Our Mission in Brief
The Cohort of Overpressured Warfighters Action Council exists because the men and women who served in the most demanding combat arms roles, infantrymen, artillery crews, mortarmen, tankers, combat engineers, breaching personnel, special operations teammates, and others who came home carrying an injury that their country had not yet learned to see.
Occupational blast overpressure exposure is not a fringe concern or an emerging hypothesis. It is a well-documented, peer-reviewed phenomenon with measurable neurological consequences – chronic, cumulative, and life-altering.
The gap between what the science now shows and what policy has so far delivered is not a knowledge problem. It is a will problem. COWAC exists to close that gap.
We are a veteran-led advocacy organization. Our board, our advisors, and the population we serve are drawn from the combat arms community – people who understand from the inside what blast exposure looks like, what it costs, and what it means to be denied recognition for an injury sustained in service to this nation. That lived experience is not incidental to our work. It is the foundation of it.
Our community of more than 3,000 active members is not an abstract constituency. They are the men and women the science is about – and they are watching what policy does next.
A Coalition of the Willing
COWAC does not work alone, and we do not believe in working alone. The scale of this issue – spanning policy, VA adjudication, federal research investment, and clinical practice demands a coordinated, multi-stakeholder response.
We actively partner with peer veteran service organizations who share a commitment to evidence-based advocacy and the long-term health of the combat arms community.
We engage medical and clinical organizations whose members are on the front lines of diagnosing and treating blast-affected veterans, often without the diagnostic frameworks or institutional support they need. We work alongside independent researchers, legal advocates, and investigative journalists whose work has brought this issue further into public view.
And we collaborate directly with Congressional staff and federal policy teams bringing primary source documentation, clinical evidence summaries, and veteran testimony to every engagement.
Our coalition is built on shared purpose, not shared politics. We welcome any organization, clinician, researcher, or advocate who is willing to follow the evidence and stand with affected veterans regardless of their broader institutional affiliations or policy orientations.
A Non-Partisan Commitment
The neurological health of combat arms veterans is not a partisan issue. It has never been. Veterans have bled under the flags of administrations from both parties, and the institutional failures that have left blast-exposed veterans without recognition or recourse span decades of Congressional and executive leadership across the political spectrum.
COWAC engages with legislators, committee staff, and federal agencies on the merits – bringing data, clinical evidence, and veteran testimony to every conversation, and asking every office the same questions regardless of party or ideology. We have found allies and champions on both sides of the aisle, and we intend to keep it that way. Our only litmus test is this: will you look at the evidence, and will you act on it?
We believe the strength of a non-partisan posture is not merely strategic. It is a reflection of who we serve. Combat arms veterans come from every state, every background, and every political tradition. Their injuries do not sort by party registration. Neither does our advocacy.
Legislative & Policy Objectives
COWAC advances a focused legislative and policy agenda on behalf of combat arms veterans exposed to occupational blast overpressure – an injury mechanism that has been systematically undercounted, underdiagnosed, and undercompensated for decades. Our objectives are grounded in peer-reviewed science, veteran testimony, and the growing evidentiary record linking repetitive low-level blast exposure to chronic neurological harm.
Take Care of America’s Veterans Act (H.R. 9237)
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.
- 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. - 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.
- 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.
- 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 simultaneously undercutting them.
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.
Modernized Blast Exposure Monitoring Standards
Current Department of War (DoW) protocols were designed to detect acute traumatic brain injury from single high-magnitude blast events. They are inadequate for the cumulative, subclinical exposures that characterize the occupational environments of artillerists, tankers, mortarmen, combat engineers, and breaching personnel.
COWAC supports the establishment of mandatory, longitudinal blast dosimetry standards across all high-risk occupational specialties — including individualized exposure tracking, threshold-based medical evaluation triggers, and centralized data reporting to support long-term epidemiological research. These standards must apply throughout a servicemember’s career, not only following documented traumatic events.
VA Service-Connection Pathways for Blast-Related Neurological Injury
Veterans with documented service in high-blast-exposure occupational specialties face a near-impossible evidentiary burden when seeking VA compensation for neurological conditions linked to repetitive blast. Without a recognized exposure record, a validated diagnostic framework, or a clear presumptive pathway, most claims are denied at the rating stage.
COWAC advocates for the establishment of presumptive service connection for qualifying neurological conditions — including chronic traumatic encephalopathy spectrum disorders, persistent post-concussive syndrome, and related cognitive and neuroendocrine dysfunction — in veterans with documented service in designated high-risk Military Occupational Specialties.
Transparent Data Collection and Institutional Accountability
For years, data on blast exposure incidence, accumulated dosimetry, and downstream health outcomes has remained siloed within DoD — inaccessible to independent researchers, treating clinicians, and veterans themselves. This opacity has served institutional interests at the direct expense of veteran health.
COWAC calls for mandatory public reporting of aggregate blast exposure data by branch and occupational specialty; independent audit authority over DoD and VA blast-related health research programs; and full transparency in the methods and findings of any internal studies bearing on service-connection determinations.
Congressional Oversight and Veteran-Centered Accountability
The neurological health crisis affecting blast-exposed combat arms veterans did not emerge overnight. Much has been accomplished, the DoD’s Warfighter Brain Health Initiative and 2026 National Defense Authorization Act (NDAA), which included blast safety officer provisions championed by our Cohort. COWAC continues to call on Congress to exercise robust oversight of both DoD/DoW blast-exposure policy and VA adjudication practices, and to hold those institutions accountable to the veterans they exist to serve.
We also recognize a practical reality that must be named directly: meritorious legislation in this space has stalled not because the science is in dispute, but because the question of budgetary offset has become a procedural obstacle that functions as a substitute for substantive engagement. COWAC rejects the premise that this is a legitimate barrier. The federal government is already bearing the costs of occupational blast overpressure injury in misattributed disability claims, in undertreated neurological disease, in the long-term social and economic consequences borne by affected veterans and their families. Those costs do not disappear when legislation stalls. They accumulate, invisibly, in a system that lacks the diagnostic and policy frameworks to address them correctly.
The choice before Congress is not between spending and not spending. It is between investing deliberately in research, recognition, and streamlined care pathways – or continuing to absorb the compounding costs of inaction. COWAC urges Congress to exercise the oversight necessary to ensure that fiscal process does not become a permanent shield against moral and scientific accountability.
Interested in partnering?
COWAC engages directly with Congressional offices, federal agencies, and peer veteran service organizations to advance these objectives.
To request a briefing, partner on advocacy, or access our evidence summary materials, contact us.
