Mr. PECKARSKY. Now you are getting into cases where I would have to examine all of the factual situation. There is a special evaluation for bedridden. The disabilities confining the veteran to the wheelchair would have to be carefully separated out to determine what the basis for the confinement was. In other words, if it was the loss of two legs, for example, it would be one thing. If it was the weakness of the entire body, it would be something else.

Mr. EDGAR. But it is your testimony before us that there are varieties of need.

Mr. PECKARSKY. Infinite varities, sir.

Mr. EDGAR. And it could be at certain points, where a veteran becomes severely helpless in terms of sanitary conditions for the veterans and in terms of need for additional aid and attendance over and above the average ordinary aid and attendance of getting dressed or of providing a mean-isn't there some level of difference-severity?

Mr. PECKARSKY. There may be, Mr. Edgar, but we are unable to perceive it to the extent that we could give criteria or support—a significant difference here.

Mr. EDGAR. Well, I think that you challenged us to put in the record a definition of "helplessness" to give you some guidance in the record if in fact we move to support the change in H.R. 10338 to change the word from "medical" to "helplessness," as was suggested yesterday by the Paralyzed Veterans. Was that the challenge that you were laying out for us?

Mr. PECKARSKY. It certainly was not intended as a challenge, Mr. Edgar. I merely pointed out that I understand what the phrase "need regular aid and attendance" means because we have interpreted it for years; and our interpretation has received, at least, the tacit agreement of the Congress. I do not know what the phrase "medical aid and attendance" is as distinguished from regular aid and attendance. It would require some sort of

Mr. EDGAR. If I can clarify that, their testimony yesterday was to change and take out the word "medical" and put in the words "constant aid and attendance" and the word "helplessness" and there was one other word that I cannot remember this morning. It was something like "severe helplessness" or something-in the language of this particular bill, so that when the two-tiered system was placed, you would then have to go to the Federal Register and define the severity of "helplessness."

They do take out the word "medical," because they think in some cases the severity of helplessness may not be a medical problem. It may simply be a physical problem that does not need medical attention as much as it needs the care of cleaning up the veteran to provide some of the basic life supports.

Mr. PECKARSKY. Well, you certainly stated the proposition accurately. We would have to go to the Federal Register with our definitions. My original posture was that it would be extremely helpful to us, in stating our regulations, if the committee stated very clearly what it had in mind with the differentation in language.

Mr. EDGAR. But I think if we move in this direction during the markup session of our legislation on compensation, some of us will try to define very carefully for you what that "helplessness" is.

Mr. PECKARSKY. I understand.

Mr. EDGAR. I appreciate your testimony. I do have one final question to ask and that is and I do not mean to raise it in a smart way. I really want to raise it in a creative way. In the 3 years and I have been here in Congress, most of the legislative initiatives on the part of the Veterans' Administration, in my opinion, have been reactions to what you know is coming (like cost-of-living or that type of thing), I was wondering: Does the Veterans' Administration ever sit around in a room discussing the possibility of creative changes in the Veterans' Administration programs that in fact, you know, from your perspective would be of great value and help or do they get short-does that kind of setting get shortcutted by the annual budget and appropriation process in not wanting to give us any hints as to what good new ideas might cost money?

Mr. PECKARSKY. That, Mr. Edgar, is an extremely difficult question to answer. [Laughter.]

I will try nonetheless. With extreme candor, yes, we do; and, yes, we do occasionally recommend changes. But when I spoke of an institutional position-there are institutional procedures to achieve an institutional position and sometimes those changes get lost between the initiation and the effectuation. I will say, however, that the staff of this committee and of the Senate committee have not been reluctant to consult with us on a staff assistance basis. I would like to think that we have been quite helpful over the years in helping your staff come up with forward-looking ideas as to the direction of legislation.

Mr. EDGAR. Just one final question just in clarifying my statement. The change that was suggested was the words (in replacing "constant medical aid and attendance") "is in need of constant aid and attendance because of severe helplessness such veterans shall be paid, in addition to such compensation, a monthly aid and attendance allowance at a rate of" (they suggest) "$900 per month, subject to the limitations of section 3203 (e) of this title." This is the legislative language drafted by the Paralyzed Veterans of America in their testimony yesterday and it is language that some of us are seriously considering in terms of our movement to this two-tier system.

Thank you, Mr. Chairman.

Mr. MONTGOMERY. Thank you, Mr. Edgar. Thank you. Our next witness is as I say, we have two witnesses. We do not want to rush them, but I believe we can finish up. Our last witness, Colonel Burke, who is a Congressional Medal of Honor winner and who will speak in behalf of the Medal of Honor winners-there is no opposition right now to his bill, so if I was him, I would not overstate today. [Laughter.] But before we call on him, we would like to hear from the DAV: Mr. John Heilman and Mr. Charles Joeckel, who represent the DAV. We would like to hear from both of these gentlemen and welcome them back to the committee.

STATEMENT OF JOHN F. HEILMAN, DEPUTY NATIONAL DIRECTOR OF LEGISLATION, DISABLED AMERICAN VETERANS, ACCOMPANIED BY CHARLES E. JOECKEL, JR., LEGISLATIVE ASSISTANT Mr. HEILMAN. Good morning, Mr. Chairman. As you have noted, Mr. Chairman, in the audience today are 30 national service officers

from our organization who are here in Washington undergoing an intensive. 2-week period of training in their skills as national service officers.

Mr. MONTGOMERY. We would like to have that group stand up, for the Members of Congress and also for the staff, so we can see you and welcome you.

[Applause; members of the audience stood.]

Mr. HEILMAN. I was going to say, if you can note the Vietnam era age group in our NSO's, that sort of belies the statement made by some that the veterans organizations do not represent the Vietnam era veteran. Over 80 percent of our NSO's are, in fact, Vietnam era veterans throughout the country.

Mr. MONTGOMERY. I congratulate you on that.

Mr. HEILMAN. Mr. Chairman, we consider the subject legislation of today's hearing to be very, very important; and, if you have no objection, I would like to read my statement in its entirety. Otherwise, I would attempt to summarize, but we consider all the bills of today's hearing to be of the utmost importance.

Mr. MONTGOMERY. Well, go ahead. Can you summarize though? Without objection, your full statement will be put in the record. If you could take each bill and summarize it for us, I believe that would help us because I would like to get these

Mr. HEILMAN. All right, sir, I will do that. I hope, in doing so, I do not de-emphasize the importance we attribute to each of these measures. H.R. 10337 would provide a 6.5 percent increase in the compensation and DIC programs. Your committee in the Congress has been diligent over the years in insuring that these benefit payments keep pace with the rise in the cost-of-living.

The most recent CPI data that we have seen indicates that in the first 3 months immediately following our last compensation increase (October 1 of last year) the CPI rose about 0.4 percent during those 3 months. The January rise was 0.8 percent. Recently we have seen that the Wholesale Price Index for the month of February has gone up by 1.1 percent, which is the highest increase in over 3 years, and this will be felt at the consumer level very shortly.

So consequently, we feel that the 6.5 percent increase recommended in 10337 will fall short, in fact, of providing the proper monetary increase come October.

Therefore, the DAV has recently introduced-had introduced a bill that would call for a 7 percent increase in compensation and DIC benefits. We feel that by the time October 1 rolls around this will, in fact, be a more realistic level.

Additionally, our bill would provide for a 7 percent increase in the special statutory "k" award, which is payable to service-connected single amputees and others who have suffered the requisite disability. Such an increase is not proposed in 10337. This award has only been increased twice in the last 26 years. A 7 percent increase would mean that these recipients would in fact only get a total of $48 per year in additional benefits; and we feel that this is a modest figure and a reasonable request.

H.R. 10336 would propose the payment of dependency allowances for veterans whose disabilities are in the 10 percent to 40 percent cate

gory. As has been stated, right now dependency allowances are only given to veterans who were service connected at the rate of 50 percent

or more.

We feel there is no justification for denying the payment of dependency allowances to these veterans in the 10 percent to 40 percent category.

I would point out that in the pension program, death pension program, vocational rehabilitations program and the GI bill, chapter 34 program, additional amounts are provided for each dependent à beneficiary may have. Of course, in the death pension for widows and in the chapter 34 program (GI bill) physical disability is not even a portion of the eligibility criteria.

On the other hand, 10 percent through 40 percent disabled veterans are service connected and they are disabled. Some of these disabilities are very severe indeed: a below the knee amputation, the enucleated loss of an eye, a severe disability involving the loss of a nose or loss of a tongue. All these are rated at 30 or 40 percent levels and, because of that, they are not able to get a dependency allowance.

We feel that any veteran who has a compensable disability should in fact receive (and I want to underscore that it would be proportionate to the 100 percent rate) a proportionate dependency allowance.

In this connection, we feel that there is a need for a general review of the dependency allowances paid under the compensation and DIC programs. In our prepared testimony we pointed out that in the pension reform bill that has recently been acted upon by the full committee, a pensioner gets an extra $1,200 a year for his spouse and $600 a year for each child that he might have. In the compensation program a 100 percent disabled veteran gets $552 for his spouse. If he has got one child, he gets another $372 and he gets decreasing amounts for other children that he might have. Also, in the pension reform bill a pension widow would get $600 a year for each of her dependents. A DIC widow presently receives only $396 per year for each of the minor children that she may have. So we feel that there is a definite need for a review of these allowances.

H.R. 10338 would propose a new aid and attendance rate for those who need constant aid and attendance. We feel that there is a very definable group of veterans who need a higher level of care than is generally associated with the term "regular aid and attendance."

A quadriplegic, for example, would need outside aid for the prevention of bedsores. He would need constant care with certain life support devices like respiratory machines. He might be in need of dialysis. He could have loss of bladder and sphincter control. He needs a greater intensity of care.

If we should give veterans in this category a higher aid and attendance allowance, many of them who are now hospitalized, because the only way they can get this care is to remain in a hospital-if we could give them additional benefits, they might in fact be able to hire someone to provide this care in their home and we could get them out of the hospital setting. So we feel this measure is very beneficial indeed and very justified.

H.R. 10352 would clarify the intent of Congress with respect to the tax exemption that is created when a military longevity retiree

receives an award or an increased award of VA disability compensation benefits. Without further belaboring this point, we feel this is a justifiable bill and that the tax exemption that the Congress intended these veterans to have should in fact be given to them. So we support this bill.

H.R. 9994 refers to the presumption of service connection for cause of death in certain cases where the veteran was totally disabled from service-connected causes at the time of death.

This has been a longstanding goal of the DAV and we support this measure very strongly. We have long felt that the VA has not been properly adjudicating the claims in this category and that they have not used the vast discretionary power that is in their hands to make favorable contributory cause of death determinations.

In response to the VA witness who alluded to a 13 percent denial rate, I want to point out that this indeed was achieved because of congressional oversight. This denial rate was pointed out in the VA studies, I believe, in 1975. However, we monitored these claims in 1976 and we found that the denial rate in this category had climbed back up to about the 1974 level of almost 25 percent.

We feel that the rating boards throughout the country are not providing just, uniform decisions in this category of claim. Our study indicated that veterans who have the same service-connected disability (for example, neuropsychiatric, multiple amputations), and primary cause of death, when it is determined that the service-connected disability was not the primary cause of death, various rating boards will in fact grant one claim in one part of the country and deny the same claim in another part of the country. So they are not uniform.

H.R. 9994 would provide this presumption if the disability existed. ten years preceding death or continuously from service discharge. It would require that the death be from natural causes and that in terms of a DIC spouse claimant, the marriage would have had to be in existence for at least 5 years. We feel, with these restrictions on the criteria, that a very deserving group of survivors of veterans would in fact be getting more uniform and just determinations from the VA on their DIC claims.

As has been pointed out, it is very modest in cost. It carries a first year cost of less than $1 million.

We strongly urge your action on this measure.

H.R. 11530 would provide for increases for certain veterans who are service connected for the loss, or loss of use of, three extremities. There are about 727 of these veterans on the rolls right now and 89 of them have actually suffered the physical loss of three extremities. We feel that the present rate of payment authorized does not reflect the catastrophic social and industrial impairment that may have occurred; and our bill simply proposes, through amendment of section 314, to provide modest increases to these veterans, ranging from 11 to 13 percent, depending upon what level of the statutory award category they are now placed in.

It is a low-cost measure for a very deserving group of veterans and we urge the committee's approval of it.