On June 10, 2026, the Take Care of America’s Veterans Act (H.R. 9237) was introduced in the House as a comprehensive veterans’ package consolidating more than 60 bipartisan bills. Committee leadership in both chambers have announced a negotiated path to passage in the coming weeks.

COWAC strongly supports enactment of Section 310 (Modification of the Precision Medicine for Veterans Initiative) and Section 311 (Establishment of the VA Blast Overpressure Task Force). These provisions are among the most consequential federal steps yet taken toward recognizing occupational blast overpressure exposure as a documented injury. In the same bill, however, Section 108 reduces disability compensation for tinnitus and sleep apnea — two of the most reliably documented sequelae of blast exposure in the peer-reviewed literature.

Section 108 directly undercuts the purpose of Sections 310 and 311. COWAC urges that Section 108(a) and Section 108(b) be struck in full, and that Sections 310 and 311 proceed to enactment.

1. What COWAC Supports: Sections 310 and 311
   Section 311 establishes a VA Blast Overpressure Task Force through the VA–DoD Joint Executive Committee, charged with improving care and benefits for veterans with blast-related conditions, prioritizing translational research across seven enumerated injury domains, establishing physiological and cognitive baselines, and — critically — recommending to Congress how VA claims processors should evaluate the evidence linking these conditions to service (§ 311(d)(2)).
   Section 310 writes “repetitive low-level blast exposure” directly into the Precision Medicine for Veterans Initiative, mandates research to identify and validate blast-associated biomarkers, establishes a VA–DoD data-sharing partnership, directs a National Academies validation contract, adds military-occupation data to suicide reporting, and authorizes dedicated appropriations through fiscal year 2032.
   Together these provisions reflect, in federal statute, the central propositions COWAC has advanced since 2020: that occupational blast overpressure is a real and documentable injury, that it warrants dedicated research and inter-agency coordination, and that VA’s evaluation of the linking evidence must improve. COWAC supports their swift enactment without reservation.
2. What COWAC Opposes: Section 108(a) and (b)
   Section 108 directs the Secretary to revise the VA rating schedule (38 U.S.C. § 1155) to reduce compensation for two conditions central to the blast-exposed combat-arms population.

Section 108(b) — Tinnitus.
Under current law, service-connected tinnitus carries a 10 percent rating. Section 108(b) provides that tinnitus “may not be assigned a separate compensable disability rating,” except a single 10 percent rating available only when tinnitus is associated with service-connected hearing loss that is itself noncompensable. A veteran with service-connected tinnitus but no compensable hearing loss — a common blast-exposure presentation — would receive no compensation for tinnitus where today they receive 10 percent.
This is directly adverse to COWAC’s population. Tinnitus is among the highest-magnitude blast-associated conditions in the peer-reviewed record (Belding et al. 2023, odds ratio 1.20; confirmed in VHA clinical records in Martindale et al. 2025), and it is frequently the entry-point diagnosis through which blast-exposure service connection is first established. Eliminating standalone tinnitus compensation removes recognition for one of the most reliable clinical markers of the very injury Sections 310 and 311 are designed to study.
Section 108(a) — Sleep Apnea.
Section 108(a) replaces the current sleep-apnea rating schedule with a treatment-response schedule: 0 percent if asymptomatic with or without treatment; 10 percent if treatment yields incomplete relief; 50 percent only if treatment is ineffective or unusable due to comorbidities and there is no end-organ damage; and 100 percent only if there is end-organ damage. Under current law, obstructive sleep apnea requiring a breathing-assistance device is rated at 50 percent. Under Section 108(a), a veteran whose sleep apnea is controlled by such a device would fall to 10 percent, or to 0 percent if deemed asymptomatic on treatment.
Sleep disturbance and sleep apnea are documented sequelae of repetitive low-level blast exposure (Martindale et al. 2025, confirmed VHA association). Section 108(a) downgrades compensation for a condition the blast-exposed population carries at elevated rates, and conditions the higher ratings on a showing that treatment has failed — a materially harder evidentiary burden than current law imposes.

3. The Core Problem: Section 108 Contradicts Sections 310 and 311
   The same bill that directs the government to study blast injury more carefully also compensates two of its hallmark signs less. Section 311 creates a Task Force to recommend how VA should evaluate evidence linking blast-related conditions to service. Section 310 funds biomarker research to strengthen the diagnostic and adjudicatory basis for those conditions. Section 108 then strips standalone compensation from tinnitus — a primary clinical marker of blast exposure — and downgrades sleep apnea, another documented blast sequela. The bill builds the evidentiary case for recognition with one hand and withdraws compensation for the evidence of that injury with the other.

This is not a general objection to rating-schedule reform, and COWAC does not take a position on the rating schedule outside its area of expertise. The objection is specific and internal to this bill: Section 108 works against the stated purpose of Sections 310 and 311. A Congress that has determined blast overpressure warrants a dedicated Task Force and dedicated research funding should not, in the same legislation, reduce compensation for the conditions that injury produces — least of all before the Task Force it is creating has issued a single report.

4. COWAC’s Request

Strike Section 108(a) and Section 108(b) in full. Advance Sections 310 and 311 to enactment. The blast-overpressure provisions of this bill are too important to lose, and the rating reductions in Section 108 are too directly contrary to those provisions’ purpose to retain. Removing Section 108(a) and (b) does not affect the cost or operation of any other provision in the package and allows the bill’s significant advances for blast-exposed veterans to proceed without simultaneously undercutting them.

COWAC stands ready to provide it with the peer-reviewed evidentiary materials, clinician resources, and presumptive-service-connection framework it has developed on occupational blast overpressure exposure.

The Take Care of America’s Veterans Act was introduced on June 10, 2026, and is in the first stage of the legislative process. It has not yet been enacted.