Other pending bills identical or similar to H. R. 405 are H. R. 6716, H. R. 9726, H. R. 10134, H. R. 10748, and H. R. 11837.

As indicated, Public Law 311, 83d Congress (now restated in sec. 2108 of Public Law 85-56), prohibits the reduction of a total disability rating which has been in effect for 20 years or more, in the absence of a showing of fraud. H. R. 12056 would extend this principle to any rating of service-connected disability which has been in force for 10 or more years. The bill would also have application to ratings which have heretofore been reduced contrary to its provisions. The approved policy of the Veterans' Administration requires that all rating agencies handle cases affected by change of medical findings or diagnosis, wherein service connection or entitlement is in effect, so as to produce the greatest degree of stability of disability evaluations consistent with the laws and regulations governing disability compensation. For the information of the committee, there is offered for the record a copy of VA Regulation 1172, entitled "Stabilization of Disability Evaluations."

1172. STABILIZATION OF DISABILITY EVALUATIONS

(A) The approved policy of the VA requires that all rating agencies handle cases affected by change of medical findings or diagnosis, wherein service connection or entitlement is in effect, including claims under part III, Veterans Regulation No. 1 (a), so as to produce the greatest degree of stability of disability evaluations consistent with the laws and regulations governing disability compensation and pension. In pursuance of this vital policy it is essential that the entire record of examinations and the medical-industrial history be reviewed to ascertain whether the recent examination is full and complete, including all special examinations indicated as a result of general examination and the entire case history. This applies especially to hospital examinations incident to treatment of intercurrent diseases and exacerbations, including bedside examinations, examinations by designated physicians, and examinations in the absence of, or without taking full advantage of, laboratory facilities and the cooperation of specialists in related lines. Examinations less full and complete than those on which payments were authorized or continued will not be used as a basis of reduction. The type of disease and the relationship between the former diagnosis and findings and the new diagnosis and findings must be closely examined. Ratings on account of diseases subject to temporary or episodic improvement, e. g., manic-depressive or other psychosis, epilepsy, psychoneurosis, coronary sclerosis (coronary occlusion or the aniginal syndrome), bronchial asthma, gastric or duodenal ulcer, many skin diseases, etc., will not be reduced on any one examination, except in those instances where all the evidence of record clearly warrants the conclusion that permanent improvement of physical or mental condition has been demonstrated. Ratings on account of diseases which become comparatively symptom free (findings absent) after prolonged rest, e. g., phlebitis, myocardial or coronary insufficiency, [ 1 etc., will not be reduced on examinations reflecting the results of bed rest. When the new diagnosis reflects mental deficiency or psychopathic inferiority only, the possibility of only temporary remission of the psychosis, psychoneurosis, or other superimposed disease will be borne in mind. When syphilis of the central nervous system or alcoholic deterioration is diagnosed following a long prior history of psychosis, psychoneurosis, epilepsy, or the like, it is rarely possible to exclude persistence, in masked form, of the preceding innocently acquired manifestations. With new diagnosis or findings reflecting change from organic eitology to functional etiology, as organic disease of the heart to neurocirculatory asthenia, vasomotor instability, or psychoneurosis, or as arthritis to psychoneurosis under similar circumstances, substantially the same degree of disability may persist under the new diagnosis as under the old one. Even though material improvement in the hysical or mental condition is clearly reflected, the rating agency will consider /hether the evidence makes it reasonably certain that the improvement will be permanent and can be maintained under the ordinary conditions of life, i. e., while employed or, if unemployed, while actively seeking employment. [ ] (Dec. 14, 1956)

(B) If, after according due consideration to all the evidence developed by the several items discussed in subparagraph (A) of this paragraph, doubt remains, the rating agency will continue the rating in effect, citing the former diagnosis with the new diagnosis in parentheses, and following the appropriate code there will be added the reference "Rating continued pending reexamination months from this date, VA Regulation 1172." The rating board will determine upon the basis of the facts in each individual case whether 18, 24, or 30 months will be allowed to elapse before the reexamination is made. (July 10, 1942.) (C) [The above provisions apply to ratings which have continued for long periods at the same level (5 years or more). They do not apply to disabilities which have not become stabilized and are likely to improve. Reexaminations disclosing improvement, physical or mental, in these disabilities will warrant reduction in rating.] (Dec. 14, 1956.)

[(D) Permanent and total disability evaluations under part III, Veterans Regulation No. 1 (a), in effect during a period of hospital treatment for active pulmonary tubercuosis will be continued for 6 months following discharge from hospital as arrested or inactive, provided the medical authorities recommend that employment be not resumed, or be resumed only for short hours, not more than 4 hours a day for a 5-day week. At the end of the 6-month period, the veteran will be reexamined and the permanent and total disability evaluation may be extended for a further period of 6 months provided there is factual evidence that the veteran is not employed in a substantially gainful capacity and that he continues to be totally incapacity. Evidence to be considered, in making this determination will be residuals of thoracoplasty, continuance of pneumothorax or pneumoperitoneum, or continued medication with antibiotic drugs and, in any event, observance of rest periods during the day-time. Similar extensions may be granted under the same conditions at the end of 12 and 18 months. Where in the opinion of the rating board the veteran at the expiration of the 24 months will not be able to maintain arrest or inactivity under the ordinary conditions of life, the case will be submitted under VA Regulations 1142.] (Dec. 14, 1956.)

FREEZE OF VA DISABILITY RATING SCHEDULE

H. R. 9730 and H. R. 11343 are identical bills proposing a freeze of the Veterans' Administration schedule for rating disabilities, 1945 edition, effective January 1, 1958, and would prohibit any additions, changes, or modifications of the schedule after January 1, 1958, until and unless they were approved by the Congress and enacted into law. However, the bill would authorize the Administrator to increase ratings under the schedule at any time should he determine their present inadequacy.

The present rating schedule was promulgated pursuant to authority of law which directs the Administrator to adopt and apply a schedule of ratings of reductions in earning capacity from specific disabilities or combinations thereof. It is required that the ratings shall be based as far as practicable upon the average impairments of earning capacity resulting from such disabilities in civil occupations. The law further directs the Administrator to readjust the schedule from time to time in accordance with experience.

The Administrator's report to the committee on these bills recites the detailed procedure and careful coordination that is followed in making adjustments in the schedule from time to time. There has been initiated a procedure of furnishing copies of proposed changes, as well as comments of the service organizations thereon, to the Veterans' Affairs Committee prior to the final action by the Administrator. It is the view of the Administrator that the proper development of the rating schedule as a standard is possible only through the sustained efforts of an administrative agency with the necessary time, experience, and facilities for effective action. The enactment of either bill would limit the right of the Administrator to clarify or interpret

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the schedule he has issued and would restrict attempts to achieve uniformity in relation thereto. It would clearly be inconsistent with the principle that adequate authority should be extended with any imposed responsibility. The Bureau of the Budget concurs with the Veterans' Administration in strongly recommending against enactment of the proposed legislation.

BURIAL ALLOWANCES

H. R. 3786, H. R. 9671, H. R. 11801 and H. R. 9710 have the same purpose, namely, to increase from $150 to $250 the maximum amount payable by the Veterans' Administration for the funeral and burial expenses of deceased veterans. The law now provides that where a veteran dies who was a veteran of any war, or who had been discharged for a service-connected disability, or who was receiving disability compensation, the Administrator may pay a sum not exceeding $150 to cover the burial and funeral expenses of the deceased veteran and the expense of preparing the body and transporting it to place of burial. If death occurs in one of its facilities the Veterans' Administration pays the actual cost, not to exceed $150, and in addition transports the body to the place of burial.

The burial allowance was last increased from a maximum of $100 to $150 by Public Law 529, 79th Congress, July 24, 1946. In 1955, in reporting to your committee (C. P. 177) on H. R. 3707, 84th Congress, a bill similar to the present bills, the Veterans' Administration pointed out the difficulty in securing contracts for complete burials within the present allowance of $150 and cited various areas of rising costs and burial services. It was concluded that an increase to $200 was adequate for that time. Considering the further advance in prices and costs since 1955, it is believed that the proposed increase to $250 can be justified. The estimated total additional cost for the first year would be about $15,300,000. The report of the Veterans' Administration on these bills encloses a copy of letter from the Bureau of the Budget setting forth the reasons why it recommends against favorable consideration of these bills at this time.

MISCELLANEOUS BILLS

H. R. 65: This bill would extend to personnel in the VA regional office in Manila certain allowances and benefits now authorized by law for members of the Foreign Service of the State Department. Programs administered by the Veterans' Administration in the Philippines are of major significance with respect to our relations with that country and involve substantial expenditures by this Government. It is therefore necessary that highly competent key personnel be employed to assure successful administration of such programs. The Veterans' Administration recognizes that authorizations of the allowances as proposed by the bill would be helpful in the recruitment and retention of personnel in our Manila regional office and has so reported to the committee. The Bureau of the Budget, however, points out that there are bills pending before the House Committee on Post Office and Civil Service which would authorize overseas allowances on a uniform basis for all of our citizens employed in foreign countries regardless of agency or location. The Bureau, therefore, does not

favor enactment of H. R. 65 but rather recommends favorable consideration by the Congress of the mentioned bills which would provide equal treatment for all civilian employees in foreign countries.

H. R. 11528: This bill would liberalize the service requirements for World War I veterans by extending potential entitlement to certain compensation, pension and medical benefits for veterans who served for any period of time provided they were in the active service on the day of November 11, 1918. Our report on this bill explains in detail the various World War I service provisions of the laws which generally require 90 days during the war period. World War I is defined as the period beginning on April 6, 1917, and ending on November 11, 1918 (or April 1, 1920, if there was service in Russia), and also includes any period of service performed by a veteran after November 11, 1918, and before July 2, 1921, if he served during the basic period of hostilities. Enactment of H. R. 11528 would be discriminatory against other presently ineligible World War I veterans whose service was of considerably greater duration, as well as veterans of other war periods similarly situated. Enactment of the bill is opposed by the Veterans' Administration and would not be in accord with the program of the President.

H. R. 330: This bill proposes to establish a statutory service-connected disability rating of 10 percent for every veteran who engaged in combat with the enemy during a war, campaign, or expedition and who as a result of being wounded or gassed was awarded the Purple Heart. If any such veteran is now rated as disabled for compensation purposes he would have his rating increased by 10 percent but not to a degree in excess of 100 percent.

The Purple Heart was awarded to members of the Armed Forces who were wounded in action against an enemy or as a direct result of a hostile act of such enemy. For such purposes a wound is defined as an injury to any part of the body from an outside force, element or agent. A physical lesion is not required. However, the wound must have necessitated treatment and evidence thereof must have been made a matter of record.

Disability ratings for the purpose of paying compensation under laws administered by the Veterans' Administration are based as far as practicable upon the average impairments of earning capacity resulting from such disabilities in civil occupations. There are liberal provisions under which service connection of a disability may be presumed and all reasonable doubt is resolved in favor of the veteran. If the wound in any case for which the Purple Heart was awarded is in fact disabling in nature and was incurred in line of duty it would be compensable under existing law. In such cases there would, of course, be no sound basis for superimposing an additional rating of 10 percent for the same condition. Enactment of the bill would be tantamount to providing for many cases a minimum pension of $19 a month for life for holders of the Purple Heart. In this connection it may be noted that the only pension authorized under existing law for the holder of a decoration or award is in the amount of $10 per month for holders of the Medal of Honor who have attained the age of 65 years. Information is not available upon which to base an accurate estimate of the cost of the bill, if enacted. It is understood that for wounds incurred during the Korean conflict the Army alone

awarded the decoration to about 117,000 persons. In the casualty records of the Defense Department almost 700,000 servicemen are listed as having received nonmortal wounds during World War II. H. R. 3867 has a similar purpose, but would be effective only as to persons awarded the Purple Heart after enactment of the bill. It would appear therefore that the bill would have no immediate effect. H. R. 3822: This bill would conclusively presume that an injury or disease was incurred in line of duty "in the absence of a certification to the contrary by the service department concerned". Section 105, Public Law 85-56 provides that generally an injury or disease incurred during service will be deemed to have been incurred in line of duty in such service unless it was the result of a person's own willful misconduct. It is provided, however, that the requirement for line of duty will not be met if at the time the disability was incurred the person was deserting the service, or absenting himself without leave materially interfering with the performance of military duties, or, under certain conditions, was confined under sentence of court-martial or civil court. Further, the law provides that venereal disease shall not be presumed to be due to willful misconduct if the person complies with service regulations as to reporting and receiving treatment.

Under administrative regulations the records of service departments are accepted in determining line of duty status of disease or injuries unless the above-mentioned conditions are present or the facts otherwise clearly warrant a contrary finding. The bill could be construed to require a not-in-line-of-duty finding in the event of a certification to that effect by the service department. In this connection it should be noted that the service departments routinely hold that any disability which preexisted service was not incurred in line of duty. Since the Veterans' Administration is not bound under existing law by such finding it may consider the question of aggravation of a preexisting condition and as a result grant benefits in proper cases.

H. R. 3971 provides that an injury causing disability of 30 percent or more which was incurred as the result of the unauthorized handling of seemingly ineffective missiles, projectiles, mines, or other explosive weapons shall not be considered to be due to willful misconduct. As a general proposition under existing law and regulations such injuries incurred as the result of violations of orders, gross negligence, or wanton disregard for the person's own safety are considered by the service departments as incurred not in line of duty and such findings are generally followed by the Veterans' Administration. Mere technical violations of regulations or ordinances, on the other hand, do not, per se, constitute willful misconduct but are factors for consideration in the light of attendant circumstances. Any injury which is the result of conscious wrong-doing or prohibited action is unfortunate and regrettable. However, it would be difficult to justify placing veterans with such disabilities, regardless of degree, on a parity with veterans having incurred disabilities in service without fault on their part. For the information of the committee in connection with this bill and the preceding bill there is furnished for the record a copy of Veterans' Administration Regulations 1065 and 1066 dealing with willful misconduct and line of duty.

1065 WILLFUL MISCONDUCT

(A) A disabling condition will be considered to be the result of willful misconduct for the purpose of all adjudications under Veterans Regulation No. 1