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Mr. GOUGH. Congressman Adair, I was just going to add this one point: A bill was presented yesterday by Madam Chairman. It is a bill we have requested. The number is H. R. 2862. That is to accomplish just what has been mentioned. I would like to insert that bill at this point:

[H. R. 2862, 83d Cong., 1st sess.]

A BILL To establish a Federal Board of Hospitalization, and for other purposes Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That there is hereby established a Federal Board of Hispitalization (hereinafter referred to as the "Board") to be composed by the Attorney General of the United States, the Secretary of Defense, the Secretary of the Interior, the Director of the Bureau of the Budget, the Federal Security Administrator, the Administrator of General Services Administration, and the Administrator of Veterans' Affairs. Each member shall appoint an alternate to serve in his absence.

SEC. 2. The Administrator of Veterans' Affairs shall be Chairman of the Board, and he shall be designated an Acting Chairman from the membership of the Board to serve as Chairman during his absence. The Board shall meet at such time and place as may be designated by the Chairman.

SEC. 3. The Board may, in accordance with the provisions of the civil-service laws, the Classification Act of 1949, and Veterans Preference Act of 1944, as amended, appoint and fix the compensation of such officers and employees, and make such expenditures, as may be necessary, to carry out its functions, within the limits of any appropriation, or appropriations, made for such purposes. Officers and employees of any other department or agency of the Government may, with the consent of the head of such department or agency, be assigned to assist the Board in carrying out its functions. The Board may, with the consent of the head of any other department or agency in the Government, utilize the facilities and services of such department, or agency, in carrying out the functions of the Board. The Board may call upon and seek the advice of experts in the fields of medicine, hospital construction, and allied fields. The number and terms of service of such advisers shall be determined by the Board, as they may, individually, be paid compensation at a rate not in excess of $50 for each day actually spent in the work for the Board, plus necessary travel and subsistence expenses.

SEC. 4. The Board shall initiate studies of and analyze and review the hospital, convalescent, and domiciliary activities of all departments and agencies of the Federal Government in order (1) to prevent overlapping, duplication, and overbuilding of such facilities; (2) to insure the most efficient and complete utilization of the total hospital, convalescent, and domiciliary facilities of the Federal Government by each department and agency; (3) to determine the need for existing or additional hospital, convalescent, and domiciliary facilities of each department and agency; (4) to determine the area and locality in which such additional facilities should be provided; (5) to determine the extent to which non-Federal facilities may be used to supply beds for any department or agency; (6) to develop a complete over-all plan relative to facilities for providing within or through the Veterans' Administration adequate hospitalization and domiciliary care for persons who have served in the Armed Forces of the United States; and (7) to make studies and recommendations with respect to such matters as may be referred to the Board by the President, or by any member of the Board: Provided, That the functions of the Board shall not include authority to determine the manner in which the responsible heads of the Federal departments and agencies concerned shall operate hospital and domiciliary facilities under their jurisdiction, or to require the transfer of medical and related personnel from one department or agency to another, or to diminish the authority of any department or agency head to determine the extent to which beds in facilities under his control and operation shall be made available for the hospitalization, care, and treatment of beneficiaries of other Federal departments or agencies.

SEC. 5. No project for acquisition of additional hospital, convalescent or domiciliary beds by new construction, major alteration, or leasing of, or contracting for existing facilities shall be undertaken by any department or agency until it has been submitted to and reviewed by the Board as to need, location, type of construction, and any other factor which the Board may consider perti

nent to the performance of its responsibilities, nor until the resulting recommendation of the Board shall have been approved by the President: Provided, That any department or agency may acquire additional beds to meet a temporary seasonal, epidemic, or emergency requirement, if such acquisition does not require new construction: Provided further, That the Departments of the Army, Navy, and Air Force may acquire limited hospital facilities involving temporary type of construction only, and not exceeding three hundred beds for any one project, if no other suitable Federal hospital facilities are available: And provided further, That each project, involving the acquisition of beds under the first and second provisos of this section, shall be reported to the Federal Board of Hospitalization at the time approval thereof is given by the head of the department or agency concerned.

SEC. 6. Recommendations of the Board accompanied by substantiating data in support of the proposal shall be transmitted by the Chairman for the consideration of the President. Whenever the adoption of any recommendation is not unanimous, such recommendation shall be accompanied by a summary of the views or objections of the minority members.

SEC. 7. There are hereby authorized to be appropriated such sums as may be necessary and appropriate to carry out the provisions and purposes of this Act.

Mr. ADAIR. Thank you. I have one final question, and I apologize for taking so much time.

The CHAIRMAN. We like to have these things brought out, and the text of H. R. 2862 may be inserted as requested.

Mr. ADAIR. The final question is this: It is estimated that we are producing veterans at the rate of at least 100,000 a month now. I assume that obviously you have taken that into account in formulating this program.

Mr. GOUGH. We have indeed, sir.

Mr. ADAIR. Looking forward into the future, since that may be the case for some time to come, do you anticipate that that will make any considerable difference in the veterans' program of hospitalization or other services?

Mr. GOUGH. No; I do not. We still feel that the figure of 131,000 beds is a figure to be attained at the present time, and we do not see that the change will be too material. Some have confused their thinking on that because unfortunately in the original recommendation of the Hoover Commission they referred to the fact that a veterans' program for benefits and services and hospitalization would be for 182 million veterans.

Actually the beds are available for only seven-tenths of 1 percent of the veteran population. That is a realistic figure if we have the beds referred to; viz, 131,000. Now, there is not anything to what some people think of in regard to all veterans indiscriminately and families, and so on, being cared for. That has never been our position. It is an infinitestimal percentage of the veterans that we are concerned about, and the veterans who do have the need for the hospital.

Mr. ADAIR. Primarily the service-connected man, Mr. Commander? Mr. GOUGH. Primarily the service connected, the neuro-psychiatric, and the TB and the chronic.

Mr. BONIN. Mr. Commander, is it the opinion of the American Legion that Public Law 361 of the 77th Congress is being fairly administered?

Mr. GOUGH. Public Law 361 is the one that refers to education, is it not?

Mr. BONIN. No. I believe that it refers to service-connected disability. However, with no proof being established, or a lack of a

record, a veteran may come along and substantiate the fact that he is service connected and therefore he may establish his service connection. Do you really believe that is being fairly administered? Mr. GOUGH. I cannot refer to the actual law by name. I know our position on service connected. I will refer to Mr. Kraabel on that; and, if I may, I would like to give you generalizations concerning our stand on that.

I would like to be more particular and specific about the particular law.

Mr. KRAABEL. I think that we should identify that law by its number and date in Congress, and then from that point I think if Mr. Stevens, our director of claims, will embellish on what is being done about it. Is it Public Law 361 of the 77th Congress?

Mr. BONIN. I am quite certain that it is. I believe that it was in 1941 in the 77th Congress.

The CHAIRMAN. For the convenience of the members I will have inserted at this point Public Law 361, 77th Congress, and pertinent VA regulations which deal with presumptive periods for chronic and tropical diseases.

(The matters referred to follow :)


(Ch. 603-1st Sess.)

H. R. 4905

AN ACT To facilitate standardization and uniformity of procedure relating to determination of service connection of injuries or diseases alleged to have been incurred in or aggravated by service in a war, campaign, or expedition

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That the Administrator of Veterans' Affairs is hereby authorized and directed to include in the regulations pertaining to service connection of disabilities additional provisions in effect requiring that in each case 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.

In the case of any veteran who engaged in combat with the enemy in active service with a military or naval organization of the United States during some war, campaign, or expedition, the Administrator of Veterans' Affairs is authorized and directed to accept as sufficient proof of service connection of any disease or injury alleged to have been incurred in or aggravated by service in such war, campaign, or expedition, 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 such veteran: Provided, That service connection of such injury or disease may be rebutted by clear and convincing evidence to the contrary. The reasons for granting or denying service connection in each such case shall be recorded in full. Approved December 20, 1941.


(c) That for the purposes of paragraph I (a) hereof a chronic disease becoming manifest to a degree of 10 percent or more within 1 year from the date of separation from active service as set forth therein shall be considered to have been incurred in or aggravated by service as specified therein notwithstanding there is no record of evidence of such disease during the period of active service, provided the person suffering from such disease served 90 days or more in the active service as specified therein: Provided, however, That where there is affirmative evidence to the contrary, or evidence to establish that an intercurrent


injury or disease which is a recognized cause of such chronic disease, has been suffered between the date of discharge and the onset of the chronic disease, or the disability is due to the person's own misconduct, service connection will not be in order: Provided further, That the term "chronic disease" as used in this paragraph shall include anemia, primary; arteriosclerosis; arthritis, bronchiectasis; calculi of the kidney, bladder, or gall bladder; cardiovascular-renal disease, including hypertension, myocarditis, Buerger's disease, and Raynaud's disease; cirrhosis of the liver; coccidiomycosis; endocarditis; diabetes, mellitus; endocrinopathies, epilepsies; Hodgkin's disease; leukemia, nephritis; osteitis, deformans; osteomalacia; organic diseases of the nervous system, including tumors of the brain, cord, or peripheral nerves; encephalitis lethargica residuals; scleroderma; tuberculosis, active (other than pulmonary); tumors, malignant; ulcers, peptic (gastric or duodenal), and such other chronic diseases as the Administrator of Veterans' Affairs may add to this list: Provided further, That active pulmonary tuberculosis developing a 10 percent degree of disability or more within 3 years, or multiple sclerosis 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 active service: And provided further, That, subject to the limitations of this subparagraph, tropical diseases, such as cholera; dysentery; filariasis; leishmaniasis; leprosy ; loiasis; malaria ; blackwater fever; onchocerciasis; oroya fever; dracontiasis; pinta; plague; shistosomiasis; yaws; yellow fever, and others and the resultant disorders or diseases originating because of therapy administered in connection with such diseases, or as a preventative thereof, shall be accorded service connection when shown to exist within 1 year after separation from active service or at a time when standard and accepted treatises indicate that the incubation period thereof commenced during active service. Nothing in this paragraph shall be construed to prevent service connection for any disease or disorder otherwise shown by sound judgment to have been incurred in or aggravated by active service.

Mr. STEVENS. Mr. Bonin, the Veterans' Administration for a long time has had a very definite regulatory requirement that the benefit of the doubt be resolved in determining whether or not there was an entitlement to service connection in favor of the veteran. Before this became a law, it was already in instruction promulgated by the Administrator of Veterans' Affairs. We not too infrequently find, unfortunately, that many of the rating boards fail to give due credence to the very positive instruction that was issued administratively and that is now in the law. But we take the individual case and battle it out; and in the long run, properly represented, we find not too much difficulty in finding a full resolution of the doubt. I will say that, Mr. Bonin.

Mr. BONIN. The reason I asked that question is because I have received numerous communications from veterans who apparently feel that it is not being properly administered.

Mr. STEVENS. The individual case, on occasion, must finally resolve itself through appellate channels before full operation of that law is resolved. There is no question of that.

Mr. BONIN. The ultimate authority on that is the Board of Veterans' Appeals; is that not right?

Mr. STEVENS. Yes. An appeal is taken to the Administrator, and that Board makes its determination. Sometimes we disagree with the Board of Veterans' Appeals decisions, and we go back and ask for a reconsideration, and not infrequently we get satisfaction on the further study by that Board, based upon representations which we make.

Mr. KRAABEL. I might add that the type of case that comes to an office such as the rehabilitation staff here is the very toughest case, and these gentlemen who are here, Dr. Shapiro and Mr. Stevens, and

their associates have been instrumental in having several of these cases reconsidered time and time again, pointing out what they felt professionally was the defect in the decision before, or the defect in the makeup of the claim before, and they have had a very outstanding record on reversals of the original decisions which were against the


I think our record will be borne out very substantially on that point. There are, however, still those cases that cannot be resolved satisfactorily to the claimant, and under the present laws we have exhausted every possibility in their behalf.

The CHAIRMAN. At a later date I think we will ask the staff of the American Legion to come before us and discuss all of the operations of the legislation. I think it would be fine if they would come.

Mr. GOUGH. May I just make this statement since the service- and non-service-connected cases have been mentioned?

It is not entirely in line with your question, sir, but I would like to call to the attention of the members of this committee an article-and I do not say this with pride of authorship-prepared for the American Legion magazine, which you all receive and it is in the current issue-relative to who is being treated in our veteran hospitals. It gives an analysis from the basis of the 1950 and 1951 very comprehensive surveys of the problem of the service- versus non-service-connected cases, bearing out that there are between 7 and 8 percent only who are in the nonservice classification, short term, for treatment in veterans' hospitals. It is a factual article as near as can be made upon the basis of the survey, and I would like to call that to your particular attention.

The CHAIRMAN. Mr. Commander, I would like to say that it will be in the Congressional Record of Thursday, February 12. It is an excellent article. It is also in the record of the last hearings.

Mr. BONIN. It is a very commendable article, Madam Chairman. I have had the privilege of reading it. I do say that it is very enlightening.

Mr. GOUGH. I am flattered, indeed. I hope that this is in the record. The CHAIRMAN. It most certainly is. By chance, if any part of it is left out, when you correct the record you may include it. We have copies of the magazine in the outer lobby, if you would like them. So many cases can be service connected after the men are hospitalized. Particularly is that true in the case of tuberculosis and neuropsychiatric cases.

Mr. AYRES. You have not gone into what your position is going to be on the GI housing program; and, since our most able chairman. has appointed that committee and I find myself chairman of it, I wonder if you would care to comment briefly on it.

Mr. GOUGH. I would be delighted to.

We have a long-range program of intensive investigation concerning the interest rates, and our position has been stated in previous conventions prior to the last one in New York, and it has been to hold the line at 4 percent.

In New York there are many factors presented on both sides, and the convention mandated me as commander to appoint a three-man committee to make a thorough investigation of this. It is a continuing investigation.

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