To concede all these causes of disability and death, common to all groups, to prisoner-of-war service in a limited group, at least from the standpoint of existing indications and knowledge, could not be rationalized. Apart from the going observations which suggest certain imponderables which would need to be considered and overcome in connection with this proposed item of research, there is the serious question whether a conclusive presumption of service connection in favor of former prisoners of war solely for the purpose of hospitalization in Veterans' Administration facilities would establish a precedent for extending such assumption by law to other groups and other benefits.

Mr. Daley, with all due respect to the Veteran's Administration and to your Administrator, I think that is typical of the letter and its is a lot of gobbledygook in my humble opinion.

Now, let's get down to cases.

Mr. DALEY. Mr. Chairman, Dr. Mueller, I trust, will have an opportunity to indicate to you the various channels of research which are being explored in connection with arrangements made with the National Research Council on the question of morbidity, mortality, disability, and other aspects of the prisoner-of-war question.

The thought that was advanced in the paragraph that you have just read particularly adverted to the question of a conclusive presumption for the purpose of hospitalization.

That had as a background, although it was not specifically expressed, the fact that in the first instance a prisoner-of-war case, a case with a prisoner-of-war experience as its history, is evaluated very liberally from the standpoint of assigning a finding of service connection from the individual's state of health or disability.

Once you have an assignment of a service connection you have a priority for hospitalization by the Veteran's Administration.

Apart from that, and if there is not a finding of service connection, any eligible war veteran is entitled to hospitalization by the Veterans' Adminstration within the limits of existing facilities, and certain presumption of service connection are given to chronic and typical diseases, the tuberculosis diseases, and neuropsychiatric disAlso a war veteran including a prisoner of war who is in need of hospitalization, if it is an emergency is entitlted to priority in admission over a nonemergency case.

eases.

If it is not an emergency and if it is not service connected, then he would, of course, take his position with other veterans who are seeking hospitalization from the Veterans' Administration.

When it comes to medical care, outpatient medical care is provided for any service-connected disability.

Incidentally, in the field of outpatient dental care, which has been the subject of some concern to the Congress and a limitation was placed in the appropriation act last year, and is proposed to be included in the appropriation act this year, the Veterans' Administration makes a special exception in the case of prisoners of war.

As to veterans suffering from dental conditions which are not entitled to compensation, but are service connected, the present regulations provide that such a case shall receive one single treatment, it being the theory that the Congress has provided adequate benefits in that particular field by permitting one single treatment.

Exceptions are made in the regulations, however, with respect to prisoners of war who may receive recurrent treatment.

I want to point out generally that the Veterans' Administration has a real and serious concern about the plight or the case of the prisoner

of war and despite this seemingly ambiguous language in the report which was addressing itself to the statistical problems more than other matters, the Veterans' Administration has sought to do all it can and with all due liberality.

I might invite your attention to an existing statute which can particularly be invoked with reference to this type of case. Public Law 361 of the 77th Congress, enacted December 20, 1941, states:

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 such case shall be recorded in full.

This particular statute crystallizes the philosophy of the regulatory provisions which are administered by the Veterans' Administration with reference to this type of case, so, Mr. Chairman, I merely want to suggest that there is no drawing back on the part of the Veterans' Administration, but a keen and earnest desire to do everything that is correct, and accurate, and scientific, if you will, considering at all times the responsibilities that have been vested in the agency and the laws under which it is controlled.

Mr. HINSHAW. Mr. Daley, I only want to say this: that there are very few persons in the United States, very few medical personsand Dr. Mueller, I think, will go along with this-who are competent with respect to this subject of malnutrition, because they have just had no experience in it.

There have been a few medical men who have been in prisoner-ofwar camps as internees or as prisoners of war, and probably 6 or 8 altogether are fairly competent on this subject.

There is no criticism of the Veterans' Administration for not having come up with a report, but it is nevertheless true that there is no status at the present time in the Veterans' Administration for presumptive disability on account of being a prisoner of war, and as a POW, subjected to malnutrition.

I have to offer the last paragraph on page 5 of this letter from the Administration;

If legislative provision for the study proposed by the subject bill is considered desirable by the Congress, it would appear to be more advantageous to place the responsibility for the study with respect to former prisoners of war with the Veterans' Administration and with respect to former civilian internees with the Public Health Service, Department of Health, Education, and Welfare, as it is understood that the War Claims Commission does not have comparable medical staff or facilities.

However, in view of the continuing research activities of the Veterans' Administration, there is for serious consideration by the committee whether there

exists any need or justification for legislation of this character with respect to matters affecting the benefit programs for veterans administered by this agency. Because of the indeterminate factors involved, the Veterans' Administration is unable to make an estimate of cost of the bill if enacted.

For the foregoing reasons, I am unable to recommend favorable consideration of H. R. 7711 by the committee.

Actually, practically everybody else is in favor of the study except the Veterans' Administration and you seem to be going along with some kind of a study of your own, and that is fine, but all malnutrition cases are fundamentally the same.

Mistreatment comes in another category. Mistreatment as to prisoners of war or of internees, and there has been much mistreatment, particularly during World War II, comes in another category.

I wonder whether or not your agency has reconsidered its adverse position on this bill and whether it desires to go along.

Mr. DALEY. Mr. Chairman, we received yesterday, and I wanted to add that to your recitation of our report and the views of the Administrator, from the Bureau of the Budget a statement that there would be no objection to the submission of that report for the reasons stated in the letter of the Veterans' Administration.

To make sure of accuracy here, the views of the Bureau of the Budget were that there is no objection to the submission of the Veterans' Administration report to the committee and that the Bureau of the Budget concurs in the views expressed by the Veterans' Administration on the bill.

I think that should succeed the statement of the Administrator. Mr. HINSHAW. Very well. We will accept that.

I am going to place in the record a little bit later a report of the War Claims Commission in respect to the bill giving its recommendations as favorable consideration of the bill, H. R. 7711.

Mr. BEAMER. That was the reason I made the comment to our colleague, Congressman Fulton, that it seemed very advisable if such a study were to be made it should not be made exclusively by one agency.

Mr. HINSHAW. These people come under the aegis of different agencies and somebody must be a coordinating head as between the various agencies which have a jurisdiction and that is the purpose of the bill.

As far as War Claims Commission is concerned, it is the one agency to which the others can bring a report and they can put it together, and the War Claims Commission could, if necessary, get a panel of doctors together to evaluate all the reports received, but I think it ought to be done in a hurry.

Mr. BEAMER. Of course, if necessary the War Claims Commission could proceed with proper authorization without the assistance of these other agencies, since they are in existence and are very capably staffed. It seems logical that these other agencies should cooperate with the War Claims Commission in order to resolve this very important problem.

Mr. HINSHAW. We have a letter from Mr. Miles D. Kennedy, of the American Legion, addressed to Mr. Wolverton, the chairman of the committee, in which he states his support and the support of the American Legion for this bill, H. R. 7711, and that will be included in the record at this point.

(The letter referred to follows:)

Hon. CHARLES A. WOLVERTON,

THE AMERICAN LEGION, NATIONAL LEGISLATURE COMMISSION, Washington, D. C., June 16, 1954.

Chairman, House Interstate and Foreign Commerce Committee,

House Office Building, Washington, D. C.

DEAR CONGRESSMAN WOLVERTON: Referring to the hearing scheduled to be held today on H. R. 7711, same being a bill to provide for a study of the mental and physical consequences of malnutrition and starvation suffered by prisoners of war and civilian internees during World War II and the hostilities in Korea, while the American Legion is not asking permission to have a witness appear and testify at the hearing, I would advise that in our opinion this bill is worthy of favorable consideration by your committee.

Being a veterans' organization, duly chartered by an act of Congress, we are naturally interested in the welfare of former members of the Armed Forces of the United States, especially those who were taken prisoners by our enemies during World War II or the Korean conflict.

We believe that much good could result from the researches that would be authorized in the field of medicine, etc., all as more fully set forth in the bill. May we therefore, respectfully request that the committee report the bill H. R. 7711.

If consistent, I would appreciate your incorporating this letter in the record of the hearings on the bill.

Thanking you for your courtesy, I am
Sincerely yours,

MILES D. KENNEDY, Director.

Mr. HINSHAW. Mr. Daley, we are going to have to answer a quorum call here very shortly. Did you wish to have Mr. Robson explain anything about this bill?

Mr. DALEY. I wonder if Mr. Robson would have anything to contribute concerning the procedures that are employed by the Veterans' Administration in connection with these cases specifically.

I think he might be able to add something to the record, Mr. Chair

man.

Mr. ROBSON. I believe, Mr. Chairman and members of the committee, that what I could contribute more than anything else is the recognition of the Claims Service which has to do with evaluation of these prisoner-of-war claims.

We recognized within the first year after cessation of hostilities that we had a problem in prisoner-of-war cases different from that of the ordinary veterans' claims because in that year, in the year 1946, from the areas where most prisoner-of-war claims came from, particularly New Mexico, we had a number of complaints from the various veterans themselves and from service organizations that claims. were not being handled properly.

The men were not being adequately examined or after they were examined the evaluation of their disability was too low.

We immediately got busy and called in a representative number of cases in 1946. As a matter of fact, we called in about 100, and together with a physician attached to my particular board, I personally reviewed those cases and came to conclusions which resulted in changing our regulations and procedure. Many of the complaints were justified.

As a matter of fact, a large number of complaints were justified, not so much because the members of the rating boards who were han

dling these cases were deliberately underrating, but because they had no precedent for rating disabilities or conditions for which there were really no findings reported by the examiner.

In other words and what you have inferred-we cannot put our finger on residuals of malnutrition, and for that reason we set up procedure giving the rating boards explicit instructions that all prisoner-of-war cases were never to be evaluated on merely the official record furnished by the War Department, which, in most cases, was inadequate, but every man was to be examined.

He was to have special examinations and in the rating of the cases particular stress was to be placed upon the man's complaints, even if not supported by findings shown on the examination.

That was some time ago, in 1946. Again in 1949 we had a problem with the regional office, Albuquerque, N. Mex. They had a great number of POW cases out there, because, I believe, that State had more men who were taken prisoner at Bataan than any other State in the Union.

Mr. HINSHAW. It seems to me that a division in California was involved also, a National Guard division.

Mr. ROBSON. Probably so.

This Albuquerque office was having considerable trouble with the rating of claims.

We appreciated their situation and we called in a number of cases from that particular office.

I again reviewed those cases, together with some physicians on the board, and as a result I wrote a letter to that office. It might be of interest to the committee if I would read one of the pertinent paragraphs which illustrates how strongly we felt toward the prisonerof-war situation. May I read what I believe to be a pertinent paragraph?

Mr. HINSHAW. You may read it.

Mr. ROBSON. It is addressed to the manager of the Albuquerque, New Mex., office:

It is quite evident from your recent report that you are fully aware of the problem presented by these cases in New Mexico, and are most anxious to comply with central-office policy governing their adjudication. There is no doubt that you are cognizant of the directives issued in that regard and, therefore, of the oft-repeated emphasis placed upon the special consideration to be accorded these veterans, and this office is convinced you have attempted to do your best for these men.

However, it cannot be emphasized too strongly that they must be given every consideration and their claims adjudicated with the utmost liberality consistent with the law and the evidence.

This does not mean that service connection is warranted by the mere fact that these veterans were prisoners of war, nor are the evaluations not to be supported by physical findings.

It does mean that every reasonable doubt is to be resolved in favor of the veteran and that reductions of evaluations, particularly severe reductions, are to be approved with utmost caution and be completely justified.

Particularly does it mean that examinations must be adequate for rating purposes and that any doubt with regard to the assignment of the greater of two evaluations will be resolved in the veterans' favor.

That was followed, Mr. Chairman, by incorporating in the regulations the following-do you wish me to read this? It is very short Mr. HINSHAW. All right.