeployment medical examination, and postdeployment health reassessment" for "and postdeployment medical examination" in introductory provisions.
Subsec. (c). Pub. L. 111–383, §712(c), inserted "and reassessments" after "medical examinations" and "and the prescription and administration of psychotropic medications" after "including immunizations".
Subsec. (d)(1). Pub. L. 111–383, §712(d)(1), substituted ", postdeployment medical examinations, and postdeployment health reassessments" for "and postdeployment medical examinations".
Subsec. (d)(2)(A). Pub. L. 111–383, §712(d)(2)(A), inserted "and reassessments" after "postdeployment health assessments".
Subsec. (d)(2)(B). Pub. L. 111–383, §712(d)(2)(B), inserted "and reassessments" after "such assessments".
2009—Subsec. (f)(3). Pub. L. 111–84 substituted "contingency" for "continency".
2008—Subsec. (b)(2)(C). Pub. L. 110–181, §1673(a)(1)(A), added subpar. (C).
Subsec. (b)(3). Pub. L. 110–181, §1673(a)(1)(B), added par. (3).
Subsec. (d)(2)(F). Pub. L. 110–181, §1673(b), added subpar. (F).
Subsec. (f). Pub. L. 110–181, §1673(c)(1), struck out "Mental Health" after "Minimum" in heading.
Subsec. (f)(2)(B). Pub. L. 110–181, §1673(c)(2), substituted ", traumatic brain injury, or" for "or".
2006—Subsec. (b). Pub. L. 109–364, §738(a), designated existing provisions as par. (1) and added par. (2).
Subsec. (d). Pub. L. 109–364, §738(d), designated existing provisions as par. (1) and added par. (2).
Subsec. (e). Pub. L. 109–364, §738(b), added subsec. (e).
Subsec. (f). Pub. L. 109–364, §738(c), added subsec. (f).
Exposure to Open Burn Pits and Toxic Airborne Chemicals or Other Airborne Contaminants as Part of Periodic Health Assessments and Other Physical Examinations
Pub. L. 116–92, div. A, title VII, §704, Dec. 20, 2019, 133 Stat. 1438, provided that:
"(a)
"(1) based or stationed at a location where an open burn pit was used; or
"(2) exposed to toxic airborne chemicals or other airborne contaminants, including any information recorded as part of the Airborne Hazards and Open Burn Pit Registry.
"(b)
"(c)
"(d)
"(1)
"(2)
"(e)
"(f)
"(1) The term 'Airborne Hazards and Open Burn Pit Registry' means the registry established by the Secretary of Veterans Affairs under section 201 of the Dignified Burial and Other Veterans' Benefits Improvement Act of 2012 (Public Law 112–260; 38 U.S.C. 527 note).
"(2) The term 'covered evaluation' means—
"(A) a periodic health assessment conducted in accordance with subsection (a);
"(B) a separation history and physical examination conducted under section 1145(a)(5) of title 10, United States Code, as amended by this section; and
"(C) a deployment assessment conducted under section 1074f(b)(2) of such title, as amended by this section.
"(3) The term 'open burn pit' has the meaning given that term in section 201(c) of the Dignified Burial and Other Veterans' Benefits Improvement Act of 2012 (Public Law 112–260; 38 U.S.C. 527 note)."
Sharing Between Department of Defense and Department of Veterans Affairs of Records and Information Retained Under the Medical Tracking System for Members of the Armed Forces Deployed Overseas
Pub. L. 112–239, div. A, title VII, §723, Jan. 2, 2013, 126 Stat. 1805, provided that:
"(a)
"(b)
Comprehensive Policy on Consistent Neurological Cognitive Assessments of Members of the Armed Forces Before and After Deployment
Pub. L. 111–383, div. A, title VII, §722, Jan. 7, 2011, 124 Stat. 4251, provided that:
"(a)
"(b)
Mental Health Assessments for Members of the Armed Forces Deployed in Connection With a Contingency Operation
Pub. L. 111–84, div. A, title VII, §708, Oct. 28, 2009, 123 Stat. 2376, which required the Secretary of Defense to issue guidance for the provision of mental health assessments for members of the Armed Forces deployed in connection with a contingency operation, was repealed by Pub. L. 112–81, div. A, title VII, §702(b), Dec. 31, 2011, 125 Stat. 1471.
Administration and Prescription of Psychotropic Medications for Members of the Armed Forces Before and During Deployment
Pub. L. 111–84, div. A, title VII, §712, Oct. 28, 2009, 123 Stat. 2379, provided that:
"(a)
"(b)
"(1) The circumstances or diagnosed conditions for which such medications may be administered or prescribed.
"(2) The medical personnel who may administer or prescribe such medications.
"(3) The method in which the administration or prescription of such medications will be documented in the medical records of members of the Armed Forces.
"(4) The exam, treatment, or other care that is required following the administration or prescription of such medications."
Pilot Projects
Pub. L. 110–181, div. A, title XVI, §1673(a)(2), Jan. 28, 2008, 122 Stat. 482, directed the Secretary of Defense to conduct three pilot projects to evaluate mechanisms for use in developing the traumatic brain injury assessment protocol required by section 1074f(b)(3) of this title and, upon the completion of the projects, required a report to Congress within 60 days and implementation of the selected mechanism within 180 days.
Implementation
Pub. L. 109–364, div. A, title VII, §738(f), Oct. 17, 2006, 120 Stat. 2304, provided that: "The Secretary of Defense shall implement the requirements of the amendments made by this section [amending this section] not later than six months after the date of the enactment of this Act [Oct. 17, 2006]."
Interim Standards for Blood Sampling
Pub. L. 108–375, div. A, title VII, §733(b), Oct. 28, 2004, 118 Stat. 1998, as amended by Pub. L. 109–364, div. A, title X, §1071(g)(9), Oct. 17, 2006, 120 Stat. 2402, provided that:
"(1)
"(A) the blood samples necessary for the predeployment medical examination of a member of the Armed Forces required under section 1074f(b) of title 10, United States Code, be drawn not earlier than 120 days before the date of the deployment; and
"(B) the blood samples necessary for the postdeployment medical examination of a member of the Armed Forces required under such section 1074f(b) of such title be drawn not later than 30 days after the date on which the deployment ends.
"(2)
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