In the other 260 positions we have no discretionary power, but must employ the persons at certain salaries not within certain limits. Of the 62 places for which limits and not definite salaries are fixed we are using the maximum in 21 instances and using less than the maximum in 41 instances. I think it is all right if you say that you can employ so many people at not to exceed a certain maximum, for everyone over, say, $2,500, but the director, if he is expected to put the job over, must be permitted to secure enough capable men to insure the success of the undertaking.

The question has been raised as to whether or not it would cause delay in making this transfer. My understanding of the Rogers bill is that whole organizations would be transferred. It will just be a question of time as to the working out of the proper relationships. It should not cause any delay over the present service which you are now providing.

There will be more satisfactory service to the men. He will have only one agency to deal with. He should be able to go to one local district office and make his application. It should be determined at one place and at one time whether he is entitled to compensation, whether he is entitled to vocational training, and what particular medical treatment he needs. America is the only country which did not determine this question before the man was discharged from the service. Now we have to go out and find him. One governmental agency should deal with him.

It would relieve the bureaus of several difficult matters. For instance, we have at the present time on our pay rolls 150 nurses who are following these men up, doing what we call "attendance work," i. e., to see that the men are in training. The Public Health Service deals with men in hospitals, and has authority to maintain hospitals. Yet men who are suffering from tuberculosis, when they reach an arrested condition, are discharged though not in physical condition to go into full employment. They should be held in what we know as a training school for a while under medical supervision. The Public Health Service does not need a school. We do not need a hospital. Consequently the Public Health Service can maintain its hospital, but can not maintain its school. We have to go out and lease school buildings, where we place men for training. The Public Health Service details doctors, but under one organization, one centralized control, there would be no hiatus between the hospital, the school, and employment. As many doctors as might be necessary and as many administrative officers as were necessary would be detailed to a training center by the one Government organization.

It would ultimately result in a saving to the Government. I do not think it would at first. It is a question of whether or not you are measuring the efficiency of the new bureau or whether you are measuring the overhead expense of the new bureau. At first you will have to have as many clerks and you will have to have as large a staff. I think you would eliminate duplication of files. I think you would eliminate a number of medical examinations, and I think you would in a few months eliminate clerks and the staff, perhaps, in the disbursing of the money and in the accounting divisions of the board.

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On the other hand, looking at it solely as to its effect on the Federal Board for Vocational Education, I think it would be a distinct advantage to disassociate the administrative work of dealing with the disabled ex-service man from the cooperative work with the States in promoting vocational education and the rehabilitation of persons disabled in industry.

I should like to say a few words about the two bills which are pending before the committee, H. R. 14677 and 14961. The first bill Col. Hallett referred to as the "Rogers bill" and the second one as the "Legion bill." In my judgment, the Rogers bill is not wise. In other words, the Rogers bill leaves the Public Health Service as it is, and would combine or consolidate the Federal Board and the Bureau of War Risk Insurance. But the relations of the Federal board are not with the War Risk Insurance Bureau, they are with the Public Health Service. The relations of the Bureau of War Risk Insurance are not particularly with the Federal board, they are with the Public Health Service. You will get nowhere if you put just the War Risk Insurance Bureau and the Federal board together. That bill measures the problem solely by money payment. It does not measure it by men who need medical treatment and at the same time are entitled to vocational training. It is not compensation service the board wants. We want the doctor to sit by the man, not the insurance officer. The man who is in vocational training and getting $100 a month needs the doctor and wants to know whether or not the training whcih is given him is what he should have. He does not need the compensation officer who is figuring on reducing his compensation when he gets through his vocational training. When you look at the problem it is not a question of combining the Compensation and Claims Division with vocational training, but it is the problem of combining medical treatment and the compensation and claims division with vocational training.

I would suggest with regard to the second bill, the Legion bill, that the Director of this new bureau, whatever you call it, be an Assistant Secretary of the Treasury or an assistant secretary of a department-I think for many reasons the bureau should not be in the Treasury Department, but that is a secondary matter. If he were an assistant secretary and a director at the same time, and the Public Health Service were placed in that department, the Surgeon General could report to him as assistant secretary on all civilian matters and to him as director on all matters pertaining to disabled men. This would give sufficient authority to the director, yet would leave the Surgeon General in his present relation and the secretary of the department.

For instance, in private business a manufacturing establishment has its general manager. In its organization is a purchasing agent, an assistant in charge of production, and a sales manager. The corporation also runs a farm which produces some of the things which the corporation, as a manufacturing establishment, uses in the manufacture of its product. The purchasing agent is in charge of the farm as the farm manager. He reports to the general manager of the corporation regarding all the products of the farm, for example, whether or not they are used in the product of the manufacturing company. As the purchasing agent of the manufacturing company

he reports to the general manager concerning the materials which he takes from the farm and uses in the manufacturing company.

If you will apply the same practice to the organization of a bureau, you will name a director, who is an assistant secretary of a department, and will put the Surgeon General of the Public Health Service under this assistant secretary in all civilian matters and have him report to the same man, called a director, in all matters pertaining to ex-service men. You have not affected the Public Health Service in its relation to the head of the department at all. In drawing a new bill you will certainly not have a director under the assistant secretary and he under the secretary of the department-you will not get anywhere if you do. You have an Assistant Secretary of the Treasury now with the Public Health Service and the Bureau of War Risk Insurance under his direction. Speaking from our viewpoint, we believe that our relations with both the Public Health Service and the Bureau of War Risk Insurance are more harmonious and more satisfactory than the relations between the Public Health Service and the War Risk Insurance Bureau. The point I am trying to make is this, when you merely consolidate the Federal board and the compensation and claims division of the Bureau of War Risk Insurance or the Federal Board and the Bureau of War Risk Insurance and you do not at the same time put the Public Health Service into the same organization, you are not giving the vocational training and you are not giving the compensations and claims division that which each of them needs, namely, medical service.

Personally, I should think that it ought not to be in the Treasury Department. The job of the Treasury Department is to handle the fiscal affairs of the Government, and this job is not to be measured so much in money as to be measured in terms of men.

Mr. RAYBURN. Is there any reason why it should not be in the Interior Department?

Mr. LAMKIN. No, sir; except this, that the disposition of public lands is now in the Interior Department, the present Bureau of Education is in the Interior Department, and, in my judgment, the Department of the Interior is the department which handles the welfare of the people of America. I mean their land settlements and their education and is really more concerned about public health than is the Treasury Department. However, I think that is immaterial. Personally, I might go further. It seems to me that the proper care and treatment of 4,000,000 men of America is of sufficient importance to justify a cabinet position.

Mr. RAYBURN. You might say that the Public Health Service ought to have a cabinet position, on the theory that it handles the health of a great many men?

Mr. LAMKIN. That is true.

Mr. RAYBURN. You might say also that the Bureau of Education should have a Cabinet position, because they handle, in a way, all the youths of the country?

Mr. LAMKIN. Yes, sir; we might agree on both of those propositions.

Mr. RAYBURN. You might say that the Indian Office, which handles all the Indians of the country and deals with their funds and lands, ought to have a Cabinet position?

Mr. LAMKIN. I think I would disagree with you there.
Mr. RAYBURN. I know; but I was simply asking you.
Mr. LAMKIN. I realize the objections to it.

My summary, then, Mr. Chairman, is that I believe that a proper view of the entire problem of returning disabled men into the civil life of the Nation, physically restored, so far as possible, and vocationally trained, with adequate compensation for the physical injury, would be better performed by one responsible agency, not only with authority to decentralize but to get into the closest possible touch with the men. I do not believe that the consolidation would be justified unless the head of the bureau had authority over the entire medical functions and operations which are necessary to return these men to civil life.

Mr. SWEET. It is not so much a question of what department it is put in?

Mr. LAMKIN. Not at all.

Mr. SWEET. As to how they shall be organized?

Mr. LAMKIN. Yes, sir.

Mr. SWEET. Your main suggestion, then, is that if it is put under a second Assistant Secretary of the Treasury that the Assistant Secretary of the Treasury be vested with the power of supervision and control over the Public Health Service, the Bureau of War Risk Insurance, and the Rehabilitation Division of the Federal Board for Vocational Education?

Mr. LAMKIN. Yes, sir.

Mr. SWEET. And that in all matters it will be for him to direct, supervise, and harmonize?

Mr. LAMKIN. Yes, sir; in other words, speaking in terms of names and men, you will have an Assistant Secretary and you will have no position for me and no position for Col. Cholmeley-Jones.

Mr. SWEET. That is the idea exactly. He should have the authority which the directors of both services have?

Mr. LAMKIN. Yes, sir.

Mr. SWEET. We thank you very much, Mr. Lamkin.

Mr. SWEET. Mr. Thomas, do you wish to be heard at this time! We have only a few minutes, because the House is now in session, but, as I remember, you told me it would not take you very long to make your statement.

STATEMENT OF MR. W. BISSELL THOMAS, WASHINGTON, D. C.

Mr. THOMAS. Mr. Chairman, I was asked to appear before your committee by Col. Galbraith, of the American Legion.

Mr. SWEET. And anyone else?

Mr. THOMAS. And several Congressmen and Senators, also, who were personally acquainted with my experience-for the reason that in addition to being a service man, not only in the World War but the Spanish War and the Philippine campaigns, I spent about six months after my return from France as an examiner in the claims division in the Bureau of War Risk Insurance, and then was transferred to the legal division of that bureau, where I spent something over one year. I may state, so that you gentlemen may make due allowance for any bias or prejudice that might run through what I

have to say, that my connection with the bureau was terminated on the 21st of last December without my knowledge or connivance or consent. If the committee is interested in hearing it, I am prepared to tell the committee just what course a claim takes from the time application is made for it until it is adjudicated. Col. Jones the other day largely explained that. If the committee already has sufficient information about it, I will go right on to something else.

Mr. SWEET. You may proceed, Mr. Thomas, and make your own

statement.

Mr. THOMAS. Would the committee care to hear how a claim is handled in the bureau?

Mr. SWEET. We will be glad to have any information that may be of benefit to us in this matter.

Mr. THOMAS. A claimant, a disabled soldier, either writes to the bureau, direct, in Washington or makes application at one of the Public Health offices located throughout the United States. When he does that his claim is given a number, a C-number, they call it, and a jacket is made in which all the files of the case are afterwards accumulated. If that claim is for a disability, not a death claim, but if it is for a disability, it is then held in the bureau awaiting a report of the medical examination by the Public Health doctors on the ground. Before that examination is made, unless they have changed the system since I left the compensation division, the man's record is procured from The Adjutant General's office, showing that he actually was in the service, that he was discharged, and also showing what, if any, medical disability his record shows. Then the Public Health doctor on the ground is ordered to examine him, and does examine him, and sends in a report.

In the days when I was in the compensation division that report went to the medical division of the bureau, a separate division, where a rating of disability was made. On that rating the examiner in the compensation division then made an award commensurate with the percentage of disability which the medical division had given. I believe now they have a medical unit with each compensation unit. They have the compensation division divided into certain units, so many examiners and a reviewer in each unit, and I understand that they have one or two doctors in each unit, and the disability rating is made by the doctor right in the unit, so that the case does not have to go back to the medical division. After that medical rating is made the examiner of the compensation division either disallows the award or allows it. Col. Jones testified the other day that the medical rating so given was not necessarily binding. I want to say this, gentlemen, that 90 per cent of the complaints now being made about disability ratings-and you gentlemen probably have had several hundred yourselves-grow out of the technical matter which I am now touching on. It is technical, but we can not get away from it. I know people as a rule are not interested in technicalities, but the bureau being all technicalities it is necessary, in order that you may have a proper idea of it, to go into the technicality of the situation even though it may not be generally interesting.

The bureau assumes, and has laid down the fundamental policy, that disability is a medical question and not an economic question; that it is a medical condition of the claimant and not an impairment