lation is not apparent. Accordingly, it is recommended that the bill, H.R. 281, be not favorably considered. The Bureau of the Budget advises that there is no objection to the submission of this report to the committee. Sincerely yours, ROBERT J. LAMPHERE, Associate Deputy Administrator (For and in the absence of Bradford Morse, Deputy Administrator). OFFICE OF THE ADMINISTRATOR OF VETERANS' AFFAIRS, Hon. OLIN E. TEAGUE, VETERANS' ADMINISTRATION, Washington, D.C., July 15, 1959. Chairman, Committee on Veterans' Affairs, DEAR MR. TEAGUE: The foliowing comments are submitted, as requested, on H.R. 279, 86th Congress. The purpose of the bill is to amend existing law to provide that malignant tumors (cancer) developing a 10-percent degree of disability or more within 2 years from the date of separation from active service, shall, in the absence of affirmative evidence to the contrary, be deemed to have been incurred in or aggravated by such service. The present law governing presumptive service connection for chronic diseases provides, generally, that a chronic disease (other than active tuberculosis and multiple sclerosis) becoming manifest to a degree of 10 percent or more within 1 year from the date of separation from active service shall, subject to rebuttal, be considered to have been incurred in or aggravated by such service. With respect to all types of active tuberculosis, a 3-year presumptive period is provided and, for multiple sclerosis, a 2-year period. These presumptions require at least 90 days' active service during a period of war, as defined in section 101 of title 38, United States Code. Direct service connection may be granted for malignant tumors (cancer) which do not become manifest within the present presumptive period of 1 year when the evidence of record is deemed adequate to warrant such a finding. In such cases, under the directive originally contained in Public Law 361, 77th Congress, December 20, 1941 (now sec. 354 of title 38, United States Code) where a veteran is seeking service connection for any disability due consideration shall be given to the places, types, and circumstances of his service as shown by his service record, the official history of each organization in which he served, his medical records, and all pertinent medical and lay evidence. The law further provides: In the case of any veteran who engaged in combat with the enemy in active service with a military, naval, or air organization of the United States during a period of war, campaign, or expedition, the Administrator shall accept as sufficient proof of service connection of any disease or injury alleged to have been incurred in or aggravated by such service satisfactory lay or other evidence of service incurrence or aggravation of such injury or disease, if consistent with the circumstances, conditions, or hardships of such service, notwithstanding the fact that there is no official record of such incurrence or aggravation in such service, and, to that end, shall resolve every reasonable doubt in favor of the veteran. Service connection of such injury or disease may be rebutted by clear and convincing evidence to the contrary. * * * The 1-year presumptive period for the service connection of a chronic disease, previously covered by regulation based upon sound medical judgment, was incorporated in veterans regulations promulgated under Public No. 2, 73d Congress, in 1933. In 1948 Congress specified certain diseases which, among others, should be deemed chronic, but did not extend the uniform 1-year presumptive period (Public Law 748, 80th Cong.). It was not until 1950 that an exception to the general rule was made in the case of active pulmonary tuberculosis (Public Law 573, 81st Cong.), and in 1951 a further presumption was authorized in the case of multiple sclerosis (Public Law 174, 82d Cong.). In 1951 the Congress extended the presumptive period for an active psychosis for the limited purposes of hospital and medical treatment, and in 1953 extended the presumptive period for all other types of active tuberculosis to 3 years. The committee will, no doubt, wish to give careful consideration to the problem of whether the proposed extension of the presumptive period for malignant tumors (cancer) will be urged as a precedent for extending the presumptive period for many other chronic diseases. It is not possible to furnish an estimate of the cost of the bill, if enacted, in view of the unknown factors involved. There are administrative provisions whereby chronic diseases, including malignant tumors, incurred within a reasonable time after the present presumptive period following active military service can be and are handled on an individual basis where there is a likelihood that the condition had its inception during military service. Accordingly, the Veterans' Administration does not recommend favorable consideration of H.R. 279 by your committee. The Bureau of the Budget advises that there is no objection to the submission of this report to the committee and that enactment of the proposed legislation would not be in accord with the program of the President. Chairman, Committee on Veterans' Affairs, House of Representatives, Washington, D.C. DEAR MR. TEAGUE: The following comments are furnished, as requested, on H.R. 280, 86th Congress. The purpose of the bill is to amend existing law (38 U.S.C. 312) to provide that psychoses developing a 10-percent degree of disability or more within 2 years from the date of separation from active service shall, in the absence of affirmative evidence to the contrary, be deemed to have been incurred in or aggravated by such service. The present law governing presumptive service connection for chronic diseases provides, generally, that a chronic disease (other than active tuberculosis and multiple sclerosis) becoming manifest to a degree of 10 percent or more within 1 year from the date of separation from active service shall, subject to rebuttal, be considered to have been incurred in or aggravated by such service. With respect to all types of active tuberculosis, a 3-year presumptive period is provided and, for multiple sclerosis, a 2-year period. These presumptions require at least 90 days' active service during a period of war, as defined in section 101 of title 38, United States Code. H.R. 280 is similar to H.R. 320, 82d Congress, as passed by the House of Representatives May 1, 1951. As you are aware, H.R. 320 was amended in the Senate by the Committee on Finance to provide a conclusive presumption of service connection for an active psychosis developing within 2 years from the date of separation from active service in World War II, but only for the purposes of hospital and medical treatment, including outpatient treatment, authorized under laws administered by the Veterans' Administration. The bill was passed by the Congress in this form and approved as Public Law 239, 82d Congress, October 30, 1951. Under this law it is not necessary that the veteran have 90 days' service for the presumption to attach and willful misconduct is not a bar. There is definite medical substantiation that the time of onset of a psychiatric disorder, whether a psychosis or a psychoneurosis, is not the only criterion in the consideration of the cause or causes. Determination of causation, or etiology, of a psychosis in an individual is to be gained by an overall psychiatric evaluation of that particular person. Psychosis may result from any one of a number of factors, many of which may be of intercurrent origin and unrelated to service. H.R. 280, however, would establish a statutory presumption, which grants a presumption of fact, of uniform application, that manifestation of a psychosis at any time up to 2 years after separation is necessarily related to the facts or circumstances of military, naval, or air service during a period of war. Direct service connection may be granted for psychosis which does not become manifest within the present presumptive period of 1 year when the evidence of record is deemed adequate to warrant such a finding. In such cases, under the directive originally contained in Public Law 361, 77th Congress, December 20, 1941 (now sec. 354 of title 38, United States Code) where a veteran is seeking service connection for any disability due consideration shall be given to the places, types, and circumstances of his service as shown by his service record, the official history of each organization in which he served, his medical records, and all pertinent medical and lay evidence. The law further provides: In the case of any veteran who engaged in combat with the enemy in active service with a military, naval, or air organization of the United States during a period of war, campaign, or expedition, the Administrator shall accept as sufficient proof of service connection of any disease or injury alleged to have been incurred in or aggravated by such service satisfactory lay or other evidence of service incurrence or aggravation of such injury or disease, if consistent with the circumstances, conditions, or hardships of such service, notwithstanding the fact that there is no official record of such incurrence or aggravation in such service, and, to that end, shall resolve every reasonable doubt in favor of the veteran. Service connection of such injury or disease may be rebutted by clear and convincing evidence to the contrary. *** The 1-year presumptive period for the service connection of a chronic disease, previously covered by regulation based upon sound medical judgment, was incorporated in veterans regulations promulgated under Public No. 2, 73d Congress, in 1933. In 1948 Congress specified certain diseases which, among others, should be deemed chronic, but did not extend the uniform 1-year presumptive period (Public Law 748, 80th Cong.). It was not until 1950 that an exception to the general rule was made in the case of active pulmonary tuberculosis (Public Law 573, 81st Cong.), and in 1951 a further presumption was authorized in the case of multiple sclerosis (Public Law 174, 82d Cong.). As stated earlier, in 1951 the Congress extended the presumptive period for an active psychosis for the limited purposes of hospital and medical treatment, including outpatient treatment, to 2 years (Public Law 239, 82d Cong., now sec. 602 of title 38, United States Code). In 1953 the presumptive period for all other types of active tuberculosis was extended to 3 years. The committee will, no doubt, wish to give careful consideration to the problem of whether the proposed extension of the presumptive period for psychoses will be urged as a precedent for extending the presumptive period for many other chronic diseases. The Veterans' Administration does not have sufficient data upon which to base an accurate estimate of the cost of the bill, if enacted. It is believed that existing law and administrative provisions are sufficiently liberal and adequate so that chronic diseases, including psychoses, incurred within a reasonable time after the present presumptive period following active military service can be and are handled on an individual basis where there is a likelihood that the condition had its inception during military service. Accordingly, the Veterans' Administration does not recommend favorable consideration of H.R. 280 by your committee. The Bureau of the Budget advises that there is no objection to the submission of this report to the committee and that enactment of the proposed legislation would not be in accord with the program of the President. Chairman, Committee on Veterans' Affairs, DEAR MR. TEAGUE: The following comments are submitted in response to your request for a report on H.R. 113, 86th Congress, à bill to prohibit the severance of a service-connected disability which has been in effect for 10 or more years, except when based on fraud. This will also serve as a report on H.R. 949, 86th Congress, which is similar in purpose to H.R. 113. The bill provides that "a service connection which has been made for compensation, pension, or insurance purposes under laws administered by the Veterans' Administration, and which has been in force for 10 or more years, shall not be severed thereafter unless on a show ing that the rating originally granting service connection was based on fraud." As you know, the laws administered by the Veterans' Administration dealing with benefits for veterans and their dependents have been revised, codified, and enacted as title 38, United States Code, effective January 1, 1959. Therefore, in keeping with the purpose of the new codification, it is suggested that any proposals such as the subject bills, on which the committee may take further action, be revised in format so as to amend specifically the new title 38. For the purposes of title 38, United States Code, the term "compensation" is defined therein as a monthly payment made by the Administrator to a veteran because of service-connected disability, or to a widow, child, or parent because of the service-connected death of the veteran occurring before January 1, 1957. In view of this definition of the term "compensation," the question arises whether the bill would apply to "dependency and indemnity compensation," defined in title 38 as a monthly payment made to a widow, child, or parent because of a service-connected death occurring after December 31, 1956. The term "pension" is defined in title 38 as a monthly payment made to a veteran because of service, age, or non-service-connected disability, or to a widow or child because of the non-service-connected death of the veteran. Service connection is not relevant to the payment of non-service-connected disability pension to war veterans or of non-service-connected_death pension to widows and children of veterans of World War I and prior wars. However, under sections 543 and 544 of title 38 death pension is payable to widows and children of World War II and Korean conflict veterans who meet certain service requirements only if at the time of the non-service-connected death (1) the veteran had a service-connected disability for which compensation would have been payable if 10 percent or more in degree disabling; or (2) he was receiving (or entitled to recive) compensation or retirement pay based upon a service-connected disability. The bill apparently assumes there is a basic relationship between service connection and the benefit of insurance. Insurance is based on a contractual right and is normally not concerned with the matter of service connection. If a veteran with a service-connected disability for compensation purposes is granted National Service Life Insurance under title 38, United States Code, section 722, or reinstates his U.S. Government life insurance under title 38, United States Code, section 759, such insurance is incontestable except for fraud, nonpayment of premiums, or on the ground that the applicant was not a member of the military, naval, or air forces of the United States, and the matter of service connection is not a factor. There is only a remote possibility that the bill, if enacted, would enable a few policyholders of U.S. Government life insurance who would not otherwise be eligible, to reinstate their insurance under section 759, or to be granted premium waiver under section 760 of title 38, United States Code. The size of the Veterans' Administration compensation program (over 2,400,000 active cases presently on the rolls) makes it inevitable that in the application of the numerous provisions of law and regulations to the cases considered service connection will be erroneously authorized on occasion. Errors in adjudication may arise from mis |