38 U.S.C. § 1173
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- (a)The Secretary shall establish a process to conduct a formal evaluation with respect to each recommendation made by the Working Group under section 1172 of this title.
- (b)The Secretary shall ensure that each formal evaluation under subsection (a) covers the following:
- (1)Scientific evidence, based on the review of available scientific literature, including human, toxicological, animal, and methodological studies, and other factors.
- (2)Claims data, based on the review of claim rate, grant rate, and service connection prevalence, and other factors.
- (3)Other factors the Secretary determines appropriate, such as—
- (A)the level of disability and mortality caused by the health effects related to the case of toxic exposure being evaluated;
- (B)the quantity and quality of the information available and reviewed;
- (C)the feasibility of and period for generating relevant information and evidence;
- (D)whether such health effects are combat- or deployment-related;
- (E)the ubiquity or rarity of the health effects; and
- (F)any time frame during which a health effect must become manifest.
- (c)
- (1)The Secretary shall ensure that each formal evaluation under subsection (a)—
- (A)reviews scientific evidence in a manner that—
- (B)
- (i)evaluates the likelihood that a positive association exists between an illness and a toxic exposure while serving in the active military, naval, air, or space service; and
- (ii)assesses the toxic exposures and illnesses and determines whether the evidence supports a finding of a positive association between the toxic exposure and the illness.
- (2)In carrying out paragraph (1)(B)(ii), a formal evaluation under subsection (a) shall include reviewing all relevant data to determine the strength of evidence for a positive association based on the following four categories:
- (A)The “sufficient” category, where the evidence is sufficient to conclude that a positive association exists.
- (B)The “equipoise and above” category, where the evidence is sufficient to conclude that a positive association is at least as likely as not, but not sufficient to conclude that a positive association exists.
- (C)The “below equipoise” category, where the evidence is not sufficient to conclude that a positive association is at least as likely as not, or is not sufficient to make a scientifically informed judgment.
- (D)The “against” category, where the evidence suggests the lack of a positive association.
- (1)The Secretary shall ensure that each formal evaluation under subsection (a)—
- (d)Not later than 120 days after the date on which a formal evaluation is commenced, the element of the Department that conducts the evaluation shall submit to the Secretary a recommendation with respect to establishing a presumption of service connection for the toxic exposure and illness, or modifying an existing presumption of service connection, covered by the evaluation.