(General district manager letter No. 37. Canceled by General Order No. 150–A) AUGUST 30, 1922. Your attention is called to central office letter of January 27, 1922, over the signature of the assistant director, rehabilitation division, to all district managers, to which was attached Forms 1317 and 1318. Form 1318, transfer request for training opportunity, is used for the purpose of seeking a training opportunity in a transfer case, and Form 1317 is the letter of introduction, which is delivered to the trainee being transferred before he leaves the home office. It is believed that these forms and the transfer regulations now in effect should be adhered to unless in some exceptional case there is justifiable reason for doing otherwise. If in the routine of a trainee's transfer under the regulations he reaches the new district or subdistrict within the transferring district prior to receipt in the new subdistrict of the case folder, it is permissible to place such trainee in training, inasmuch as a copy of Form 1318 will have been transmitted to the registration officer In the subdistrict where the trainee is to receive training. The necessary forms in the 107 series and other papers will be executed when the trainees' folder is received. T. H. SCOTT, Acting Director. (General district manager letter No. 38. Obsolete) AUGUST 31, 1922. There is being sent this date 1,000 copies of Form 2510 (certificate of injury, United States Veterans' Bureau) for use in the district office. These forms are to be used in all cases where application is made for certificate of injury or where there is already on file a compensation claim. It should also be made out in all cases where claim has been filed prior to August 9, 1922, or within one year from date of separation from service, whichever is the later date, where a disease or injury of service origin or aggravation is shown but where the disability is not of sufficient degree to entitle the claimant to compensation. No certificate is to be issued where a claim was filed after August 9, 1922, or more than one year after separation from service, whichever is the later date, or where an application for certificate of injury was made after the expiration of the time limit specified above. The blank will be dated not later than August 8, 1922, unless issued within one year from separation from service, in which case it shall be given the current date. In the second line in the body of the certificate following the word "that" the claimant's name is to be inserted; in the third line following the word "formerly,' the rank, and in the fourth line the organization should appear; in the fifth line following the word "on" the date of discharge or separation from active service should be shown. In the sixth line following the word "on" the date of examination during service or at the time of separation from service or after separation from service, where it is actually discovered that the claimant suffered from a disease or injury of service origin, shall appear. In the ninth line following the word "from" the injury or disease existing at the time of discharge which would likely result in death or disability should be named. The certificate is to be made out in triplicate, one copy to be placed in the claimant's file, the original and one copy to be forwarded to the central office, attention board of appeals, accompanied by one copy of the most recent rating sheet showing the status of the disabilities named in the certificate. The district manager will be responsible for the correctness of the certificate, and the initials of the district manager and of the district officer responsible for the actual making of the certificate will appear on the carbon forwarded to the central office, which carbon will be filed in the master file of the central office, together with the copy of the rating sheet, the original certificate being forwarded to the claimant after signature by the assistant director, medical division, and the director of the bureau. In all cases where the application for certificate of injury is received by the district office and where no claim for compensation is made and where no claim has previously been filed, the correspondence and all available information pertaining thereto shall be forwarded to the central office, attention board of review. T. H. SCOTT, Acting Director. (General District Manager Letter No. 39. Modified by General Order No. 328) PROCEDURE ON DEATH CLAIMS AND INQUIRIES REGARDING COMPENSATION FOR HOSPITALIZATION SEPTEMBER 5, 1922. The letter of August 10, 1921, transmitting United States Veterans' Bureau General Order No. 5, is hereby amended with reference to the procedure on decentralized cases in the event of death of the claimant. Heretofore it has been the duty of the district offices to see that the claims for compensation death and insurance benefits are properly prepared and in the proper form when transmitted to Washington to be acted upon by the central office. Hereafter the only action to be taken by the district office will be that of requesting the data listed on page 3 of the letter of August 10, 1921. The file when forwarded to central office should contain a notation showing that the forms were dispatched to the proper person. The case should in no event be held by the district office until those forms are completed, nor should the district request those forms returned to the district office. The forms should be forwarded with instructions that when completed they are to be mailed to the central office direct. If the claims folder shows that the necessary data has been requested, central office will not be requesting duplication of necessary evidence. This instruction does not debar district offices and subdistrict offices from aiding beneficiaries in completing the forms sent out because of death of the claimant. 4228-29-124 Another type of case which seems to be giving considerable dissatisfaction is that in which a claimant is hospitalized for a disability not connected with service. When a letter is received by the claims division in the district office requesting information on compensation for a hospitalization period, it should be handled in the following manner: If compensation can not be paid for a hospitalization period because the disability is not of service origin, it should be stated specifically that the claimant is receiving compensation for a certain disability, service connected (quote specific disability), and that the hospitalization was for a different disability (quote specific disability) not service connected. This, of course, only relates to information to be given when the claimant is not entitled to receive a rating for hospitalization. The American Red Cross and the American Legion are sending numerous communications on such cases before they receive the desired information from the bureau. This will be obviated if the reply is given as above indicated. T. H. SCOTT, Acting Director. (General District Manager Letter No. 40. Obsolete) REEXAMINATIONS SEPTEMBER 12, 1922. It has come to the attention of this office that in many cases where information is requested from the district regarding the status of the claim, as in a case where such information is requested in connection with an application for reinstatement of insurance, that the report received from the district will show that there has been no physical examination for many months, in some cases as long as 18 months or 2 years, and that the current awards upon temporary ratings are based upon these old examinations and old ratings. Ordinarily in all instances, except statutory permanent total cases where examinations are not required except for special reasons or upon application of the claimant himself, reexaminations should be obtained not less than once in six months. You are therefore instructed to take immediate steps to obtain reexaminations in all cases of this character where no examination has been obtained within the last six months, and to have reratings made upon these cases. C. R. FORBES, Director. (General District Manager Letter No. 41. Obsolete) AUTHORITY TO PURCHASE POSTAGE STAMPS SEPTEMBER 13, 1922. District Manager Letter, Director's Office, No. 10, dated June 1, 1922, authorizing purchase of postage stamps in the amount not to exceed $100 per month, is hereby rescinded. You are directed to forward to central office, immediately upon receipt of this letter, a revised estimate of the amount of postage stamps needed in your district per month. Your estimate will be given prompt attention and if found to be reasonable individual authorization covering purchase of postage stamps for your district will be forwarded to you. C. R. FORBES, Director. Canceled by General Order No. 336) (General District Manager Letter No. 42. AMERICAN LEGION NATIONAL CONVENTION TO BE HELD IN NEW ORLEANS, LA., OCTOBER 16 TO 20, INCLUSIVE SEPTEMBER 29, 1922. The national convention of the American Legion will be held in New Orleans, La., October 16 to 20, inclusive. You are authorized to issue special leave of absence to trainees who desire to attend this convention. This will apply to the trainees who are officers of this organization, delegates to the convention, or simply members of the American Legion who desire to attend this convention. You will grant such leaves as are necessary to cover the actual days of the convention, and sufficient time to travel from present residence to convention and return. No transportation will be paid by the Government under any circumstances to any trainees attending this convention. C. R. FORBES, Director. (General District Manager Letter No. 43. Canceled by General Order No. 222-B) OCTOBER 3, 1922. As no fees are listed in the fee tables issued prior to Regulation No. 17 of February 23, 1922, for gold fillings and gold inlays in anterior teeth, which involve the incisal edge, you are advised that the fees provided for gold fillings and gold inlays in anterior teeth under Regulation No. 17 will apply in these cases. C. R. FORBES, Director. (General District Manager Letter No. 44. Canceled by General Order No. 336) FIRST ANNUAL CONVENTION, UNITED STATES BLIND VETERANS OF THE WORLD WAR TO BE HELD AT BALTIMORE THE WEEK OF NOVEMBER 6 TO 11, 1922, INCLUSIVE OCTOBER 5, 1922. The United States blind veterans of the World War have formed an organization and will hold their first annual convention at Baltimore, Md., November 6 to 11, 1922, inclusive. 2. You are authorized to issue special leave of absence to all trainees who are blind or whose eyesight is seriously defective who may desire to attend this convention. 3. You will grant such leaves as are necessary to cover the actual days of the convention and sufficient time to travel from residence to the convention and return. 4. No transportation will be paid by the Government under any circumstances to any trainee or attendant to trainee attending this convention. Maintenance and support allowance will be continued during the period covered by excused leaves of absence. Those in charge of the conference will report the names of those attending with date, to central office, who will in turn advise the respective districts. C. R. FORBES, Director. (General District Manager Letter No. 45. Canceled by General Order No. 150-A) DISCONTINUANCE OF TRAINING WITHOUT COMPETENT EVIDENCE OF THE TRAINEES' INABILITY TO CONTINUE HIS TRAINING NOVEMBER 7, 1922. 1. Notwithstanding the instructions outlined on Form 1301, report of trainee discontinuing training on account of illness, these reports are constantly reaching central office indicating that the instructions of the bureau are not being followed in this report, and the form appears to have been executed in a perfunctory manner by a follow-up nurse. 2. Not only is the reason given as cause of breakdown unsatisfactory, but it further indicates that the trainee was allowed to discontinue his training simply on the opinion of the nurse or the statement of a private physician. 3. Instances are quite frequent in which a man, after having been in training from one to two years, is reported as having broken down in his training and returned to his home because of some minor disability, showing quite conclusively that sufficient investigation and examination was not made before training was discontinued. 4. Once a man enters training, the medical division, through its physicians and follow-up nurses, will cooperate in every way with the rehabilitation division, using any of the resources of the bureau necessary to keep him in such training. 5. Follow-up reports indicate that each year nearly 8,000 men discontinue their training because of illness. This appears to be due to one of two principal reasons; either that feasibility is not satisfactorily determined at the time the man is placed in training, or that proper supervision is not being exercised after training has begun. No trainee, therefore, will be carried on the record as having discontinued training because of his physical condition until it has been established by competent medical examination that training was in fact discontinued for this reason. Each trainee who wishes to discontinue training because of physical condition shall be examined by a medical representative of the bureau, who will file a written report with the subdistrict medical officer at the time such examination is made, stating why in his opinion the trainee is unable to continue his training. If the trainee, during this period of investigation is not receiving instruction or authorized hospital treatment or authorized home treatment, he shall be carried on the status, "instruction interrupted," without maintenance and support allowance, but shall, if compensable at the time of such interruption of instruction, receive such amounts as may be designated by the claims division. Such status-Instruction Interruptedshall continue for not more than one month, after which the trainee, if he has not within that time returned for further instruction or authorized hospital or home treatment, shall be carried on the permanently discontinued status. The trainee will not otherwise be carried on the Permanently discontinued status because of physical reasons, until such recommendation is approved personally by the subdistrict medical officer who, if he finds the reasons given by the trainee and shown by report of physical examination do not justify such discontinuance, will direct the trainee to report back to his training, and so inform the registration officer. If the trainee refuses to comply with the instructions, he will be reported as not profiting by his training, and the subdistrict registration officer will take the necessary steps to have the trainee's status changed to Permanently discontinued. 6. The term, "discontinuance of training," must not be confused with short periods of Interruption of instruction due to physical reasons of a minor nature, such as some slight acute illness, and from which an early recovery and resumption of instruction may be expected. (General District Manager Letter No. 46) T. H. SCOTT, Acting Director. RETURNING OF CORRESPONDENCE ON PERMANENT TOTAL AND DEATH CASES BY THE DISTRICTS NOVEMBER 14, 1922. It has been called to my attention that some of the districts, when receiving correspondence on total permanent and death cases, etc., which had been forwarded to central office, are returning the correspondence to the addressor with the statement that the same should have been forwarded to central office as the district has no jurisdiction over the case. In the future any correspondence received in the district office pertaining to the functions of the bureau will be received and forwarded to proper destination within the bureau, i. e., if it is in connection with a death case which had been forwarded to central office, the correspondence will immediately be forwarded to the central office, and the addressor promptly advised of the action taken, and that future correspondence on such a case should be conducted with central office direct. C. R. FORBES, Director. (General District Manager Letter No. 47. Canceled by General District Manager, Directors' Office, No. 47-D) DATA FOR CENTRAL OFFICE BOARD OF APPEALS NOVEMBER 22, 1922. It has been brought to my attention that a number of cases are coming through for consideration by central office board of appeals in which medical examination is not complete, or was not conducted under a recent date. You are instructed that medical examinations in cases forwarded for consideration by central office board of appeals must be dated within six weeks of the dispatch of case folder. There are now pending in central offices board of appeals more than 500 cases on which it has been necessary for central office board of appeals to request additional evidence or current medical examinations. You must realize, of course, that many of these cases are of an urgent type, and it is necessary that the medical examinations requested by the board be expedited in every possible way and forwarded to central office promptly. They should be plainly marked with a rubber stamp as follows: "For Central Office Board of Appeals, from District No. " The use of this stamp on incoming examinations will make unnecessary the forwarding of a letter of transmittal. You are further instructed that where a case folder has heretofore been forwarded to the central office without such a report of recent examination, that the request for the reexamination received from the central office should be given expedited action. C. R. FORBES, Director. (General District Manager Letter No. 47-A. Canceled by General District Manager, Directors' Office, 47–D) DATA FOR CONSIDERATION OF THE CENTRAL BOARD OF APPEALS FEBRUARY 20, 1923. An opinion having been rendered by the general counsel concerning an interpretation of the first sentence of the second paragraph of General District Manager Letter, Director's Office, No. 47, which reads as follows, "You are instructed that medical examinations in cases forwarded for consideration by central office board of appeals must be dated within six weeks of the dispatch of case folder," the following change and modification in those instructions is made: You are instructed that no case should be forwarded for consideration by the central office board of appeals unless there is in the file a report of physical or mental examination of the claimant, as the nature of the disability requires, made not more than six weeks prior to the date of the decision by the district board of appeals, from which the appeal is taken to the central office, or not more than six weeks prior to the date of the decision by the district office board of appeals to forward the case to central office board of appeals for consideration as to permanent and total disability. You are further instructed that decisions of the central office board of appeals will be based on the same evidence that was before the district board of appeals when its decision, from which the appeal is taken, was made. It is not considered to be one of the functions of the central office board of appeals to further develop the case submitted by requesting additional affidavits or new examinations before rendering its decision, although additional evidence presented to the central office board of appeals by the claimant or his duly authorized agent will be considered. The following classes of cases are not intended to be covered by the foregoing procedure: 1. Where the only question submitted is whether or not the disability is of service origin, and a new examination would not affect the decision of the central board of appeals. 2. Where the claim is one for an increase of compensation covering some period time in the past, and a new examination would not affect the decision of the general board of appeals. 3. Where the claimant is suffering from a mental disease and is confined in a contract hospital under State control and a report of a complete examination is not obtainable. In these cases it will be sufficient to submit a statement from the medical officer in charge of the hospital showing how long the claimant has been hospitalized in his institution; whether there is mental deterioration and the prognosis of the case. All cases forwarded for consideration by the central board of appeals must be regarded as of an urgent type, and your active cooperation is expected in securing full and complete examinations of the claimant and in promptly forwarding the case folder to the central office with a brief memorandum in which is clearly stated the purpose for which the appeal is taken. GEORGE E. IJAMS, Acting Director. (General District Manager Letter No. 47-B. Canceled by General District Manager, Director's Office, DATA FOR CONSIDERATION OF PERMANENT TOTAL DISABILITY JUNE 14, 1923. In all instances where a case is forwarded for consideration by the central office board of appeals the requirements of District Manager Letter No. 47-A, director's office, dated February 20, 1923, requiring an examination within six weeks from the date the case is forwarded, will be followed. Cases referred to the central office for consideration of permanent total disability will also conform to the requirements of District Letter No. 47-A, except that in any case where the evidence is deemed to be sufficiently clear to indicate the existence of a permanent total disability, the case should be forwarded at once, even though the last examination in the file is more than six weeks old. Where there is any question in the case, or where the examination is so old that it can not be used as a basis for decision, a new examination should be obtained, otherwise the reference of the case to central office should not be delayed for the making of a special examination. FRANK T. HINES, Director. (General District Manager Letter No. 47-C. Canceled by General District Manager, Director's Office, No. 47-D) DATA FOR CONSIDERATION OF THE CENTRAL BOARD OF APPEALS JANUARY 30, 1924. The provisions of General District Manager Letter, Director's Office, No. 47-A, that no case should be forwarded for consideration by the central board of appeals unless there is in file a report of physical or mental examination of the claimant made not more than six weeks prior to the date of any action by the district board of appeals, is hereby amended to provide that in cases where there is a satisfactory physical examination report indicating permanent disability in file made by a board of three medical officers under the provisions of Regulation No. 47 within a period of four months prior to the action of the district board of appeals as provided above, the case may be forwarded without necessity for obtaining new examination. FRANK T. HINES, Director. (General District Manager Letter No. 47-D. Canceled by General Orders No. 302 and 190-B) DATA FOR CONSIDERATION OF THE CENTRAL BOARD OF APPEALS MAY 31, 1924. General District Manager Letters, Director's Office, Nos. 47, 47-A, 47-B, and 47-C are hereby canceled. Cases may be forwarded for consideration of central board of appeals without the necessity for procuring a reexamination of the claimant for this purpose, except where the necessity for such a reexamination is indicated by the nature of the disability, i. e., where it is probable that a change in the degree or nature of the disability has taken place since the last physical examination in the case file. In any case forwarded to central board of appeals for consideration where the claimant has a disability of permanent nature, the case file must include a physical examination report by a board of three medical officers in accordance with Regulation No. 47. Where a case is referred to central office for consideration of total and permanent disability, there should be included in the case file a report of physical examination by a board of three medical officers under Regulation No. 47, unless it is not practicable to obtain such an examination report and the report of examination in the file clearly shows evidence of permanent and total disability. District managers will be held to strict accountability for compliance with this letter. FRANK T. HINES, Director. (General District Manager Letter No. 48. Canceled by Circular No. 324) FORM 550 AND FORM 523 OR THE ORIGINAL BRIEF FACE FOR THE DISTRICT OFFICES NOVEMBER 23, 1922. Hereafter whenever a case is received in the central office from a district and is ready for adjudication, a copy of the amended award Form 550, disallowance Form 523, or original brief face will be forwarded to the district interested. This applies to insurance as well as compensation awards. By this procedure the district office file will show the exact status of each and every claim which is forwarded by the district to the central office. All such papers forwarded by the claims division, central office, will bear the legend "For District Files,' and the clerks whose duties consist of reading incoming mail should, therefore, be instructed to route such papers direct to the files and to be careful not to return the same to the central office. C. R. FORBES, Director. |