---
kind: "section"
citation: "38 U.S.C. § 1173"
title: "38"
title_heading: "Veterans’ Benefits"
number: "1173"
heading: "Formal evaluation of recommendations"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/38/1173"
units:
  - "Part II — General Benefits"
  - "Chapter 11 — Compensation for Service-Connected Disability or Death"
  - "Subchapter VII — Determinations Relating to Presumptions of Service Connection Based on Toxic Exposure"
---

# §1173. Formal evaluation of recommendations

- (a) **Formal Evaluations.—** The [Secretary](/usc/38/101.md?p=1) 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](/usc/38/1172.md).
- (b) **Evidence, Data, and Factors.—** The [Secretary](/usc/38/101.md?p=1) shall ensure that each formal evaluation under [subsection (a)](#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](/usc/38/101.md?p=1) determines appropriate, such as—
    - (A) the level of [disability](/usc/38/1701.md?p=1) and mortality caused by the health effects related to the case of [toxic exposure](/usc/38/101.md?p=37) 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) **Conduct of Evaluations.—**
  - (1) The [Secretary](/usc/38/101.md?p=1) shall ensure that each formal evaluation under [subsection (a)](#a)—
    - (A) reviews scientific evidence in a manner that—
      - (i) conforms to principles of scientific and data integrity;
      - (ii) is free from suppression or distortion of scientific or technological findings, data, information, conclusions, or technical results; and
    - (B)
      - (i) evaluates the likelihood that a positive association exists between an [illness](/usc/38/1171.md?p=b-1) and a [toxic exposure](/usc/38/101.md?p=37) while serving in the [active military, naval, air, or space service](/usc/38/101.md?p=24); and
      - (ii) assesses the [toxic exposures](/usc/38/101.md?p=37) and [illnesses](/usc/38/1171.md?p=b-1) and determines whether the evidence supports a finding of a positive association between the [toxic exposure](/usc/38/101.md?p=37) and the [illness](/usc/38/1171.md?p=b-1).
  - (2) In carrying out [paragraph (1)(B)(ii)](#c-1-B-ii), a formal evaluation under [subsection (a)](#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.
- (d) **Recommendation for Establishing a Presumption of Service Connection.—** Not later than 120 days after the date on which a formal evaluation is commenced, the element of the [Department](/usc/38/101.md?p=1) that conducts the evaluation shall submit to the [Secretary](/usc/38/101.md?p=1) a recommendation with respect to establishing a presumption of service connection for the [toxic exposure](/usc/38/101.md?p=37) and [illness](/usc/38/1171.md?p=b-1), or modifying an existing presumption of service connection, covered by the evaluation.

## Source credit

(Added Pub. L. 117–168, title II, § 202(a), Aug. 10, 2022, 136 Stat. 1769.)