CHAPTER I-COMPENSATION FOR SERVICE-CONNECTED DISABILITIES AND DEATH RECOMMENDATION NO. 1 The Commission recommends that the basic compensation rate payable to the service-connected totally disabled veteran be increased by $100 monthly. Background to Recommendation The Disability Rating Schedule endeavors to evaluate the average impairment of earning capacities resulting in civilian occupations from service-related diseases or injuries. A recent pilot study in connection with the Economic Validation of the Rating Schedule confirmed the unemployability of the totally disabled. The study indicated that the totally disabled veteran does not have the capacity to earn a living and must rely solely on disability compensation for his economic support. Disability compensation at present rates of $300 a month for total disability imposes a standard of living on totally disabled veterans which is much lower than that which they would have attained except for their service-connected disabilities, and much lower than the median national income level of wage earners. Therefore, in order to compensate the totally disabled at a rate which would more closely approximate their loss in earnings resulting from disabilities incurred in service, the Commission recommends that the basic compensation rate payable to these veterans be increased by $100 per month. A similar increase is recommended in the higher statutory awards, pending the completion of the reevaulation of the rating schedule. RECOMMENDATION NO. 2 The Commission recommends that the compensation rates payable to veterans whose disabilities are evaluated from 10 to 90 percent be increased not less than the rise of the cost of living as measured by the Consumer Price Index, since December 1, 1965. Background to Recommendation In order to maintain compensation rates at levels which are economically realistic, it has been necessary from time to time to adjust these rates to the changing cost of living in America. Most recently, compensation rate increases of about six percent were made in 1962 and 1965. Between the effective date of the last increase, December 1965, and December 1967, the cost of living (according to the Consumer Price Index) has risen 6.5 percent and is continuing to rise. The Commission wishes to establish the most equitable rate structure possible. This is not possible until the study being undertaken on Economic Validation of the Rating Schedule is completed. Until this time, we want to protect the 10 to 90 percent disabled veteran from the economic cost resulting from substantial increases in the cost of living. Therefore, we recommend an appropriate increase in the compensation rates payable to these veterans, including the additional benefits for dependents. This recommendation is made in conjunction with our recommendation for a $100 monthly compensation rate increase for the totally disabled and for an increase in statutory allowances. RECOMMENDATION NO. 3 The Commission endorses the principle of equalization of compensation payable for disabilities rated less than 100 percent and recommends that this principle be given serious consideration in the current economic validation study of the rating schedule. Background to Recommendation Disability compensation rates, from their inception in 1933 until June 30, 1952, were related to the stated degree of disablement in a manner which provided equal intervals between assigned evaluations. A disability rated 10 percent, for example, was paid ten percent of the amount payable for the 100 percent disability. Other percentage ratings bore a similar fixed ratio to the 100 percent disability rating, Public Law 356, 82d Congress, effective July 1, 1952, provided proportionately greater compensation for the more seriously disabled based on the belief that economic impairment at that level and above was disproportionately greater than for lesser evaluations. This has been extended since that time. At present a veteran 10 percent disabled receives $21 per month; 30 percent dis abled, $60 per month; 50 percent disabled, $113 per month; and 100 percent disabled, $300 per month in base compensation. This subject has probably occasioned more controversy than any other item in the veterans' program. Each regional hearing and each veterans organization has produced resolutions and recommendations endorsing the principle of payment of disability compensation in accordance with the proportion that the rated degree of disability bears to the amount that the 100 percent rating receives. The ratings assessed, by law, are based as far as practicable upon the average impairment of earning capacity in civil occupations. These averages have never been statistically determined. There are many disabilities which by their, overwhelming nature, are obviously totally disabling. Assignment of lesser degrees of disability has been a very thoughtful process based on the best medical, legal and occupational opinion, but has not been validated in any meaningful manner. The Veterans Administration, in cooperation with the Bureau of the Census, has recently undertaken a study in depth of the relationship of rated degrees of disability to the average amount of economic handicap borne by the veteran with the disability. The Commission feels that this validation is long overdue and should be expedited. It further recommends that the principle of equalization of compensation with degree of disability should be kept firmly in mind in the evaluation of the results of this survey. RECOMMENDATION NO. 9 The Commission recommends that the date of admission to a private hospital be made the date of claim for increased compensation during a period of hospitalization, provided the VA is notified within 90 days of discharge. Background to Recommendation Under the present law, when a veteran is admitted to a Veterans Administratration hospital for a service-connected disability, he is entitled to an increased amount of compensation during the period of hospitalization. The date of admission counts as the date of claims. If a veteran is admitted to a private hospital for the same service-connected disability, he can only receive the increase from the date he notifies the Veterans Administration he is in the hospital. The Commission recommends that the increased payment should be made from the date of his admission to the private hospital, provided the Veterans Administration is notified within 90 days of his discharge from the hospital. The Commission recommends an increase in the special statutory award of $47 for specified single disabilities based on the increased cost of living. Background to Recommendation The cost of living has risen substantially since special statutory compensation awards were last increased in 1952. The fact that compensation rates were increased four times from 1952 to the present attests to the continuing need to adjust compensation payments to the cost of living. The some disabled veterans, the statutory award is all, or a major portion of, the actual compensation they receive. The problem of specific statutory awards is being studied in conjunction with the economic validation study. Until that study is completed, it is necessary that the special awards be increased to keep pace with the increasing costs. Therefore, the Commission recommends an increase in the statutory awards to correspond with the increased cost of living since 1952. RECOMMENDATION NO. 11 The Commission recommends that loss of procreative power constitute the criterion to qualify for the special statutory compensation award. The Commission further recommends that such change be for future application so that no one now receiving this special award will have his compensation reduced because of such change in criterion. Background to Recommendation The special monthly compensation paid for loss or loss of use of certain organs and senses (Section 314 (k) of Title 38 U.S.C.) was established to compensate for impairment other than economic, which is included in disability ratings. The special award provides compensation for such obvious and serious conditions as amputation of a limb, loss of an eye, deafness of both ears, or inability to communicate by speech. The law also provides this special award for veterans suffering anatomical loss or loss of use of a creative organ. However, with the loss of only one paired procreative organ, parenthood can still be achieved. Thus, benefits are now paid when there is, in fact, no absence of procreative power. History suggests that Congress intended to grant this special award for such defects as loss of procreative power. The Commission recommends the law be clarified so that in the future a loss of procreative power rather than organ will be the governing criterion. To avoid hardship, however, we feel that veterans now receiving payment for anatomical loss or loss of use of a creative organ should continue to receive this payment, whether or not they retain procreative power. The Commission recommends discontinuation of the statutory award and graduated ratings for arrested tuberculosis with the provision that veterans receiving compensation under the present law continue to receive payment. Background to Recommendation At present, the law (Title 38 U.S.C., Section 314 (q)) provides a minimum rate of disability compensation ($67 per month for wartime cases and $54 per month for peacetime cases) for veterans with service-connected tuberculosis which has reached a state of complete arrest. Section 356 of Title 38 U.S.C. prescribes gradually reduced disability ratings for tuberculosis during the 11-year period after the disease has first become arrested. A minimum rate of compensation for arrested tuberculosis has been provided almost continuously since 1926. At that time, tuberculosis was a dread disease. It was believed that few persons suffering from the disease could expect to live more than 20 years; that even if arrested, the disease was almost certain to recur; and that the only effective therapy was the "rest cure" followed by a slow and progressive course of exercise. The death rate from tuberculosis in the United States in 1926 was 74.9 per 100,000 population. Medical authorities believed then that people with arrested tuberculosis would never have the strength to meet the demands of their previous employment. The employability of persons who had had tuberculosis was further curtailed by the popular attitude that since the disease was contagious, those suffering from it should be avoided. The grim expectations of 1926 have not been realized. Experience has demontrated that most World War I veterans receiving the minimum rate of compensation for arrested tuberculosis had no recurrence of the disease. Furthermore, the causes of death for this group closely resembled those of the general population. At present, modern methods of medical treatment achieve rapid and stable arrest of tuberculosis. These methods have accelerated the decline in the occurrence of the disease and have lowered the death rate from tuberculosis to a point of relative insignificance. In 1965, the death rate from tuberculosis in the United States was 3.8 per 100,000 population. By now, the general public has stopped considering those who have had tuberculosis as outcasts. Ordinarily, there is no loss of employability in cases of arrested tuberculosis. Veterans who have received modern treatment for the disease are generally able to return to their homes with assurance of normal industrial acceptance and fulltime employment. Thus, the compensation these veterans receive (in the form of a statutory award) does not reflect average economic impairment, as compensation is intended to do. Because of this, the compensation received by veterans with arrested tuberculosis discriminate against all other veterans. The Commission feels that disability ratings for all veterans should be related to demonstrable physical impairment. We therefore recommend that veterans with tuberculosis should be assigned, a 100-percent disability rating during the period of active disease and for two years thereafter, while convalescence takes place. After this two-year period, disability compensation should reflect actual economic impairment. If some degree of disability remains, the rating schedule provides ample authority and criteria for evaluating and compensating for such residual disability. To avoid hardship, however, we feel that veterans now receiving compensation under the present law should continue to receive this payment. RECOMMENDATION NO. 15 The Commission recommends that a clothing allowance of $150 per year be provided to veterans who have insured additional expenses because of clothing wear caused by prosthetic appliances. Background to Recommendation Veterans who wear prosthetic appliances that cause excessive wear on clothes can now send their clothing to the Veterans Administration for repair. Because of the considerable period of time a veteran is thus deprived of his clothing, most of the cost is, in effect, absorbed by him. The Commission therefore recommends that veterans who have incurred additional expenses because of wearing of prosthetic appliances, be paid $150 a year as a special allowance. STATEMENT OF CHARLES L. HUBER, NATIONAL DIRECTOR OF LEGISLATION, DISABLED AMERICAN VETERANS, ACCOMPANIED BY WILLIAM FLAHERTY, ASSISTANT DIRECTOR OF LEGISLATION; AND WILLIAM GARDINER, ASSISTANT DIRECTOR FOR LEGISLATIVE RESEARCH Mr. KORNEGAY. We are happy to have as our first witness the representative of the Disabled American Veterans, our old friend Chet Huber. Mr. Huber, you may proceed as you may desire. Mr. HUBER. Thank you, sir. I am accompanied this morning by Mr. Bill Flaherty, our assistant director of legislation; and Bill Gardiner, our assistant director for legislative research. On behalf of the Disabled American Veterans, I wish to thank you for this opportunity of appearing before the committee to present our views on pending compensation and related bills which you have under consideration. As you know, our organization has steadfastly maintained, as basic policy, that the Government has a paramount obligation to provide veterans' benefits, particularly disability compensation, to those who incurred disease and injury in the defense of our country. In consonance with this fundamental principle, our attention is necessarily and consistently focused upon legislative objectives which seek to provide adequate and just compensation for service-incurred disabilities. After reviewing the matter, it is the opinion of the DAV that the prevailing compensation rates, especially those for the totally disabled, are far from sufficient to insure the disabled veteran and his family an adequate standard of living. Much has been said concerning the adverse effect of the continued increase in the cost of living upon those who are forced by circumstance to subsist on fixed incomes. The 90th Congress has already enacted legislation to ease the economic burden of military personnel, Federal employees, social security beneficiaries, and non-service-connected pensioners. Sponsors of this legislation, in each instance, have documented and justified the necessity of increasing these benefits to bring them more closely in balance with the rise in the cost of living. The DAV recognizes the need for these increases to offset the shrinking value of yesterday's dollar on today's market. We would only recall here that disability compensation is also fixed income established by law. The service-connected disabled veteran has been caught in the same economic squeeze that has so seriously affected other Federal beneficiaries. It has been the practice to adjust disability compensation rates from time to time in order to keep pace with the fundamental changes in price levels, the most recent increase having been granted by Public Law 89-311, effective on December 1, 1965. The increases provided by this law were most welcome and were particularly helpful to the most seriously disabled. However, true comparability with the increase in the cost of living was not achieved. In the period from 1933-when the present system of disability evaluation was established-to 1965, when the last compensation increase was granted, there had been a 141-percent rise in the cost of living, and generally speaking, a 126-percent increase in the rates of disability compensation. The average increase of 10 percent provided by Public Law 89-311 narrowed but did not fill the gap between the purchasing power of the compensation dollar and the increase in the cost of living. Thus, in 1965 there still remained a deficiency of at least 5 percent. This deficiency has since been compounded by an additional 7.1-percent increase in living costs. Accordingly, the service-connected disabled have suffered a substantial decrease in the value of their compensation dollar. We think it is abundantly clear that an overwhelming case exists for restoring the full value of disability compensation at the earliest possible date. A cost-of-living increase in the rates of service-connected disability compensation, therefore, commands a very high priority in the DAV legislative program. This objection can be accomplished through enactment of H.R. 14995, a bill recently introduced at DAV request by Mr. Teague, the distinguished chairman of the full committee. Based upon resolutions adopted at our most recent national convention, the bill is a comprehensive measure to amend title 38 of the United States Code, to provide increased rates of disability compensation, improve serviceconnected benefits, and for other purposes. Since today's hearing covers only disability compensation measures, I shall omit any mention of those sections of the bill pertaining to educational, medical, or death benefits and confine my remarks to matters associated with the disability compensation program. As you know, Mr. Chairman, the basic rates of wartime disability compensation presently range from $21.00 for 10-percent disability to $300.00 a month for total disability. An additional amount of $47.00 a month is payable for the loss, or loss of use of a foot, hand, both buttocks, or creative organ, blindness of one eye, complete organic aphonia, or deafness of both ears. Existing law also provides a special rate of $67.00 monthly for arrested tuberculosis. Additional amounts are also payable to veterans rated 50 percent or more for a wife, child, or dependent parents. Conditions of helplessness, blindness, multiple amputations, et cetera, provide rates from $400.00 to $600.00 a month. Veterans who are so severely disabled as to be in need of regular aid and attendance receive $250.00 a month. Certain other seriously disabled veterans, who are housebound because of service-connected disabilities, receive a monthly rate of $350.00. H.R. 14995 and several other identical measures pending before the committee would provide meaningful increases in both the basic com |