Now, on the 10-percent increase bill, H. R. 3372, for example, we would have to refer to the hearings of last spring, where we gave a 1-year estimate in those cases.

I would like to mention that there are certain other bills in this group on which I think probably we should have something inserted into the record.

We have bills that would liberalize the provisions regarding the evaluation of disability for permanent and total disability. They would bear on part III, which provides pensions for permanent and total disability, and also concern disability compensation which is for service-connected disability.

The bills are directed toward having ratings made that are not provided by the schedule of disability ratings, which is the standard scientific standard used by rating bodies in the Veterans' Administration.

However, for convenience because it is difficult to find this by looking around for it in the record-certain material in the VĂ regulations that now pertains to service-connected cases might be helpful. In those cases where the schedule does not specifically provide a rate in a case, where we think it should be rated higher, they may send the case in for review, and it is reviewed by the very board that develops the schedule, and an evaluation is made.

Furthermore, the schedule contains liberalized provisions with reference to the evaluation of permanent and total disability for pension purposes, and that includes the matter of percentages and degrees of disability, reduced as you get into the higher ages.

I would like to have such material inserted in the record, for your information.

Mr. SAYLOR. Without objection, it may be made a part of the record at this point.

(The matter referred to is as follows:)

EXTRACT FROM SCHEDULE OF DISABILITY RATINGS 1945

16. TOTAL DISABILITY RATINGS BASED ON UNEMPLOYABILITY OF THE INDIVIDUAL.-Total disability ratings under Veterans Regulation 1 (a), Parts I and II, and, when the requirements of permanence are met, under Part III, may be assigned without regard to the specific provisions of the rating schedule when the disabled person is, in the judgment of the rating agency, unable to secure or follow a substantially gainful occupation as a result of this disabilities Provided, That if there is only one disability, this disability shall be ratable at 60 percent or more, and that, if there are two or more disabilities, there shall be at least one disability ratable at 40 percent or more, and sufficient additional disability to bring the combined rating to 70 percent or more. Total disability ratings, when the above conditions are met, may be granted for deafness, the organic loss of speech, for the amputation or loss of use of either hand or of either lower extremity above the knee when followed by unemployability, as single disabilities, or for other organic disabilities or combinations including organic disabilities. For the above purpose of the 60 percent disability, or one 40 percent disability in combination, or the reduced numerical requirements according to age, the following will be considered as one disability: (1) disabilities of one or both upper extremities or of one or both lower extremities, including the bilateral factor, if applicable, (2) disabilities resulting from a single accident, or (3) disabilities affecting a single body system, e. g., digestive, respiratory, cardiovascular-renal, neuropsychiatric, or (4) MULTIPLE INJURIES INCURRED IN ACTION.

17. SPECIAL CONSIDERATION OF AGE IN NONSERVICE CASES.-For the purpose of Veterans Regulation 1 (a), part III only, the percentage requirements of the preceding paragraph are reduced, on the attainment of age 55, to a 60 percent rating for one or more disabilities, with no percentage requirement for any one

disability. The requirement at age 60 will be a 50 percent rating for one or more disabilities. At age 65, there will be no percentage requirement other than one disability ratable at 10 percent or more. When these reduced percentage requirements are met, and the disabilities involved are of permanent nature, rating as permanently and totally disabled will be assigned if the veteran is determined to be unable to secure and follow substantially gainful employment by reason of such disability. In making such determinations the following will be used as guides.

(a) Marginal employment, for example, on own farm, in own business, or at odd jobs, at less than half the usual hours of work or less than half the usual remuneration will not be considered incompatible with a determination of unemployment and unemployability, if the restriction, as to securing or retaining better employment, is due to the disabilities.

(b) The fact that unemployable persons meeting the percentage standards have also physical, mental, or personality defects of congenital or developmental nature, which may be a partial cause of the unemployability, will not preclude favorable rating.

(c) As it is the policy of the Administration that all veterans who are basically eligible and who are unable to secure and follow a substantially gainful occupation by reason of disabilities which are likely to be permanent shall be rated as permanently and totally disabled for the purposes of Veterans Regulation 1 (a), part III-therefore the cases of all veterans who fail to meet the percentage standards, who meet basic entitlement criteria, but who are unemployable, will be referred to Central Office under R&P R-1142, with statement as to unemployability by the rating board. (Section 17-Extension 5, SDR)

Mr. BIRDSALL. The special action that I referred to on some of your total and permanent compensation cases, is contained in paragraph 1142 of our regulations, and I think it should be placed in these hearings, so that you may have that information.

Mr. SAYLOR. Without objection, that will be made a part of the record at this point.

(The matter referred to is as follows:)

1142. SPECIAL ACTION WHERE EVALUATIONS PROVIDED UNDER THE RATING SCHEDULE, 1945, ARE CONSIDERED INADEQUATE OR EXCESSIVE.

(A) Exceptional cases to which the application of the 1945 Schedule is not understood, or with regard to which evaluation under this schedule is considered inadequate or excessive, may be submitted by the Adjudication Officer for advisory opinion or for reevaluation to the Director. [Veterans Claims Service, Central Office. Questionable special monthly compensation cases and cases involving severe disabilities considered total, but for which current procedure does not authorize a total rating will be similarly submitted.] Where total disability is claimed and a submission hereunder is contemplated, a VA Form 8-527, Employment Statement, will be obtained and other indicated development of the evidence accomplished prior to the release of the records by the custodial office. The submission in any case comprehended by this regulation will include the claims folder, a recent medical examination, and definite recommendations from the submitting agency concerning evaluation of every disability under the schedule as interpreted by the submitting agency and concerning schedular changes deemed advisable by reason of the particular situation encountered. However, cases will not be withdrawn from appellate channels for submission under this regulation, except as the Board of Veterans Appeals may join in reference of such cases with their recommendation (Vet. Reg. 3 (a)). (October 19, 1949.)

(B) Rating agencies are authorized to assign total disability ratings under parts I and II, Veterans Regulation No. 1 (a), as authorized by paragraph 16, page 5, 1945 Rating Schedule, regardless of the age of the veteran; and under part III, Veterans Regulation No. 1 (a), subject to the age requirements of Extension 5, 1945 Rating Schedule. In favorable determinations of permanence of total disability in cases of veterans under 40 years of age, the rating agency must assure itself, by deliberative consideration in which all three members of the board participate, that there is reasonable certainty of continuance of this degree of disability throughout life. Single disabilities of the extremities, even though severe, such as amputations, should not be taken to produce permanent and total disability until it is shown after hospitalization and convalescence that the veteran has been unable to secure employment on account of the disability and through no fault of his own. With these younger men, the fact that

mu

of Mar. 28, 1934, as amended, provides a presumption of service connection for neuropsychiatric disease, spinal meningitis, and active tuberculosis disease, paralysis agitans, and encephalitis lethargica, or amoebic dysentery, developing to a 10 percent degree of disability or more prior to Jan. 1, 1925. Under the World War the Veterans' Act, the said presumption in the cases of active tuberculosis diseases and spinal meningitis was des conclusive, as was the presumption of soundness at time of enlistment contained in the same section, but the under the law, as restored with limitations, these presumptions are rebuttable by clear and unmistakable

and

evidence.

(b) As to World War II veterans and those with active service on or after June 27, 1950, Public Law 239, the 82d Cong., Oct. 30, 1951, contains a presumption of service connection for active psychosis developing to a abi 10-percent degree or more within 2 years after separation from active service, but this presumption is applied solely for the purposes of hospital and medical treatment, including outpatient treatment.

(c) As to veterans of the Spanish-American War, including the Boxer Rebellion and Philippine Insurrection, their disabilities are deemed to have been incurred in line of duty during such war, solely for the purposes of outpatient treatment when need therefor is established.

injuries, including single or multiple fractures or diseases such as pulmonary tuberculosis, coronary thrombosis, or malignant growths, appear resistant to treatment, or have involved, or are likely to involve, long periods of treatment or industrial inactivity, does not indicate permanence of total disability unless the end result of treatment is more likely than not to be total disability. The general rules regarding permanence, as applied to total disability ratings, are set forth in R. and P. R-1167 and R-1168. Employment as a member employee or similar employment other than in VA centers, obtainable only in competition with disabled individuals, will not be considered as evidence of employability. (August 31, 1950.)

Mr. BIRDSALL. Another matter concerns the presumption of service connection.

You have quite a few bills in that category covering multiple sclerosis, psychoses, and so forth, and our reports are digested in my previous remarks with reference to those bills.

However, I think it would be convenient for you to have this comparative table as a part of the record.

We had this table which you had in the hearings last spring brought up to date. It covers every bill that you have before the committee, stating the existing law on the subject in the left-hand column, and the existing law on a particular presumption.

Then, we have the provisions of the bill in the appropriate columns, showing what change would be made by the bill in that presumption. Mr. SAYLOR. In other words, from that chart, you would be able to compare the present law with the proposed changes on each one of these bills?

Mr. BIRDSALL. Yes, sir; on each and every one.

Mr. SAYLOR. Then without objection, that will be made a part of the record.

(The matter referred to appears on facing page.)

Mr. BIRDSALL. Also, in connection with increases of rates for compensation, I am quite certain that you would like to have a current statement of the total numbers on the rolls receiving disability compensation, by percentage of degrees of disability, and broken down by numbers between the Regular Establishment, Korean veterans, World War I, World War II, and the Spanish-American War veterans. That is very convenient in knowing where you stand on these various rates.

Mr. SAYLOR. Mr. Birdsall, does that breakdown which you have prepared reflect the most recent bill which has been signed by the President, showing those service-connected cases over 20 years? Mr. BIRDSALL. No, sir; it does not.

Mr. SAYLOR. Would it be possible for you to submit, in addition to this report, a report reflecting the number of cases that can no longer be disputed by reason of the President signing the recent bill? Mr. BIRDSALL. Mr. Chairman, it is possible that Dr. Dyess could give you some information on that at this time.

Dr. DYESS. I do not think it is possible to get these data, because our statistical records do not indicate, except through a study of the individual case folders, whether a man has been so rated for a period of 20 consecutive years.

Mr. SAYLOR. I appreciate that, but in view of the fact that that has been the most recent law that was passed, I wondered whether or not it would be possible to get that information to the committee, but since it cannot be obtained except by a detailed study, I know that the committee would not ask for it.

(The matter referred to is as follows:)