Annual Report

ANNUAL REPORT

OF THE DIRECTOR UNITED STATES VETERANS’ BUREAU

FOR THE FISCAL YEAR ENDED JUNE 30

1928

UNITED STATES GOVERNMENT PRINTING OFFICE WASHINGTON 1928 F-----. * .- ...... ,

ADDITIONAL COPIES OFTHISPUBLICATIONMAYBE PROCUREDFROM THESUPERINTENDENTOYDOCUMENTS U.S.GOVERNMENTPRINTINOOFFICE WA8H1NGTON,D.C. 16CENTSA;ER COPY

,.. CONTENTS

Listofcllarts ------Listoftables ------Letter oftransmittal ------Introduction ------Ne\\'legislation------Hospitalization ------______------Governmex]thospitalfacilities------Diagnostic centers ------Future hospital construction ------Development and maintenance of bureau hospitals------Expenditures and operatingcostsat bureau hospiU_ ------Outpatient relief ------Dental relief ------Prosthetics ------Disability compensation------Death compensation ------_ Term and autornati cinsurance ckims---____tit------___ Cor]verted.insurance claims ------_----- Insurance ------Adjusted compensation------Committees on recoveries------Central board of appeals ------Director’s advisory group on appe@------Rehabilitation ------Finance ------kgal ------I'ersonllel ------_ .4nDendix: Statistical tables ------P(lblic acts ------I1ldes ------111

b LIST OF CHARTS FOR THE 1928 ANNUAL REPORT, UNITED STATES VETERANS’ BUREAU, IN ORDER OF APPEARANCE

Pam CHART ~o. I.—United States Veterans’ Bureau, actual number of patients remaining in all hospitals from October, 1919, to July, 1928 facing. - 6 CHART No. 2.—United States Veterans’ Bureau, active compensation disability awards each month from January, 1919, to July, 1928 facing- 19 CHART No. 3.—United States Veterans’ Bureau, personnel from 1917 to l928------facing-- 42 v

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. LIST OF TABLES FOR THE ANNUAL REPORT, FISCAL YEAR 1928

MEDICALTABLES

TABLE No. I.—Clinical laboratory classified tests in the United States Veterans’ Bureau dispensaries for fiscal years 1924, 1925, 1926, 1927, and l928------44 TABLE No. 2.—Clinical laboratory classified tests in the United States veterans’ hospitals for fiscal years 1924 1925, 1926, 1927, and 1928-- 44 TABLE N0.3.— X-ray exaxninations inthe ’United States Veterans’ Bureau dispensaries for fiscal years 1924, 1925, 1926, 1927, and 1928, classifiedby type of examination ------45 TABLE No. 4.—X-ray examinations in the United States veterans’ hos- pitalsfor the fiscal years 1924, 1925, 1926, 1927, and 1928, classifiedby type of examination ------45 TABLE No. 5.—Total out-patient medical service, by service rendered, for 6scalyears 1924, 1925, 1926, 1927, and 1928------45 TABLE No. 6.—Classification of total examinations by kind of examination for fiscal ears 1924,1925, 1926, 1927, and 1928------45 TABLE No.7.— 6 lassification of total treatments by kind of treatment for fiscal years 1924,1925, 1926, 1927, and 1928------46 TABLE No. 8.—Total treatments divided into medical and dental, salary and fee, with percent of fee, for the fiscal years 1924, 1925, 1926, 1927, and l928------46 TABLE No. 9.—Total examinations divided into medical and dental, salary and fee, with per cent of fee, for fiscal years 1924, 1925, 1926, 1927, and l928------46 TABLE No. 10.—Physiotherapy activities in hospitals and dispensaries, fiscal year l928------46 TABLE No. 11.—Regional nursing activities for fiscal years 1925, 1926, 1927, atldl928------47 TABLE No. 12.—Distrib~ltion of patients receiving occupational therapy and classification of hours given to each subject in United States veterans’ and contract hospitals for fiscal years 1925, 1926, 1927, and l928------47 TABLE No. 13.—Hospital report of United States Veterans’ Bureau patients in Government and civilian institutions, as of June 30, 1928--- - 48 TABLE No. 14.—Admissions of United States Veterans’ Bureau patients to allhospitals by fiscal years 1920–1928------48 T~~LE No. 15.— Admissions of United States Veterans’ Bureau patients to all hospitals, by beneficiary, groups of hospitals, and type of patient, fiscal ycarl928------49 TABLE No, 16,—Admissions of United States Veterans’ Bureau patients to all hospitals, by branch of service, type of patient, and type of admission, fiscal year l928------50 TABLE No. 17.—Admissions to hospitals of United States veterans of all wars without regard to nature or origin of their disability, as authorized in paragraph 10, section 202, \Vorld \Var Veterans’ Act, 1924, revised, by type of beneficiary and groups of hospitals, fiscal years l92&l928------51 TABLE No. 18.— .4dmissions of United States Veterans’ Bureau patients to all hospitals, by branch of service, type of patient, and sex and color, fiscal year l928------51 TABLE No. 19.—Yearly turnover of patients in United States veterans’ hospitals operating during the entire Y’earfor the fiscal years 1920- 1928-- 52 TABLE No. 20.—Patients of the United States Veterans’ Bureau under treatment in all hospitals, June 30, 1928, by class of beneficiary, groups ofhospitals, andtype of patient------53 T.4BLE No. 21 .—Patients of the United States Veterans’ Bureau under treatment in all hospitals, by sex and color, at the close of each fiscal year, l923-l928------54 TABLE No. 22.—Patients under treatment by the United States Veterans’ Bureau in all hospitals, by branch of service, type of patient, and home address (State), June 30, 1928 ------54 VII VIII LIST OF TABLES

Page TABLU No. 23 .—Pa+ients of the Unitid States Veterans’ Bureau under treattient in hospitals in their home Sta+e by groups of hospitals and type of patient, at the close of each fiscal year 1923–1928------58 TABLE No. 24.—Patients of the United States Veterans’ Bureau under treatment in all hos itals, by State location of hospital and patient’s State of residence, ? une 30, 1928 ------60 TA~E No. 25.—Discharges of United States Veterans’ Bureau patients by class, of disease and dis osition or condition on disposition, showing avera e days hospitalize $,fiscal year 1928------64 TABLE # o. 26.— ~lovemeut of patient population, snowing type of admission and result of treatment, fiscal year 1928------66 TABLE No. 27.—Discharges from hospitals of patients of the United States Veterans’ Bureau by disposition or condition on disposition and type ofpatient, fiscal year 1928 ------68 TABLE No. 28.—Comparison of principal causes of death (1) of Vnited States Veterans’ Bureau patienti in all hospitals, fiscal years 1924-1928- 69 * COMPE~SA’I’IONTABLES TABLE No. 29.—Summary of regional activities------_- -_ --- _------71 TABLE No. 30.— Number of compensation death and disability. claims received by fiscal ears from October 1, 1917, to June 30, 1928, inclusi~re- - 72 TABLE No. 31.—.4 umber of compensation death and disability awards by fiscal ~3~om October 1, 1917, to June 30, 1928, incluslve_ _. _---- 72 TABLE $ . .—Gross number of compensation a~vartis oIi which payments have been terminated, analyzed as to reasons for terminations during fiscal year 1928------72 TABLE No. 33.—Compensation, active disability awards; comparative analysis of type of major disability by extent of disability, by fiscal years l923-l928------73 TABLE No. 34.—Compensation, active disability a~vards; degree of impairment and extent of disability correlated with classification of major disability, showing number of disabled veterans and amount of monthly payments, as of June 30, 1928 ------74 TABLE No. 35.—Compensation, active disability awards; number of disabled ve~rans showing relationship of dependents and amount of. monthly payments, asof June 30, 192S ______77 TABLE No. 36.— Compensation, active death awards; number of deceased vetirans, showing relationship of beneficiaries to deceased veteran and amount of monthly payments, as of June 30, 1928--- - _------_- _-- 77 TABLE No. 37.—Compensation, active death awards; number of deceased vetirans whose beneficiaries are receiving compensation or con~pensation and insurance payments, with amount of monthly payments as of June 30, 1928 ------77 INS~RA~CE TABLES

TABLE No. 38.—Nuxnber of United States Governnlcnt term and converted insurance claims received by fiscal years from Octobcr, 1917, to June 30, l928------78 TABLE No. 39.—Number of ~Tnited States Government term and converted insurance death and disability awards, by fiscal years from October, 1917, to June 30, 1928 ------78 TABLE No. 40.—Term insurance, active disability and death awards; classification of major disability causing permanent total disability or death of veteran, as of June 30, 1928 ------79 TABLE No. 41.— Term insurance, terminated disability and death awards; classification of major disability of veterans and reasons for tern]il~a- tion, as of June 30, 1928-_ ------80 TABLE No. 42.—Automatic insurance, active disability and death awards; classification of major disability causing permanent total disability ordeathof veteran, as of June 30,1928 ------81 TABLE No. 43.—Automatic insurance, terminated disability and death awards; classification of major disability of veteran and reasons for &rmination, as of June30, 1928 ------81 TABLE No. 44.—Converted insurance death claims awarded during calendar year 1927, classified by plan of insurance------82 IJIST OF TABIJES Ix

Page TABLE No. 45.—Converted insurance disability claims awarded during calendar year 1927, classified by plan of insurance- ____---- ___ ------_ 83 TAFJLE No, 46,—Converted insurance disability claims terminated during calendar year 1927 on account of cieath of insured, classified by plan ofillsurance ------84 TABLE No. 47.—Converted insurance disability claims terminated during calendar year 1927 on account of recovery, classified by plan of insurax]ce------85 TABLE No. 48.—Converted insurance death claims a}varded during calendar year 1927, by class of disability causing death ------_ ------86 TABLE No. 49.—Converted ins{lrance disability claims awarded during calendar year 1927, classified by cause of disability- - __------_ ------87 TABLE No. 50.—Converted insurance disability clalms terminated during calendar year 1927, on account of death of insured., by class of disability- 88 TABLE No. 51 .—Converted insurance disability clalms terminated during calendar. ... year 1927 on account of recovery, classified by cause of disability ------90 TABLE No. 52.— Report of United States Government life insurance in force Dece~nber 3f, l927------92 TABLR: No. 53.— Report of United States Government life insurance in force, bv plan, as of December 31, 1927 ------92 TABLE h-o. 5-t.-Policy loans, L’nited States Government life-insurance funcl______93 TABLE No. 55.—~inancial statement of the united States Government life-insurance fund by calendar years from origin of fund to December 31, 1927------94 TABLE No. 56.-13ond investments of United States Government life- ins~lrance fund as of June 30, 1928 ------95 ADJUSTEDCOMPENSATIONTABLES TABLE No. 57.— Number of applications for adjusted compensation received by fiscal years from Septelnber, 1924, to June 30, 1928--- -- _- 96 TABLE No. 58.—Action taken on applications for adjusted compensation to J~lt]e30, l928------96 TABI.E No. 59.—Death claims a~varded on acco[lnt of adjusted service certificates, arranged by beneficiary, as of June 30, 1928 ------_ --- 96 CENTRALBOARDOF APPEALSTABLE TABLE No. 60.— Appeal cases disposed of by sections of central board of appeals and appeal group on central office cases for fiscal year 1928--- 97 ADVISORYGROUPON APPEALSTABLE TABLE No. 61.—~ction by advisory group on appeals for the fiscal year l928------98 FINANCETABLES TABLE No. 62.—Appropriations versus disbursements to June 30, 1928-- 100 TABLE No. 63.— Analysis of obligations from all appropriations, fiscal year 1928 ------___ 102 TABLE No. 64.—Disbursements made from all appropriations by fiscal .\,ears-__---______-______-__-___----_w ------103 CO~STRUCTIONTABLE TABLE No. 65.—Statement sho~ving United States veterans’ hospitals, existing facilities, and development of facilities under present appropriations or allthorization only (the construction and evacuation program as outlined by this table is tentative, and is subject to such changes as may be indicated by ftltllre development in the hospital load)__ - __- _- 105 PERSONNEL TABLE TABLE No. 66.— Comparative statement sho}ving by location the total personnel and aggregate ann~lal salaries paid from all appropriations, together \vith the net increase or decrease, fiscal year 1927–28------108 . .’

LETTER OF TRANSMITTAL

UNITED STATES VETERANS’ BUREAU, Washington)D. C., December 3,1928. To the PRESIDENT OF THE SENATE AND THE SPEAKER OF THE HOUSE OF REPRESENTATIVES OF THE SEVENTIETH CONGRESS: Pursuant to the provisions of section 140ftheactof June7, 1924 (Public, ~o.242, 68th Cong.), Ihave the honor to submit the following report of activities of the United States Veterans’ Bureau for the fiscal year ended June 30, 1928. This, the Seventh Annual Report of the United States Veterans’ Bureau, discloses the extent to which the bureau has carried out the laws passed by the Congress for the relief of veterans. The report as prepared for most of the activities having to do with the extension of direct benefits to veterms, analyzes the load at the close of that period, comments briefly upon the major changes and developments during that year, and shows the trend for the past several years. It also describes the policies and procedures inaugurated during that period which it is believed have resulted in improved service to beneficiaries. In addition, it itemizes the new legislation enacted by the Congress during that fiscal year amending the basic laws under which the bureau operates. It also contains a final report of the results of vocational training, which activity terminated by law on July 2, 1928. Respectfully, FRANK T. HINES, Director. XI

ANNUAL REPORT FOR THE FISCAL YEAR ENDED JUNE 30, 1928

INTRODUCTION

The activities for the conduct of which the bureau irresponsible under existing laws were increased during the fiscal year ended June 30, 1928, by the act of May 24, 1928, which made eligible for retirement benefits, under certain conditions, the officers and former officers of the Army, Navy, and Marine Corps, other than officers of the Regular Army, Navy, or Marine Corps, who incurred physical disabilities in line of duty during the World War. This was the only legislation passed during the above period which conferred upon veterans a new type of benefit, although both the World War veterans’ act and the World War adjusted compensation act were amended in a number of important respects. The benefits under this retirement act were so entirely separate and distinct from any heretofore administered by the bureau that it was necessary to perfect a complete organization in central office to handle all phases of this work. Up to June 30, 1928, there had been received in the bureau 4,194 informal applications for retirement benefits. The scope of the amendments to both the World War veterans’ act and the World war adjusted compensation act is shown under the heading, “New legislation,” which appears in another section of this report. Foremost of the policies inaugurated during this yea!, which it is believed will result in improved service to beneficiaries, was the decentralization of insurance activities to the bureau’s regional offices. under this plan of procedure, which was approved toward the close of this year, policy holders are to be required in all matters affecting their contracts of insurance to establish direct contact with the particular field office of the bureau located within the State of their residence. The advantages of such a plan are obvious, for not only will delays be minimized but there will also result closer contact with olicy holders, which should permit the Government to conduct its rife insurance business with a standard of service comparable to that of the prominent life insurance companies of the United States. In addition, premium receipts will be available for investment much more rapidly than heretofore, thereby materially increasing the interest return on the Government life insurance fund. This mattir is treated in detail in that part of this report covering insurance activities. In line with the bureau’s responsibility to provide hospitalization for the veterans of all wars, there was presented to the congress during this year a new hospital construction program, which antici- pated as far as could reasonably be determined the hospital require- 1 2 REPORT OF ~ITED STATES VETERANS’ BUREAU ments of the bureau for the next several years. The program as submitted dealt principally with increased facilities for neuropsychiatric atients, for which type of case an unfilled demand for Government Beds still exists. Perhaps the most noticeable feature of the program is its adherence to the established policy of the bureau in recom- mending , wh?rever ,a~~arently justified, the expansion and development o f exlstlng facfities rather than the erection of hospitals at new locations. In the two instances where the construction of new hospi- t~s was recommended by the burctiu, one is to ~eplace leased facilities and the other Government buildings which are structurally unsuitable for indefinite use. The bureau’s program, with certain additions, was approved by the Congress, and there was authorized to be appropriated the sum of $15,000,000, of which amount $7,000,000 was actually made available on hlay 29, 1928. The completion of this pro ram will be expedited, particularly that part relatin~ to increase t facilities for neuropsychlatric patients. During this year much attention has be:n gi~en to. tl?e improvement of the administrative procedure deahng with exlstlng laws, to the development of a medical program to the end that the physical improvement of bureau beneficiaries may be carried out to a greater degree, to expediting and improving the adjudication of claims, and b the continuation of the policy of dealing s~rnpatheticall~ and generously in all matters of veterans’ relief. For jhe future the bureau will continue these policies, and at the sanle time }Vill devote constant study to its established procedure in order that other policies of like purport may be adopted wherever indicated. In keeping with the announced policy of attempting at all times to render the highes~ type of medical service, the bureau proposes to establish supply points throughout the country where its nledical officers will be trained to meet the several medical problems before the bureau, and from these points assigned JO the various activities as needed. It will also be the policy to detail initially newly appointed medical personnel to veterans’ hospitals for the purpose of practically testing their professional qualifications before being assigned to definite duties and responsibilities. The director of the bureau has given considerable study to the subject of veterans’ relief, and has publicly proposed that there be established a separate department to handle all matters afiecting the extension of direct benefits to veterans and to the dependents of veterans; and will vigorously support any legislation that has f{)r its object this unified plan of control. In the opinion of the director, the main advantage of such a consolidation would be in bringing together in one definite a ?ncy under the President matters which are so closely related at tk s time as to make it essentitil for those charged with the administrative duties to be familiar with 811phases of the problem. The director of the bureau is also deeply interested in the question of employment of veterans. It is the behef of the director that this responsibility should be vested in the Veterans’ Bureau alone, instead of being divided as at present. As this change would require action by the Congress, steps will be taken to bring the matter to the at ten- $ion of the proper committees of congress. REPORT OF UNITED STATES VETERANS’ BUREAU 3

NEW LEGISLATION There was enacted, on December 22, 1927, Public, No. 2 (70th Cong.), making appropriations to supply deficiencies in certain appropriations for the fiscal year ending June 30, 1928, and prior fiscal years, to provide supplemental appropriations for the fiscal year ending June 30, 1928, and for other purposes. Of significance to the bureau in this act was the appropriation of $19,400,000 for the payment of military and naval compensation accruing during the fiscal year 1928 or in prior fiscal years. In addition thereto the unexpended balances of certain appropriations of the bureau for prior fiscal years were reappropriated and made available under the appropriation ‘i Military and naval compensation, Veterans’ Bureau, fiscal year 1928 and prior years. ” Publi~, No. 400 (70th Cong.), passed on May 16, 1928, included an appropriation of $485! 560,000 for the regular activities of the bureau for the fiscal year ending June 30, 1929. The President approved, on May 23, 1928, Public, No. 480 (70th Cong.), an act to authorize an appropriation to provide additional hospital, domiciliary, and out-patient dispensary facilities for persons entitled to hospitalization under the lVorld l~ar veterans’ act, 1924, as amended, and for other purposes. This act authorized an appropriation of $15,000,000, to be immediately available and to remain available until expended. The Houso and Senate, on May 24, 1928, passed by over the necessary two-thirds vote Public, No. 506 (70t,h Cong. ), an act making ehgible for retirement, under certain conditions, officers and former officers of the Army, Navy, and hfarine Corps of the United States, other than officers of the Regular Army, Navy, or Marine Corps, who incurred physical disability in line of duty while in the service of the United States during the }Vorld lVar. This act provides for the retirement of ex-emergency officers of the JVorld JVar who incurred physical disability in line of duty and who have been or may hereafter, within one year, be rated in accordance with law at not less than 30 per cent permanent disability by the United States Veterans’ Bureau for disability resulting directly from such war service, with i pay at the rate of 75 per cent of the pay to which they were entitled at time of discharge from their commissioned service, this pay to be in lieu of all disability compensation to which they are entitled under the TYorld l~ar veterans’ act, as amended. This act also accords these ex-emergency officers the privilege of hospitalization and medical treatment from the Veterans’ Bureau. It further provides that these ex-officers shall be entitled to the s~me privileges as are now provided or may hereafter be provided for the officers of the Regular Army, h’avy, or .Marine Corps, retired for physical disability incurred in line of duty. The same class of officers who have been, or hereafter may be, rated less than 30 per cent and more than 10 per cent permanently: dis~bled by the United States Veterans’ Bureau for disability resultlng directly from such war service and incurred in line of duty, are entitled to have their names plmced on the appropriate emergency offic{!’s’ retired list with the rank held by them when discharged fron~ tht’ir commissioned service, but without retired pay, and are entitled onlay to such compensation ~nd other benefits as are now or may hereafter be provided by law or regulations of the United States Veterans’ Bureau, togetht’r with all privileges as are now or may here- 4 REPORT OF UNITED ST.\TES VETERANS ‘ BUREAU after be provided by law or regulations for officers of the Regular Army, Navy, or Marine Corps, who have been retired for physical disability incurred in line of duty. The act provides that the retired list created thereby of the officers of the Army shall be ublished annually in the Army Register, and said retired lists of tEe Navy and ~ea~s~erCorps, respectively, shall be published annually in the Navy

F he ‘ President approved, on Ylay 29, 1928, Public, 585 (7~lth Cong.), an amendment to the l~orld l~ar veterans’ act, as amended, which contains the following in~portant provisions: (a) A statute of limitations on insurance suits providing that suits on contracts of insurance must be brought within six years after the claim accrues or one year after the passage of the act, whichever is the later. Heretofore, under the Conformity Act the statutes of limitations of the different States applied. (b) Authority for pavlnent of expenses of original, appointments of guardians, ~~~hensuch pay]nent is authorized by the dirmtor. (c) A provision relieving disbursing officers fronl liability for any amount paid by thenl to any person where the recovery of such amount is waived under the section which provides that there shall be no recovery of payments from any person, who, in the judgment of the director, is without fault on hls part, and where, in the judgment of the director, s[lch recovery }vould defeat the purpose of benefits otherwise authorized or would be against ec[uity and good conscience. (d) Authoritv for the director tt~contract for the service of translators. This ~~nendnlent will facilitate translation of foreign mail which is received in the l~eterans’ Bureau from practically all the countries in the world. (e) Authority ftlr the purchase of transcripts of records including all evidence of trial of litigated cases. ) Authority for the payl~~ent of expenses of l~~edical exan~inations, anf inspections when necessar~, in connection with the reinstate] ]~ent of insurance or the detern~inatlon of the fact of permanent and total disability for insurance p~lrposes, and the date of beginning or termination thereof. b) Authority for the payn~ent of dependency conlpensation to parents irrespective of the ti~ne the clependency arises, but to continue only during the existence of act[lal dependency, and not until the death of the parent, as forl~~erly provided. (h) Provision for the pavn]ent of $107 for burial and fun~’ral expenses in all cases in which the direct(lr,. in his discretion and ~vith due regard to the circlln~st~nces of the case, n]ay decide. Contracts for burial services are authorized to be ]~~adewithin the linlits of the amount allowed without regard to the laws prescribing advertise~~lcnt for pro osals for supplies and services or the awarding of contrtiets to the Yowest bidder. This }rill pcr]nit the bureau to procure the best funeral for the money, regardless of the provisions of the Revised Statutes requiring the acceptance of the lowest bid. It is further provided that no de(l~lction shall be ~nade froln the amount allowed because of any contribution toward the b[irial by a State, county, municipality, or other political subdivision. (i) Authoritv for the pay~~l.ent of death con]pensation to children after the age of 18 and until the col~~pletion of education or training (but not after the age of 21 years). REPORT OF UNITED STATES VETERANS’ BUREAU 5

(j) Pro\'isiono to~tlthorize thedirector,i nh~sdiscretion, toappor- tion compensation \vhere the ~’eteran is a patient in the hospital or for any other reason is separated from his wife and children. This amendment, is designed to o~”ercome the difficulty encountered in the former la~r under which an apportionment \vas mandatory regardless of the circumstances surrounding the separation, which resulted occasionally in an apportionment of the ~~eteran’s compensation to an undeser~~ing \\-ife. (k) The time for filing proof of a claim was extended to April 6, 1930, and the director v-as authorized, in his discretion, to extend the time for filing clain~s to ~lpril 6, 1930. (1) The rates of compensation for ~vido~vs and children recei~~ing compensation by }-irtue of an accrued right under the ~-ar-risl< insurance act }vas e(~ualized so as to n~ake them entitled to the same amount as is pfiyable to wido~~s and children recei~-ing benefits under the l~orld ll”ar \-eterans’ act. on) The provision permitting the payment of Go%-ernment insurance to a restricted class IVaS amended in so far as con~’erted insurance is concerned, there now being no restriction on the designation of ?Jeneficiaries for thfit type of insurance. (n) Pro~-ision v-as made for recon~-ersion of insurance to policies carrying a lo}ver rate of premium, \\-herethe insured is in good health, pro~ided, ho~rever, that no reconl-ersion may be made to the 5-year level premium form of policy. This amendment is effecti~~e as of June 7, 1924. (o) Pro~-ision is made for the granting of con~’erted insurance to any person ]vho has heretofore applied or been eligible to apply for yearly rene~~able term insurance or United States Go~~ernnlent life lnsurancej pro~~idecl such person is in good health and furnishes e~~i- dence satisfactory to the clirector. The pro~~isions of this section apply only, to persons in the military or na~~al forces of the United States during the \Yorld ~Tar, and no more than $10,000 insurance nlay be carried by any. one person at any time, nor can any person who has surrendered hls United States Go~”ernment life (con}-erted) insurtince for its cash surrender value apply for such insurance to the extent of the amount so surrendered. (])) I)rovision is n~ade for the inclusion of a new clause in the L“nited St atcs ~o~ernnlent life (converted) insurance policy whereby an insured t~-ho is totally disabled for a period of 12 consecutive months shall be paid disability benefits under the contr~ct as though he }\-ere pernlanentl~ and t(~tall~ disabled. This clause trill be inserted only upon apphcation and upon paynlent of the necessary prelniun~. Benefits under this clause do not prejudice the rights of an insured IVhO is other}vise pern~anently anti totally disabled. (y) Compensation )vhich is uncollected by reason of the provisions of section 310 of the }1-ar risk insurance act, as aI~~ended, or section ~lo of the }~’orld ~~ar ycterans’ act, 1~~~, as arnen~ed, ~-hich ]iI~~it the period over }vhich retroacti}~e con~pensation is payable, is made a~~ailable for the purpose of the re}-i~-al of insurance under section 305 of the ll”orld ~}-ar veterans’ act, as amended. This provision places the legislatil-e stare of appro~~al upon the bureau’s construction of this section, and nu rlifies the ruling of the Comptroller General that the law would not permit the use of compensation uncollectible 18119-2&2 6 REPORT OF UNITED STATES VETERANS ‘ BUREAU by remon of the provision limiting retroactive payments for the revival of insurance. The President approved, on May 29, 1928, an amendment to the World War adjusted compensation act, as amended (Public, 570, 70th Cong.), which contains the following important pro~-isions: (a) The time for filing applications for benefits under the \Vorld War adjusted compensation act is extended two y(Iars, from Jfinuary 1, 1928, to January 2, 1930. (b) The Secretary of l~ar or the Secretary of the Navy, as the case nlay be, is authorized, where the records of the department show that an application has been filed within the recjuired time, but the application itself can not be found, to certify to the Veterans’ Bureau the adjusted ser~-ice credit of the veteran, the application of the veterfin being presunled in the absence of affirmative evidence to the contrary to have been yalid when originally filed. This will permit the extension of benefits to \-eterans and their dependents in cases where the tipplic~t ions hat-e been lost after receipt in the proper departnlent. (c) The death of a veteran is presumed where he has been absent fronl his honle tind family for a period of seven years during which no intelligence of his existence has been received. (d) Provision is nlade that where the erson entitled is a minor, mentally ineon]petent, or under othtlr regal disability, payment may be I]lade to the legally constituted guardian, curator, or conservator of the perst)n cnt itled to a}-]~]ent, or to the person found .by the director tt~ be t)th(’rwise legalYy vest eci with the care of the person entitled to p~~-xl~entor of his estate. It is provided that prior to receipt of notice ?)Y-the bureau that any such person entitled to payment is under such legal disnk}ilit~, payment may be made to such person direct. (e) ~iuthoritv is given to the veteran to designate more than one beneficiary u~der his adjusted service certificate. (f) False and fraudu]ellt statenlents in connection with securing duplicate certificates are brought ~~ithin the penal provisions of the law. There was enacted, on May 29, 1928, Public, No. 563 (70th Cong. ), making appropriations to supply deficiencies in certain appropriations for the fiscal year ending June 30, 1928, and prior fiscal ~-ears, to provide supplemental appropriations for th~’ fiscal ~-e~rs ending June 30, 1928, and .June 30, 1929, and for other purposes. L)l sigmficance to the United States Veterans’ Bureau in this act \vas the appropriation of $7,000 ~000 for hospital facilities and services, as authorized by Public, No. 480, apprt)ved hlay 23, 1{J28.

HOSPITALIZATION Remaining under treatment.—Patients remaining under treatn~ent at the end of the fiscal year 1928 numbered 25,899, as compared ~~-ith

25,310 hospitalized on June 30, 1927. ii stufi~ of these cases indicates that 12,839, or 50 per cent, of these patients are hospitalized for a neuropsychiatric disability; 6,273, or 24 per cent, for tut)erculosis, including 228 cases of extra pulmonary tuberculosis; and 6,787, or 26 per cent, for a general medical or surgical disability. There has been a constant decrea~e in the number of pulmona~y tut)ercultlsis cases under hospitalization, and a similarly constant Increase in the neuropsychiatric and general medical and surgical cases. Of the total patients under hospitalization, 69 per cent ~~-ere in United States veterans’ hospitals; -73 per c(~ntitlother GOvernIll~)nt CHART NO.1 U. S. VETERANS BUREAU Actual Number of Patients Remaining In All Hospitals

October, 1919–July, 1928

,11-.!;,1, 1.,1 I

,1 1’ I I 1! I I I I 1[ I I I [:1 1 I I I I I I I I I I 1 I [ AS ON DJt,MAIti JJ/l SO Yi)JF.M.i IM~J AS ON DJFMAMJJ AS ON DJFM4MJJASON DJFMAMJJ -1920 J---1921--–—- 1922 ---- c-—l923----- . 1924------1925------1926 ---- —----1 927-- ‘—---1928—

FISCAL YEARS !6119—2S. (Face P. 6) 8 REPORT OF UNITED STATES VETERANS’ BUREAU the general medical and sur “calgroup, v~here section 202 (10) cases formed 33.13 percent of the Yoadin1925, and 69.64 per centin 1928, or ~n increaseof 36.51 percent. It is to be expected that there ivill be fe~ver hospitalizations for service-connected tuberculous cases asweget further from the period of the v-ar, because of the large number of cases reaching a state of arrest and the high rate of mortali~y of tuberculosis compared }rith neuropsychiatric and general medical and surgical diseases. It is also expected that hospitalizations for general medical and surgical cases, w~herethe disability resulted from service, v~ill decrease as time goes on, as many cases \vill have reached a stage \vhere there can be no benefits from further hospitalization. The fact that there is a comparatively low recovery rate in neuropsychiatric cases requiring hospitalization, as ~vell as a lo~~-death rate, is responsible for the fact that the number of patients hospitalized for neuropsychiatric disabilities has consistently increased until it no~~-forms 50 per cent of the total hospital load. .4d~~~issions.—The extent to ~vhich the hospitalization of veterans of the }Yorld \Yar and other v~ars has been carried on first by the Public Health Service and then by this bureau, is evidenced by the fact that the admissions to all hospitals during the past nine years total 707,384. Reaching a peak in 1922, admissions decreased n~ate- rimlly until 1925, v-hen more than 12,000 adnlissions ~trerereported th~n for 1924, Beginning ~-ith 1926 the ~dnlissions have increased approxin]ately 2,000 annually. The admissions during the fiscal year 1928 totaled 73,270, as compared with 71,967 for the preceding year. ~tdmissions to State and civil hospitals which formed 19.36 per cent of the total during the fiscal year 1924, represented but 3.3 per cent of the total for this year. This material decrease in the admissions to contract hospitals is due largely to the acquisition of additional Government beds. ild]~].issions for the treatnl.ent of pulmonary tuberculosis formed 17 per cent of the total during this year, those for neuropsychiatric diseases, 16 per cent, and those for general Inedical and surgical conditions, 67 per cent. Of the patients admitted for ncuropsychiatric diseases, 41286 or 37.42 er cent of the total for this type had never been prevlc)usly hospita Fized by the bureau for any disease or condition, \vhile of the total patients admitted during this year, 35,598 or 48.,58 per cent occupiecl a sin}.ilar status. ~~n analysis of the adnlis- sii~ns for the treatn~ent of general medical and surgical conditions, \vhieh formed by far the largest group of the three nlajor types of cases, show-s thnt diseases of the digestive sysienl, and of the ear, nose, and throat were the most frequently treated, follow-cd in order of frequency by diseases of joints and bursae, the circulatory systenl, and respirat~}ry systenl. Of the patients admitted for the treatment of psychiatric diseases, 50 per cent ~vere for dementia prmcox, while general paralysis of the insane and maniac depressive ps~chosis, together, formed the next largest group, representing 18.61 per cent of the total. .knalyzing the admissions to date of patients under section 202, paragraph 10 of the world V’ar veterans’ act, as amended, \vhich authority does not question the origin of the disability for which hospitalization is required, there is found a marked and fairly con- sistent yearly increase since the enactment of this legislation, the REPORT OF UNITED STATES VETERANS ‘ BUREAU 7 hospitals; and 8 per cent in State and civil institutions. The use of State institutions is confined almost exclusively to neuropsychiatric patients, and while the present authorized load in these hospitals is the smallest in the history of the bureau, it is expected that the completion of the bureau’s new hospital construction program will permit all of the service-connected cases of this type to recei~~e hospitalization in Government facilities, if desired. Of the total number of veterans under hospital treatment, 96 per cent saw service in the World lVar, and of this number, 66 per cent were receiving treatment for disabilities resulting from service. There were 1,138 veterans of some war, occupation, or expedition other than the World W7ar, and of this number, 83 per cent were veterans of the S anish American War. Approximately one third of the total colored ! ospital population of 1,780 was under treatment in the veterans’ hospital at Tuskegee, .ila. The policy of the bureau of hospitalizing veterans as near to their homes as possible is evidenced by the fact that 56 per cent of all ~~~~~ss are hospitalized within the State of their reported home Because it is the general belief among tuberculous patients that the climate in certain parts of the country is beneficial to the treatment of their condition, the hospitalization {~f tu})erculous veterans within their home State has been possible in only 51 per cent of the tuberculous cases. However, 56 per cent of R1l 1~~’~lrol~s~cl~iatric cases, and 62 per cent of the general medical and surgical cases are hos ltalized within their home State. J ases hospitalized for nonservice-connected conditions under seetion 202(10) and remaining under treatment at the end of the fiscal year 1928, formed 37 per cent of the total hospit al lotid. The following table shows the increase in hospitalization under section 202(1 O), classified as to the disability for which such hospitaliz~tion was tiuthorized, for patients under treatment at the end of each fiscal year beginning with 1925.

I 1 1 Pulmonarytub~r- NeuropsYchiatricj General Total culosis I I , ——— —— , II Fiscalyear Per I Per 1 Per l~; l I All 1202(10) ~;t 1 All 202(10) All 202(10)‘ centof .411 202(lo)jc~t I cases ‘w - 202(10)cm cases ~o~lo)/‘w cm= 202(10)I cm= IW2(10) c- Casa cases cases I — — . — — ——’— ‘- - ~—’——1--- 192Js------9,314 898 9.64 11,W5 1,155 9.70 5,391 1,7s6 33.13 26,610 3,839 1 14.43 19a3------7,308 1,196 16.37 1Z220 1,387 11.35 , 5,%7 2, ~m 45. @ 24,915 5,012 2(I.12 1927------6,658 & 046 30.73 I 12,538 1,B2 13.81 I 6,114 3$~o 593? 25.310 j ~,~~ I ~J.fl 1928------‘ 6,046 2,532 41.89 12,839 2,211 17.22 \ 7,015 4,885 I 69.64 25, 8% 9,628 37.18 I 1 I

The total number of patients hospitalized for pulmonary tuberculosis decreased from 9,314 on June 30, 1925, to 9,045 on June 30, 1928, whereas the percentage of these cases hosplttilized under section 202 (10) increased from 9.64 per cent to 41.89 per cent during the sti~ne period. The neuropsychiatric hospital load increased from 11,905 at the end of 1925 to 12,839 in 1928. Section 202 (1O) neuropsychiatric cases increased from 9.7 per cent in 1925 to 17.22 per cent in 192S, or an increase of 7.52 per cent, as conl.pared with an increase of 32.25 per cent in the tuberculous grou~?. ‘rhe greatest increase is seen in REPORT OF UNITED STATES VETER.4NS’ BUREAU 9

percentage of these cases to the total admissions at the end of each fiscal year being as follows: 1925, 17.24 percent; 1926,34 .83p ercent; 1927, 49.17 percent; and 1928, 62.55 per cent. ~lhnost three times as many admissions were authorized under the second provision of section 202 (10) as under the first provision of that section, due in a large measure to the fact that admissions under the latter authority are limited to certain diseases and conditions, and to the further fact that the majority of l~orld JTar veterans admitted to hospitalization for tuberculosis and neuropsychiatric diseases, which are specifically mentioned and which form the bulk of admissions under the first provision, have had such disabilities connected either directly or presun~ptively with military service. Spanish-American War veterans, as in vears past, form the majority of veterans of wars, other than the Ivorld l~ar, who were admitted for treatment during this year, numbering 4,384, or 82 per cent of the total. of these Spanish- American \Yar veterans 81 per cent were admitted for general n~edical and surgical conditions. The admission of 4,989 colored veterans was authorized during the year, 98 per cent of these being to Government hospitals. Seventy-one per cent of these admissions were for the treatment of general medical and surgical conditions, and 19 per cent for puhnonary tllberculosis. Female patients admitted numbered 508, the n~ajorit,y of these being treated in Government hospitals. \Yon~en admitted to hospitals for treatn~ent of general medical and surgical conditions represented about 68 per cent of the total, the remainder being abollt equally divided between tubcrculous and neuropsyehiatric diseases. .~dmis- ~ions of ~]lie(~ ~ct{~rans dllring this year nulnbered 482, 86 per cent of \vhoIn were C’anadian veterans. The majority of allied veterans were treated for general medical and surgical conditions. .i comparison of the past three years reveals that admissions of veterans for treatment of service-connected disabilities are steadily on the de(’line, having decreased 39 per cent since 1926. This undoubtedly is due in a large measure to the fact that the disabilities of many veterans have reached a stationary level, or are now being treated either in hospitals or out-patient chnics, or can not be bene- fitteti by further hospitalization. Year7y turnoz*er and replace ment.—The yearly per cent of turnover since 1920 is an excellent index of the stabilization of hospitalization in bureau hospitals. In 1920 the patient turnover for all types of veterans’ hospitals was once every three and one-half months, as compared with once every six months in 1928, The present low turnover rate for all types of hospitals is due largely to the increasing number of psychotic patients, who, by remainin under continuous treatment, offset the increasing number of genera F patients ~vho require but comparatively short hospital episodes. As is to be expected, hospitals devoted largely to the treatInent of neuropsychiatric diseases have the lowest turnover rate, since the majority of psychotic patients require institutional care indefinitely, and the death rate is low. Based upon the experience of the fiscal years 1927 and 1928, hospitals of the foregoing type have a complete patient turnover once every two years. During this fiscal year the turnover rate for hospitals devoted pri- marily to the treatment of tuberculosis ~vas once every six months. This low rate of turnover is highly desirable among the tuberculous veterans, inasmuch as arrestment of the disease is seldom attained in 10 REPORT OF UNITED STATES VETERANS’ BUREAU less than one year of intensive care, treatment, and exercise. The turnover rate for hospitals of this type is influenced to a large extent by the restless moving of the tuberculous patient from one hospital to another, one climate to another, or, irking at long hospital periods, necessary rules and restrictions, he leaves without permission or against medical advice. When atients of this type voluntarily terminate their hospital episodes by Yeating withou t permission or against medical advice they in most instances negative the good results of the treatment already obtained. The per cent of turnover in hospitals treating a majority of general medical and surgical patients is more than three times as great as in those treating tuberculosis, and about 14 times as great as In those caring for neuropsychiatric cases. Discharges.-The best index of the results of the hospitalization of veterans is obtained from a eneral survey of the discharges from hospitals. Of the 37,285 genera Fpatients who remained in hospitals during this period until the completionof the treatmentepisode,5,051 recovered, 29,119 were improved, 1,621 were unimproved, and 1,494 died. It will thus be seen that of the total discharges above nlentioned, 34,170 or 92 per cent improved to a sufficient degree to be discharged as having received the maximum benefit from hospitalization. The group of patients who have reached some degree of in~provement fronl hospitalization has increased from 37.06 per cent in 1925 to 56.49 per cent in 1928, which is due largely to the fact that appro.tinlat ely, 19 per cent more atients remained under treatn~ent during this period until the comp ! etion of the hospital episode. -A con)parison of the results of treatment and avera e periods of hospit alization is presented in the series of tables on disc %arges. An analysis of the classes of diseases treated and the results obtained discloses that the highest per cent of cases showing co]nplete recovery was reported for patients treated for hernia, in ~rhich surgical inter- vention is usual in approximately two-thirds of the cases. This operation was performed over 1,400 times during this year, find was successful in practically all cases. In the majority of the general classes of diseases, approximately 65 per cent of the patients were in~- proved after an average hospital period of 52 days. The highest percentage of unimproved cases among the general group were those treated for abnormalities and con enital malformations, and those of the tumor class, which latter inc7udes cancers and other n~.alignant tumors. There was the usual increase during this year of ternlinal cases of ulmonary tuberculosis dischfirged with fin unfavorable progn- osis. 4 his number, though conl.paratively Sn]all, has increased over 50 er cent since 1925. # he average period of hospitalization for the tuberculous patients discharged from hospitals during this year was 175 da s, for neuropsychiatric patients 217 days, and for general medics r and surgical patients 46 days. The experience of the bureau indicates that the average time necessary to Improve a pulmonary tuberculous case is 367 days, a neuropsychiatric case, 147 days, and a general medical and surgical case, 49 days. The high percentage of “discharges against advice” and “wit bout permission” of the pulmonary tuberculosis patients indicates that there comes to patients of this type a period of discouragement and dissatisfaction after an average of 200 days’ hospitalization. If, at this period, patients demanding discharge could be persuaded to re- REPORT OF UNITED STATES VETERANS’ BUREAU 11 main, much more might be accomplished in the treatment of this disease. A slightly higher percentage of arrested cases this year indicates that a few more” patients have been persuaded to remain in the hospital the length of time necessary to bring the disease to a stage of arrestment. Deaths among veterans under treatment for pulmonar tuberculosis numbered 1,923 or 50 per cent of the total deaths in ar1 hospitals during this year; for neuropsychiatric diseases 414 or 11 per cent; and for general medical and surgical conditions 1,494 or 39 per cent. The percentage of patients treated for pulmonary tuberculosis who die in hospitals has increased from 9.03 per cent in 1925 to 14.56 per cent in 1928, despite the fact that the number of discharges for this t~~peof case (including deaths) has decreased from 19,752 in 1925 to ~3,210 in 1928. A further analysis of the deaths in hospitals is made by classifying the primary cause by the second revision of the International List of Causes of Death. Table No. 28 offers a comparison of the deaths for each fiscal year since 1924. In each year, the outstanding primary cause of death is that of tuberculosis of the lungs. The next in point of numbers is organic diseases of the heart, which has increased from 98 or 3.92 per cent of the total deaths in 1924 to 318 or 8.3 per cent in 1928. Deaths from cancer and other malignant tumors are on the increase, ad~-ancing from 55 in 1924 to 220 in 1928. Diseases of the respiratory system, exclusive of tuberculosis, and diseases of the digestive system as causes of death are rapidly increasing, having more than doubled since 1924. The number of deaths from Bright’s disease continues to mount in the same manner as those from cerebral hemorrhage, which is attributed to the admissions for treatment in large numbers of Spanish-American Jvar veterans, whose average age is much higher than that of the TVorld war veterans. There were 26,167 surgical operations performed in all hospitals during this year, or approximately 1 to every 4 patients treated. Of this nllmber, 12,841 or 49.07 per cent were performed in bureau hospitals; 5,2GS or 20.11 per cent in Army hospitals; 5)244 or 20.04 per cent in Navy hospitals; 391 or 1.5 per cent in contract hospitals; and the remainder, 2,428 or 9.28 per cent, in other Government instit utlions. Artificial pneumothorax was successfully performed five hundred and thirty-one times during this year on the moderately and far advanced cases of pulmonary tuberculosis.

GOVERNMENT HOSPITAL FACILITIES On July 1, 1927, the 50 hospitals operated by this bureau had a combined capacity of 20,810 beds. These beds, classified according to the type of case for which each hospital was principally used, were as follows: Tuberculosis, 6,387; neuropsychiatric, 9,219; and general medical and surgical, 5,204. On June 30, 1928, the same number of hospitals was bein operated with a total rated capacity of 22,156 beds. Practically aY1 of this increase of 1,346 beds was at hospitals devoted largely to the treatment of neuropsychiatric diseases. During this period there was an increase of 1,803 beds in permanent Government-owned structures. Of particular interest in this latter connection is the progress that has been made by the bureau in the development of permanent Government-owned hos- 12 REPORT OF UNITED STATES VETERANS’ BUREAU pital facilities. .An analysis of the 22,156 beds in bureau hospitals on June 30, 1928, discloses that 19,921 of that nun~ber were classed as being in permanent Government-ov-ned structures, 1,012 were in temporary Government-ov-ned buildings, and the balance of 1,223 were in leased institutions. It is expected that wlthln the next several years all of the leased institutions will have been evacuated and the temporary Government facilities materially reduced. The only new veterans’ hospital opened for the reception of patients during this year was at Northport, Long Island, which h~s a patient capacity of 1,000 beds. Construction worlt, however, had been completed at the expiration of this period on the ne~r 350-bed hospital at Bedford, hIass. .idditional beds were ac(~uired during this year at Palo .ilto, Calif., North Chicago, 111.,and hTorthanlpton, h~ass., while facilities for 165 per~~~anenttbeds to replace a like nun~- ber in temporary structures were completed and opened for patients at Oteen, N. C. The hospital at ~ilgiers, La., which had been operating at a reduced capacity since its reopening sllbsequent to the Nlississippi flood, functioned at its full c~pacity for the last thr~~e months of this period. In addition to the hospitals operated by this bureau, there was on June 30, 1928, a total of 8,413 beds reserved for bt’nt’ficiaries of this bureau in hospitals operated by otht~r Gov(’rnn~t’nt agencies. These beds, classified by individual Governm(?nt agency, l~rere ~S follows: National Holl~es for Disabled Vol{lnteer Soldiers, 2,243; Cmted States Navy, 2,720; Llnited States ~lrll:y, 2,684; Intt’rior Depart]~~ent (St. Elizabeth Hospital), 359; and L nited States Public Health Service, 407. Of the foregoing beds, 2,008 were for tuberculous conditions; 1,868 for neuropsychiatric disorders, and 4,537 for general l~~edical and surgical conditions. In all Government hospitals, on June 30, 1928, there \vas a total of 30,569 beds available to this bureau, as compared with ?9,425 at the beginning of this fiscal year, representing an increase of 1,144.

DIAGNOSTIC CENTERS A new United States veterans’ Diagnostic Center ~~-asopened January 3, 1928, at the bureau’s hospital, Palo .ilto, C’alif. There are now three diagnostic centers operated by the bureau, the others being located at Cincinnati, Ohio, and Washln$gton, D. C’. TO these centers are referred, for intensive obser~’atl(~n and study, those problem cases in medicine in which there is difference (}f opinion as to diagnosis or appropriate treatment. The new center at Pti10 Alto, Calif., will receive such cases from the Pacific coast find South- western States, the centers at Cincinnati, Ohio, and ]Ytishingt~~n, D. C., serving the mid-west, and the eastern an~i southern se[~board States, respectively. Admissions to these centers during the fiscal year 192S totaled 1~804 and were divided as follows: 11’ashington, D. C., 1,185; Cin- c~nnati, Ohio, 487; and Palo .Alto, C’alif., 132. Of the tottil patients admitted, 1,440, or 80 per cent, had been previously under hospit alizatlon by the bureau one or more times. ?n June 30, 1928, the combined patient population of the di~gnost lc centers was 194, consisting of 178 white males, 7 females, mnd 9 colored males. During the year there were 1,781 patients (lischargcd f’r~)nl these centers, of which nun~ber 1,208 were from Ivashington, D. C’., 473 REPORT OF UNITED STATES VETERANS’ BUREAU 13

from Cincinnati, and 100 from Palo Alto, the average periods of hospitalization being 45.5, 15.4, and 35.6 days, respectively. The comparatively high average period of hospitalization in the center at \Yashington, D. C:, is partly the result of administering special treatment in conjunction with observation and examination in some of the more dificult medical and surgical cases in the treatment unit, which was added as an adjunct to the clinic. The success obtained in subsequent hospitalization through the use of the clinical findings and the treatments outlined by the diagnostic centers, reflect in a measure their actual accomplishment. Studies made during the year showing the subsequent action taken on the recommendations made by these centers reveal most grati- fying results, This is particularly true in cases where further treatment \vas not recommended, an analysis of these cases showing that although in many instances the period of time elapsing since the patient was discharged with no further treatment indicated was approximately six months, but 19 per cent had applied for further hospitalization at the close of the fiscal year. This fact is of greater significance when it is considered that the n~ajority of these patients had had from 1 to 15 previous hospital episodes, this being evidence that the economy resulting from the elin]ination of unnecessary hospitalizations, is being effected concurrently with the giving of general satisfaction to the claimants themselves. Changes in rating status of 40 per cent of the awards were effected, where claims and rating boards had available the findings of the diagnostic centers, resulting in increased ratings in 73 per cent of the cases and decreased ratings in the remaining 27 per cent. In those cases where no further treatment was recomn~ended but the veteran returned to the hospital within a month, the diagnostic clinics’ findings were available, and in 60 per cent of the cases treatment was instituted without the delay occasioned by further diagnostic work. An analysis of the cases where further treatlnent was recommended revealed that, in 70 per cent of the cases the clinics’ diagnoses were used by the hospitals furnishing treatment. The diagnostic center at ~~ashington, D. C., besides its usefulness in establishing a diagnosis in problem cases, and outlining methods of treatnlent, has been used during the year as a training school for selected medictil officers to fit them for special work. Intensive special training has also been given bureau nurses at this center.

FUTURE HOSPITAL CONSTRUCTION .It the expiration of this fiscal year construction work was in progress on the following major projects: (a) 26 l-bed hospital at Tucson, Ariz., to replace the existing facilities of temporary construction at that location; (b) 300-bed hospital at Portland, Oreg., to replace the leased institlltion now operated in that city; and (c) erection of facilities at Fargb, N. Dak., to house the regional office and to provide 57 hospital beds for ohservntion cases or those patients requiring but brief hospital episodes. The contract dates of completion of the construction on the above projects are as follows: Tucson, Ariz., .iugust 16, 1928; Portland, Oreg., November 25, 1928; and Fargo, ~. Dak., January 2, 1929. with the placing of the foregoing work under contract there remains but one other project, Alexandria, La., in order to complete the program comprehended under the $10,000,000 au- 14 REPORT OF UNITED STATES VETERANS’ BUREAU theorization for hospital construction as pro~tided in Public, No. 587, Sixty-eighth Congress, March3, 1925. It is expected that the contract for the new Alexandria hospital will be awarded shortly after theclose of this period. During this year the bureau presented to theCongressthe following new hospital construction program: (a) 130 ~dditional beds at Bed- ford, ~lass.; (b) 200 beds ofpermanent construction to replace alike number in temporary structure at Oteen, N. C.; (c) 300 additional beds, personnel quarters, and utility buildings at North Chicago, Ill.; (d) 100 additional beds at St. Cloud, Llinn.; (e) attendants’ and staff quarters at Palo Alto, Calif.; ~) 100 additional beds at iimerican Lake, Wash.; (?) replacement of structurally unsuitable Go\-ernment facilities at Philadelphia, Pa., either as one con~plete plant of 800 beds in Pennsylvania or New Jersey or as two separate plants of 400 beds each in Pennsyl\~ania and New Jersey; (}1) new hospital of 200 beds, Atlanta, Ga., to replace the present lntidequate 85-bed Go\’ernment-owned institution; (i) 130 additional beds at C’hillicothe, Ohio; G) construction of personnel quarters at hlay\vood, 111.,in order that space in m~in building now occupied by personnel may be used for approximately 430 patients; (k) new infirnlary I)uilfling of 100 beds at Walla Walla, ~Tash. ; (1) 130 additional beds ~t North Little Itock, Ark.; (m) 100 additional beds at Tusliegee, illfi.; (?t) new hospital of 300 beds to ser~-e the States of IIansas, Nel)rfisl

for the next se~'eral years plusanallowance forthesame proportion of nonservice-connected cases at that time as existed when the program was prepared. l~hile it might appear that in reality the bureau’s program con- templates the construction of hospital facilities for nonservice- connected cases, this is for the reason that under existing law where Government facilities are available nonservice-connected cases of the neuropsychiatric and tuberculous types must be hospitalized, and whereas additional beds may be authorized to be acquired for service- connected cases it must be appreciated that during the process of filling these beds a number of nonservice-connected cases will be admitted. The Committee on lYorld War Veterans’ Legislation of the House of Representatives accepted the bureau’s program as submitted, but made the following additions thereto: (a) A new 250-bed hospital for southern New England; (b) a new 250-bed hospital for Kentucky; (c) a 100-bed neuropsychiatric unit for the J$Talter Reed Hospital operated in ~l~ashington, D. C., by the LTnited States Army; and (d) increased the special fund by $635,oOO to cover the cost of an additional building for women veterans at or near the N!lount Alto Hospital in ~~ashington, D. C., as well as to revamp the tuberculous facilities at Fort Lyon, Colo., to care for neuropsychiatric cases. These additions by the House committee increased the amount of the bureau’s program to $15,00 ?,000, which is the sum carried in the act authorizing an appropriation to provide additional hospital, . domiciliary, and out-patient facilities for persons entitled to hospitalization under the l~orld l~ar }-eterans’ act approved on Alay 23, 1928 (Public, No. 480, 70tl~ Cong.). The sum of $7,000,000 under this authority was appropriated on hf~y 29, 1928 (Public, N-o. 563, 70th Cong. ), and the bureau is now directing its efforts toward placing under contract at an early date those projects which it has determined should receive priority consideration under this program, The extent to which additional hospital construction, beyond that provided for in the $15,000,000 authorization, will be recommended to the Congress by the bureau is problematic]. .1s time goes on it becomes increasingly evident that the Government hospital facilities now nvailable or planned should prove ample under normal conditions for both the service-connected and nonservico-connected cases of the tuberculous and general medical and surgical types for some time to come. The trend of the service connected load for both of these types is and has been for some time past downward, and there is no apparent reason at, this time to expect anoychange in this condition. The need to-day, as for some time past, 1s additional hospital accommodations for psychotic patients since the load for this type of case is increasing and should continue to do so in the future. It ~~as been previously pointed out that the additional neuro- ps~~chiatric facilities included in the $15,000,000 program v-ill meet the estimated needs of the bureau for the next several years. Consideration again was given at the last session of Congress to the placing of the NTational Homes for Disabled Volunteer Soldiers under the jurisdiction of this bureau, If this action is taken the facilities thus acquired would undoubtedly have a derided influence upon future hospital construction programs of the bureau.

G \

16 REPORT OF UNITED STATES VETERANS’ BUREAU

THE DEVELOPMENT AND MAINTENANCE OF BUREAU HOSPITALS

In addition to the nw construction which provided facilities for atients, the following developnlent program ‘was acconl lished at Eureau hospitals during this period: (a) Relnodel.ing buiYdin s for doctors, nurses, and attendants at ~iugusta, Ga.; (b) recreation f uild- in , storehouse, shop buildings, greenhouse, residence for nledical o# cer in charge, gate lodge, and covered walks at S~ln~]~ount,ST.l“.; (c) covered ~~allis at Sheridan, \Tyo.; (d) cnltirging infirl~~ar~~kitchen at Le ion, Tex.; (e) attendants’ c[uarters at Livernlore, ~alif.; (f) atten f ants’ cluarters at Northampton, hlass.; Q) storehouse at Chil- licothe, Ohio; (h) l~undry building at Gulfport, Xliss.; and (i) shop building at Jefferson Barracks, Nlo. The corn letion of the above work is in line with the policy of the bureau to / evelop eventually con~plete and n~odern opertiting plants at those hospitals which w1ll undoubtedly be continued in operation for an indefinite period. Llpon the erection of new hospitals it is necessary at til~~es, principally by reason of lin~ited funds, to defer the construction of cert~in of the desirable but not absolutely essential hospital buildings; ~rhile tit older hospitals the requirenlents of the bureau often indicate the need for nlodernizing the facilities. During this year 6,861 l~~aintenance tind repair re(~uests were received frol~~ bureau hospitals, covering new construction tind supplies for ]~laintenance repairs and nlinor alterations to bllildings, mechanical ecluipnlent, and the ~lplieep of grounds. . EXPENDITURES AND OPERATING COSTS AT BUREAU HOSPITALS

Gross expendit(lres at bureau hospitals during this year anlounted to $30,537,235.61, while the net operating expenses totaled $26,091, - 386.90. The an~ount shown for net operatin: expenses does not include expenditures for ne~v construction, nonexpendable ecjllipn~ent, or those incident to the furnishing of out-patient relief. Through- out this fiscal period there \\-as R daily average of 542 nlore p~tients of all types under treatment than for the preceding fiscal year. The average er dieI]~ rnte for Rll hospitals during this period was $4, the same as rast year. The cost of operating hospitals used principally for tubereulous patients decreased $501,486.03 during this as con~pared with the fiscal year 1927, d[le prin~ar~l~ to the closing of one hospital, which is to be replaced by facilities of pt’rl]~nnent construction) nnd the general decline in the patient lend of this type. ~[lring this year these hospitals c~red for n daily average of 342 less patients than in 1927, while the per dienl cost of operation was $0.09 Inore for this year. .In increase of $855,325.27 in operating expense occurred at hospitals of the neuropsychiatric type, the direct result of the opening of a ne~v ne~lropsychiatric hospital and a daily avera:e @ 564 more patients than in 1927. The per dien~ cost of operation for these hospitnls during this year was $2.92, an increase of $0.09 over that for 1927. The cost of operating hospitals of the general nledical ~nd surgical type increased $432,978.93 during this year, due largely to the fact that the finily average of patients increased 330. The per diem rate for hospitals of this type during this year decreased $0.05 over the preceding year.

4 REPORT OF UNITED STATES VETERANS; BUREAU 17

OUT-PATIENT RELIEF

Out-patient supervi~ion, care, and treatment of bureau beneficiaries within the continental limits of the Llnited States was provided during this fiscal year through the 54 regional offices located in all of the States, except Delaware; through medical treatment stations strategically located in smaller centers of population; through the ser~’ices of designated examiners located in remoter communities not readily accessible to the regional office facilities; and through the facilities of this character established at a number of LTnited States Veterans’ hospitals. In addition, contact with sick veterans in their homes is maintained through periodical visits of follow-up nurses and social workers. In extending medical relief to beneficiaries resident in the insular and Territorial possessions of the LTnited States the bureau operates out-patient clinics in conjunction with its offices established at klanila, P. I., San Juan, P. R., and Honolulu, Hawaii. JIedical care and treatment of bureau beneficiaries living in the Panama Canal Zone is provided by the LTnited States Public Health Ser~’ice. In foreign countries, the matter of obtaining suitable medical care and treatment for bureau beneficiaries is handled by the Department of State, through its foreign service officers. The total number of physical examinations in regional offices during the past fiscal year was 871,756, a reduction of 50,608 from the fiscal year ending June 301 1927. Of this number 850,023 were medical and 21.,733 dental. Eight hundred and thirty thousand nine hundred and slxt y-two or 97 .S per cent of the medical examinations and 19.,191 or 88.3 per cent of the dental examinations were *made by physicians on a salary basis. Examinations made by phys~cians on fee basis represented 2.48 per cent of the total examinations as compared with 2.59 per cent of the total made by fee bwis physicians during the fiscal year 1927. Treatments administered through regional offices totaled 827,122 as compared with 873,577 for last year. of this number 747,019 were n~edical and 80,103 dental. hfedical and dental treatments on salary basis totaled 649,598 and 68,366 respefltively, and represented 87 and 85.3 per cent of the total treatments. Fee basis treatments represented 13.2 per cent of the total treatments made during the past fiscal year, as compared with 9.4 per cent for the fiscal year 1927. As of June 30, 1928, there were 15,000 beneficiaries under the supervision of follow-up nurses.

DENTAL RELIEF The ~-olun~eof dental work of the bureau decreased slightly during . this as compared with the fiscal ye~r 1927. The number of dental clinics in bureau hospitals on June 30, 1928, was 49, one less than on June 30, 1927. Patients furnished dental relief in hospitals decreased from 25)149 during the fiscal year 1927 to 18,772 for this year. The number of cases completed however, increased from 13,543 to 15,345, which, particularly in view of the reduction in the total number of patients, shows a growing tendency to complete the authorized relief while the patient is still in the hospital. .The actual cost of rendering this relief was $430,957, which represents an average cost per patient of $22.95, as compared with $16.32 for the fiscal year 1927. The 18 REPORT OF UNITED STATES VETERANS’ BUREAU number of sittings was 177,124 for this year, an increase of 3,076 over last year. Complete reports of the dental relief furnished beneficiaries hospitalized for nonservice-connected disabilities under the provisions of section 202 (1O) of the l~orld War veterans’ act, 1924, as amended, are for the first time available for the entire fiscal year. The following table shows the value of this class of dental relief computed on a fee basis, the actual cost thereof, and the percentage it represents of the total amount of dental relief rendered in veterans’ hospitals: _—_— — —. I I ‘- ‘ -- Value P:fcee;:ge .kctual Type of hospital computed on fee , cost work I basis I I I ‘-” ‘--- Perct nt Oemrd------~ $148,740 $99,M7 m~8------62,798 42012 :; NeW0Wytii8triC------32,901 22,679 20 Allt~-. ------.---....---..-.----..------.------.j 245,439 164,198 38

The dental administrative work in regional offices has, on the whole~ decreased duting the fiscal year 1928, although along certain lines Increases are shown. For instance, the total number of cases rated for compensation purposes shows an increase of 162, while the number of cases entitled to treatment increased by 64. The number of authorizations for dental relief for service-connected disabilities increased 273, the increase in value being $12,672.25, while the number of cases authorized as adjunct to the treatment of physical disabilities decreased 752 cases, with a decrease in value of $22,880.71. A decrease of 1,185 occurred in the number of cases referred to bureau ctinics for relief, while the number of cases referred to designated dentists on a fee basis increased 259. The number of dental clinics in regional offices increased from 31 h 33, although the number of patients treated decreased from 15,290 to 8,272, a reduction of 7,018. The number of completed cases also decreased from 6,579 in the fiscal year 1927, to 5,089 in this fiscal year, although the percentage of cases completed increased materially. The number of sittings decreased from 72,670 to 60,156. The net cost of operating dental clinics has been reduced from $21 O,W8.22 in the fiscal year 1927 to $172,734.11 in the fiscal year 1928, a net reduction of $38,264.11. The average cost of dental relief for each beneficiary increased from $14.22 in fiscal year 1927 to $20.88 during the fiscal year 1928. The increase In the average cost of dental relief per individual, in both hospital and regional ofice clinics, is due, as indicated above, to the greater volume of work accomplished for each beneficiary.

ORTHOPEDIC AND PROSTHETIC APPLIANCES

Durin this year orthopedic and prosthetic appliances were furnished to a tota 5 of 23,021 beneficiaries at a cost of $288,816.01, an increase of 2,271 in the number of beneficiaries and $41,665.83 in expenditures over the fiscal year 1927. This increase is due largely to the following: (a) The furnishing of appliances to an added number of clain]ants CHART NO. 2 U. S. VETERANS BUREAU

ACTIVE COMPENSATION DISABILITY AWARDS

Each Month from January, 1919, to July, 1928

II’:, 60,000 ];-*I] ! ]-I--’~ ~ 11’ I l::

I II,

I I

I 30,000 ~“-~’I t

I ,! II I I I I I ( I 111 ! , I 11(111 [11 I 1!11 111111 I<”?J””L’””’ ‘Illl!lljlllllllll ASONOJFMAMJ JASONOJFMAMJ JASONDJ FMAMJJASONDJFMAMJ JASONOJFMAMJ JASONOJFMAM ‘0 ARJJASON DJFMAMJ JASON DJFMAMJ JASON OJFMAMJ J ~~1928— ——1924 —+ 925 ~—l 926 ~U927 -1919’ —1920—~ 1921 ——1922~— 1923 REPORT OF UNITED STATES VETERANS’ BUREAU 19 whose disabilities have not been determined to be of service origin, as authorized under the amendment of July 2, 1926, to the World War veterans’ act; (b) an increase of 116 in the number of artificial limbs furnished as replacements of old ones and for reamputation cases; and (c) an increase of 293 in the number of claimants furnished special shoes, supplies, etc. Approximately 45 per cent of the above- mentioned increase in cost occurred under item (b), due to the furnishing of a new type metal limb costing about twice as much as the wood or fiber limb heretofore provided but which due to its lightness in weight is preferred by many beneficiaries. Every effort has been made to eliminate travel for claimants in securing prope~ly fitting appliances of special construction. Afuch transport ation 1s obviated through a working arrangement with contractors from whom special apphances are purchased to have mewure- ments and diagrams of appliances made by a competent representative at the claimant’s home, the contractor accepting all responsibility for correctness of fit. This eliminates at least one trip for the veteran, and frequently the appliance can be satisfactorily fitted and adjusted at his home, which eliminates all transportation on the part of the veteran. The bureau continued to operate orthopedic workshops at Boston, Mass.; New York, N. Y.; Atlanta, Ga.; Chicago, Ill.; and Muskogee, Okla. The cost of operating these shops during this year was approximately $20,000 less than the value of the work accomplished, breed on contract rates. It is expected during the coming fiscal year to make greater use of these workshops, particularly for major repairs which heretofore have been accomplished largely by private contractors. DISABILITY COMPENSATION

Claims for death and disability compensation have been filed by or on behalf of 1,099,803 veterans, representing approximately 20 per cent of the men who served in the armed forces of the United States during the World War, of these claims, 546,619 have been allowed, and to date there has been disbursed for this purpose $1 ,249~821,507, exclusive of insurance. During the fiscal year 1928, the rating boards in the various regional offices were engaged in completing a review of all service connected cases rated at less than 10 per cent, in order to establish a rating in accordance with the new rating schedule. In a number of cases, the degree of disability had increased since the time of last rating, and a compensable ratin was given for this reason. In other instances, disabilities rated at fess than 10 per cent under the old schedule were rated compensable when the re-war occupation of the veteran was considered utier the Schedu 1’e of Disability’ Ratings, 1925. During the fiscal year 1928, 12,262 original awards were made, and of this number 2,387 were neuropsychiatric cases, 3,104 were tuberculosis cases, and 6,771 were general medical and surgical cases. Of the cases in which original awards were made, 3,704 had been previously disallowed as “not of service” origin” and 3,574 as “less than 10 per cent. ” The awarding of the $5o statutory award has continued in tuberculosis cases where the disease has reached a stage of complete arrestment, resulting in 9,765 “new statutory awards during 1928. A total 20 REPORT OF UNITED STATES VETERANS’ BUREAU of 40,904 veterans are now receiving this $50 award at an expenditure to date of $32,205,434. This means a monthly increased disbursement of $1,472,409 over the compensation previously paid veterans who have an arrested tuberculous condition. Of the 40,904 veterans who are now receiving the statutory $50 award, 30,447 were receiving some compensation for tuberculosis prior to the amendment of July 2, 1926. In 9,588 eases, compensation had been discontinued because the disability was rated as “less than 10 per cent, ” and in 869 cases, compensation had never been paid. In most of these cases new evidence was presented, and as a result the disability was connected with service. Awards of compensation for disabilities resulting from service are being paid to 257,536 veterans at a monthly disbursement of approximately $12,700,000, the actual monthly value of these awards being $11,574,308.. The nun~ber of veterans receiving disability compensation awards increased 13,925 during the past year. On ,June 30, 1928, the average award for all types of nellrc)psyt’l~i~~triccases was $52.78; for tuberculosis cases $64.36; and for general medical and surgical cases $33.60; or an average for all cases of $44.94. Neuropsychiatric cases form 21 per cent of the total compensable load, tuberculosis cases 24 per cent, and general medical and surgical cases 55 per cent. Compensation paid on account of neuropsychiatric and tuberculosis disabilities amounts to 59 per cent of the total disbursements, whereas these cases form only 45 per cent of the total number on which compensation is being paid. This is in part due to the fact that there are more permanent total cases amen the veterans suffering from neuropsychiatric and tuberculosis disabif ities and to the further fact that a large percentage of general medical and surgical cases are rated between 10 per cent and 20 per cent. of a total of 33,307 permanent total cases, 17,080 are neuropsychiatric cases and 10,831 are tuberculosis cases. Adherence to the policy of rating cases on a permanent basis as soon as the disability reaches a stationary level, is shown by the fact that 69 per cent of the con~- pensable case? are rated on a permanent basis. In 61 per cent of all cases now being paid disability compensation, the effective date of the original award was prior to December 31, 1919, thus indicating the large number of cases which are directly connected with the service. However, the effect of the presumptive period provided by the }Vorld War veterans’ act, 1924, is shown by the material increase in awards on neuropsychiatric and tuberculosis cases. On June 30, 1924, there were 32,103 neuropsychiatric cases and 39,099 tuberculosis cases. To-day there are 54,958 neuropsychiatric cases and 60,690 tuberculosis cases, or an increase of 22,855 in neuropsychiatric cases and 21,591 in tuberculosis cases. The application of the new rating schedule has been largely responsible for the increase in the value of the average monthly award. There has been an average increase of $7.39 on each award since January 1, 1926, the date of the application of this schedule. There are 8,029 compensable cases due to amputations, and of this number 563, are rated on a pernlanent total basis. In addition to compensation p.ayn~ents, 11,201 vet crans who are rated permanent total are receiving payments of insurance. In 58 cases, disabled veterans are drawing compensation in the amollnt of REPORT OF UNITED STATES VETERANS’ BUREAU 21

$200 a month for double permanent total ratings, and of this number, 37 are receiving payments of insurance in addition to compensation. A study of type of disease correlated with the age of the veteran indicates that, in neuropsychiatric cases, the percentage is higher as the age increases; the highest percentage being in the age group over 45; whereas in the tuberculosis group, the highest percentage is in the age roup under 30 years, and the lowest in the group over 45 years. f n. general medical and surgical cases, the percentage of disability increases as the agelncreases. Compensation awards are being paid to 1,161 veterans who reside in the insular possessions of the United States. These monthly payments average $64,598. Compensation is also being paid to 1,569 veterans who reside in foreign countries, in the monthly amount of $77,966. The largest number of these veterans reside in Italy, where 445 are receiving monthly compensation payments. It is interesting to note that the incidence of tuberculosis is higher among the veterans residing outside the continental limits of the United States. Tuberculosis cases form 34 per cent of the foreign cases, whereas they form but 23.5 per cent of the total compensable case load. The percentage of neuropsychiatric cases is only slightly higher for the veterans residing in foreign countries. This type of case forms 21.61 per cent of the foreign compensable cases, as against 21.34 per cent of the total compensable cases, \ ~~onthly compensation payments are being paid to 2,247 women who served during the }Vorld lVar, these monthly payments averaging $53.66. of this number, 1,895 were Army nurses, 350 were in the naval service , and 2 were rnarinettes. Of these women, 351 are now rated as permanently and totally disabled.

DEATH COMPENSATION On June 30, 1928, monthly payments of compensation were being made to the dependents of 85,634 veterans who died in actual service or from a disability resulting fron~ service during the Jvorld lVar. Approximately 35,5oo of these deaths occurred during service, of which 5,400 occurred during September, 1918, 16,600 in October, and 3,000 during the first 11 days of No\~ember. The dependents to w-horn ron~pensation was being paid on June 30, 1928, consisted of 78,821 parents, 19,260 widows, and 27,314 children. hlonthly disbursements for compensation to these dependents amounted to $2,542,103 in June, 1928. In addition to (Jonlpensation, 74 per cent of these dependents are receiving payments of some fornl of Government insurance. The dependents of 6,686 deceased veterans reside outside the United States, and monthly con~pensation payments to these beneficiaries amount to $178,155.

TERM AND AUTOMATIC INSURANCE CLAIMS on June 30, 1928, Inonthly insta]hnents of ter~n insurance ~vere being paid to ] 1,761 permanently and totally disabled veterans, the payments averaging $45.44. Veterans suffering frolll a neuropsy - (Ihiatric disabilit~- or fronl tuberculosis w-ere being paid 76 per cent 18119—2s—--3 22 REPORT OF UNITED STATES YETERJiNS’ BURE.4U of these aw-~rds. I’ayments for permanent and tottil disability have been discontinued in 3,561 eases becallse of recovory and in 15,895 cases because of the death of the veteran. Tuljerc’ulosis Ivas tl~e cause of death in 11,273 of these (Iases. The beneficiaries of 13!1,412 de(Ieased v(’tertins \vere receiving montlhly pn~ments of terln insllrance on ,Jllne 30, 1928, the tivertige payment being $50.92. ~lonthly ~Ja?-nlents h[ive been (Discontinued entirely in 7,732 oases [~nd in part in 3,658 cRses, bc(IaIIse of the payment of the insurnn(’t’ in luIIlp SUI]I Il})on the detith of the beneficiar~ naIned by the T-cteran. on ,June :~(), 1!)28, n~onthly paynlents were being made to l)enefi(’inries resi(ling outside the LJnited States in 6,595 cases on insurtince vtilut’d Rt $55,43 S, f302. Parents of dece~ls(~dT-eter[ins lvere tlh~~})eneii{’iaries in 04 per Centl of all ternl insllr[lnce a}vtirds, the ~~i(lows in 14 per cent, the children in 2 per cent, and tile brothersl sisters, and otl~er bene{ici~~ries in the permitted clmss in 20 per cent. Automatic insllrance payments }vere being ;nade to 287 pern~a- nently disabled vetertins [~nd to tl~e dependents of 7,477 det’[’ased veterans at the rate of $25 a month on ,June ;;(), 1928. This insurance was provided by the (Iovernnlent for veterans ~vho ~vere per- mancntl}’ and totally disal~led or ~vho died t)(’f’ore they ]vcrc ~ble to avail thenlselves of ti]t’ opportunity tt) apply for }!-~~rrisk insurance.

(:ONVERTED INSURANCE CLAIMS To date, 16, 1S1 converted insurtin~’e clainls ha~-e been filed, resulting in 9,236 awards on account of death and 3)551 a~vards 011 account of permanent and total dis~]l)ilit~-. These death cltiinls in- volve the p}i~nle~~tof insurance in the an~ount of $44,193,743, find the disability clal[]~s insurance valued at $18,088,358. l>etith clainls fire paid in lulnp sufn or in installn~cnts ~(~~’t)rdingto th(’ plan sele(’ted by the insured, Of the 9,236 death atrtirds, 7,140 \vere paid in lunlp sum, this insllrance amounting to $34,624,335. Conv~’rted insurance is being paid in installments in 2,075 (+ases, and in 21 cases the payment of installments has been {’onlpleted. During the calendar year 1927, a}vards of insurance \rere made on 1,523 death claims and on 795 disability claims, as against 1,288 death awards and 769 disability awards for the calendar year 1926. An analysis of the plan of insurance (’arried b,v these deceased veterans indicates that 30.7 per cent carried ordinary-life policies, 22.7 per centl 20-year endov-ment policies, and Z 1.S per cent 20-pay nlent life policies. Alonthly payments of converted insur~]nce for permanent total disability were terminated during the c~ilendar yenr 1927 in 147 cases because of death and in 46 cases beca[lse of recovery. .~n tinalysis of the CRSL’S terminated be(’allse of death shows that only 47 had received insurance payments for a perit}t~ of l]]t~re thtin tlvo years. A stlldy of callses of death in cases on ~vhich insurance cltiInls \vere awarded during 1927 indicates that 19.9 per cent of the total resu]ted from disetises of the circulatory system, incl~]ding heart disease; 20.8 per cent from miscellaneous distibilities, including accidents and injuries; nncl 14.5 per cent from tuberc[llosis. T}]is pert’ent ag[~ from tuberculosis tvollld be In{lch higher \vere it n(}[ for the fa(’t thnt a large Ilulnt)er of tuberculosis vet~’r~llls ret’(’ivc’({ p(’rlnanent total REI’ORT OF UNITED STATES VETERANS’ BUREAU 23

awards of term insurance, and upon the death of these veterans payments of term insurance are continued to the beneficiaries of these veterans. It is interesting to note that while tuberculosis \vas the cause of death ill 14.5 per cent of the death awards, it was the cause of permanent total disability in 41. ? per cent of the disability awtirds, indicating the disabling effect of this disease.

INSURANCE

~ft the beginning of this fiscal year the bureau was confronted with the ttisl< of handling an enormous volume of applications for Govern- ment life (ronverted) insurance, which were submitted in the closing ~eelis inlmedintely. prior to July 2, 1927, the final date Ilnder the law for applying for ths insurance. ~~pproxin~ately 245,000 applications wrere received, aggregating $1,400,000)000 of insuranc~, which re- flects both the veterans’ tippreciatlon of this valuable right and the success of the hllreau’s efforts, through its nation-wide can~paign, to induce them to tal

follow the same procedure on a “ State” basis that the central office is now following nationally with reference to these insurance ~ctivities. Closer contact with Government life insurance policyholders will De established by this new facility, which will enable the bureau to conduct its Government life insurance business with a standard of service comparable to that of the prominent life insurance companies. Under the improved method of collections the funds involved will be made available for investment more rapidly than under the present method, thereby increasing the interest retllrn on the C~overnn~ent life insurance fund.

APPLICATIONS FOR UNITED STATES GOVERN}lENT LIFE (COXYERTKD) lNSURANCE

Applications for United States Governl~~el~t iife insur~ulce, approved during the fiscal year totaled 187,579, aggreg~ting $1 ,028,923, !)38, compared with 94,775 applications a~nounting to $528,392,81 {1 approved during the fiscal year 1927. ‘I’he total applications apprt}vt’d to June 30, 1928, is 814,853, amounting to $3,636,868,157 insurance, The following table shows the number nnd an~ount of United Statt’s Government life insurance policies issued by 1llt)nths for the fiscal year 1928: ...——. —-— Date Number ‘ Amount Date Number Amount Ii - . —.-—- —-- I ..–– 1927 1928-C ontinuOd July ------33, 2s9 $211,05& 116 February ------2,361 $11,746,582 August ------53,004 312,816,074 March ------1,983 9,380,879 Sepbmkr ------55,556 235,133,872 , April ------1,231 6,191,857 October ------20,007 95,232,839 May ------885 3,805,096 November ------9,612 45,706,207 June ------465 2,563,529 Dwembr ------4,262 21,369,174 Total ------187,579 i 1,026, 9X, 938 192n ,1 January ------4,739 23,919,713 I — — ———— —

ANALYSIS BY PLAN OF UNITED STATES GOVE RNhlENT LIFE INSL’ltANCE

The following table shows the number and till]ount, the percentage and the avertige amounts of United States ~lovernnlellt life ins{lrance policies issued to June 30, 1928, classified by plan: —.—— — —— -1 I I per~nt of tots] .4\’erage Number Amount -—– -– - policy h-umber i Amount .— .—. —.— -— Ordinary lifeT------167285- Wfi 791 KJ; I 20. m- 23.81 I $5,175.55 Wpayment l!fe------I m:,,, 87~683; IW 25.07 23.04 4,2C2.39 30-pay mentllfe ------32,423 ;~~yg; I ~: ,;:: ;~;; ~-ywendowment ------210,617 Wy~rendowment ------42,000 177,451:290 5:15 4: w 4:224:13 Endowment atage 62.- ...... ------39,963 192,978,717 4. w 5.31 4,828.93 5-year convertible terIn ------, 118,2$5 803,345,204 14.Y2 22.09 6, 791.07 —— Total ------814, S53 3,636, 86% 157 100.00 100.00 I 4, ‘ttiJ.22 .——— _————.—I REPORT OF UNITED STATES VETERANS’ BURE.4U 25

~T~IT~D STATES GovER~hl~~T LIFE (cONVERTED) lNsuRA~cE IN FORCE

.it the close of the fiscal year 1928 there were in force 660,108 ITnited States Government life-insurance policies, amounting to $3,111,994)905 insurance. This represented an increase of 159,228 policies, amountingto $891,025,081, compared with the number and anlount of United States Government life-insurance policies in force at the close of the preceding fiscal year. During the fiscal year 5,554 policies, amounting to $25,369,806, were reinstated.

I-NITIJD STATES GOVERNhIENTT LIFE (TERhf AND CONVERTED) INstTR.4h-CE IN FORCE

The following table shows by fiscal years the number and amo[lnt of yearly renewable term and the United States Government, life insurance in force: — — I I Yearly renewable term United States Govern- Total insurance ment life insurance Fiscal yrar cn(}ed June 30- Number .~mount Number Amount IA-umber .Amount —1 I 397, ‘yiy40fg: ,23.5 2,53, 500 651,O.w $3,849, 375, 73.? 3C4), 588 ‘m, 852 I 1;033: 581, 778 3,348, 400, 474 ‘ 240, 1:8!54:145:790 319, 774 , 1,216, E 500,065 3,070, Zo\),817 209, 1,609, ON, &34 353,215 1,375, 924 502, 2, 9W, 573, 458 177, 1,372,091, 391 375,012 1,492, 338 552,% 2,86.5,o2h, 729 130, 1,008,511, 344 423, 557 1,773, CK14 553, 2,781, M7, 008 87. 672.074. 816 500.880 2.220. 824 587, 980 2,893, 044, 1;654, 277 108 3; 111;994;005 Otio,374 3, 113,049, ——— -—

UNITED STATES GOVE RNMEh”T LIFE-INSLTRANCE POLICIES SURRENDERED FOR CASH AND PAID-C’P INSURANCE

United States Government life-insurance policies provide that after having been in force one year they may be surrendered for cash or for paid-up insurance. During the fiscal year ended J~lne 30, 1928, there were 4,555 policies, amounting to $16,348,535.04, surrendered for cash. The total number of policies surrendered for cash to June 30, 1928, is 38,637, amounting to $102,502,839.85 of insurance. During this year the value of policies surrendered for paid-up insurance amounted to $300,000, while 58 paid-up policies, to the value of $74,934,16, were issued. Up to June 30, 1928, policies to the value of $2,239,000 have been surrendered for paid-up insurance, and 441 paid-up policies, amounting to $379,870.74 of insurance, have been issued.

UNITED STATES GOVERNMENT LIFE-INSURANCE PREhlIUM INCO~fE

United States Government life-i~urance premiums are deposited to the credit of the United States Government life-insurance fund, from which are paid claims on account of total permanent disability and death, dividends, and refunds. During the fiscal year ending June 30, 1928, there were 3,593,159 premiums, amounting to $71,113, - 025.18, received on United States Government life-insurance policies. The amount of United States Government life-insurance premiunls received to date totals $334,717,696.38. 26 REPORT OF UNITED STATES VETERAN-S ‘ BUREAU

YEARLY RENEWABLE TERM INSIJRANCE P1ik:Nl117XIIXCON1l:

The following table shows, by sources, the total aIllOUIlt Of ~CtiI’1~ renewable term insurance premium income to ,JIIne 30, 192S: Deposited direct irlto the Treasury by: .inlo(illt War Departr~~ex~t______...... $272, 332, 051. S3 Navy De artn~ent ______. 28, 328, 882.87 Marine $ orbs ------. . . . q, {)~~, 970. 10 Coast Gua~d_ ------T------. 509, 025. 04 U.oS. Publlc Health Service ------...... 230. {)0 Paid direct to bureau ______. . . . . 14S,51(~,372.O!~ ————. .—-— — Gross receipts ______----- . - ...... 45-l, 7ti0.132. s3 hss— Refunds n~adeby insurance cas}~iers----- $1,555, 171. 4{) Refunds nladeby disbursiI~g clerk _-_... _ 806, {;33. {JO —— —. __—— 2, 421, S05. 39 —..———— Net receipts ------. ~~~,~:

DIVIDENDS PAID ON UNITED STATES GOVB:RN}IKN’I’ LIFE IX S[’1{.IXCE

The fund from ~rhich dividends on [’l}it~’d St ~]tt’sGo~erl~l~lent life insurance are apportioned is accun~ulated frt~l~~t~vt)sourtI(’s--- s~i~il~gs due to deferred mortality and excess interest On t II(’ amC)IiIIt etirned on invested funds over the assumed rate of 3 ~~ p(’r c(’nt. ‘1’llt’l’e \Yerc? 519,442 dividends amounting to $4,712,528.74 ptiid during tl]e fiscal year ending June 30, 1928. The total dividends paid t~>date are 2,633,202 amounting to $19,858,623,18. ‘rh(~ fOllo\ving ttil)l~’ shows the dividends paid in 1928 on policies for $1,000 i~s{ied at the age of 30 in force on their anniversaries:

——.— — I E n(i of I ordinary 20-pay - :1()-paj;- ~ ~~j~~~~,[i Year of issue policy nary Iitl’ rnent life Tll(’nt llft’ lllent year II I ------l--– — I l______1 1927------$1.73 $1.76 $1.7! $1. s1 IW-. -.-. -... -...... l : 1.76 1.82 1.7s l,g~ 1 lW-----. --. -.. -..... I 1.t30 1.88 1.s:] ?. 04 ;g:024:::::-::::.::::: : 1.83 1.M 1.87 2.16 2.01 1.V2 5 1.87 ;“ ;; I 1922-... ---: ...... -. G 1.00 2.08 1.97 lW1------7, I.M 2.15 ~. ~] 2.,56 ] 1820------1.98 2.22 2.07 2. 70 I 1919----. --- ...... I II 2.02 2.30 2.12 2. S3 1 I I ———I I —-— ..—— -. — ——.

ADJUSTED COMPENSATION

The original l~orld lVar adjusted col~]pensat iol~ tict fixed ,JanuaIoy 1, 1928, as the final date for the filing of applications for benefits thereunder. At the last session of Congress ~n anlendatory act was passed, which among other things, extended the time lin~lt for the fig of claims to January 2, 1930. The claims for benefits under the JITorld l~ar adjusted con~pensation act that had been adjudicated to June 30, 1928, totaled 3,508,549, and were valued at $3,408,643,666. Of this n[~n~ber, 3,302,[)67 represented adjusted service certificates isslled t(> veterans, ~~:~l(ledat $3?372,166,278; 115,016 were cash paylncnts to veterans lrl]~~se adjusted service credit did not exceed $50, amollnting tt) $4,034,!l!l,5; REPORT OF UNITED STATES VETERANS’ BUREAU 27

86,068 were claims on which quarterly payments were made to the dependents of veterans whose adjusted service credit wasrnore than $50, aggregating $31,065,540; and 5,398 were cash payments to dependents of veterans whose adjusted service credit was less than $50, anlountlin gto$147,263. The sum of $l,229,590h asbeen paid on claims for the $60 bonus to the dependents of veterans who died in service and therefore did not recei~-e this benefit upon the ternli- nation of said service. Death claims to the value of $51,139,856 have been awarded to the l~eneficiaries of 50,080 deceased veterans \vho had received adjusted ser~-iee certificates. During the fiscal ~;ear 1928, 124,175 veterans filed application for adjusted compensation benefits, while 125,019 applications were approved during this sfinle period. Since :Ipril 1, 1927, a total of 757)706 loans, amounting to $’i3,- 884,775, has been made direct by the bureau to veterans upon the security of their adjusted service certificates. Up to and including June 30, 1928, collections on these loans totaled $1,120,170.84, while as of the sanle date the bureau ha(i redeemed loans made direct by bfinl~s to the value of $24,405,242.

COMMITTEES ON RECOVERIES The committees on recoveries were established under authority contained in section 28 of the W’orld T1’ar veterans’ act, as amended. The central committee on recoveries has original jurisdiction to consider and adjudicate all overpayment cases arising in the central office, and similar cases arising in the field wherein the overpayment involved is more than $300. The regional committees in the field have authority to adjudicate, finally, subject to appeal, cases involv- ing overpayment of not more $han $300, wherein the overpayment or overpayments were not discovered within a period of three months of the time such overpayment or overpayments were made. The central committee has appellate jurisdiction over all cases appealed from the decisions of re~onal committees. ~idjudications by central office and regional committees on recoveries for this fiscal year were as follows:

Ollerpaymer~ts disposed oj -. r--–- 1 I Waived N’ot waived Total ~ ! i I , I Number Amount Number Amount A’umber Amount

——— ——— — ! I — —-1 l—- I Central committee on recoveries: Central o~ce cases ------848 $235,055.71 7,51 $522,161.69 1,566 $757,217.40 Regional— Onreview cues ------218 175,185.59 620 398,633.34 838 573,818.93 On appeal cases ------13 2,392.47 31 8,567.19 44 10,959.66 Total ------1,079 412,633.77 1,402 — 929,302.22 2,481 1,341,695.96 Regional committees on recoveries. 1, 152 w, 313. ?4 2,444 215,366.74 3,596 305,702.40 ___ .— Grand total ------2,231 502,947.51 3,846 , 1,144,750. !36 6,077 1,647,698.47 —— . —.——. . . , ———

During the fiscal year 6,077 cases of overpayments were acted upon in central office and in regional offices, of which number 2,231, or 36.7 per cent, of the overpayments were waived. The central 28 REPORT OF UNITED STATES VETERANS’ BUREAU office committee on recoveries authorized waivers on 43.5 per cent of the cases handled by that section, as compared with 32 per cent of the overpayments ~vaived on cases handled in re~onal offices. The average overpayment handled by the central office committee on ~eco}7eries amounted to $54o.91, and in regional offices the average w’as $85.01, The average amount of the overpayment waived by the central ofice committee v’as $382.42, as compared \vith the average of $78.40 for regional office cases on \vhich o~’erpayrnent was vaived, CENTRAL BOARD OF APPEALS The central board of appeals as no~v constituted consists of a chairman with legal and medical assistants in the central ofice and five sections located in Ne\v l-ork, N. l-.; hTetv-Orleans, 1~~.; C’hicago, Ill.; San Francisco, Calif.; and in the central ofice, \Vashington, D. C. The sections are designated as follo~vs: Section ~, section ~, section D, section E, and the appeal group on central of~lce cases, respectively. Section B, in addition to the usual procedure before the board of appeals, controls and operates traveling boards from New l-ork to Boston for the purpose of granting to clainlants in that section of the country personal hearings. The other sectif~ns conduct their \vork from one central point and all hearings are held in the offices of the section. The appeal group on central office cases dfiers sorne}vhat from the other sections by reason of regulatory authority and handles, in addition to all death cases and insurance questions, all emergency cases presented in the central office. The procedure established in these sections is such that a claimant appearing before any one of them may receive a personal hearing and consideration of all phases of his claim over which the board has appellate jurisdiction under the World 11’ar veterans’ act as amended. The purpose of this board is to provide an absolutely equitable and fair adjudication in every case coming before it and to effect, under laws and regulations interpretative thereof, a decision f~ir to the claimant and just to the bureau, avoiding }vhere possible unnecessary reviews or revisions of the decisions of the cases previously service connected by properly constituted authority of the bureau. During the fiscal vear 13,572 cases }vere referred to the board and 13,225 eases \vere di~posed of, there ha~-ing been 548 crises on han{i at the beginning of this year. The number of pending cases before all sections of the board on June 30, 1928, \vfis 895 cases. DIRECTOR’S ADVISORY GROUP ON APPEALS

‘~he purpose of this group is to give impartial study and make unlimited inquiry intu the merits of cases appealed to the director, and to make recommendations to him on the merits of the appeal. It is composed of specially chosen men with medical or legal training and of such as have had wide experience in this class of work. Appeals are entertained from claimants who are dissatisfied with the action of the regular appellate bodies, and by designated officials of the bureau upon presentation of proper reasons therefor. 11~the matter of presenting cases no formal appeal is required. A mere request for review, with a statement of the particular features appealed fronl and upon what error or defect the appeal is based, is sufficient. The claimant or his duly authorized representati~-e may appear at a hearing before the group and personnall,v present the case. Personal hearing lS had in approximately 17 ~ per sent of all cases. A transcript of the hearing is made a part of the clalmant’s record in order that it may be given consideration when the case is reviewed. As to the method of handling cases, upon completion of the study of the file by individual members of the group, open discussion IS held until the most tenable conclusion with reference to the question at issue has been reached. ii n~emorandurn brief, with a discussion of the case followed by the conclusion reached, is then transmitted to the director with recommendation for disposing of the case. This action is tentative, and unless approved by the director it has no necessary part in the final decision. At the beginning of this fiscal year there were 533 cases awaiting review by this group. The number of new cases received during the year was 5,595, an increase of 1,601 over the number received during the fiscal year 1927. During this year decisions were rendered in 4,471 cases, and action other than decisions was taken in 994 cases. The total number of cases pending at the close of this year was 663. 29 REHABILITATION

The end of this fiscal year \vitncsscd the cessation of rehabilitation activities which commenced immediately following the enactment by Congress on June 27, 1918, of the vocational rehabilitation act (Public 178, 65th Cong.) which provided subst antialll~ under —.Section ... II the~epf, that any enlisted person or officer of the .~rmy,. Navy, or =e Corps, or member of tl~e Army, NalTy, or Alarlne Corps (female) in active service who, after honorable discharge, in the opinion of the board, was unable to carry on in a gainful occupation successfully, should be furnished when vocational rehabilitation was feasible such course of rehabilitation as the board should prescribe and provide. The act, among other things, imposed the responsibility to provide such facilities, courses, and instructors necessfiry to insure proper training; to prescribe the courses to be followed; to a allowancc~ for maintenance and support of trainees and their ! *----epen ents, and““- other necessary expenses incidental to folroti~ing the prescribed courses; to do all things necessary to insure vocationtil rehabilitation; to provide for the placement of rehabilitated persons in suitable or gainful occupations and to make or cause to have nl[~de I studies, investigations, and reports regarding the vocational rehabilitation of disab[ed persons and their placem~nt in suitable or g~inful occupations. Under Section III of that act training was provided to those honorably discharged veterans who suffered a com~ensable disability M the result of their war service, but who=ere not i“oiationally Kiridiiappbd to the extent that t~aini.ng was required. Persons in this class were provided with courses of instruction including tuition and necessary supplies, but not with maintenance ~nd support allowance while in trfiining. The responsibility for carrying out these provisions was vested in the Federal Board for f~ocational Education. On .August 9, 1921, Congress established an independent bureau (Public 47, 67th Cong.) under the President, which was called the United States l~eterans) Bureau. All of the duties, functions, and powers previously conferred upon the Federal Board for \Tocational Education and the Bureau of lVar-Risk Insurance, were transferred and made a part of the United States Veterans’ Bureau. There was organized in this bureau a rehabilitation division, which took over the work of vocational rehabilitation begun by the Federal board. JVhile numerous changes have been made in the laws by Congress from time to time, which materially affected the adrninistration of this work, the essentials remained unchanged, that is, that all honorably discharged veterans of the \Vorld ~f~ar who, because of service- incurred disabilities, were unable to follow their pre-war occupations, were given the opportunity to learn another at Government expense. No attempt has been made to ascertain the individual successes in employment of each of the thousands of veterans whom the Federal Government has equipped and ~ssisted into gainful occupations, as the expense of continuous follow-up’ necessary to determine this was unauthorized. A record has been maintained, however, of the complete training history and progress of each person tr~ined and of 30 REPORT OF UNITED STATES VETERANS’ BURE.~U 31

the initial employment engaged in by all at the time of rehabilitation. Special studies and criteria respecting all the major phases of the work have been made, however, and are available in the files of the bureau. These include extensive discussions pertaining to the fields of agriculture, commercial, professional, and trade and industrial training; treatment and training of the tuberculous, treatment and training of the neuropsychiatric, special training for the blind, deaf and defective speech cases, etc. ; treatises upon the application of vocational guidance, intelligence tests, master training programs outlining the requirements of occupations in all fields, as well as the value of various types of institutional and placement training facilities and methods of providing emplo~ment for the rehabilitated veterans. The bureau’s experience In this work has demonstrated that the key to successful training of the disabled is the a VOC*l advisement principles from the out tfi occuptitlbn ‘or e-rnplo~~~~jective for which training is to be given, although the subsequent steps in the general procedure are perhaps equally important. Errors in the initial advisement of veter- and the time wasted so~r~~l . the last follr years of the bureau’s supervision of this work f~llowing its adoption of definite principles of advisement prerequisite to approval of training in each individual case and the training of personnel responsible for the application of those principles. After the selection of an employment objective that was reasonably possible of attainment by the veteran, the next step was to ascertain the various phases and operations involved in that objective up to the point of initifil employment, and the selection of a training facility in which these could be taught. This involved a consideration and approval of appropriate school, college, and university courses or training on the job in some establishment under controlled conditions, and frequently a combination of both. For each occupation selected a training program was outlined listing and organizing all of the units of instruction, including knowledge and skill required for employability in that occupation, the type of training for each unit and the appropriate time for completion of the same so that the progress of the trainee might be measured by the supervising officers. The training program thus executed and signed by the trainee, trainor, and the supervising officer of the bureau, constituted an agreement between the parties concerned as to the course of training to be provided. Upon satisfactory completion of the program, the veteran was declared rehabilitate J . It was the policy during the last several years of this work to place trainees not requiring institutional instruction in establishments in a position to guarantee employment to the veteran upon rehabilitation. This method of training was the least expensive, the most practical, and by far the more satisfactory as to final employment. It provided for instruction on the job, step by step, through the various operations of the occupation, with gradual increase of productive value to the prospective employer and of the earning power of the trainee until sufficient ability had been demonstrated to justify payment of the usual entrance wage for the occupation. The cooperation of schools, colleges, and industrial establishments with the bureau both as to arrangements for training, superl’ision, 32 REPORT OF UNITED ST.\TES YETER.-IXS’ BITRE.417

and emp]oj-rncnt was with fcw exceptions excellent, and much credit is due them for their part in restoring the disabled veterans to productive usefulness. hlany of the schot)ls set up entirely new courses to meet the needs of the bureau. This }vas particularly the case in the field of trfide and industrial training becnuse of the lack of existing standardized collrses of that nfiture and in figriculturnl project training (independent farming upon land leased or {Jwned by the I l’eteran). No Government or other organization has ever before been called upon to supervise the ~’ocatiofial training of so nlany ndults, in so many places, in so wide a variety of courses. The work denlandcd R high degree of practical Itnowledge of ~ocational training, keen in- sight into human nature, and initiative and res(~{]rcefulness in dealing with unforeseen perplexities. Sllper~-isi(Jl~by. personfil (Iolltnct with Itrainees at institutions once each month and t}vlce n]onthl~ for trainees in industrial establishments W8S condllcted to insure against expi~Jita- tion or failure to follow a constructive plmn of trfiinil]~ and to initiate any changes in t}r ~~ariation of the tr~ining prograln ~s the circllnl- stances reqllired. The bureall’s early poli(’y of lltilizing 01ll% “existing” institlltions and courses f~)r training \vas soon ch~nged ~~hen it was found that many ~’eterans were unable to profit f’idly f’ro~l~ instr(lction gi~-en J lq~f~th no-~ field showed thfit few fac=s were n}-a this type of disabled ~-eterans. Traininx ct’nters \vI’re therelore established in nearly all districts to n~cet this need for perlimintiry academic instruction prior to the assign n~ent f~f cases to rc~[lltir institutional courses or training on the job. This type of training facility was disc(>ntinued as soon as the need f(>rthis special f~lndan~ental training in a district had been n~ct. Resident ~-ocational schools }vcre also cstal)lished and t)pertited by the bureau to receive trainees imn~cdintely [ip(~n (lischargc fronl hospitals, so that they might receive tryollt lnstr[lction l~nder ct)ntr~}lled conditions in a helpful environment, as nlany n~en c(>nv}~lescing fronl tuberculosis? nerl-ous and mental disease’s brol{e down shortly after entering training tind had to be rehospittilized. The pr!~gram of }~orl{ at these schools ~~-asorganized c~refully for those speclnl groups and usually began with two or three hours of instruction or active work daily, with plenty of rest and recreation, with the time for acti~re ~vork being zradualll- increased until a full day’s worl< ~ould ~~et~l~en in the chos~n”objecti~-e without ill effect. This “ hardening up” process was under the close s~lpervision of medical (~fficers. ~~hen the occupation most suitable had been determined and it was denlonstrated that a trainee was al>le to do a normal day’s worl< he was tr~nsferred to another suitable training facility where his trfiining could be continued and completed. Jwell-regulated resident sch~ols of this type made it possible to e~-entually readjust a large number of trainees whose success would otherwise hal-e been questionable and who certainly would ha~-e been Go\-ernment chfirges for a lnuch longer period of time. Definite standards go~~erning all types of training in the fields of agricllltllre, con~ll~creial, tra~~e, Rnfi ~ndllstrial and professiontil were laid down for the sllpcrvising ofiiccrs to fol]o~v, so that the st~in(]ar<~s fixed for the .leclaration of rehfibilitntion and col]lpleti(~n of tr~iil~ing REPORT OF UNITED STATES VETERANS’ BUREAU 33

wer(’ l)ase(l ~lpon proof of aecluired ability to enter the occupations for }~-hich tr~line(l ~vh~’thcr the training IVaS received at an institution, on the jo?}, or a (Jolnbintition of both. Training ]~-as fliscontinued in C8SCS of severe phrsical disability upon advice of nle(lical officers, ancl in cases \\hcre fnllurc or u n\\-lllingness to progress FIftcr reasonable trial It-as evi,{ent, an(i in cas(’s of voluntary Ivithdra]t-al. Training lln{l.cr section 111 (402) of the act ~s r(’ferre(l to above, grantt~{]. to IJcrsons not vocationally handicappe(i bllt in receipt of conlpensation for st’rvice-incurred disal)ilities, consiste(l of r[~glllar institutional courses or t’orrcspondence collrses of rec(~gnizecl ‘stand- ing, (lcsiognet~ to assist the voter’an to progress in his joi) and to increase hls earning po~ver. .\s the veterans recei~-e~i no nlaintenance tin[i sllpport al]o\vancc for th[’n~s(>]vcs or d.epen[lcnts }~-bile fol]o~ving this type of training, the gcnel.nl ]Jractice was to pursue these collrses at evening, night school, or I);i- correspondence, so as not to interfere }vith their regl~lar (’lnplo:~’nlent. This type of training ~v~s tern~inatcd in each case ~~hen the prcs(’riijecl collrsc had be[’n completed or the trainee for various reasons ~~~asunable to nlake nornla] progress in his stu{ii(’s. Since th(’ 1):’ginniI?g of this ]~-orlrofessiol]al ser\'ice------16:45 Dolllestic al~d personal service------1.58 Clerical occupatioxls ------13.08 S])eC’lalstlldellts__------1.02 34 REPORT OF UNITED STATES VETERANS’ BUREAU

The term “Special students” as used above includes Braille and speech correction, etc. The extent and variety of supervision required is best understood when consideration is given to the fact that approximately 420 separate and distinct employment objectives were spectied in the training program of the 17g,000 veterans who entered training. The difficulty of advisement is further illustrated by the fact that the educational ualifications of the veterans rated eligible for training varied from 1i literacy to college education. The following table shows the educational qualifications of the veterans under sef’tion 400 of the act: Education: Percentoftotal Notgi\’en ______7.04 NoeducatioI1------___ . . . . ______1.1S lto3years elementar~------—-- -- 4.7 4t08~ears ______.~~_-_-__ 54.71 lto2years high school ______13.2S 3t04years high school ______10.93 6 months or more business school ______.._. _. -_. - 1.64 lto2~ears trade school __. _... ____ _._. ______.24 2t04~ears trade school ______. . .._ . ______.05 lto2years cO1legeorunivers~ty ---- ...... ------4.01 3t04Years college oruniverslty..-_. ______2.22 The following table is the result of a study of three groups of veterans, based on educational (~ualifications, showing the pre-war wage and wage at tilne of en~ployment after rehabilitation: —. -. -. —————. —. I 1-3 years elemen- 3-4 ;~o:righ 3-4 years college or tary university _—— .—— \~age scale I Before .4fter Before \ After Before -After rehabili- I rehabili- rehabili- rehabili- rehabili - r.e~i~;i- tation tatiou tation 1 tation tat ion — —I —— — __— Per cent I Per cent Per cent Per ~; Per cent Per c(nt upto$7w ------26.21 ~ 14.92 13.82 5.93 3.71 $750 to$l,ooo ------21.70 : 20.31 19.53 6:98 9.67 4. w $l,oooto $l,250------19.38 24.91 YJ. 16 17. 5s 16.W2 12.16 $1.250 to $l,m.. -.-... --. -.. ------...-.-., 13.31 18.76 14.88 20.72 11.30 11.49 $l;wto$l,750------8,30 9.25 8.62 13.53 9.34 $l,750to $2,000------5.82 7.08 Q.71 20.57 1: Y) 20.31 $2,wto$2,m ------2.35 1.86 3.56 7.06 4. W2 7.78 $2,250 to$2,5cm)-- _-.. .- . . . ..--- ...... --.. 1.44 1.30 2.98 5.29 7.45 12.16 $2,500 to$2,750--- ...... , .53 . 57 1, 15 2.01 2.21 1 3.63 $2,750 to@,ooo-- ...... -. .----- ...... 35 .27 .W’ 1.11 4.43 5.34 $3,000 to$3,500...... 33 .37 .671 .85 2. so 3.11 $3,500 to$4,000------, 15 .53 .63 4.89 3.18 $4,000 andup. ..-.. -...... 13 :;! .51 .65 11.65 3.71 -.——

A review of the nllrnl)er of veterans of eacl~ racc~who availed thel~l- selves of the benefits of the rehabilitation prt~~a]n shows the following per cent: Race: Per cent of total Callctisiti1~______96.2S Ethio~)ial). . . ..______3.5:] hlo1lgolial]------.02 Indiall ______.05 NIalay______. 12 Of the total ntlnlbcr entering trnining, 65.SS per cent sa]v s{’rvice overseas. The extent of the training progrfinl is indictited by the “fti(tt that 3~9,9~9 ~-eternlls re~zi~t~,l.t,({.> for trliill~~lgt., 1~~~,~]~ ~Iltered trailliIl~, ~nd REPORT OF UNITED STATES VETERANS’ BUREAU 35

a total of 5,000,000 training months were required to complete the rehabilitation activities of the bureau, necessitating a total expenditure of $645,007,450.62. Following the policy of providing an employment opportunity to ., each trained veteran, the bureau through its.,...... +.emplo~me~k-~rvice.- .. .s. ~1 established and maintained active “-lIai’ion bet~veen the emplo~~ing \ .... .—.. public, the f acfli.timftia~=-tiQ~.~-~bor:~ ‘ernP~OXfieRt service, : and-a~ lGtaI civic and welfare agencies throughout the country, and thr~ugh those mediums and the individual efforts of its training ancl employment officers furnished jobs for virtually all rehabilitated veterans. Much praise is due those agencies for their warm response and cooperation in this w-ork. ‘1’he primary purpose of the rehabilit ation program, as stated above, was the retraining of the disabled veterans into productive employment in an occupation in which the disability incurred in service Ivould not be a vocational handicap. The extent to w-hich the read- justment into industry has been effected may be judged by the fact that of the 118,355 completed training

It ~~-illbe noted from the table given above that the salary ranges from $4,000 Ilp show a slight decrease. This does not necessarily n~ean that there has been a decrease in those ranges, since many positions commanding returns equivalent to the ranges indicated are filled on a commission or amount earned basis. Theworld Iyar veterans’ act of 1924 states: “The test of rehabilitation shall be employ ability.” The results of retraining, therefore, may be measured by the per cent of veterans trained into gainful en~ploynlent. The records pert aining to employment of veterans trained under section 400 of the act referred to above sho~v that 97,8 per cent }vere employed at the time training was terminated.

FINANCE The net disbursements for all purposes dllring the fiscal year ended

~Jnitefl St:~tes (;(lvernnler]t life insurt]nre ftln(i . . . . . 11,$04,371.2!! 17,6(A,3W. 21 .krrny :lll~)trnent~...... 1hh, !)73,71 I 32,W9. 67 N[ivy allotments ..-...... 1 lo, fl12.16 1 1,{)14.78 3ft\rlne (’orl). :lll{ltitlenl~ I 7h7. k:) 1 I 1, 184,h3 Cortst (;uprtl :lllf)tment~ I 4(;.00 ‘ I 15,00 -—. .— — ‘1’otill exi~en(lit{ir(’s !05, 34S,Ai47.70 ~-t:){),137,19!!.63

The abol-e figures include allotnlcnt~ ~~f $4,496,31~.~~ and $4,849,481,54 nladc d~lring the fiscal ~-cars 1927 and 1928, respectively, to the LTnitcd States I)ul)lic 1-Ie/~lth Service, N/ition~l Hon~es for Disabled Volllnt(’cr Soldiers, tind the JYtir, Navy, and Interior Dep~irt- n~ents for the care and treatl]]ent of })~lrei~llbeneficiaries in hospitals operated by these Governl~~ent agencies. The total al]lount of L,nited States (lovern]]~ent life insurance f[]nds in~-ested in C~overnll~ent securities incretised $9,444,346.76 during this year, as conlp}~red with an increase of $27,121 ,f;45 .29 for tht’ ])re(’edin: fiscal year. This decrease in the tin~ollnt in~-ested in 1{123 is d~le to th[’ f’:ict tlltit direct loans by the bllre[il~ on adjl]sted s(’rvic(’ certificate’s, which are pti~-able frol~~ the LTnited States C~overn]n[’nt life insurance fllnd, ~rerc l~~adefor only three nlonths of 1927 as ct]t~iparetl ~vith the whole of 1928. REPORT OF ~-NITED ST.ATES YETER.4NS “ BURE.\U 37

The percentage distril)ution of all disbursenlents made during the fiscal year 1928, as col~~pared ~vith th~t for 1927, is gi~-en in the fo]lowing table. These figures represent disbursenlents only, and when all encunlbr}inccs for this yeilr are recorded slight changes will occur. Included in the salaries ior field ofiices are salaries paid the professional and technical personnel tit clinic,:, which should be elil~~inated from adnlinistrative overhead. Deducting the salaries of this personnel at fielcl ofkices the pcrcent~l:e for this item is lllaterially lower.

19n 1927 —. ———.— -~._ Sa]aries: IIospitds ------3.71 3.57 Fieltl offices ...... 2. ,50 3.10 ~entraloffic[~-... ------1.89 1.59 .id~ninistratit-e cxpenscs (other tl]ans[~laries) ------.54 .70 Vocatimal rehal)ilita[lon: l'raining llll{)lvances ------.04 .46 Other training exI>tlr]ses------.01 .09 XIedical and hosljital c~pcnscs (other than salari(,s) ------6.87 7. 78 l~ospi(al facilities and servic(’s (construction) ------1.19 1.13 C'ort]pc,nsati()Il ...... _-- ._ ...... -. ---. -... ______.------41.39 42. W ‘1’ernl insuranc[~ ..-_. _._.. -... -... -.. ---... -... _-_. --. ---_ -.. ------..-. -.--- . . ..l 27.50 29.84 Llnitcd States (Jovern]]lent lifcins[lrance.. ---. -.--. -.-. ---. --. -.-. ------.--. -.. -.. -- . . ..i 4, o~ 2.93 .

[email protected] this period the legal department of central office rendered some 1,541 strictly legal opinions covering all phases of the World War veterans’ act and the World War adjusted compensation act, and affecting every right of bureau beneficiaries under these laws. An analysis of these opinions disclosed that 321 had to do with insurance benefits of one character or another, 330 con- cenled beneficiaries under legal disability (that is, guardianship cases), 164 settled compensation rights, 77 determined ad “usted compensation payments, and 649 may be classified as miscel \aneous opinions. In point of volume the largest item of the year’s legal activities in ~entral office centered about requests for advisory opinions covering m one way or another virtually every phase of the bureau’s multi- farious affairs. The table for these general submissions for the year shows the following results: Number of questions: , Onhand July l,1927------9(; Wceived ------5,736 Disposed of ------5,734 Onhand June 30, 1928 ______9s These figures include the 1,541 strictly legal opinions above mentioned. CiwiZ suits.—The defense of actions brought against the Vnited States in connection with Veterans’ Bureau suits is committed gen- erally to the Department of Justice and the local United States attorney for the district in which suit is brought. The bureau in all instances assists the United States attorney in the preparation and trial of cases through the services of its regional attorneys and central office attorneys especially trained in this class of litigation. During this fiscal year 21o insurance suits were disposed of, 70 resulting in judgments for the plaintiffs and 140 terminating m favor of the Government. Of those terminating in favor of the Government, 25 resulted in judgments, 112 were dismissed either by stipulation or on motion, and 3 were disposed of otherwise. These suits involved a total of $1,918,790.15, while the cases on hand at the close of this year involved over $5,000,000. The judgments recovered by plfiin- tiffs in the 70 cases amounted to a total of $342,360.41, although the insurance involved and which may be payable In future installments totals $650,983.02. The suits resulting favorably to the Govern- ment involved insurance to the amount of $1,267,807.13. The following table indicates the insurance cases on hand July 1, 1927, the number received and disposed of during this year, and the balance on hand as of June 30, 1928: — I ‘- ‘-— I Suits on contrscts of insuranca I On hau(l 1‘e@i’”d 1‘is%sed 1 ‘alance l——— I—— In litigation-.. --. ------.--. -.------..--. ----. ------.---- ..---l I 368 425 210 I ~~ Threa@nd ------204 712 513 403 _—- — , Prosecutwns. —The prosecution of criminal cases is also committed to the Department of Justice, but, as in litigation in civil proceedings on insurance contracts, the bureau prepares the tr~inscript of the cases for submission to that department, and attorneys from central ofFice have in several instances assisted in the present at ion of these cases to the grand juries as well as in the actual trial of the same. ~1 large REPORT OF UNITED STATES VETERANS’ BUREAU 39 proportion of such cases involves some elements of fraud, falling under the penal provisions of the various acts relating to the bureau; but where these statutes do not cover the particular offense, the cases are then prepared llnder the germane provisions of the Federal Criminal Code. At the beginning of this fiscal year there were 197 criminal cases on hand. During the year 170 such cases were received and 167 disposed of, leaving a balance on July 1, 1928, of 200 cases. of the cases disposed of, 119 were dismissed by the Department of Justice or the grand j ur~ failed to return indictments. Nine were. prosecutions under section 35 of the Federal Criminal Code, the maximum penalty for which was set by the court as two years in the penitentiary. Two were prosecuted under section 505 of the \Vorld l~~ar veterans’ act, 1924, and both indicted. Two were prosecuted for embezzlement under section 47 of the Federal Criminal Code; one pleaded guilty and the other was nol-pressed. Three were prosecut~d for charging excessive fees under section 13, article 1, war-risk insurance act, 1917. The nlaximuln penalty was one year in jail. TWO charges were forgery under section 29, Federal Criminal Code, and both pleaded guilty. Ten were charged with excessive fees under section 500, \T~~rld\Var veterans’ act, 1924, with a maximun~ fine of $250 assessed hy, the (Iourt. Three were prosecuted for making or procuring false afhdavits, and a maximum penalty of $3OO and six months in jail was assessed. Four were charged with taking unlawful fees under section 309, l~(~rld \Var adjusted compensation act, and all found guilty. Thr[~e ~vere charged with making false affidavits under section 25 of the war-risk insurance act and the maximum of 10 months in jail and $~[)0 fine assessed. Five were prosecuted for taking unlawful fees under sections 304 and 503 of the lVorld lVar adjusted compensation act. one was prosecuted for making false affidavits under sections 25 and 27 of the war-risk insurance act. One was fined $350 and costs of $405.7(1 in connection with dental frauds. Two were f~~}nd guilty under s~?ction 503 of the IVorld ~~ar veterans’ act for recelvlng money from the Government to which they were not entitled, and the maximllm penalty of 18 months in the penitentiary was assessed. One was sentenced to jail for removing and concealing records under section 128 of the Federal Criminal Code, and one was placed on pr~bation for five years for forging records. One was con~icted for filing false claim under sections 25, 26, and 27 of the war-risk insurance act, and one was fin~d under section 3?, Federal Criminal Code, on a charge of falsely pretending to be a United States officer. Suits against bureau ofic~als.-To the legal department of central office also falls the preparation of the defense where bureall officials have hef’n shed as individuals in connection with their official acts. There were 20 such suits against the bureall and individual officials settled during the last fiscal year. One of these was for coal delivered at New York City and resulted in a judgment of $2,042.50 for the plaintiff; one was a suit to recover money paid under an erroneolls adju(l.i(’ation and resulted in a recovery for th~ ~~overnrnent. of $1,870 .96.; one was a suit brollght by a beneficiary for travehn.g expenses in connection with reporting for physical examination. This shit }ras (Iislnissed. Four were injunction sllits and till were dis- misse(l. l<;]f~vell~}-er[~~llmndfilillls proceedings, tind th(’ rlllr in e~ch was dischargetl. one J!as a haheas corplls petition an(l th~’ petition 40 ItEPOItT OF ~NITEIJ ST.\TES VETEI1.lXS’ BUItE.~U

—— —— ———— . .. .——— ‘—---- -1 - -

Total ______1S,9[)1 Judgments in favor of ])lairltiffs, l)eilc~illg J~lr]c 30, l{)ZS _ _ - _ ------14Z, 700

Grand total ------l(;l,(j!)l REPORT OF LTNITED STiiTES VETER.INS ‘ BURE.4U 41

banks and trust companies and 3,123 individuals serving as legal custodians of minors and nlentally incompetent beneficiaries. The bureau endeavor-s to have legal custodians recognized whenever possible in order to obviate the payment of court costs and counsel fees ordinarily involved in connection with the administration of the estate by a fiduciary. of the total number of hospitalized incompetent veterans, there are 5,254 for whom fiduciaries have not been appointed but for whom th[’ medical oficers in charge of the institutions in which such beneficiaries arc receiving treatment are ndministcring the payments of compensation received from the Government for the necessities and comforts of the patients, thus eliminating the costs of securing the fi~JpOintm(’nt of R fiduciary and the expense of subsequent fiduciary’s t“tjl~~nlissions and attorney’s fees. ln ~11 cases where it ]s feasible to do so, the regional attorneys pr~’pare the legal pfipers in connection with the appointments of fiduciaries, the filing of petitions, and the prep~ring of accounts. ‘1’his legal service results in a saving to the assets of the wnrds which xnay be estimated as 2 ~2 per cent of the amount paid annually. Tllc policy of the bureau of limiting commissions of fiduciaries to 5 pcr cent of the annual income of the trust estates results in an additional saving of approximately 2~2 per rent of the entire amount paid annually. Therefore, the value of this service to the Govern- r]~(’l~t’s legally disabled wards may be estimated conservatively to be in excess of $2,000,000 annually. In addition to these savings, how- .’ ever, there was recovered for the use of these Government wards ‘ duril]: the past fiscal year the sum of approximately $619,781, which ‘ rec~)}-ery was due in part to the excellent cooperation of the State I {’ourts. l’he bureau has 18 neuropsychiatrie hospitals, of which but 5 are allthorized to receive pntients duly conlmitted by the State authori- ties. The other burenu hospitals are without legal authority to detain in custody. any patient received thel$ein for care and treat- nlel]t. .Appreciatlng the necessity for uniformity in the various States regarding the conlmitment of patients to bureau hospitals at~(l the ndministrntion of’ estates of burea~l beneficiaries, the bureau llRS drafted a uniform probfite act to be known ~s the “Uniform ~-etcrans’ guardianship act, ” which tentative draft was submitted to the ~imerlcan 13ar .Association and the national conference of com- missioners on uniform State laws. The association and the conference approved the proposed act with Ininor reservations. This act provides, in genernl, the method of appointment of a fiduciary for a buretiu beneficiary under legal disability, for the filing of petitions and accounts, states the grounds upon which fiduciaries may be relnoved, and provides the manner of removal; limits commissions of fiduciaries to 5 per cent of the income, outlines the method of safe- guarding trust funds of wards, and provides for commitment of bureau beneficiaries to United States veterans’ hospitals and, if passed by the several State legislatures, will be a material advtince step in the administration of guardianship matters. ~lpproximately 3,500 social surveys of Government wards under legal disability are made each month in order to ascertain whether the necessary care and treatment, permitted under law and bureau regulations are being accorded incompetent and n~inor beneficiaries. PERSONNEL on June 30, 1927 there were 23,696 en~ployees on the bureau’s rolls? whose aggregate annual salarles (includlng allowances, but ex- cludln the compensation paid per diem and per hour employees) totale t $38,939,054, as compared with 23,933 employees and $39,707, - 541 in annual salaries on June 30, 1928. In other words, there was a net increase of 237 employees and $768,487 in ~nn~lal sa]aries during this one-year period. During this year the nun~ber of personnel in central office increased from 4,338 to 4,508, and the annual pay roll frol~l $7,593,528 to $8,062,085. Tbs represents a net increase of 170 in the total en~- pioyees and $468,557 in annual saltiries. The increase in the nunlber of employees was due largely to the increased activities of the new division established toward the C1OSCof the fisctil year 1{)27, for the purpose of administering, recording, and otherwise htindling the loans now made direct by the bureau to veterans {Ipon the secl[rity of their adjusted-service certificates, and to the ne~~-sul)flivision cretitc(i during this year for handling the emergency olficers’ retirenlent [~ct. In regional and allied field offices there was a net redl]ction of 365 employees an(] $538,334 in finnual sal~ries. The tot~l personnel assigned to these offices on June 30, 1928, was 5,648 and the finnual pay roll $11,064,543, as compared }vith 6,013 enlployees and $11,602, - 877 in annual salaries on June 30, 1927. This nltiterial reduction may be attributed direc~l~ to a closer supervision of reqlliren~ents and a consolidation of activities and duties wherever indicated. During this year the personnel on duty at veterans’ hospitals increased from 13,079 to 13,542, and the annual pay roll from $19,180, - 464 to $20,126,760. This increase of 463 cn~ployees was largely the result of the opening of one ne]~rhospital anti the operation of additional patient facilities at a number of others. Study of the nlorale problem among l)uretill personnel has continued. Action with reference to promotions, demotions, an~iodis- continuances has been based on efficiency, length of service, n~llltary preference, etc. Before discontinuing enlployees who have l)econ~e surplus to the needs of certain bureau activities, ~n etiort has been made to place them elsewhere. This practice h~s resulted in the re- assignment of a number of worthy en~pl?yees. During this year the policy was continued of not pron~oting any employee in central office to the next higher grfide unless he had the ~ghest efficiency rating in the next lo~ver grade find htid a proper CIVI1service status, exception to be ~nade only when the higher position calls for a person with special, professional, or technical qualifications. In making new appointments, and in aflecting discontinuances on account of reduction programs, the policy of extending preference to ex-service employees has been carefully followed. The same preference has been extended in filling vacancies occurring in the staff positions of the bureau. Eliminating the so-called floating personnel in bureau hospitals, such as ward attendants, waiters, kitchen helr~ers, etc., 57.96 per cent of the total male enlployees on the bureau’s rolls on June 30, 1928, were ex-service, and 10.95 per cent of the female personnel had such status, while 34.21 per cent of total permanent personnel of the bureau was ex-service on the aI)ovc date. 42 CHART NO.3

u. S.VETERANS BUREAU PERSONNEL Vocational Schools Administrative Hospitals

•1 ❑

NUMBER

“’”””~ I L

_——

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,, I ___–_ -–-]g~~.—— 1923 –— ~-1917 1-1918+~919+i920~ l92l-:l922-}l923~l924}i925jl926- 1: —-——t––––– J a L _—.——-—— 1 92%——––– –--— I, FISCA1. YEA? ● (1.~)ltp r * FIEL.[1 l~,,ard If Appeal%. II Highest peak of each year fmIn 19:7 to 1926 supply 1). ~ts l\ll!,—2s. (}’,,(, [1 12 ) STATISTICAL TABLES

.— 43 UNITED STATES VETER.\NS’

—— —

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TABLE No. 3.—X-rul/ exuminationg in the United States Veterans’ Bureau dispensaries for j,scal ~ears 192J, 1925, 1926, 1927, and 192,9, classi$ed bg type oj examination

1 I 1 I 1 I I A-um- Tota) Fiscal her Xr-rav ‘card’ O- y~::” Uro- Bones ~ For- C host vascu- Miscel- yenr cases exami- lar tinal genital Dental Sinuses an tract rayed nations I stripe tract joints I be~g~= ‘aneou —— —-l—1 -— ------1 --- l.-.–! I I I 1924...... 1 120,690 132,213 49,359 6,601 7, 622 1,526 17,636 6,287 38,761 I 1,810 2,611 1925------112,716 128,355 52, 419 6, 265 8,496 1,654 18, 169 7,017 30,979 950 2,406 1926------93,992 114,997 46,407 7, 331 7,803 1,523 , 15,973 5,358 27, 174 810 2,618 1927. ----- 81, 131 107,829 43,562 5,759 7, 482 1,447 10,904 4, 159 24,551 9,330 1928. ..--- I 67,631 104,836 [ 33, ~ 4,857 6,629 1,626 13,561 4,180 24,3921 E: 15,773

I I I ——_ —_ ____ . I I I — I I 1

TABLE No. 4.—X-ra:y examinations in the (~nited ,States veterans’ hospitals for the jiscal pegrs 1924, 1925, 1926, 1997, and 1928, classified bg type oj examination ——_____

I h~ey- Tot al Cardi& qastro- ~lro. Fiscal , X-ray Bones For- (’best v~ru- ;:$- genital hliscel- year cases ex:imi- Dental Sinuses and “~n“ 1aneous rayed I nations I stripe tract tract joints bodies —. _ ,-__, ____., ~_ _, _____/__ , i 1924------! 78,713 85,632 5,339 1,615 18,841 3,845 15,909 419 I 1, 697 1925------92,304 97, 765 6,395 2, 161 , 19,217 4,259 15,511 353 1,555 1926------94,871 103,Wo 7, 120 2,443 19,014 6,230 19,654 362 1,771 1927------97,298 114,256 9,025 2,518 19,225 5,408 20,436 503 9, 7a59 1928------100,389 129,329 10,281 2, .5Cfi~ 17,097 5,561 22,478 298 22,357

TABLE No. 5.—l’otal out-patient medical serwice, by service rendered, for jiscal years 192.4, 1926, 1926, 192?, and 1928

I Individ- ~xami- Fiscal year Treated Treat- Opera- Anesshet- Sent to Hospital Home ments uals n~tions examined tlons hospital visits visits

1924------763,789 1,703,317 ------1,363,295 15,312 3,758 47,065 95,992 45, 152 192b------568,097 1,257,967 ------1,144,330 5,863 3,085 59,916 81,680 38,091 1926------346, 96~ 1,044, 124 331,947 936,744 4,289 2,177 67,871 49,259 35,063 1927---. --.--1 262,420 873,577 338,761 922,364 2,600 1,081 71,340 28,800 34,972 1928------260,590 827, 122 322,302 871,756 2,364 423 73, 472 19,666 38,633 —_——. _ _ _

TABLE No. 6.—Classijicatzon of tolal examinations by kind oj examination for jiscal years 1924, 1925, 1926, 1927, and 1928 — —.——

::’ ~;~ :sycg- Surgical Fisml year (Ieneral 1 I,abora- Tubcr- IIeart medical , tory an(i or- thr~at at ric culosis thopedic

1924-_--. ..-. ._ . . .._. -_. . ..-... - 527,845 i-–-–. ------182,589 -;; ‘;wy,- 143,452 ---.-.-..- 1925--. -.-...... 399254 ‘------147 6Q4 110;238 176:980 105,463 ------19M------337’116 ------111:207 89, 179 143,317 91,945 ------1927------374; 684 ------94,475 76,210 138,(?60 86,905 ------1928. ..-. ------208,765 156,597 8,659 73,267 93,882 79,698 28,750

I I X-ray Physio- ‘encreal Genito- ____ Fiscsl year and non- ‘- thera- Dental Totsl venereal urinary I Lfedical ; Dental , phy ————______.— .--—— —.—— 1924-- ...... 19,222 ...... 150,469 ...... 13,406 35,704 1,3&3,295 1925...... 16,792 ...... 154,263 ...... 9,572 24,074 1,144,330 1926. ------... -.. -...--.-’ 14,781 . ------109,476 15,336 3,076 21,311 936,744 1927...... 10,684 ..--.. . . . 104,818 15, 180 2,111 19, X7 922,364 1928------‘------7, m 94,064 21, %2 1, 775 21,733 871, 756 46 REPORT OF UNITED ST.4TES l-ETERiiNS’ BUREAU

TABLE No. 7.—Cl(lssijcation of total treutr))ents !)g kind of treatr)letlt for fiscal years 1924, 192:;, 1926, 1927, o?)({ 1923 —. Hye, ear, Ncuro- Surgicsl (ien~ral I.abora- Tuher- I and or- ~ I1eart Fiscal year medicai tory nose’, and psychi- culosis throat atric tilopodic ——— ———,-..——.–—-—–– - 1-— —. 1- ‘i Id ------568,495 ...... - 191,409 ’43, C27 70,051 78,645 ------

lw5------389,619 ...... 153,952 38,584 60,004 64,228 ...... - lm------250,548 . ------115,4%5 40,042 93,00” 53,156 ‘------Iw------lW, 569 -... i.6%. M, 4bl ~~,~i~I 87,553 ; 40,910 1.- ...... lm------166,556 ,’ W2,712 41, W6 74, 556 ! 39, 171 s, 806 — _ —.._———. —. .— — .JL —.— —. . ..—= I \’enereal (]pnito- _ X-ray Physio- Fiscal year and non- —’ thera- Dental : ‘i’otai , venereal urinary hIedical I I)cntril ~ phy , ,-_.–- — I lm ------16,586 ---- . . . ..i 3,7s1 ...... 542,839 ~ 187,884 1,703,317 1925------~ ;;,;;; 2,314 ...... 419,589 I lj:! 81; 1,257, Y67 Id------~:::--1 4,306 I k~q I 3s1, sh~ , 1,044, 124 1927------9:324 . . -...... 1 1,3W 706 I 33~, 60S , 50: 1;s 873,577 1928------...... ’ 9,356 1 1, 671 512 310,060 ) ho, 103 , W27,122

TABLE No. 8.—l’otal trcat~)~e)its di~vided into ~tledicul al~d derttai, salary u)ld f(’e, with per cent of Jeej for fiscal years 1324, 192.;, 1926, 192T, and 1928 — .—-.— —-—-— l– i ‘- ! lfedical I Dental I Fiscal year 1 Total ~al~y I Fee Per cent Total Salary Fee Per cent fee 1 I ‘ec 1 _ .— – 1 --—--—l—–—l—1 ——l —-- —— 19U------1,515,433 1,4.56,5S5 58,848 ! 3.9 187,884 179,933 7, 951 4. ~ 1925------1,141,152 1,099, 0s9 3. i’ 116,s15 111, 103 5,712 4.9 42,063 ~ . 19%------.---.. -.....1 950,307 y8, ~; 45,922 4.8 93,727 87,446 6,281 Len------793,389 9.5 80, 18S 72, 998 ~, 1~ :; 19%------747,019 649; 598 2,%: 13.0 ~ 80,103 68,366 , 11,737 14.7 —

TABLE No. 9.—Total examinatio?~s divided z)tto medical ar~d dental, salary and fee, with per cent of fee, for fiscal years 1924, 1925, 1926, 1927, and 1928

hIedical Dental 1 I ——. — —. Fiscai year I salary Per Wnt Per cent Total Fee fee Total Salary Fee ‘W ______–-j--–”.”- .—.—— . —— 19M------.------...-.. 1,327,591 1 1,273,547 : 54,044 35,704 33,111 2,593 7.3 19%------1,120,256 1,084,067 36, 159 ?; ’24,074 22,014 2,066 8.6 I’M------886,072 28,461 3.1 21,311 19,830 1,481 6.9 lW------.-.---.---....-.I g:g s80, 956 22,171 I 2.5. 19, a? I 17,478 1, 759 9, 1 lW-----..-----.---....--I , 830,962 19,061 ‘2,2 21,733 19, 191 2,542 11.7 I

TABLE No. 10.—Physiotherapy acti~tties in hospitals a~td disi)ensaries, fiscal year 19JS

I N-unl- ber of Mas- Electro- tHydro- .kctinic TherIno-~ ~xerciw differ- Different services I sage therapy therapy ray therapy ~ Total ent pa- I tients i treated —-. —— I United Stat8s veterans’ hospitals: I Tuberculosis .-.. .- . . . . ---- 61,571 40,616 3,011 482,472 ‘ YJ,(572I 62, %4 703,526 21,667 Neuropsychiatric -...... 33,571 58, 519 346,759 91.645 I 119.338 / 715. 4{13 1.365 ?’?fi 55. 3% Generai ------83, 130 85,051 79, 266 225; 206 163;500 ,58;os1 ‘6ti’: ~~; 27; 671 National soldiers’ homes ------10,923 10,335 I 6,302 40,108 20,593 58, 132 146.393 1 7. 7.w UnitedStates veterans’dispensaries.-.--- ...... 41,506 56, 7% 2S, 181 76, 5M j 67, 37,5 14,919 2s5, 259 22, 143 I.— I —— -——— ———. —-.. ———.— —-——. ——— Total -.. -- ...... - . . . ..l 230,701 251,249 463,519 915, 9S1 424,354 WS, W 3, 194,743 134,637 Average monthly ..-- . . . . 19,225 20, V37 38,627 76, 332 I 35, 365 ~ 75, 742 26(;,2LW 11,~ti~ .. —_— —_. ,.- .-. ..———- — REPORT STATES ~rETERA4Ns‘ BuREAu 47 ,

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‘1’.ABLE No. 28.—Cornpurison oj principal ca[~ses oj death 1 of LTnited ,States Veterans’ 13!lrea~l patie)its irI, all ho.sl)itclls, jiscal years 192~–1928

I Fiscal year of death Cause of death —— 1924 1925 1926 1927 1928 I ~neral (iiscri:lanclcrou]~ ...... _. ------1 ------1 Influenz:>------1 . . . ..-. 1 2 Dysentt'ry ------2 ------; 4 Leprosy ...... - ...... ------...... 1 ..----4 ----- ..------1 Yt'llow fc'\.cr...... ------...... ---- .------Erysilwlas ...... 1 3 : 3 ()t}ler e~ji[itllnic (lisc~&ses. -. ..-. .---. -.. ---- ...... -...-. . ----- . . Purulent infection tind se~~tict~nli a------1; 18 24 3; 3; 'r[Jtallus ...... ----.------1 ------Pellagra ...... - 2 6 : 9 Nlycoscs ------.-----?------. 1 2 3 IlcritJ~~ri...... - 1 ...... ------'rllbercult)sls oftllelur]gs . ..- . . ..- . . . ------1, 556 1, MO 1,850 1,73: 1,753 .\cute]niliiiry tub(, rculosis ------7~) 92 110 131 178 Tub~rculous xnerlingitis ------30 17 26 29 27 .Atrdomina] tuberculosis ------5 11 Pott'sdisci~se ------1! :: :: 8 JVllit[>s\v(llings . . . .____ ------.-. -.!:- 3 1 Tuberctllosls of[)tller organs ..-. -_.. -. . . ..-. ..-. ..- . . ..--.. 14 1: ; 6 15 I)issemi~l~]tc,(ltubcrculosis ._.. ___. _... - ...... ------19 3 4 2 l{icktts ...... - - . ------Sy[)hdis ...... ---- ...... ’ -----:- 1: 23 21 21 Go]]ococ~c.usin fc(.tion ...... ------. ------. ------Canct~r and other rntdignant tumors of the I,uccal ca~ity... 1; Cancer and other m:llignant tumors of the stomach, liver.. 1; 2! 3; 46 : Cancer an{i other malignant tumors of the INritoncum, intestines, rectum ...... 7 12 14 29 36 Cancer an{i oth(,r malignant tumors of the female genital organs ...... ------, ------.- 1 Canw’r and other malignant tumors of the skin...... ------2i 5 ; Cancer au(l other malignant tUIn(JrS of other organs, or of orgnnsnot sl)ecifie(l ...... 36 47 76 9s 96 Other tumors (tuulors of tho female gt’nits] organs ekceljted). 7 2 1 ~ 1 1 .\cUt(~art i(,tllar rll(>umatism . . . ------1 ------~hrollic' rilculnatism anci gout. .--. .- . . . ..-. -.. -- . . ..-- . . . . -----. ------Dilit)ct(.s ...... 10 11 2; ExoIllltllNnli(, goitel _. . . . ------2 3 .kti(iison’s disease...... ------. I.euk(~n]ia ...... 16 12 2; ~\nclllia ...... 15 14 18 , Other gen(~ral {iisea~es ...... -. --...... 5 6 .Alcoholism (acute or chronic) ...... : 6 ~hronic occulJationtd lJoisonin~s. -.. -.-...... ; ------. ------. 1------Diseases oft he nervous systcm an(i of t he organs of sl~cial sense: Enw'~)h:\litis ...... 15 10 I 11 Simr)lc meningitis...... 18 10 12 1 21 2 Loconlotor ataxla ------2 2 4 Other diseases of thespinal c(,r(l ...... 4 Cerebral hcmorrhag(,, a~)of)lcxy. ..-. ..--. .- ...... ------16 : ;: Softt.ning of the brain ...... ------...... ------.-,------.---.-- Paralysis fvithouts~)ecified cause ------; Oeneral [l~ralyslsof the insane ...... - ...... ------10: 117 14; 1;! 12i Other forms of mental alienation . . . ..--- . . . ..--.. -... -.-.-.-’ 24 44 31 18 EI)ilepsv ...... ' 13 71 tr ii Convulsions (nonl]ucr~)crd) .-. ----... -.-. -.. -.---- .-. ----- 1..---!4. 1 2 :------1 (’horea ------...... ----- ...... ------. ------‘ ------. . Other dist,,ases of the ner~~ous syste]ll ------8 10 21 I ‘.20 2: l~iseases oft be ear ...... ------. ..--. .-- ...... 3 ------1------Disemes of theeyes andtheir annl,xa ------. ------. . 1 Diseases of the circulatory system: Pericartlitis.. -... -.--- .-. --... ----- ...... --- .------.--' 5 .kcuteentior:ir< iitis ...... _.. _.. _-...... - . . ..- . . . ..-.. ----` : 1; Organie dlsc:ist, softhti heart ------!)8 lW 210 257 3?: .ingina ])ectoris ------...... 6 Diseases of the e.rt(,rles, athercma, aneurysm, etc... ------1 : 1; 2: 4! ~mbolism an(ithrornbosis ...... I 16 7 18 19 ;; Diseases of tile veins (variccs, hemorrhoifls, ~)hlcbitis, etc.).’ ------1 Diseaqes of the lymphatic system (Ismphangitis, etc.) -.-.. I ; 2 1 .---. -:. i IIemorrhaSe; other diseases of t hc circulator y system . . . . . -I 11 6 10 5 8 Diseases of the respiratory system: lJiseoses oftl]ena>al foss3 .. . ------..-.-.------.------1 .-..-- I>isemcs ofth(, l,~rynx. -... -.. ----...... ------,. ----- lJis~~mes oftllethyroi

TABLE No. 28.—Com~)arison oj I)ri)icil)(tl c(buses of (ic(~th o-f V?&it(’d ,Ytates l-eterans’ Bureau patie?tts in uil hospitals, jiscul years 19L4–19Z8—CoI~tiIl~lc>d — —.— =-”–-””- K’iscal }-ear of death

Cause of death I 1y~.t 1Y25 I lw2ti , 1W27 1928 _———— I r — 1 Diseases of the res iratory system—Continued. Chronic bronc E’“ltls . . . ------. . . I 8 Bronchopueumonia ------...... 34 37 ; 4941 d 7,5 Pneumon18 ...... 30 50 ::) 87 100 .’) 10 Pleurisy -.----- ...... 7 I 12 Pulmonary congestion, pulmonary apoplexy...... 7 10 24 27 :; Gan~eneo fthelurlg ...... T...... 3 ,5 ~...... ~ Asthma ...... 4~ 11 5 1: Pulmonary elllphyst'IIl}l ...... i 1 . . ..-. -...... -. , 1 ------Other diseases of th[) res~)lratorv s~stern (tul)ercu](),. is excepted) ...... 4 24 21 24 18 Diseases of the digestive systenl: Diseaws of themouth and annexa. .- ...... 1 ‘2 2 Diw~s of the pharyn~ ...... -. -.. ---. -... -.-.. -- ...... l 1 . . . ..- . . 2 : Diaeases of the6sophlgus . . ..- ...... - ...... - ...... --l. -.- ...... 1 Ulmrofthe st{)m:ich ...... 5 I 1: 5 6 Other diseases of the stomach (cancer exc(>uted).. -...... - 2 I 6 1: 11 Diarrhea anclenteritis ...... ~ ...... 11 (; I 11 14 18 In@stinal parasites ...... -i 1 ...... ------. Ap~ndicitis an(ityphlitis .. . ..--.. -.. - ...... -l ~1 i) I 10 14 Hernia, inWstinal obstrllctlt)Il ...... 1: 21 Other diw~sof the intestines ...... 11 1~1 11 5 4 AcuWyellow' atrol)hy cJfttle liver ...... ~...... --.. 3 Cirrhosis of the liver ...... 2 ,r) 1: 17 4 Biliary calruli ...... -.1 ...... 1, 2 3 ----- . . Other diwawsof ttleliver .. ..- ...... --. -.. -.. -...... l 3 9 23 Diaeases of the spleen...... -- ...... I 1 --....5...... !!. 1 2 ~imple peritonitis (nonpuer~wral) ...... 13 21 25 21 24 Other diseaws of the digestive system (cancer and tut~cr- culosis excepted ~-...... 2 3’ 3 2 s Nonvenereal diseases of the genitouriniiry systcm anti annexa: .&cu@nephritis ...... - 22 n] 11 Bdght's diwaw ...... 49 64 Il; IN 159 Other diseases of the kidneys and :llltle~:~--- ...... 10 11 13 Diwawsof the bladder ...... ------g- .- . ...!- 3 6 Calculi of theurinary [massages ...... - 1 l------: 4 Diseases of the urethra, urinary abscess, etc . .. . . ------..--.!. ..-. ----! 2 1 ~ Diwawsof theprostnte ...... ------.. --. --1------1 6 The puerperal state: .Accidents of l)regntincy ...... ------1 ------. ------. . Diseases of the skin and of the c~’llulor tissue: Gangrene ...... 1 5 3 Furuncle ------.--. --!- 1 ---..-!. ----- . Acutiabswss ------4 2 1 Other diseases of the skin and anllextl. ..-. ------2 1 --.-..2. 1 Diae=s of the bones and oft he organs of locomotion: Diseases of the bones (tutirculosis excepted)...... ----- 5 2 4 5 Diseases of the joints (tuberculosis and rheumatism ex- mpwd) ...... - 2 ------1 Other diseases of the organs of locomotion ...... ------..------.---?. ------Old age: &nilty ------..--.--- --.------1 External causes: Suiddeby piwn ------3 ------Suiddeby mphyxia ------..:- --.---:- Suicide by hanging or strangulation ------1 5 ; ; Stiddeby drowting ...... ------1 2 1 Stiddeby fimarnls ...... -.. -.. - ...... -. -.------.-.-l ; 1 3 ------Suicide by cutting or pierciu instruments ...... ------1 3 2 Suicide byjum ing from hlg plains ...... ------’ 1 -.-..-3. 1 Suicide bycrus [ lng ...... ‘i...... l ...... 3. 2 .---. -!. Other suicides ...... - 4 ~ : 5 Acu@~isonings ...... I ~1 6 Burns (conflagration e~cepte(i) ------...... -..--.4.’...... !. 3 ...... 6 Accidental (browning ...... - 2 1 1 ------1 Absorption of deleterious gases (conflagration e~c{i~)ttd)...... 2 1 Tmuatism by fircarnls ...... 1’ i --...-- Traumatism by cutting or piercing instruments ...... ---..--’ 1 ‘-.----?. Tmmatism by fall ...... 1 ; Q Traumatism by crushing (vehicles, railways, lands lidl,s, etc.) ------...... --... -.1-.. -----, 4 1 Starvation ...... ------...... -.!. 1 Effects of heat ...... -.. -....1 3 l...... - 1 I Homicide by firenrms ...... 1 1 . . . . ---- 1 Homicide byother me:]ns ...... 1 1 ...... ,.... -.! ------Fmctures, cauwn(]t s[xcifie(i ...... ‘.. -.....’ 2 7 ~ 4 Other external violence ...... 4 JI 7 8 5 Illdefined diseases: Cause of death not spet’ified, or Ill defined...... 30 19 15 24 24 . — — Total ------...... 2,502 2, SW 3,412 3,523 3,b31 COMPENSATION TABLES

TABLE No. 29.—Sum?nary ojregional acti~’ities

Status of compensation rlaims as of Jlefi,ical treattnents and eY- amtnatlons during ftscal June 30, IWM .krijn- year 1928 d ic’fi- tions —— Regional o~cr? lis{’al ‘1 - ~ndi. I ‘-‘- year In(ii- ~rea+- Acti\-elTcrmi- Disnl- ~’;n\~- Totid Ig~~ ~id~lal~l,IleIlt~ ~i~ualS ~t~;i; cases cases 1nrit t’(1 1OWC(1 CaS(JS treat Q(i ex- ‘ amined ‘ / ---- — —. — .— ,-–—- — —.— —.

~~,{).9 Boston, hIass. . . . . ------. 20, Y2fi’ 21,83fi1 15.51(-134, I j, 247, Portlan{i, ift’...... --...... 1 3, 7H.5 2,0)6 1,347 2, 1, ~.t~ 2, Jlanchcster, X. 11.. ------2,720 1,470 1,‘4341 Pro~:ificn(.c~, 1{. I.. .------. . . 5, Jti5 2, 895‘ 4,330 2,110 4. Burlington, Vt .. . ..- ...... 2, 0s3 1. 1s41 618’ fiw2, 1,fio!4 Ncv’ York, X. Y . . . lfl, 3WI 47, 2fi(i 30, 33,305’1 21, 794 ,51,,573 Buffalo, N. J-...... [),S;it 15,007 ,5, ti, 753 6,81’0 8, 598 Iiartforil, (’onn...... 3, 4(M’ 7,?27 4, 7,310 4, WJ8’ 9, 332 N’ewlrli, X.dJ...... ----- . . . 5, ,594 16,312 6, 6, 41(;’ 5,219 12,34,5 Philadcll]hia, I’a . . . ----- . . . 11,7’20 34, i9b 12, 1(,,W:3 11,rti4 23,6,51 Pittshuri!l. }’:l...... ?, 665. 16,734 ~, .5,777 7, m 1tit 249 \Va~hington, 1). (’ . . . . . ------3,8561 13,842 7, 7, 46$ 16,961‘ 34, 21i3 Ba]timor<>, 31{i. . ..--- ...... 3, 571/ 1, 7S81 ~, C941 9, 4ss !,5 3, xl!} 3,610 10,W5 Richnl(Jn~i,Vri ...... 3P159 1,457 1,441 122 9.182 3,877 4,.4751 7, I-, ~tah...... 981 868 8 3. 2M 1.412 7%0’ 2,467 1,6651 3,698 Casr)or, JV,yo...... 9b2 ~17 I 19 .2, 5171 1;444 418 749 1,343 San Francisco, [’rtlif...... 6,984 3,027 1s1 232 11,#2.5 23, 6;4 20, 601 41,918 I,OS .inuelt~s, (’iilif...... 10,191 3,010 1%1%, ‘Ma’ 1,5,578 31,270 14, 627, 25,537 l’hot~nix, .kriz. .-. -- ...... -. 2,911 ma 391 4, 719 4, %yJ’ 9, 20s 3, 1.53 2, 3s7 15,229 Seattle, JVash. .-- ...... ---- 3,,502. 48 10,89s 7, W37 f-l,552 12 F6 Boise, Idaho . . . ------464 3, 304 I,W5 9%’ 1.523 Portlan{l, oreg------2, ;6 ], 429 ti’ 2~’2 2,872 18,:H 11, 5051 21; 338 l)allas, TeY...... 4,736 1.594’ 107 Ii 2C4‘ 5,419 11.746 4. 18,931 IJittlft Rock, .\rk...... 5, Y24 139 9,905 4, 8fi5! 19,950 olilahoma Oity, okra...... ,5,793 7, Zll 1!56, s, 340 6, 73:3,24, m~ \Vichita, Kans ...... 2, 672 3, 4W) rfl 3,048 2,8361 14,475 San ~irrtorrio, Tea \ ...... 3, 8(}1 4, 33% 100 6,381 4, :{37 18,273 Rcno, h’cv ...... ——_23? ~—cmo 41 239 413 &31 Total ...... 256,.w7 142,653,313,260I t ,5,1747 $7,504j3,=--1—-1–-–~—--S,:12,5260,.5tWW27,122 322, W2871,756

&TOTE.—~jgUTeS in this table are taken from regional off]ce reports. 71 72 REPORT OF UNITED STATES VETERANS’ BUREAU

TABLE No. 30,—.Y((mbcr ojcornpensation death and disability claims received, by fiscal .yeurs, jrom Octoberl, 1917, to June 90, 1998, inclusive

I Total Date Total I —— .,— ~ —

‘1’otal to June 30, 191S.... 12,025 ‘ 8,936 20,961 I Fiscal year ended June Fisctil year ended June 3* I 3%~??-d; .-- . . . . 6,693 36,931 43,624 1919------1Z,762 94,937 ;9y ;g 1926------8,516 24,987 33,503 1920.. ----... ----..--1 12,242 179,546 1927------6,045 20,772 35,817 )921------4,445 1~7,638 212:083 278 28,274 I 1928------%, 552 1922------4,343 186,675 191,018 — — 1923------4,222 75,059 79, 2U1 Grand total .-. -... 191,147 ~, 656 1,099,803 1924------4,576 36,001 40,477 , I

TABLE No. 31.—.Vumber oj compensation death and disability awards, by $scal years, jrom October 1, 1917, to June 30, 1928, inclusive ———— . —— I Original Disability I Tot al d::;a~sy changed original to death awards

Total to Jun~30, 1918------1,664 1,156 ------2,820 Fiscal year ended June 3P l9l9------23,225 27,128 ...... 50,35s lwo------19,657 156,121 721 175,778 1921------5,764 m, 905 1,628 104,669 l9E------4,734 72, 402 1,482 77,136 lm ------2,532 32, Y27 3,389 35,359 l924------2,011 13,251 2,939 15,262 l{+25------4, W5 23,886 28,881 l926------9,175 17,605 :E 26, 784) lY27------2,303 13, 126 3,514 15,429 lm------1,800 12,262 3,370 14, 152 —— . Orand total ------77,950 4W, 669 25,322 546,619 ——.. . —.———_ — — —

TABLE No. 32.—Gross number oj compensation awards on which pa ments have been terminated, analyzed as to reasons jor terminations during $sca Y year 1998

.Wumber terminated h-umber terminated ;&ng fi~cal year durtng fiscal ywr 192a Reason Reason Disa- Tota, ; Death ~ilit y Disa- Tota] ‘ath bitity I

I Claims withdrawn ------.--..- Disability not result of serv - Enterwi vocational training-. ----..., 4; im ------8 338 346 Nlarittd status ------812 hfiwonduct ------Payee dead ------1,845 Child becomes of age------1; .-.. -!- 1; Refuses compensation------Pending accounting of guar- Erroneous award ------7 dian ------13 22 Pending appointment of Dishonorable discharge. ------.-. -.!- 1 1 gtlardian ------167 841 1,008 Failure to report for exad- Can not lwate claimant ------1s 703 811 nation ------1, 521 1,521 PendinK investifrfltion or Nliscellanww ------8 1,068 1,076 exami-nation.. -.:------71 1,668 1,739 — — — Rwnlistti ------..- 46 46 Total ------2,961 11,413 l% 374 Disabi]ity less than 10 per ceIlt ------3,998 3,908 1------,i ~ REPORT OF UNITED STATES l’ETERANS’ BUREAU

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I REPORT OF UNITED STATES VETER.4NS’ BUREAU 77

TABLE h“o. 35.—CO?I1 pcrlsutiorL.—Act ive disability awards; n ttmher of disabled veterajts sholuinq rclatiorish ip of (le))cr[(l~)its arid (1rnou?it of monthly payments, as of J[l)ie 30, 192S — NUm- ~SIonthly I I N#~- 1310nthly Beneficiary relalionshi~j Beneficiary relationship Iler pii~![le!lt payment ——.—..—. — I 1- I Self. ---...... 1 :)45. 4C4 I Self,, parent or parents, and 3 Se]f~ndrhil(l...... chll[!ren ...... 4 $163 ~e]f~nd 2chil(lren ...... _ ‘ Self, I,,lren: or parents, and 4 Self an~13chil~ircrl ...... chi](lren ...... 4 383 Self and 4 chil{iren ...... Self, parent or parents, and 5 Self and 5 rhil~lrerl- ...... (,hiltiren ...... -. 22 Self and (; cllil{irell ...... Self, wife, nn(i parent or parents. g?; 43,386 Self ai]fl l~ife. 634, Self, \vife, I)arent or ~~:lrents, Self, wife, an(i ch:l(l ...... 590, nndchil(]...... 634 35,499 Self, wife, and 2 t,l]lldren ...... ‘ 533. Self, \vife, parent or parents, Self, wife, :lnd :; cl~ll(iren ...... ~)fi, and 2t, hildrer] ...... I 415 23,772 Self, v,ife, and 4 [,hil~lren ...... 134< Self, wife, parent or parents, Self, wife, and 5 ~,hil(iren ..- . . . ..l :4, :Irl(l:l cllil(lrerl ...... --.....’ 224 13,906 Self, wife, :tnd fi children...... 1:. Self, \vife, parent or parents, Self, wife, and 7 ch!ldrell ...... and4 children ...... -. ----- 3,799 Self, wife, und 8 chtl{ircrl...... ,Self, wife, parent or parents, I Se]f, \vife, arl[i 9 chil~irell ...... and

/ ~[lnj. 1}[~~th]y ~ Num- Nfonthly BellefiCi8rS’ relationshill Beneficiary relationship I her 1payment I ber payment —.————. — l-__~ 1’--—--—–”——— ‘- ‘- Widow ...... 7,454 $222,90Q ~ Parent or parents and 3 children-. 67 $4, 12b }Yidowandchil(l ...... ,5,M6 199,510 I’arent or parents and 4 rhildren-- 1; 1,175 lVidow and 2 children ...... 2,310 1 103.750 Parent or parents and 5 children-. 210 Widow and 3 chil~iren...... - 749 37,929 I)arent or parents and 6 children .- Widow and 4 children .-...... 257 14,[)06 lVidow and parent or parents . . . . . 1, 88} 98,51: lVidow and 5 children ...... 80 , 5, I20 Widow, parent or parents, and Widow and6 children .-. --...... 1s 1, ~~5 child...... - ...... ------993 62, 135 Widow and 7 children -.--...... ; 4s0 Widow, parent or parents, and 2 Widow and 8 cl~il~iren .- . . ------75 children ...... 341 22,865 Widow and9 children ------40 Widow, parent or parents, and 3 Child ------4, 88; 97,640 children . . .- . . ..- . . . . . ------110 7,785 2chjldren ------1,354 40,510 Widow, parent or parents, and 4 3chlldrcn ------372 14,875 chddren ------33 2,475 4ch}ldren ------70 3,;: ~ Widow’, parent or parents, and 5 bchlldren ------1: chddren...... 11 600 6chlldren ------220 ~ Widow, parent or parents, and 6 Parent or parents ...... ------57,647 1,310, w children ------2 150 Parent or parents and child . . . ..--l 1,~~~ 68,710 Parent or parents and 2 children --, - 18,005 1 Total ------85,634 2,340,040 , ! —! 1

TABLE No. 37.—Compensation.-A ctire death awards; n?~mber of deceased veterans whose beneficiaries are rece~ving compensation or compensation and instLr- ance payments, wzth amownt of monthly payments, as of June 30, 1928

‘ Nb:;- Monthly Kind of claim payment

Compensation only.. ------21,975 $678,230 Compensation and contract jterm) lnsuranw ------,? :: 1,5:2 ;;: Compensation and ayt?matlc insurance- .---- ..t--7------“, Compensation and Vnlted States Go\~ernment hfe insurance ------1, 139 36: h35 Comk)ensnt ion and contract (term) insurance and United States Go\-ernment life insuanCe ------, 166 5,395 Total ------85,634 2,040,040 78 REPORT OF UNITED STATES VETERANS’ BUREAU

INSURANCE TABLES T.i~~~ No. 38,—.V(~mber of United States Government term and converted insurance claims received by fiscal years from October, 1917, to June 30, 1998

Term Con- insur- verted Date ante insur - Total claims ante claims

Total to June30, l9l8------13,318 ...... - 13,318 Fiscal year ended June 3k l9l9------105,382 ,------.- 105,382 19X------20,302 20,522 1921-----. ------: ~j~~~~~lll ------21,868 1, E 23,092 1922------15,610 1,252 16,862 19n---. -.--. --.. ------.--::::::::::::::::::::::::::::::::::::::::: 14,604 1,630 16,234 l9u------13,086 1,598 14,684 l9%------15,788 1,795 17,583 l9%------20,842 2,298 23,140 l9n------13,072 & 454 15,526 19B------446 3,710 4,156 —— . Grand total ------254,318 16,181 270, 4W

TABLE No. 39 .—.Y(lnxber of United States Government term and converted insurance death and disability at[’ards, by fiscal years, from October, 1917, to June 30, 1928

Insurance awards 1 Term insurance Converted insurance Date I! Dis- O:~:hal Original ability O::;:a, Original Original disability changed cleath disability to death awmds

—— 1 I

To June W,1918------5,722 ------5,722 ------Fiscal year ended June 3U- 1919------08,695 ------,------...... 19N-. ----....------::::::::::::::::::. 21,912 4,% 1,867 ~ 104 1921----. ----- ..------.------.----, 4, m 7,310 2,655 19=--- .----- .-. ------.--. -.---- .--.-, 2,868 5, 723 2,633 z 19N------1,676 3,504 2,456 883 426 lea------908 2,671 842 1925------1,166 & 830 ;:% 970 2 19%--- .-.---.-..--.::::::::::::::::::: 1,254 3,092 1,538 1,014 836 1927------. 1,303 852 1,199 1928------. . :E %7 680, 1,822 1,E I._ _ Total ------140,432 32,153 16,067 ! 172,585 8,242 4,545

Converted insurance Total

Date Dis- Total Dis- Grand ability Original Original ability total changed original death disability changed awards original to death to death awards —. —. I —- I 1 I To June 30, 1918------5,722 ------.---.--.- 5,722 Fiscal year ended June 30- 1919------. 98,695 220 ------98,m lam-----... ------.-. ---. -.------.!------. -3- 105 22,016 4, w 1,867 26,914 1921------5,471 7,389 2,658 12 g 1922---. --. ---.. -.--- .----- .------.---1 1,E? 3,770 19X------.-. -.------.----- .-. -:.-----I 1% 1,319 2,559 2% 2E 6:589 1924------120 1,346 1,840 3,175 1,934 b 015 1925------149 1,464 2.136 3,324 1,727 s, 46a 1926------173 1,850 2; 268 3,028 1,711 6, 196 lea------1,957 1,887 2,061 1,042 3, W8 :E 2,914 2,310 19%--- .------..------. ..---- .-----. --’ ——1,599 898 3, m Total ------994 12,787 148,674 36,698 17,061 185,372 I , REPORT OF UNITED ST.ITES VETERANS ‘ 13URE.4U 79

Disability I)eath

Clnssificatiorrs N-umber Amount .Number Amount of Number Amount of of of of insurance of vet erans insurance veterans \’eterans insurance — Abnormalities and congenital mnlformstions ...... $7,000 1 $3,000 $Io, ooo Blood and blood-formirrg organs. 1: 101,?Jb 236.- 1,W8, 041 2, 00!),269 Bones nnd cartilages...... 68 570, WN !,, 456, 113 1,026,622 Circulatory system .. ..- ...... 566 4, 05{),632 3. of7 25, 107,881 YJ,167,513 Communicable and infcrtinus diseases ...... - . . .._. - . . . . . 7.5 ,5~5,~A\ 33,4<4, 121 3, W2 34,069,409 IJigestive s}stem. ..-. ______91 727, 770 18, 17h,!588 2, 2ti5 18,906,358 Ear, nose, nnd throat -...... 04!5,2457 2, 107,174 343 2,752,431 Endocrines ...... E fitio,138 4,686, fwti fj36 ,5,43.55,784 Eyenndanne~a ...... --.. .-. -... 34{) 2, w~B,5% 107,6!57 3,007,245 Genito.urinary system--- .-... _. 157 1, 297,374 11,h41,.t9ti 13, 138,870 I{ernia ...... y4, gl(] 345.7$3 440, 703 Joints and bursae ...... 3;: 2, 617,0s4 351, 09H 2, 96%,182 Lyml}hatic systen .. . . -- ...... _.1 1 10,OIM 110 Wl, 833 911,833 Nluscles, fast]=, tencions, and ,. ten(iorl slletltl]s ------7 62,000 34,S38 96,838 Ner\rous systen ------1,013 7, 733, 672 2, 44; 21,021,605 3, 4E 28, 755,367 Obstetric and gynecological conditions . ---- . . . ..- . ------1 10,000 6 Parasitic {iiseases. . . ------13 68,6.53 3: %ZE Poisonings and intoxications ---- 15,000 525 4, 5:; 4,248, W Psychiatric dise~$es .-. -... ----- 3,99: 32, 149,3%) 547 4,542 36,277,671 Respirntory system...... _ 148 977,948 49,052 442 49, m 450.258.251 Skin and its appendages...... 7 46,408 47 ,54 ‘441; 663 Tuberculosis . . ..- . . . ------3,879 30, 2.58,107 15, 290 19,169 lM, 975,095 Tumors .---. .._. -.. -... _._- . . . . 48 407,684 878 926 7,629,829 Venereal diseases ------67 516,704 241, 21s 1,757,922 Miscellaneous I------166 1,433, 607 57, :;; I 769, 133 522,~2, 740 Amputations ------493 4, 4W, 158 354,988 ‘534 4,845, 146 Fractures. -.-.. -.---- .-. ------.-/ 5s 4W, 516 d; I ———5, 440, 9m -— 725 5,931,445 92,944,625 139,412 1, 234,586,090 151, 173 1,327,530,715 I 1Includes battle deaths, accidents, and inj uriea. 80 REPORT OF ~ITED STATES VETER.kXS ‘ BURE.LU

TABLE No. 41.— Term insurance, terminated disability (I~i(l dcot]) a )i(Ir[i.Q: cla.~.4i.fi- cat~n oj major diaabilzt y of veterans and reaso~bs jor ter r~~ill at io!l, (IS o.f J I(rte 39, 1938 -- — Disability awards I ,)eath:Iw[,r(ls

1 ‘~Tern~in,]fe(it)V- Terminated by Terminated hy Tot:Il 1111111)-s1111)‘ recovery cleat h Claesiflcation

Num Am;funt Num. Amount ber 01 ber of of vet- insuranw veterans erans insurance I _—— I Abnormalities and congeni- I -“—l—- talmalformations .-. ------2 $m, (n)O ------.-. . $’)(), 000 ----- Blood and blood-forming 1 ------115 $946,626 Bti~~d ‘-tilages ------‘ 132 2.51,932 Circulatory system ------81 7= 6,720,555 Communicable and infec- tiouadiscaaea------.-- 95,000 705,558 I sol), 5,;s 1,692,018 Digestive system ------E 189,000 2:: 2,035, 762 2, 224, 762 745.273 Ear nose, and throat ------43 400,000 314,512 i 714, 512 Endmrinw ------165, W 3:: 3,037,333 3,202,333 Eyeand annexa ------~ 375,546 398,406 773,952 Genito-urinary system ------438,149 w? 4,607, 64t5 I 5, 045, 7M Hernia ------20,000 1:\(). 04M) Jointiand bow------1+ 1,004,828 :; ;s, M I 1,694,957 10,m 64 516,851 I 526, b51 3&3ei?:2::iindGni:- and tendon sheaths------4 . ---..1..- ...... Nervouss .stam-.------.-- 152 44 194 1, 00!5,433 Parasitic d“lseaaea ------; 5 Poisonings and intoxications- Psychiatric dfaeases ------303 81! 41 :;:% Resptitory syst8m ------78 312 4,227 ,22,626,663 Skin and its appendages ----- .----...... ------TuWtiosis ------2,03: 1, 27; 1,272 I 7, 83X, 662 Tumors ------367 66 354,925 Venereal di~----..-.--. - :; 94 14 73, S57 Miscellaneous 1---.------. - 148 95 4,570 123,673, 180 Amputitio~-.--.----.----- . 54 , 4X,828 Fractma-----.----.----.-. - :3 1;401;963 17 4; ] 260, W32 .— —— — Total ------3,,561 0,661,558 5,895 11,390 ltil, 275, 329

1 Includes battle deaths, acoidenk, and injuries. REPORT OF UNITED ST.LTES I-ETERANS’ BURE.AU 81

TABLE X(>. 42.-.1 ILtor)Latic insllrance, (z[’tire llisability and dcalh allqards; clQssifi- cation of ~)~ajor di,sabil~!y ca t~sinq per)r~(trlent total disability or death oj vctera )~, as oj J [1nc ,3[1, l,9?s’

Disability Death Total 1__— . —— — (’lassificat ions Nurn- Num- I Num- ber of Amount of her of Amount of ber of Amount of veter- insurnnce veter- insurance I veter- insurance ans ans ans . Blood and bloorl-forrning organs. -.. ----...’ ------18 $34, 752 $34,752 }Ionesau{i Carthage< ...... -- . . ..--l.. --$oi20i2- 8, 688 2 8,688 ~irculator~- system...... ------3 23? 1,o~~,{),57 240 1,037,989 (’ommllnlcai)le axlci infectious diseases- . . . 2 8:688 456 ], 980, 356 458 ], g~g, 044 I)lgestive system . . . ..-. ---...... -.. -- Al------182 7W, 571 182 790,571 Ear, no~e, andthroat . ..-... -.. -.--.. -.--..l 41 17,376 26 112, 30 la. 466 Rndocrlnos ...... -.. -.j - ...... 39 163,710 39 163,710 l;yennd annex:] ...... 34,752 -.--.-.------.... 8 34,752 (Ienlto-uricary sy>ten...... 2 8,688 ] 8; 372, 164 87 380,852 hernia ...... -.. -.-. --... -...... [. ---..3- .--.. i3.032. 13,032 13,032 Joints antll)ursae ...... 5 21, 720 i 34,752 I.ymphatic system...... ------3 13,032 13,032 hluscles, fa.~ciae, tendons a n d t e n do n 13 sheaths...... ------4,344 Nervgl\s syster]l- ...... - . . . ..-. -.-... --.l 14 I 60,816 4%: 1,86;: 44; 1,924,392 Parasltlcfllsea~es . .. F...... ------2 2 8,688 Poisonings and mtoxlcatlorrs ...... --.. i:i. ----i5i-5i2- 92 39$ 3W, 648 Psychiatric diseases ...... 58 250, 2: 1, W1,913 Respiratory system ...... ------. --.:---- 3,563 15,474, 3.563 15,474,878 Skin an(ilty appencinges ------. . . ..6i. . ..-.---g-oi6- 4 17,376 Ttlt~er(’tllL)sis ------719 3, 0:; 3,311,047 Tumors...... 1 -4:344 30 128, 1;:, :: I-enereal tiiseases ...... ------1 4,344 Nfiscellaneous l ...... 1 4 344 1,4: 6, I:t 6, 184;564 .imi~lltatlons ------11 47; 784 8 34, 82, 1~ Fractures ...... -. - . . . . . ------...... - 86 373. 373,584 — —— I——.__.—_——. —. Total ..--. --... -... ---. ---.. --.-----’ 287 ~ 1,2~6,~~ ] 7,477, 3~,3~3,622 ; 7,764 33,620, 3~

—. ———. _.—— —. —— . . _—— .—— .—. 1Includes battle deaths, accidents, anti injuries.

T-kBL13 ~(1. 4:3.—.4lfto??latic il~sllrance, ter?ninated disability and (Ieath at~’ards; class ijic(btion oj ~najor disabi~it.ij oj l’eteran a)~d reasons jor ter)ni?~ationt as oj Jz~ne 30, 1998 —— -—— .—— — Disability awards Death awards; no beneficiary in Terminated by Term;~;~:d by - Tot al permit ted class recovery (Classification -—— :e:rn; An]ount Num- Amollnt Num- ~r of pr:; A:;yt ber of ‘~~.nt of in- veter- 0[ in- veter- veter- veter- suranm surance surance surance ans ● ans ans ans _——

Blood and blood-forming organs.. ..-. -2. ------$34 -ii2------$ii-4io- $4,344 Circulatory system.-- ...... ------$8,688 8 , 10 ,, 3; 147,6% Communicable and infectious tilseases . . . . . ------.--.------4,344 4,344 42 182,081 Digestive system...... 4,344 ; ; 13,0Y2 17 73,848 Ear, nose and throat .--...... ; 8,688 --.--i- .---:-:-1 8,688 ------Endocrines ------1 4,344 : 13,032 Eye,and qrrnexa ...... ------1 4:344 4,344 1!----ii. -----.-.--:: (Iemto-urlnarys ystem--- ...... ------3 13,032 : 13,0J2 ,1 : lIernia ...... ------,------~ Joints an~bl]rsat'.. -... -.-. -...... l--_ . . ..l ------.---- .-..1 -.-. -.-1 ------2 I :, :;: Lyn~phatlc system...... ------.--. -i- ----~-i~i. -----j. ‘--i~-~3~-1-----4- ‘ ------4~ 4,344 h’ervous system...... i’,376 ~ 191,136 Poisonings and intoxications.. -.. ~-.---ti- ---3g-oi6- ----i~- i---iu:-ii2- ‘---~j-!--ll~-2~~-11 1: ~ 69,504 Psychiatric diseases ...... 21, 130 Respiral[jr~ system...... -. -ii. -. iiG:ti40. b, 088 -2 ~: (ih8 I 361 1, 567,804 Tuberc~dosls- ...... ------18? 786, 920 217 948,960 81 , 342,642 ‘Humors ...... ------. ..-. -.---’ . ..--...... ’ 4,34 Venereal diseases ------1 4,344 I 1 ‘1,344 ; 8,688 hfiscellnn~ous }...... - ...... (-...... -.--.2. ---.g.i%- ‘----.2. \.. ------140 608, 160 .kmputotl(lns ...... -. -... ------.------8\6SS ------‘------Fractl]res ...... 1 4; 344 4,344 4 17,376 _ —.. 1—— 11 .—.—— — — Tottil... -.. -.. -.----- .--.---l 52 I 231,.544 225 978,056 277 1,209,600 770 3,332, 8G _——— .— 1 Includes battle deaths, accidents, and injuries. REPORT OF UNITED ST.\TES VETERANS’ BUREAU

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TABLE No. 52.— Report of United Statea Government life insurance in jorce Decem- ber 31, 19~7 TOTAL-ALL PLANS

Amount Amount

Insurance in forca Dec. 31, 19%------463,520 1,977,959,452.45 Issued during 19~------q 687 1,274406,047.00 TotN ------.------.-.--- 688,218 k 252,455,499.45 Terminations: Death claims awarded ------1,;: 8,357,083.06 Disability claims awarded ------3,787,926.69 Matured endowments ------10, w. 00 Surrendered for cash ------4, Id 14304,413.00 Surrendered for paid-up insuranw ------402000. a) Lapwd ------11, 2; 46, 7% 40s. 00 Dbhonorable diwh~ges ------5,000, m Redumd ------; 1,100, 135.00 Candled ------1.369.067.00 Expired ------3, ?4 9; 8s7; 909. (m Change in data ------4,736 21,361,355.00

Total terminations ------26,380 107,313,296.75 Additions: Rerated disability claims ------63 181,566.00 Paid-up insurance issued ------%,581. W Revived ------3, 6~g 16,017,218.00 Continued under extended insurance ------4,989 17,066,442.00 Change in data ------4,766 21,404, 175.00 Total additions ------13,556 54,857,982.00 Net terminations ------. . . ..-. -. .------.----- l%824 52,455,314.75 Insurancain force Dec. 31, 1927------.-, 075,339 3, m, 000,134.70

TABLE No. 53.— Report of United States Government life insurance in force, by plan, as of December $1, 1927

Plan Number Amount —— . I Ordinary life ------139,390 $753,240,352.45 Wpayment life ------17%m 759,411,389.07 W-payment life ------150,005,339.57 Oyearendowment ------la;: 40&667,563.75 %ymendowment ------35, g30 la 352466.08 Endowment [email protected]. ----. --.. -.-. -----.-, 3~:~; 173,701,502.95 5-year convertible term. ------7~3:$g Extended bswanm ------\ 16,897 *V. Total --- .------.-.--- .------.---. ------. ----. ------.. -l 675,3S9 3, m, 000,184.70 REPORT OF UNITED STATES VETERANS’ BUREAU 93

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ADJUSTED COMPENSATION TABLES TABLB No. 57.—,Vumber of application jor adjusted compensation recei~~ed by $acal years from September, 1924, to June 30, 1988 .— —. —. ———-—.__—____

Fiscal year

1925. ------. 2,845,180 l926------;~ ~ ~9M-19n------124175 Total ------3,549,679 — ——

TABLE No. 58 .—Actio~z talcen on applications jor adjuated compensation to June 30, 19g8 —— —. —

l\riinch of service Claim h-umber Amount

.Arrny---.--...------Cash : (a) Veterans ------106,993 $3,812664.01 (b) Dependents ------4,972 135470.25 Dependents (over $W)------76, 205 26,996,033.21 Certificates ------2,827,446 2, 8S8, 456,872.00 $Mlump-sum payments ------.------. 1,114,330. m Total ------3,015,616 2,890,515,369.47 Navy ------Cash: (a) ~“eterans ------7,593 208,024.44 (b) Dependents------l 377 9,365.50 Depended@ (over $5O)------7,743 3,212,148.02 Certificates ------412,754 446,191,063. W $60 tump-sum payments------. . . 75,300.60 Total ------428,467 449,695,900.96 31~lrine Corps ------Cash: (a) Veterans ------430 14,306.67 (b) Dependents ------1,427.49 Dependents (over $ti)------2,1$ 85%859.35 Certificates ------61,867 67, 5:~ ~. ~ $601ump-sum paynlents ------.- /,. Total ------64,466 68,432,396.51 Grand total ------3,508,549 3,408,643,666.94

TABLE No. 59.—Death claims awarded on account of adi?~sled service cerii$cates,. arranged by beneficiary, as of Jun; SO: 1928 —.—- .-

1 Payments to ‘ Payments to Deaths Total I ‘:?:?$ts ; ‘;E:::::’ ‘* bonus IJeneflciary _____ l—-=- ‘-- - 1 I Num- 1 .4mount ~:e~- ~ INum- ber Amount , ~er Amount Amount ‘buwm- Amount — — — — —— . — .—- I Pyt~e;~ parents and ------$13,647 ------Estate ------2, 8;: 2,998,200 ‘------..- }Vife or hnaband ------24,274 B, 857,607 23,407 $8, W, 783 1,~ q;: $109,140 Child or children ----- 1,135 I 1,105,486 5,583 1,9% 229 110,460 Nlother----.------10,628 10,691,246 46,663 16,49%693 &~5 ::: ~: 832, 3!Ui Father------%237 2,316, ~4 7,683 2,731,033 159,9al Other relatives ------7,372 7,579,497 369 146,091 18 ‘491 No relative ------966 , 1,047,476 -----.------.------.------!-?- Orr)hangage, hospital, eta------30,749 ---.------..-.------.-. -i 30,740 h’o relationship shown 4E 498,864 ,------.--.------.------2; 4%, 864 — —— . — — ‘rotal ------50,080 51,139, W6 83,705 30,100,829 5,384 147,m? 1,215,900 .39,169 /82,604,392 REPORT OF UNITED STATES VETER.4NS’ BUREAU 97

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_,,~,lII ,11

I 98 REPORT OF UNITED STATES VETERANS’ BUREAU

ADVISORY GROUP ON APPEALS TABLE

TAII I.E No. G 1.—.1 ct ion by advisory group on appeals for the $acal year 1928

Cases-on hand at 1)(’ginningof year ------Cascs~rcceivcd(l\lril]gthe year ------5,;;; ~ascs acted [ll)ol~: (J. I)(>(tisi()lls rctlclcred ______4,471 (). ilction other than decisions ------992 c. l~et(irned, rloactiol] ------2

d. '~otal ------5,465 Cases olllla]~datcndof year ------663 Daily aver:ige forgrotl~) d(lring year ------18.3 ——— ——.. —- 1 Source of appeals I . Sections Appeal —. —.— —_ group ig) other Total Wurm

—— — —— —-—-l————l—————— —— I Decisions reverse{i: Increased ratlag ...... -. ----- . . . . ---- 12 9 2 7 44 Permanent total rating... ------&l : ------8 Service corrnection ...... ------51 2: B7 Itetroactive rating ------; 28 22 E 220 Protesting rating ------4 fil : 66 15 60 232 Iteimbursement for medical treat- merit ------.------. 1 l------l 1 3 5 Question of competency ...... - . ------1------l{ating for insurance j)ur~)osw. -.. ------2 1 2 : ; (’hange of occui)ational status... ------.--.---1----.---1 1 ------. 2 2 l)e~)en{lency allo}vancw...... _’------1 ------.------.- . ------1 Question of susl)ension {~fcom- I)ensation ------1-----.------. 1 1 l’rotcstlng forfeiture of rights. -...1 ------.------, ------1 ------1 . —. Total ------8 115 { 117 157 70 130 227 824 . — .—— - - . Decisions sustaine{l: [ncrcased rating .- . . . ------2 75 64 83 48 25 l’rrmancnt total rating ...... 27 SerViCe Cull[lectioll. . . --.. .-...... ‘ : 3: 4ti &7 267 &; ltetruactive rallng...... 13 6s 42 80 110 Itating for instlrancc~)ur{)osw.--- -.--.-.- 2 ------l’rotesting ratixu ...... 1 2 4 47 25 11: lt(~irllt)urst:llletlt Illetiical treat- merit ------3 ------13 Further trailing. .- ...... --- I------1 ------; 2 Ratings ul~(ier s[~(ti(~n213------.------, ------2 1 (’hange ofoccul)ntlonfds talus.-.. ------4 2 ------i’rt)testing rcco}ery of o\erlJay- I merit.. --. -.- ...... -. - . . . ..-. -.-’ ------.------,.------,------13 .!ttendant fillo}vi~rlcl’ ------.------. .------]--. -----1------1 ~’rtJtesting forfeiture of rights ------.-. --. -+------1 .------1------..- t/uestion ofeoIIl~)eterlcy ------3 ; l’rot~>sting ~lcclsioIls------.-..----1------. : 3 Del)endency allowance ...... ‘------.---~------.. : l.-.------.--.:------——— — Total ------23 5MI 553 779 I 479 I 469 796 3,647 - - — (irand total ------i 31 I 673 I 670 936 549 589 1,023 4,471 m - — - I- l—— Perm~llt revemed ------25.81 17.WI jlfi 22.19 18.43 Percent smtairlt’f~ ------?4. 19 82.91 . 77.81 81.57 . — Number of hearings during the year -- E ‘------,------.-- .------1,127 Number of discussions during the year ...... ------...... --..--- .------.----- . .------,------,-.---- 9ofI — ——— —— —— I Represents cases on which previous decision was made by section A, whi~ was consolidated with section U on JIaY 15, 19m. REPORT OF UNITED STATES VETERANS’ BUREAU 99

TABLE No. 61. —Action by advisory group on appeals for the fiscal year 1928—Con. —— I Appeal I I cl. grrgn D E Total Om~ I (’ase9 . — Casw received on appeal by advisory group from various sections . . . ------15 996 889 1, 3m 717 220 413 4,558 C NW returned for further consideration ------.. ---, -.------.---- ,------1,037 — . —— Total ------:------~----.-. ------., .. ------S, M6 —— —. 1 Represents cases on which previous decision was made by section A, which was consolidated with Section B on hfay 15, 1927. r .

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I REPORT OF UNITED STATES VETERANS’ BUREAU 101

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18119—28—8 102 REPORT OF UNITED STATES ~TERANS’ BUREAU

TABLE No. 6a.—Andy8i8 of obligation from d appropriation, jiscal year 1928 — Classifleation Total —— s Puaoovi~: ------$35,962,431.52 mdmiso@lla@w pa~en@------3,642, 171.82 Y '4h%z:?&TsksuPPlia ------43{),353.35 Mdi@and hmpitdsuppliw ------1,050,078.12 StientMcandeducatioti suppHw------44,273.86 md------807.819.63 Wmtiappud wdwwing suppliw------141;051.97 ------...... ------...... ------. 95,685.54 L%hk”:: ------...... ------...... 7,587,566.95 Smtiysupplim ------...... ------n7, 010.71 _dcation service: Td~aphwrdm ------23,478.00 Tekphonewrvi@------124,2%. 19 Othwmmmunicationwrvim------26,408.85 Travelexpenses: Transportation------1,932,395.79 Bubsktince------NO,125.95 SPMmdmkmHwmw exmmwhcident totra~’el------261,N. 24 Transportationof things------. . ..- ...... S41,361.36 Rintingand binding,engravin , lithographing,photographing,and typewriting (serv- h) obwork): Printingand$ indu ------122,938.30 Furnisf ingof heat,light, power,etc------764,369.37 titi ------1,W2,744.13 -mddtir8tiom ------3,6b0,355.95 S~admism~mmm cwentex~m ------224,127.08 Peneion~tirementsalaries,annuitias,World War allowance, and insuranceslHOS: mmgdowmw ------189,551.77 Military and Naval com~mation for deathand dkability------182,156,239.56 OtherWorld War allowanm (~jwted mmwmation)------10,160,249.6S Insurancelosses(mnvertid insWanm)------20,m, 069.00 MUtary and navalimwanW ------120,WJ, 258.34 Granta,subsidias,and contributions: Bti&------1,700,000.00 Ttition.------. ---. ------... ------. ------.---- .------' 24,$W4.51 ‘ti$=;~, furnishinf,~d5xtuw ------1,133,!)67.96 Educationfd,scienti c, andmcmationd equipment------10$i,{)74.5!) Otherequipment------36:),625.58 Structuresand parts and nonstructuralimprovementsto land (includingfixedequij)- mat) ------6,969,076.62 Inveatments(includesworking-capitalfunds): Investmentof trustfunds- 1. Governmentltiei~n@ tmtfund ------71,3W3,303.00 2. Adjwted wrvi@mrtifimti fmd------112,m,m. oo —— ToM------58771~~,489.~ REPORT OF UNITED ST.4TES VETERANS’ BURE.4U 103

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I UNITED STATES VETERANS’ BUREAU

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APPENDIX

109 .

. PUBLIC ACTS

[EXTRA{IT FRO~l PUBLIC L~JV No. 2, 70TH CONGR~SS]

[11.R. 5m]

An Act Xfaking apl)ropriations to supply deficiencies in certain appro])riations for the fiscal year ending June 30, 1928,and prior fiscal years, to provide supplenlental approl)riations for the fiscal year ending June 30, 19M,and for other purposes.

UNITHD STATES VETERANS’ BUREAU

Nlilitary and l]aval compensation: For an additional anlount for the payment of military and Ila\’al conlpensation accr[li~lg during the fiscal year 1928 or in prior fiscal years, $19,400,000~ and in additiorl thereto unexpended balances of the appropriations of the Llnlted States J’cteran.s’ B~lreall are hereby rcappro- ]~riated and made available llnder the appropriation ‘‘ NXilitary and l]aval colll- pensation, Vetcralls’ 13ureau, fiscal year 192S and prior years, ” as follo~vs: Jlilitary al~d I]aval coll~pe]lsation, fiscal Year 1926, $1,732,000; military and I]aval conlpeusatioll, fiscal year 1927, $239,000; salaries auci expenses, fiscal Jcar. 1~~~, $3,13ti,000;salaries and expenses, fiscal year 1927, $5,517,()()0; lllecllc:ll and IIospital services, fiscal year 1926, $1,148,000; nledieal and hos]jital services, fiscal vear 1927, $4,499,000; vocational rehal)ilitatioll, fiscal vear 1926, $lti6,()()O; voca~ioflal” rehabilitation, fiscal year 1926, $10, 140,000; pr~]~ting and })i~~ding, fiscal yt’ar 1926, $83,000; lnilittiry and naval insura;~ce, fiscal year 1{)~~, $~,g~~,()()()e Damage claims: To pay claims for damages to or losses of pri~atelv o~vned ]Jroperty adjllsted and determined by the LTl]ited States Veteral]s’” l~ureau llnder t Ile provisions of the Act, ellt it le[l ‘‘ An .Act to provide a method for the settlement of claims arising against the ~ol~erl]ment of tile L-nite(l States in sums !)ot exceeding $1,000 in ally one case, ” approved Deceml)er 2S, 1922, as flllly set forth in IIo1lsc Document N’umbercd 731, Sixty -nillt h Congress, $477.02. Approved, December 22, 1927.

[EXTRACT FRO}X PUBLIC LA\v No. 400, 70TH CONGRESS]

An .kct }Iakillg appropriations for the Executive OffIceand sundry iudeperrdent executi%rebureaus, boards, commissions, and o~lces, for the fiscal year ending June 30, 1929,and for other purposes.

~“NITED STATES VETERANS’ BLTRE.ltT

1+’or carrving ollt the provisions of an Act entitled “.in ,\ct to csta}~]ish a ~’ctera~ls’ ljureau and to improve the facilities and services of such burcall and to further amend and n~odify the }Var Risk Ins(lrance Act appro~’cd .lugust 9, 1921, ” and to carry ollt tile provisions of the .$ct entitled “ \Vorld }Var Veterans’ ilet, 1924, ” approved June 7, 1924, as amended, and for administ rat ive expenses ill carrying out the provisions of the \Vorld War Adjustccl Compensation Act of hIay 19, 1924, including salaries of personnel in the District of Columbia and else\\-here i]] accordance ~~ith the Classification :\ct of 192t3, and expenses of the central off]ce at lYashington, District of Col[lmhi?, and regio~]al offices and silb- Ofrlces, and including salaries, stationery, and minor Office supplies, furniture, e(\uil)ment and s~lpplies, rentals, auci alterations, heat! light, and ~vater, n~is- cellaneous ex])enscst incllldillg telephones, telegrams, frelgllt, express, la~v books, hooks of refer{ ’nee, periodicals, alnbulancc service, to~vel service, laundry servi(e, re])airs to C(lllipnlent, storage, ice, taxi service, car fare, stamps an(l I)ox rent, traveling and s[ll~sistencc, inelllc]ing not to exceed $4,000 for the expenses, ekcept men~bcrship fees, of employees detailed by the director to attend nleetings 111 112 mPORT OF UNITED STATES VETERAXS ‘ 13URE.\U

of associations for the promotion of medical science and annual national conven- tions of such organizations as may be recognized by the director in the presentation or adjudication of claims under authority of section 500 of the l~orld 11’ar Veterans’ Act aa amended, and traveling expenses of en~ployees transferred fron~ one official station to another when incurred on the written order of the director, salaries and expenses of employees engaged in field investigation and s~lpervision, passenger-carrying and other motor vehicles, including purchase, maintenance, repairs, and operation of same, salaries and operating ex]~enses of the ~lrlingt on Building and annex, including repairs and mechanical ccl~lipment, f~lel, electric current, ice, ash removal, and miscellaneous items; :il~d including the salaries and allowances, where applicable, wages, travel and SIII)sistt’nce of (’ivil ernf)loyees at the United States veterans’ hospitals, supply depots, dispensaries, anti chnit>s, including the furnishing and laundering of white dll(’k sl]its, and ~vhite canvas shoes to employees whose duties make necessary the wearing of same, $40,000,000: Prczrided, That physicians, dentists, and nurses of the medical service of the United States Veterans’ Bureau, in addition to their con]pensation, when t rans- ferred from one official station to another for permanent dllt y, may he allo~vcd, within the discretion and under written order of the director, the expenses incurred for packing, crating, drayage, and transport at ion of their llo~lsehold effects and other personal property not exceeding in all 5,000 pounds. Such portion of this appropriation as may be necessary shall be allotted from time to time by the United States Veterans’ Bureau to t be Public Health Service and shall be available for expenditure by the Public Hcalt h Service for llecessa~y ersonnel, the pay, allowances, and travel of commissioned officers of the Pubhc k ealth Service detailed to the United States Veterans’ l~llreau for d ut v. For printing and binding for the United States I’et crans’ Burea(l,’ including all of its bureaus, offices, institutions, and services located in Washington, Dis- trict of Columbia, and elsewhere, $135,000. Compensation: For the payment of military and naval compensation accruing during the fiscal year 1929 or in prior fiscal years for d~’ath or disability provided by the Act approved October 6, 1917, as amended, and the World War Veterans’ Act 1924, approved June 7, 1924, as amended, $195,0(J(J,000. Medical and hospital services: For medical, surgical, dental, dispensary, and hospital services and facilities, convalescent care, necessary and reasonable after care, welfare of, nursing, prosthetic appliances (inclu(iing speciaI clothing made necessary by the wearing of prosthetic appliances prescribed by the b~lreau), medical examinations, funeral, burial, and other incidental expenses (including reparation for shipment and transportation of ren]ains) accruing during the # seal ear 1929, or in prior fiscal years, traveling expenses, and supplies, and not excee i ing $100,000 for library books, magazines, and papers for beneficiaries of the Unitid States Veterans’ Bureau, court or other expenses incident to any investigation or court proceeding for the appointment or ren}oval of al] J- gu;irdian, curator, conservator, or other ~rson legally vested \vith tt~e care of the clain~- ant, or his estate, or in connection with the administration of such est at c by such fiduciaries, including court costs and other expenses incident to proceedings heretofore or hereafter taken for commitment of mel~tallv incompetent persotls to hospitals for the care and treatment of the insane, $;11,675,000. This appropriation shall be disbursed by the United St rites Veterans’ B~lreau, and such portion thereof as may be necessary shall t~c allotte(l frolll 1ill]e to time to the Public Health Service, and the War, N“avy, and I1lterior Dt’l)art Illt’nts, and transferred to their credit for disbursement, by t hexn for the p[irpo>es set forth in the foregoing paragraph. No part of this appropriation shall be expended for the purchase of any site for a new hospital, for or toward the construction of aIIy neiv hospital, or for the purchase of any hospital; and not more than $3,30 !J,384 of this a~)propriat ion may be used to alter, improve, or provide facilities in the several hospitals under the jurisdiction of the United States Veterans’ Bureau so as to furnish adecl uat e accommodations for its beneficiaries either by contract or by the hire of ten~- porary employees and the purchme of materials. The allotments made to the Public Health Service, War, Navy, and Interior Departments shall be available for ex~enditure for care and treatment of beneficiaries of the United States Veterans Bureau, and for necessary n~illor repairs and improvements of existing facilities, under the various headings of aplJropria- tions made to said departments as ma}- be necessary. Adjusted service certificate fund: For an amount necessary under s~~ction 505 of the World War Adjusted Compensation Act of hl ay 19, 1924, to provide for the payment of the face value of each adjusted service c~lrtificate in t~vent}- years REPORT O F UNITED STATES T’ETER.4XS’ BUREAU 113

from its date or on the prior death of the veteran, $112,000,000, to remain available until expended. For military and naval insurance accruing during the fiscal year 1929 or in prior fiscal rears, $106,750,000. Total, U~lited States J’eterans’ Bureau, $4 S,5,560,000. .4pproved, Jlay 16, 192S.

[PUItLIC-NO. 480-70TH CONCi IiESS] [H. R. 12&21]

An Act To authorize an appropriation to provide ntlditional hospital, domiciliary< and out-patient dispensary faciliti~s for persons entitled to hospitalization under the \VorldWar 1 eterans’Act, 1924,as alnendcd,and for other purposes.

[1( it e~irrct~clb;~ the Scr~ate a?ld Hot~se ofRe~)rese)~tatives oj the United Stales oj A ?)((ric(t i)~ ~or~gi-css assc??)hlcd, That il] order to provicle sufficient hospital, don]iciliar~’, and out-pntient dispensary facilities to care for the increasing load of mental]y afflicted l\”orld }Yar veterans and to enable the Llnited States \reter- ans’ }~ureuu to care for its beneficiaries in Yetcr,ans’ Bureau hospitals rather than in contract temporary facilities and otiler institutions, the Director of the United St:ltcs I’ctcrans’ Bllrenll, s~lbjeet to the a]~proval of the President, is hereby authorize[l to ljrovi{le ad([itional llos])it:i], don~iciliary, and o(lt-patient dispensary facilities for persons entitled to hospitalization under the lVorld lVar J7eterans’ Act, 1924, as amended, by purehaset replaccnlcnt, and remodeling, or extension of existing plants, and by construction on sites no~v o]vned by the Government or on sites to l~e acquirecl by pllrchase , con(iemnation, gift, or other}~ ise, of such hospitals, clolliiciliary , :ind out-patient dispcnsar? facilities, to inclucie the necessary buildings and auxiliary structures, mechanical equipment, approach ~vork, roacls, and trackage facilities~nding thereto; vehicles, livestock, furniture, equipment, ant! accc’sscrrieti-; ancl also to provide accommodations for officers, nurses, and :itte~]ding personnel; and 91s0 to provide ]>roper and suitable recreational centers; and the Director of the Unite(l St:~tcs \7eterans’ Bureau is authorized to accept gifts or donations for any of the purposes named herein, Such hospital and domiciliary plants to be constructed shall be of fireproof constrllction, and existing plants purcl~}~scri shall be ren]odeled to be fireproof, and the location and natllre thereof, Ivlletller for domiciliary care or the treatment of tuberculosis, neuropsyclliotric, or general n~edical and surgical cases, shall be in the discretion of the Director of the United States Veterans’ Bureau, subject to the approval of t!le President. LSEC.2. The construction of ne}v hospitals, domiciliary facilities or c]ispensaries, or the replacement, extension, alteration, remodeling, or repair of all hospitals, don~i ciliary facilities or dis]~ensaries l]eretofore or hereafter constructed shall be done in s(lch n~anner as tile President may determine, and he is authorized to re[jllire the architectur:il, engineering, constructing, or other forces of any of the departments of the Government to do or assist In sllch ~vork, anc[ to employ individuals and agencies not nolv connected ~vith the Government, if in his opinion (lesiral~le, at such compensation as he may consider reasonable. S~Co ~. }/or ~arrJ-ingintoe[fecttheprecedil]g sections relating to additional hospitals and donliciliary and out-patient ~is])ensary facilities there is hereby authorized to }Ie :l~)proprlate(i, out of any money in the Treasury not otherwise Qp])rol)ri:lted, t he sllln of $15,000,000, to l~e inlmediatcly available and to remain available until exlje]](ie{l. That not to exceed :3 per centum of this sum shall be available for tl~e e~l~ploy.ll]ent in tl~e District of Colun~bia and in the field of necessary technical ancl cle.rlcal assistants at the custoulary. rates of conlpcnsation, exclusively to aid in the prepariltion of the p]:ins und specifications for the projects authorized herein and for tllc supervision of tile execution thereof, an(] for traveling expenses, field-oflicc e(lui~~n~cnt, an(i supplit’s in connection there~vith. S~:u. 4. The President is further aut]lorized to accept from any State or other poiiticn] ~[lbdivision, or frol]~ any corl~oratiol~, association, inciividllal or indi- vicill:ils, :iny l)llilding , structl:rej c{luii)ment, or grounds suitable for the care of the [Iis:iblcd, }vith dl]e regard to fire or other hazarcls, state of repair, ancl all other ljc’rtinent considerations and to {iesignate ~vhat department, bllreau, boitr(i, collllnission, or other governn]ental ~igcncy shall have the (Iontrol and managenlent thereof. !Sk;c. 0.- The (Iirector is hereby ailthorized to constrllct and lllaintain on hospital rescr~”utions of the bureau garages for the accommodation of privately 114 REPORT OF UNITED STATES VETERANS ‘ BUREAU

owned automobiles of employees at such hospitals. Elllployees Ilsing SIICI1 garages shall make such reimbursement t herefor as the director ma~ tiCJCIIII reasonable. %Ioney received from the use of S(ICI1 g: L~:Lges shall 1)C cc)ycr~~f1 into the Treasllry of the United States :is n]iscellantlo{ls receipts. SEC. 6. The Director of the United States Veter:ills’ B[lreaLl is l~tJrcIJy:,11. thorized to sell at private sale not more than fifty acres of the hos]~ital rt’ser\’::- tion of the Ilnited States Veterans’ Hospital Numberc(l !):]J Legion, ‘~(’x:i<, t llc size, price, and location thereof to t)e determined b}- t lltI (1]rector. SEC. 7. The Director of the United States Veteraxls’ l]llrea{l is llc~r(tb~ :1[1- thorized to have appraised and, after advertisement, to sell to the highest bldtic’r or bidders, as a whole or in parcels in his discretion an(l on sl]ch terms as he may deem proper, the United States Veterans’ Bureau H o.]~it:~l reservation in t ht’ county of Dekalb, State of Georgia, acquired by tile United States by dectt dated April 15, 1920, and to make, execute, and deliver :ill needful conveyances. The director shall have the right to reject any and all Ilicls. The net ~)rocectls of such sale or sales shall be covered into the Treas~lry of the ~nitc’(i iSt:ttes :1s miscellaneous receipts. SEC. 8. Section 4 of the Act entitled “An Act to ant Ilorize an a])])ropriatioll to provide additional hospital and out-patient dispells:irv facilities for perst)l]s entitled to hospitalization under the l~-orld \Yar Vetcr:irls; ;\ct, 1924, ” ~ipl~roye(i hlarch 3, 1925 (United States Code, title 38, seetion 43s), is hereby repealed. Approved, May 23, 1928.

[PUBLI~NO. 506-70TH CONGRESS]

[s. 777] An Act Makingeligibleforretirement,underoertainconditions,orncersand formerorncersof the Army, Navy, and Marine Corps of the United St8tw~other than o~ers of the RegularArm~, Xav~, or MarineCorps,who incurredphysicaldisabilitym lineof duty whilein theserviceof the L’nitedS~ates durfngthe World War.

Be it enaded by the Senate and House of Representatives of the United States of America in Congress assembled, That all persons who have served as officers of the Army, Navy, or Marine Corps of the United States during the World War other than as officers of the Regular Army, Navy, or J IariIle Corps who d~lring such service have incurred physical disability in line of duty, and who have been, or may hereafter, within one year,. be, rated in accordance with law at not less than 30 per centum permanent disability by the Llnited States Veterans’ Bureau for disability resulting directly from such war service, shall, from date of receipt o? application by the Director of the United States Veterans’ Bureau, be placed upon, and thereafter continued on, separate retired lists, hereby created as part of the Army, Navy, and Marine Corps of the United States, to be known as the emergency officers’ retired list of the Army, Navy, or hlarine Corps of the United States, respectively, with the rank held by them when discharged from their commissioned service, and shall be entitled to the same privileges as are now or may hereafter be provided for by law or reglllations for officers of the Regular Army, Navy, or Marine Corps who have been rt~tired for physical ciis- ability incurred in line of duty, and shall be entitled to all hospitalization privileges and medical treatment as are now or may hereafter I]e authorized t>y the United States Veterans’ Bureau, and shall receive from [late of receipt of their application retired pay at the rate of 75 per centum of the pay to whit h they were entitled at the time of their discharge from their commissioned service, except pay under the Act of May 18, 1920: ProL~zded, That all pa,y and allowances to which such persons or officers may be entitled Ilnder the provisions of this law shall be paid solely out of the military and naval compensation appropriation fund of the United ,States Veterans’ Bureau, and shall be in lieu of all disability compensation benefits to such officers or persons pro vialed in t Ile Worl(i War Veterans’ Act, 1924, and amendments thereto, except as otherwise authorized herein, and except ~ provided by the Act of Decenlber 18, 1922: Provided further, That all persons who have served as officers of the Army, Navy, or Marine Corps of the United States during the World War, other than as officers of the Regular Army, Navy, or Marine Cor s, who during such service have incurred physical disability in line of duty, an x who have heretofore or may hereafter be rated less than 30 per centum and more than 10 per centum permanent disability by the United States Veterans’ Bureau, for disahilit y result ing directly from such war service, shall, from date of receipt of application by the Director REPORT OF UNITED STATES VETERANS’ BURE.AU 115

of the [“!lited states Veterans’ Bureall, be placed upon, and thereafter continued 01), the appropriate cl~lergc[lcy oficers’ retired list, created by this Act, with the rank hcl(l l)y tl)c’11~J1-llcnr]ischarged from their conllllissioned service, but without retirc(l pay, and shall l)e entitlerl only to such compensation and other benefits as arc Ilow or Illay llercafter I)c provided bv law or regulations of the United States Yetcrans’ B~]rea\l, together with all privileges as are now or may hereafter be provided by la~v or regulations for oficers of the lleg~dar Army, Navy, or Llarille Corps who have t)cen retired for physical disability incurred in line of duty : .-1rbfi [)ro)idcfl f ~lrther, ‘1’hattheretired list created by this Act of officers of the ~lrll~y shall be pl~})lishe~ annually in the Army Regi;ter, and said retired lists of officers of the Navy and Nlarine Corps, respectively, shall be published annllallv ill the Navy Register. SEC. ~. NTOperson shall be entitled to benefits undrr the provisions of this Act exce~)t he n]ake application as hcreinbcfore providc(l and his application is receivrd in the [Tnitecl St~~tes Veterans’ Bureau within twelve months after the passage of this Act: Prolided, That the said director shall establish a register, and a~)plicatiol~s ]nade hcreun(ier shall be entered therein as of the actual date of receipt, in the order of receipt in the Veterans’ Bureau, and such register shall be conclusi~~e as to date of receipt of any application filed under this Act. The terln ‘‘ \Vorld lyar,” as used herein, is defined as including the period from April 6, 1917, to .July 2, 1921. NICHOLAS LONGWORTH Speaker of the Hot(se of Representat~ces. CHARLES G. DAW~S I’ice President of the United )9tates and President of the Senate.

IN THE SENATE OF THE U~IT~D STATES

J{ay 3 (calendar day .Ilay 24), 1998

The Senate having proceeded, in pursuance of the Constitution, to reconsider the hill (S, 777) entitled “An Act making eligible for retirement, under certain conditions, officers and former officers of the Army, Navy, and Marine Corps of the United States, other than officers of the Regular Army, h’avy, or Marine Corps, who incurred physical disability in line of duty whale in the service of the Pllited States during the World }TTar,” returned to the Senate by the President of the L;nited States, \vith his objections tl~ereto, with the message of the President returning the bill; and Reso/red, That the bill do pass, two-thirds of the Senate agreeing to pass the same. Attest: EDWIN P. THAYER, Secretary.

IN THE HOUSE OF REPRESENTATIVES, UNITED STATES

May $4, 1928

The House having proceeded, in pursuance of the Constitution, to reconsider the bill (S. 777) entitled “An Act making eligible for retirement, under certain conditions, officers and former officers of the Army, Navy, and Marine Corps of the United States, other than officers of the Regular Army, Navy, or Marine Corps, who incurred physical disability in line of duty while in the service of the United States during the World War,i’ returned by the President of the United States to the Senate, in which it originated, with his objections, and passed by the Senate on a reconsideration of the same, it was Resell’ed, That the bill pass, two-thirds of the Representatives present having voted in the affirmative. Attest: WM. TYLER PAaE, Clerk. 116 REPORT OF UNITED STATES VETERANS’ BUREAU

[PUBLIhNO. 585-70TH CONGRESS]

[H. R. 13039] An Act To amendthe World Wsr Veterans’.kct, 1924 Be d m&d by the Senate and House oj Representatives oj the United States oj Aticu in Congree8 a88e~bled, That section 19 of the World War J’eterans’ Act, 1924, = amended (section 445, title 38, of the United States Code), be amended by adding the followin : “No suit shall be af owed under this section unless the same shall have been brought within six years after the right accrued for which the claim is made, or within one year from the date of the approval of this amendatory Act, whichever h the later date: Prw”ded, That for the purposes of this section it shall be deemed that the right accrued on the happening of the contingency on which the claim is founded: Provided jurther, That this limitation is suspended for the period elapsing between the filing in the bureau of the claim sued upon and the denial of said claim by the director. Infants, insane persons, or persons under other legal disability, or persons rated as incompetent or insane by the b(lreau shall have three years in which to bring suit after the removal of their disabilities. If suit is seasonably begun and fails for defect in process, or for other reasons not affecting the merits? a new action, if one lies, may be brought ~~itllin a year though the period of imitations has elapsed. Judgn]cnt,s heretofore rendered againet the person or persons claiming under the contract of war-risk ills~lra ]lce on the ground that the claim was barred by the statute of limitations shall l~ot be a bar to the institution of another suit on the same clainl. No St:itc or other statuti of limitations shall be applicable to suits filed under this section. “~llis section shall apply to all suits now pending against the IJliited Stat es u]~dcr the provisions of this section.” SEC. 2. That section 21, subdivision (2), of the World War Jreterans’ Act, 1924, as amended (section 450, title 38, of the United States Code), be hercl]y mended to read as follows: “(2) Whenever it appears that any guardian, curator, conservator, or other n is not, in the opinion of the director, properly executing the dllties of his r st or has collected or is attempting to collect fees, commissions, or allo}v:~nces @t are inequitable or are in excess of those allowed by law for the duties performed or expenses incurred or has failed to make SUCh payments as may be necessary for the benefit of tke ward or the dependents of the ward, then and in that event the director is hereby empowered by his duly authorized at torl~ey to Appear in the court which has appointed such fiduciary and make proper presentation of such matters to the court: Provided, That the director, in his discretion, may suspend payments to any such guardian, curator, co[lservator, or other person who shaU neglect or refuse, af tir reasonable notice, to rcn tier an account to the director from time to time showing the application of such payments for the benefit of such minor or incompetent beneficiary. ~~AUthority is hereby granted for the payment of an}’ Collrt Or other expenses incident to any investigation or court proceeding for” the appoint n~ent of ally guardian, curator, conservator, or other person legally ~csted wit 11 the care of the claimant or his estate or the removal of such fiduciary and a]jpoil]t Il]ent of another, and of expenses in connection with the administ r:ition of s[lch estates by such fiduciaries, when such payment is authorized by the director. ” SEC. 3. That section 28 of the World War }’eterans’ Act, as am{’n(iefl (section 453, title 38, of the United States Code), is hereby amended to read as fol]o~vs: 1($Ec. 28, There shall be no recovery of payments f roln [tny per~on) ~~1101i11 the judgment of the director, is without fault on his ]>art, and wll(’rc, in the judgment of the director, suoh recovery would defeat the purpose of benefits otherwise authorized or would be against equity and good conscience. No disbursing officer shali be held liable for any amount paid by him to any ]jerson where the recover of such amount is waived under this section. “ When under t{ e provisions Qf this section the recoverv of a p:~ynlent n~ade from the United States GovernWent life-insurance fund is waive(l, the1“nitc(i Statis Government life-insurance fund shall be reinlbursed for t lle tilllollnt involved from the current appropriation for military and naval ins(lr:lnce. ” SEC. 4. That a new section be added to Title I of tile \Vorld \l”:~r \’(~ter:~ns’ Act, ‘1924, as amended (title 38, United States Code), to be known :is scrti~)n 34 and to read as foil ows: “ SEC. 34. The director is hereby authorized to contr~ict for tllc services of translators ~vitbout regard to the provisions of the Act of August .5, 1SS2 (sec- REPORT OF UNITED STATES VETERANS’ BUREAU 117 118 REPORT OF UNITED STATES VETERANS’ BUREAU which shall be made by any State, county, or municipality, but the aggrt’gutc of the sum allowed plus such contribution or contributions shall not excee(l the actual cost of tll(’ burial. “ (2) The ];aylnellt of compensation to a l~idolv shall [’ollt inue until 1(cr fit’:it 11 or remarriage. “ (3) ‘1’ht’ ]~a)l]lent of compensation to or for a cllilfl shall continue ll]~til ~ut’h child reaches tile age’ of eighteell }-ears or nlarries, or if SU(’11rhild be perl]l:t]]c]itiy incapable of self-support by reason of nlental or physi(’fil flcfcct, then dllril]g silt’h incapacity: l’~f)?’i(lcd, That the payment of com]jensatioll shall be further (’ol,ti~]- ued after tile age of eighteen years and until com]jletion of education t)r tr:iilling (but not aft(~r sllch child reaches the age of t~vcx)ty-on(l ~ears), to any child ~t11{)is or may hereafter be pursuing a course of i]lstru(’tloll at a s(’11001,college, a(’:l{!enly, semin “y, techr]ical institute, or university, particularly designated bj IIinl nlid appro ? ed by the director, which shall have agreed to report to the d]re~tor the terminatioli of attendance of such child, al]d if any s1lc1l i]lstitution of lt~arl)il~g fails to make sil(’1~ report promptly the al~]~ro~.al shall }~e Jvithdra}vn.’” SEC. 8. g’hat section 202, subdivision ( 1), paragr:lpil (e) of the Yi’tj!”l{l ‘}!’:lr Veterans’ A~’t, 1!)24, as amended (section 475, title 3s, I’nite(l States ~’il(lr’, I)e hereby amcljdt’d to read as follows: “ (e) If li( l~:is a nlother or father, either or l)oth depentl[~]]t on him for sll])]lo~t, then, in adt!ition to the al)ove al]~oul~ts, $10 for each par(’lit so dept~n[l{’]lt: i’) tJ- vided, That t 11[’,~tat us of dependency shall be determillc(l as of the first (l:~y l)f each year, al]d the director is authorized to re(~uire the submission of s(Jch l)r{~l~f of dependen(’y as he, in his discretion, deems ]lecessar~-: l’rot~ided f~~rll~~r, That upon refusal (lr neglect of the claimant to supply sLlch proof of dependency i~l a reasonable time, tile payment of such additional con]pel]sation as hereiri l)ruti(l~’d shall be suspcllded or dlscontinlled. ” SEC. 9. That section 202, subdivision 12, of the J\-orld JYar Veter:l]]s” .Itt, 1924, as an~en(lc’d (section 486, title 3S, [-nited States Code), be herebl’ anlcrldcd to read as follo~vs: “ (12) Where the disabled person is a patient in a hospital, or where for arly other reason tllc clisabled person and his wife are not living together, or ‘,rllere the children arc not in the custody of the disabled persoli, the amount of the c~>n}- pensation may be apportioned as may be prescribed by reg(llations.” SEC. 10. That section 206 of the ~ orld JJ”ar Veterans’ Actt 1924, as anlelllied (section 495, title 38, lTnited States Code), is amended to read as follo~vs: “ SEC. 206. That no compensation shall be payable for death or disabilit)- ~illi{’h does not occur ])rior to or }vithill, one year after discharge or resignation fr(~m the service, except aS provided in section 200 of this Act, and e~eept ~vhere tilere is an oficial record of the injury during servirc or at the time of separation fr~]nl active service, or where prior to April 6, 1930, satisfactory evidence is fur]lished the bureau to estalllish that the injury was suffered or aggravated during a[tive service. }Yher(~ there is oficial record of injury durit)g service conjpcllsati(~n shall be payable in accordance with the provisions of this title, for death or disability whene~”er occurring, proximately resulting from sllch injury.” SEC. 11. Tl~at the second paragraph of section 209 of t hc l\”orld War T“eterans’ Act, 1924, as amended (section 498, title 38, United States Code), is an]ellded to read as folloivs: “ The time herein provided may be extended by the director up to .\])ril (;, 1930, for good cause shown. If at the time that any rigilt accrues to ally person under the provisions of this title such person is a minor, or is of unso(in(i n~ind or physically unable to make a claim, the time herein provided shall Ilot begin to run until s~lch disability ceases.” SEC. 12. That section 212 of the JYorld l~ar Veterans’ Act, 1924, as alnt’Il(it’(i (section 422, title 38, United States Code), be amended by adding thcr~to tllc following proviso: “ Provided f l~rt~ler, That where the widow, chilci, or children, of a ~lc(eased veteran are cnt itled to compensation by virtue of an accrued right uli(i~’r t lle W’ar Risk Insurance Act, as amended, the rates of compensation shall l~e tile same as those provided by section 201 of this Act, ” SEC. 13. That section 300 of the W’orld War Veterans’ Act, 1924, as :~nl(’n[ie~i (section 511, tit le 38, of the United States Code), be hereby amended to rca(i :ks follows : “ SEC. 300. In order to give to every commissioned ofi]cer and enliste(] n~an and to every member of the Army Nurse Corps (female) and of the Navy A“ursc Corps (fenlale) ~vhen employed in active service under the }Var Depart nlel~t or Navy Depart nlent protection for themselves and their dependents, the 1’ !Iited REPORT OF UNITED STA~S VETERANS’ BUREAU 119

States, upon application to the bureau and without medical examination, shall grant Llnited States Government life insurance (converted insurance) against the death or t{~tal pernlanent disability of ally- such person in any multiple of $500, and not less than $1,000 or more than $10,000 upon the p~yrnent of the premi~lnls as hereinafter provicied. S(lch it]surauce must be apphcd for within one hundred and twellt~ days after eldist]tlent or after elltral~(’e i]ltfl or en~ploy- mcnt ill tile active servlcc arid I)efore discharge or resigt]atioll: ~>rol’iclc’[l, ‘rhat any nlcnlbcr of the rcscr~-c forres ~r!lose :Ll~plication \Yasacreptcd at a tinle when he was i]) attclld:~llce at a nlilitary or J)aval training can~p or station, and from whom premiums ~vcre collected, and ~vho becomes or has beeonlc totally and perma]lently dismbled, or ~iies or has died, shall be cicen~ed to have n~ade valid application therefore This proviso shall not allthorizc the gral~ting of more than $10,000 insurance to any one person: l’ro~i(ie(l j{~rtl~er, ‘1’hat each officer and enlisted man of the Coast Guard who is scrvill~ on acti~’e dllty at the tilnc of the p: Lss:tgc of this aI~~cl~datory Act, or Ivl}{) s~lbsc(}~}el~t thereto enters the Coast Guard service, shall be granted ins(lraIl(c ill a(>cordanre with the terms of this section IIpOII application lvithin one hlln(lrcd an(l twenty davs of the passage of this al~lcl~(latory .lvt, or date of eulistnlellt or elltr?’ into tl~e coast Guard, whichever is tllc later date, and before retirement, discharge, or resignation. “ l-early rcne~val~le terln insural~(:e shall IJ(’ paj-:Ll~lc OIIIY to a spouse, child, grandchi~d, parent, brotilcr, sister, [lncle, auIlt, Ilcpl)elv, lliecc, br,)tller-in-law, or sister-ill-latv, or to ally or all of the[n, allcf also during total an(l permanent disability to the injured person. ‘$lVhere the beneficiary for yearly rcnetvat)le tcrn~ insurance at the tilne of designation by the insured is wlthill the pernlitted class of bclleficiarics and is the designated t)e]lcfi~jiary at the time of tl]e Iutitllrity of the insurance because of the death of tllc insured, such beneficiary shall be cieemed to be within the perluitted class even tho(lgh the stat[ls of such beneficiary shall have been changed. “‘~hc [~llited States shall l)ear the ex~~e]lses of adn~ll~istration atld the excess mortality and disal)ility cost res~lltillg fr[)m tl~c hazards of ~var. ‘l’lie prcmillm rates shall I)c tile Ilet rates based l]l)on tllc ~lnlerical~ I;x~)criellce Tal)le of Jlor- tality and il~tercst at 3% per ce!lt~lm ]~cr al~ll{Inl, ‘1’his section, as amended, shall be decll~ed tt) I)(I il] effect as of J[ine i’, 1(~24,” S1;C. 14. ‘~lla,t section 301 of the JVorld \\-ar Ycterans’ ilct, 1924, as an~cnded (section 512, title 38, ~Tnited States Code), be hereby anlendecl to read as follows: “ SJ:C. 301. Excel)t as ~)rovidcd in the second paragral~ll of this section, not later than J[l~~ 2, 1927, all tern) yearly rellc~val)le ins~lranee held by persons \vho were in the mllltary scrvicc after .ipril 6, 1917, shall IJCconverted, wltho(lt n~edical exalnination, into such form or forlns of illsllran~”e as may I)e prescribed by regulations :in(] us t}le illsllred nlaj- re(~llest, ltcgl~latio[ls shall provide for the right to convert into ordinary life, t~rcnty-paynlcnt life, cndo~vn~cnt nlatllring at age sixty -t~vo, five-year level premium terln, and into other us(lal forms of insurance, and for recon~rcrsion of any such policies to a lligller pren~iunl rate or, upon proof of good health satisfactory to the Director, to a lo~ver premiunl rate, in accordance with regulations to be issued by the director, and shall l)rescribe the time and method of ~)aynlent of the pren~i~lnls thereon, bllt paynlcnts of prenliums in advance shall not l)e rec{llircd for periods of more than one m(~nth each, and rna.y be, deducted fronl the pay or deposit of the insllred or he otherwise made at hls election: Prooicle(l, ‘rhatno reconversion shall be made to the five-year level prenlillnl form of policy. ‘[ All yearly renefvable term insurance shall cease on July 2, 1927, except when death or total permanent disability shall hat’e occurred before Jujy 2, 1927: Pro- uiie(l, ho~~~rrer,‘1’hat the director may by regulatioxl extend the tln]e for the con- tinlling of yearly rencwal)le term insllrance anti the conversion tilereof in any case }vhere on Jlllv 2, 1927, conversion of such yearly renc~~al)lc term insllran(’e is ilnpractical)le or ~mpossil)le due to the mental condition or disappearan(’e of the insured. “In case where an insured whose ytcarly. rene~val)le terlll insurance has matured by reason of total permanent disabdit~- 1s follnd and declared to l~e no longer pernlanently and totally disal)lcd, and where the insllred is rec~llired llnder reg~~- lations to renetr paylnent of prcmiulns on saicl term in}jllranec, and ~vhere this contingency is extended t)eyond the period d(lri~~g ~vhich said yearly rene}vable term insllrance (~ther~rise mllst be converted, there shall I)c given s(lch il~s~lrcd an additional pcri~)d of t~vo years from the date on ~~’l~ichhe is re(lliircd to renew paym(’ilt of l)renlilln~s in whit’h to convert said term ins(lrance as hereinbefore provided: I’~~i’i(/(’(1, ‘1’Ilat ~vhere the tin~e for conversion has been extended under the second paragraph of this section because of the mental condition or disap- 120 REPORT OF UNITED STATES VETER.\N S ‘ Dl~RE.t~7 pearance of the insured, there shall be allowed to the ins~lred an addit illnal eriod of two years from the date on which he rect)vers from his nlel~tal disa- Eility or reappears in which to convert. “ The insurance except as provided herein shall be l~:]yal~le il] two huudr(’d and forty equal monthly installments: Pro/ided, That JYII(Int 11(’amolll)t of al) in(ii- vidual monthly payment is less than $5, such amount III:I~r in th(’ (ii~cr(’tioll of the director I)c allo~ved to accumu]atc without int crest :t Ild IJC (lisburs(~d am~LI:dly. Provisions for maturity at certain ages, for Continut)u> illstalhne~~ts flurillg ~ho life of the insured or beneficiaries, or both, for cash, lt):i]~. l)aid up an(l e~t~’llci~’d values, dividends from gains and savings, and such ot llt’r ]Jrovisioxls for t hc’ ]jro- tection and advantage of and for alternative benefit> to t }lc insured an(l tllc beneficiaries as may be found to be reasonable :]nd pr:lt’i i(-:~1)lt’, ma} I)CI])rovid~’d for in the contract of insurance, or from time to tixue l)}’ r(’gulations. ,\ll c~:Llc~~lations shall be based upon the American Expcricnt’t’ ‘~;t})l(’ of hIort:tlity and interest at 3~2 per centum per annum, except that no (It’tluct ion shal 1 I)c nlfide for continuous installments during the life of the insured iIl c:isc~his tottil :~tld pt~rnl:i- nent disability continues more than two hundred an~l fort:” l]; onths. ~S{ll)j{’ct to regulations, the insured shall at all tim{’s have tht’ right to (’ll:!,llge til(” 1)(’!lt,fici:iry or beneficiaries without the consent of such bcn(~fi(’i;~rj or l)(,lleticiari(~s, IJllt only within the classes herein provided. “If no beneficiary \Je designated by the insured :~s })(’1~(’ficiary for converted insurance granted under the provisions of Article I\r of {1][’ \l’ar l{isk Il~s~lr:il~t’e Act, or Title III of this Act, either in his lifetime or }JY l~is liist }vill and t~st:~nlellt, or If the designated beneficiary does not survive th(’ itlsure(t, then tilt’rc shall I)(’ paid to the estate of the insured the present valu(’ of tll~’ relna,ining u[lpni(i monthly installments; or if the designated bencfici:~rj’ ~llryil.es the il~surc’(i :LI1(I dies before receiving all of the installments of rol~v(~rl(Jd il~suranc(’ }):ty:~lJILI:L1)(I applicable, then there shall be paid to the estate of su(’11 I)t’lleficiary the l)r(’~ellt value of the remaining unpaid monthly installments: l)rorided) That 1~()p:tY- ments shall be made to any estate which under the’ Ialvs of the residence of the insured or the beneficiary, as the case may be, Tvoul(i (Isch(’at, I)ut s:~mcI sh:~ll eScheat to t}le ~~nitcd States aI~d be credited to t]l(, lTIlit~~(~ states Goy(JrI~Ill(’llt life insurauce fund. “The bureau may make provision in the contr:~(,t for (“onvert(’(1 illsllr:kll(’[’ for optional settlements! to be selected by tile iIISlil”(’(i, ~v]l(trcby s1l(o1lillsurallt’e may be made payab}c clther in one SUIII or in inst:~llul(’llts ~or thirt:-~ix luolltlls or more. The bllrcau may also include in said cont r:~(l :1 provisiO1l allillt)rizing the beneficiary to elect to receive payment of the ills{lr;~u(’c in ill.~t:~lll]l(>l~tsfor thirty-six months or more, but only if the insured l~:i> ]lot (“;(~rcis(’fl t h(’ right of elect]on as hereinbefore provided; and cvt’n though tl](’ ill.ured l]i:Lv Il:ivt’ (’xtIr- cised his right of election the said contra{:t may autlloriztl th(~ ben(’fi;i:irv to elect h receive such insurance in installments spread over a gr(~:~ttr perio(i of ~ill]~~t l~all that selected bv the insured. This section, as an~en(l(l(i, sh:~ll be (ie~~llic(i to I)c in effect as of Ju~;e 7, 1924. ” SEC. 15. That a ncw section be added to the lYorl[l \\’:ir t’eterall?:’ .\(’t, 1{)2!, as amended (title 38, L-nited States Code), to be Iitlotvll :1~ SeCtiOll ;jlo :lll(i tO read as follows: “ SEC. 310. N“ot~vithstanding the provisions of so(’t iol]s :100 :Lu(i i301 of t 11(’ World War J7etcrwns’ Act, 1924, as amended (se(”tiol]> 511 an(i 512, titie :\S, United States Code), the l“nited States, upon :]p])li(:Ll ion to th(’ I)ur(’au, sh:il 1 grant United States Government life (cou~rertcd} illsllral~(’c agaill~t (Ie:{t h or permanent total disability in any nlultil~le of $50[) :Lrld not less than $1 ,01)(~or more than $10,000 to any person who has hert’toft~r{~ :L])])li(’(i or I)e(’11t’ligil )lc~to apply for ~“early renewable term insurance or l’rlit~>{i St:~tes C,ov[>rl~ln~’nt Iif(’ (converted) insurance: Prorided, That such person i~ ill good health au(i fllrl~isl~(~s evidence satisfactory to the director to this (Iite(*t: l’r(~rit~ed f~~r~he~.,‘1’h:it 1!(J person ma,y carry more than $10,000 of [Jnited Statt’s Government lift’ il]s[lr:~ncf~ at one time: Provided jt~rther, That no ~}erson ~vho h:I.s surrendered his 1‘l~it~’(i States Government life (converted) insurnnce for its ():Is1l ~[irrer](l~’r ~’alu(~ ~h:ll[ be entitled to apply for insurance under this scctiol~ tothe(~xtent of tht’ aluo~ll~t of the insurance so surrendered: Proz~ided f l~rther, ‘1’h:~t the provisioIls of tl~is section shall not appll” to any person Ivho did not ~crv(’ ill t he nlilit:kry or II: LV:L1 forces of the United states in the course c~fthe \frorl(i l~nr. ” SEC. 16. That a ne~v section be added to the JYt)rlci \\’:tr Veterans’ lot, 1!121, as amended (title 38, LTnited States Code), to be l;lll)~~]~ as secti(~ll 311 ~i]~(ito read as foilows: “SEc. 311. The director is hereby allthorizeci an(i (iirect(’d to il~(’lu(i(’ ill tll( United States Government life (convertcd~ i]~sura]~c(: policy, provi~ioll tvi~er~ll)y REPORT OF UNITEI) sT.\TES lrETElti\NS’ BURE.AU 121

.4n Act To amend the \Yorld \Yar.Adjusted ~om~)erlsatiorl.ict, as amexlde(i.

I{r ~i enacteti by i}~e Senate and IIotise OJ Rc]~re,serit(rti~t.vof tl~e Cnitc(i States oj .4 rr~(rit a i?? Co?/~rcss assc?tlhlcd, That subdivisions (b) and (c) of section 302 of the }I”or]d War ~ldjusted ~onlpensatioll .lct, as amended, are amended, to take eflvct as of Decenll>er :;l, 1927, to read as fo]lo~vs: “ (1)I Such application shall t)e nlmde and filed on or before .Januarl-. 2, 1930, (1) pers(~llallv by the ~~eteran, or (2) in case physical or mental ineapnclty prevents the making or filing of a personal application, then by sIlch representative of the veteran and in sllch ltlanncr as lnay t~e by regulations pres[rihert. .AIAapplica- tion madc by a person other than the representative allthorized by any sllch reglllai iol~, or not filed on or before Jarl~lary 2, 1{)130,shall IJe held }’oid. If the Vcterall (hes after tile applic:~tiol~ is Illadc and before it ix filed it may l)e filed by any p(’r~on: Pro2~iflc/1,hrr?r(’1’cr,That if the veteran died bct~!een A[ay 10, 1924, and .JI1lY 1, 192+, ~vithout n~aking the application, leaving a \vido\v surviving hinl, the applicatl(~n n~~y be ~nade by the ~~ido~v and shall I)e ~ulid ]vith the same force and ef~ect in e~’ery respect as if the application 118c1I)ecIl rnadc by the vet cra]l. ‘ L((1’) If the veterat~ dies after t l~c a])plieal ion is madc, it shall be valici if the Se(’retary of Jyar or the Secretary of the .\’avy, as Illc case nlay be, finds that it bears the bona fide sig[lature of the nppli(antl disclost~s an intention to elailn the benefits of this ,Ict on behalf of the veteran, and is tilec~ on or before .Januar-y 2, ]{}~](), ,~het}ler or not f~)e yetcrall is alive at t]le tilllc it is fil~d. If ~he ~[:teran dies a~ld payments arc nAadc to his depc[l(lents under Title \’1, and thereafter a valid application is filed ~lnder this secti{)n, t i~en if the a(ljusted service credit of the vet(~ran is more than $,50, payl~lent shall t)e n]ade in necor(lance \vith Title V, less any amounts already paid under ‘l’itIt’ 1’1. SEC. 2. Section 602 of the \Vorld \Yar ~idj~lsl cd Con~pcnsntion .Act, as alnended, is an]eIlded, to take effect as of December 31, 1{)27, to read as follok~s: ,. , hI?CT.602. (a) N’o payn]ent {Illder section [;01 shall t)(>n~a{lc to a ~vido~r if she has rell]arried before n]aking and filing application, or if at the tinle of tllc death of the veteran Ivas living apart frolll hiul t}y reason of her o~vn ~villf~d act; nor unless dependent at the tilnc of the death of the veteran or at any tin]c thereafter 122 , REPORT OF UNITED STATES VETER:\NS’ BITtiE\lT and before January 3, 1930. The widow shall be preslln]ed to have been dependent at the time of the death of the veteran UPO1] a sllo~villg of the nlaritul cohabitation. “ (b) Payment under section 601 shall be made t{) a child if (1) under eighteen years of age at the time of the death of the veteran, or (2) at any time thereafter and before January 3, 1930, incapable of self-support by reason of mclltal or physical defect. “ (c) No payment under section 601 shall be macic to a nlother or father unless dependent at the time of the death of the vetera[) or at any tin]e thereafter and before January 3, 1930. If at the time of the death of the veteran or at any time thereafter and before January 3, l\~30, the n]t)t i~er is (Illnlarried or over sixty years of age, or the father is over sixty yc’:irs of age, s{lch nlother or father, respectively, shall be presumecl to be depe Ildcl]t. ” SEC. 3. Subdivision (b) and (c) of section 60-1 of s{lch ;Ict, ns an~ended, are amended, to take effect as of December 31, 1927, to read as follo}rs: “ (b) Applications for such benefits, whether vcst~’[1 or contingent, shall be made and filed by the dependents of the veteral~ 011 or before Jal~uary 2, 1930; except that in the case of the death of the veteratl d{lri r~gt]]e six months in~n]e- diatel y precedin such date the application shall be nl:i(]e alld filed at at~~ tin~e within six mont t s after the death of the vet erall. l’aylllents un([er this title shall be made only to dependents who have made art{] fil(’d apl)licatiol) ill n(’corcl- ance with the provisions of this subdivision. “ (c) An application shall be made and filed (1) persol~ally I)y the ({cl)~’lldel]t if sixteen years of age or over, or (2) in case ~~hysic:~l or nlrl]tal i]]cap:icity or legal disability prevents the making or filing of a ]jersol~al al)l~licatio~l, t hell by such representative of the dependent and in s1lc1l n]al~ller as the Se(’r[’t ary of War and the Secretary of the Navy shall jointly }~y rcglllatioll ~)r~seril)~. .~n application made or filed by a person other thnn the rcpresel~tativc authorized by such regulation shall be held void.” SEC. 4. Title III of such Act, as amended, is amcl}fle(l, to take c[Fc(t as of May 19, 1924? by adding at the end thereof nclv se(!tiolls to r~ii(l as follotvs:” “ SEC. 311. JVhere the records of the War Departn~cl~t t)r tl~e Navy J)c’l)artllient show that an application, disclosing an intelltio]) tt~ claill~ the I)ellctits of any provision of this Act, has been filed on or before January 2, 1930, all(l the application can not be found, such application shall be ~)rcs{lllle(l, il] tllc* al)sctice of affirmative evidence to the contrary, to have been vali(i \vhcn origil~ally filed. Ill such case the Secretary of lTar or the secretary of the Xayy, as the case Jnay be, shall not be required to transmit to the Dire(ttor tile :~pl)llc:itioll (as ljr(l~itlcd in sections 303 and 605) unless a ne}v applicatit)~l is file(l, ill i~}licll c:~s(’ tllc Ilclv application shall be considered to have been filed ol~ tl~c (iate of iilil]g of tile lost ap~lication. SEC. 312. (a) If satisfactory evidence is prod~lcc(l est al )lishing the fact of the continued and unexplained absence of ally. il]divi(lual froxll his llf~nle a~ld family for a period of seven years, during whlcll p~)rit)(l 110 itltclligellcc flf his existence has been received, the death of such indivi(l[lal as of t lle ciate of t be expiration of such period shall, for the purposes of this .I(’t, IJC col]sid(’red as sufficiently proved. “ (b) If in the case of any such individual who is a ~et(r:il~ it a])])ears that his application was not made and filed prior to tllc llcgil~llillg of silcl~ sevell-year ~riod, or that altl~ou.gh entitled to receive adj~lstetl scrvic( pay lIC di~l l~ot receive It pr~or to the be~nnlng of such seven-year period, t llcl~ l~is de]~ellde[lts \vllo i]ave made and filed application before the date of t 11(’ex])irat io]l of SLICIIsc’veil-y(’ar period (if such period began before Jan~lar~ 3, 19;)0) shall I)(’ el}title{] to rc’(’cive t&l~~Iunt of his adjusted service credit in acct}rd:~llce ]vith the }~rovisit)lls of

“ (c) For the purposes of subdivision (b) of this scction- “ (1) The widow shall be considered to be del)el~(l(’llt, ]iitllin tl)c’nit’;il)i]]g of section 602, if she was dependent at the beginl~il~g t:f s{lt”ll sc~ ~~1~-year~)(’riod or at any time thereafter and before the expirat iorl of sl](’1~ ])cri{ )(i, ‘1’lic J!i(ioJ*- shall be presumed to have been dependent at the l)egil~lling ~~fs1lc}l SCVC1l-)ear period upon a showing of the marital cohabit at ion. “ (2) A child shall be considered incapable of self -sllpl)(}rt, ~~it hi]] t1)(’ nlc:tlling of section 602~ if incapable of self-s(lpport by reasol~ t~f nle]ltal or ])l]ysical (i(’it’ct at the beginmng of such seven-year period or at aIly tiIl)c tl](~r(~aft(~rmlcl I)efore the expiration of such period. “ (3) The mother or father shall be considere(l t{) l)c’ (icpend(l~t, ]vitllin the meaning of section 602, if dependent at the begillllillg of s~lcll scvel~-~”ear l)t~rit~d or at any time thereafter and before the exl)iration of s[lcI1 ~)eriocl. If :lt tile REPORT OF UNITE]) ST;ITES VETERANS’ BURE44U 123 expirfition of sllch seven-year period the mother is llnmarricd or over sixty years of age, or the father is o~cr sixty years of age, sllch mother or father, respectively, shall be presumed to be dependent. “ (d) In the case of a veteran, if it appears that he is still living, payments to dependents in res]~cct of his death shall cease, and, if he has filed a I’slid aljplica- ti~on Iln(lcr the provisions of section 30ti, any payments alreaciy made shall be dcd~lctcd from tile face val(lc of his aclj(lsted service certificate, or from the alllollnt of his adjllsted serviee credit if such credit is not more than fiSO. In tile case of a dependent, if it appears tl]at slleh dcpcn(icnt is still li~in~, pay- Inents to de]jcndents later in l)referencc under this ~lct shall cease, and, lf such dependent .1)2s filed a valid application Ilnder the provisions of seetion (;t)~l, the remainder of the payments shall be made in accordance ~vith the provisions of Title J’1. “ SI:(,. 1113. Tl)at Tvhcre anv pa~-nlent under this .Iet is to he made to a nlinor, otllcr than a person in the nl;litary or naval forces of the (Tnited States, or to a person mentally incompct ent, or under other legal disal)ility adj[ldged by a co[lrt of com]~ctent jllrisdiction, s~lch payment may l]c made to the legally con- stitllted gllardial~, cllrator, or conservator of the person entitled to payn]ent, or to the person fflllnd hy the Director to he othcrlf-ise legally Yested tvitll tile care of tile person entitled to pa~ ment or of his estate. }}rior to the reccil)t of notice by tl~e B~lreall that any s{lch person eniitied to payment is lllldcr sllch legal dlsal}ility, payment ma)- IJe made to such person direct. ” L.l,?’ c. 5. Title V of sllch .~ct, as amended, is amended by adding at the end thereof a nc~v secti~)n to read as follo~vs: “ Nl;(’. .508. Not~~ithstanding any other provision of this .Ict a veteran may, lllldt~r rcglllati{~ns l)rescril)ed by the Director, name more than (llle beneficiary, an(l ll]~y frtlln tinle to time, ~vith the a])l)roval of tile Director, change SIICIL l)ellcficlaries. If the Director is llnal~le to ascertain the beneficiary na]ncd by the veteran, l)?)n][~]lt shfill I)c ma(lc to tllc estate of tile veteran. ” Si4:~. (i. Scctlon 702 of gllcll ..~~t, as anl(,]ldc(l, is anlcnde~ to read as fO]lo~ys: “ SI?C. 702, \Trhocvcr ]inolvingly n~akcs any false or fraudulent stat(!nlent of a nlat(,rial f:i(’1 ill nny application, c(’rtificaie, or document lnade llnd(’r tho pro- ~’isions of Title III, IV, l’, TI, or VII, or of any regulation n]ade llnder any such title, ~hall, llpon conviction tht’rcof, he fined not more than $1,000, or illlprlsoned not nlore than five yenrs, or I>oth.” Sl:c’. 7. This .\ct shall l]ot invali(late an) payments I)lodc or apl)lications rcr~’ive(l, }~efore tile enactment of this .4ct, uncier the 1~’orld lYar ~~dj~lstc(l C’olll~)ens:Ltion Jlct, as amended. 1’ayniel]ts 11.llder awards heretofore or ll~rc- aftcr ]l]:]dc shall l)e n)ade to the cl(’pc]ld(’nt elltltl(~d thereto r(’gardlcss of change ill status, unless another cl(~])rndent estal)li

[ExTR.4c11 I~ROII l>L’T~I.IC LA\V No. S63, ?OTII ~ON(iI{J.;ss] [H. R. 13873] An .lut Ira’.ing appropriations to SIIPPIY deficiencies in certain appropriations for the ftsrrtl year cn(iing Jllnc 30, 19Js, anti I,rior fiscal years, to provi{le supl)lflnental appro~,riatiorrs f,)r the !istiil years en(ling .Jl]ne 30, 1928, an(i J tine 30, 1929, ancl for other pllrposes.

D:illlage rlain:s: To pay a claim for danlagcs to or loss of pri~-fite]y o~vned property adjusted and dctcrnlined l~y the ~nitcd States Veterans’ Bureau, illlder tile provisio[ls of the .A(’t e[]titled “ ,In .~ct to provide :h lilethod for the s~ltTl(’ment of claims arisi)~g against the Governn~ent of the [’nite(i States in sulli~ I)ot excccding $1,000 in a,lly ollc case, ” approved Decell~l)cLr 28, 1!)22, a,s fully set forth ill 11ouse Docun)c’nt nulnbercd 271, Seventieth (~ol~gress, S[j17.(~9. 1! ,}s}~ita! faciliti(’s and services: For carrj-ing out the provisions of the .lct Cntitli’d “ .\n ifet to authori~e an al~propriatioll to provide additional h(j~lJital, donli[ i liar:, , all(l out-patient dispen~ary facilities for persons cntitlt’d to hospi- tali,!:~tioll {Inder the Ivorld l~ar Veterans’ .4ct 1924, as amended, and for other pllrlJos( s.” fipprovcd IIay 2;3, 192S, fiscal ~-ears 192S and 1929, $7,000,000. .4pproved, hlay 29, 192S.

IA’DEX

I’age .lcljllstt’{l eollllJc,rls:~tioIl ______26 .\ci, anlt’lltlnlt,lltb to, and nlost illl]~orta]lt ]Jr{lv~sions of ______.i(’t, aIl:l(’t to aIllL~Il(i______12; ~!etiontnkeIl oIlaJ~l)lieatiollsfor, t~}J1il~c~30, 192S, Table No. 5S---- 96 ~\p])licatioI~s r(’c(~ivcrl, l)y fiscal ~’c~:lrs, ‘1’ai>]e h-o. S7-_- ______--- 96 , .i)cath elaiIlis alvar(leci on accoilntl of a(ijllste[] service certificates, ‘I’~})]e \-[ J______------___ 96 .lclnliskiol]s: ]~j” l~f’nc~fici;lry, grollps of llosl)itals, and t~’])(’ CIfllati(’lit, Ta}>le So. 15_ 49 IIy l)ratl(’}1 of st’ryiie, tyl)c of l):iti(,]~t, aIIfl t~])c of ac?nlissiol], ‘~a})le h-o. lo;______50 BJ’ llra!~{’11of servile, type of ))ati(~rlt, ali(l s~~x:ln(l rolor, Talllc No, 1S_ 51 lly tis,Ial years 1!J20-1!12S, ‘1’at]l(~ X(). n______48 ‘ 13Y tvpe of a(lnlissioll, Tal~lc No. if; ______6(; llo~~iital, :~llal.y~is ()f______8 (Tllficr a~ltl~orlt}’ of paragrallil 10, settioll 2(12, l~r(jrl(i 11’ar veterans’ art, ‘1’nl)l(’ NT(I.lo ______51 {rlltlt,r alttllority of par:lgr:il)ll lo, s~’rt-iol~ 202, 11’orl[i \\rar vctc~ransz act, a!lai~-~is of------s .-~(lvistlr}’ gr(JllJ) OTI a])pt)als. (,$CC al)])[,als.) .\lliefl vt’tt~r:]lls, ‘1’al)lt~ So. 20______5:3 .!ppeals : ;iction I)y a(lvisory grol]p 011:]]JI)(’LIIs,‘1’aljle NcJ. [;l - _ --- _ ------.Idvisorv gro[lp 011 :ippeals, pilrpos(~ of :iI)(i ]Jroce(itlre------;: (’as(’s cli51)ostI(i of l)y s(’cti{)!ls of ce]itra] I)o:lr[i of a\)pcals ant] api]eal grollps 0]1 central ofiicc c:~s(’s, ‘]’:~j)]~xT(). 6()______C(L]~tr:il l)o:lr[i of n~)l)cals, organizatiol~, i>r(lre(lllre an{] I)llrpose of ---- :: .+ppropriations: ilna]ysis of ot~ligaliol~s froln tiil, Ta})lc No. 63__ --- ______102 .\lll tlorize,l ill I’lll)lir, No. -ioo,” Seventieth CoI~grc~>- ______111 .\lltllorize(i in l>~ll~lic, No. 4S0, Se~elltiet h Congress- _ --- ______-- 113 ~~efi(’iency an(i sll~)l)l(~nlenfal, alltllorize(i in I}[lijli(’, No. 2, Sevel~tieth Congress ______111 D(’fi(iel~(”y :]llci sll~]l]lt’l~ll~llt:~l,a~ltllorized in l}~ll)lie, No, 563, Seventieth (<{JIlgrews------123 Dis!)llrbcIll~,l]ts I]lacie from all, Ta!)le No. 64------103 l+l+tilllate(i for fis(.alycar 19110------37 Forfiscaly~Jars 1928 an(i 1929 ------Vers~l& (iis})~lrsexllel~t}:, ‘~a}~le No. 62.. ------_____ - 1;6 ~~ltonlati(~ ill+llraI](’c. (,$( t Inhliran(’e.,) .%~var(ls: C’onlp(’llsatioll. (i$ee ~onlpc’nsation a~varcis.) lIlsllr:illce. (,Sre Illsllranc(> a~vards.) Be[is, oc(tllpiecl, llnocc~lpied, and availa}>le, l)y t ype, Taljle Xo. 13----- _ 48 Benefi(kinry: (lln~< of, a(inlitte(i to l]ospifnls, Tal)le No. lo ------49 Claks of, ren)aining in hospitals, Ta])le No. 20------_ - _ - __ 53 Rclationsl]ii~ of, and an~ollnt of nlonthly paynlents, in conlpensation active (disability a~vards, Tal)lc A-o. 35------77 Relatioll*hip of, to (ie(~ease[i veteran, and alno(lnt of monthly payments, in (’ornpensation a(’tive (ieath a~var(is, Tal)le No. 36----- _ 77 l~onci i nYest nlents of lJnite(i States Go~ernn~ent Iife-insllranee f~lnd, Tal)le Xo.5[j ------95 Callse of (ieat h, prinlary, of patiel~ts, fiscal years 1924 -192S, Tal~le A-o. 2S - 69 Central I)oar(l of al)peals. (,See .ip~)ealh.) 125 126

Claims: Compensation. (See Compensation claims.) Insurance. (See Insurance claims.) Clinical laborator~- classified tests: Pa80 In United States Veterans’ Bureau dispensaries, Table No. 1._. ---- 44 In United States veterans’ hospitals, Table No. 2- _ _. - ____ -- ______44 Colored patients (see:lso Sex and color) ______Q Committee onrecoverles------: -.---: ------~~ Compensable beneficiaries remalnlng in hospitals, 1 able No. 20------Compensation: Activities ______19,21,26 Adjusted. (See Adjusted compensation.) Corn nsation awards: E oath, active, by relationship of beneficiary to deceased veteran, Table No. 36-_ --7-- _-._ -_-. -_-:______77 Death, active, showing kind of clalm, number of deceased veterans, and amount of monthly payments, Table No. 37_ _ --- _ --- _ --- _ _ 77 Death, active, analysis of ------21 D~ath and disability, by fiscal years, “~ablc No. 31------72 Dlsablllty, active, analysis of--- __. -_.____ 7______-,_J______Disability, active, by beneficiary relatlonshlp, Table No” ~~ ------;; Disability, active, comparative analysis of type of major disability by .extent, Table No. 33-. _-_- ___-- _-=------73 Dlsablllty, active, showing degree of impairment and extent of disability correlated with classification of major disability, Tal)le N-O.34 74 Disability, active, terminated and disalloweci, in regional offices, Table .No..29------71 Dlsablhty, by fiscal years, Table No. Al ------______72 Disability, each month, January, 1919-July, 1927, Chart .No.. Z--___ -:------Facing D?sab?l?ty, m?nthly disbursement for ------;: Dlsablht y ratings, review of cases rated at less than 10 per cent____ - 19 Statu~ory-- _-_ T______.---_--7___.__- 19 Termlnated during fiscal year, analyze(l as to reason for termlnatlon, Table No. 32------72 Corn ensatlon clalms: L eath and disability, received by fis(’al }Tcars fronl Oct(Jbcr 1, 1917, to y~ June 30, 1928, inclusive, Table No. DO------Regiol~al activities, Table No.2~------71 Construction: Development and maintenance of bilrcall hospitals __ --- _ -- ___ --- __ 16 Hospital, facilities existing and de~clopmcnt of, llnder present :ipl]ropriations, Tal}leh-o. 65------105 Hospital, f~~tllre (see also Public Acts, No. 480 anfl 563, i~]~p~n~lls) --- 1:3 Converted insllrance. (See Insurance.) Costs at bureall hospitals, expenditures and o~)erat ing ______- _ _ _ -- ____ - 16 Death and disability compensation awards. (,See Conll)ens:ltion a~varcls.) Death and disability compensation claixns. (See Conl]lcnsation claims.) Death and disability insllrance awards. (See In~llrancc.) Death claims awarded on accollnt of adj ~lst.cd scrvicc cert ificatcs, ‘1’able No.59------96 ~e;~~scompensation awards. (ASecConll)cnsation tiwar{is.)

Analysis of__ ------:----T------11 In hospitals, by fiscal years 1924–192X, s}lo\vlng primary ca(lsc, Table No. 28------69 Decentralization of insurance activities -_ -- _------_ --- _ --- _ --- 23 Dental rehef (see also Tables Nos. 3, 4, 6, 7, 8, an(l 9)__ -- _---- _ --- _--- 17 12 Diagnostic centers, functions of, analysis of acco~lli)lisllll~(~nts _ - _ _- ___ - _ - Disability and death insurance awards. (See Insurance aw?rds.) Disability compensation awards, active. (SCCJCompensation awards.) Disability compensat~?n awards, active, showing, degree of i:npairnlent .andoextentof disablllty, Table No. 34------74 ~sablllt y compensation clalms received by fiscal years, ‘~ablc NTO.30---- 72 Disability ratings, review of cases rated less tllal~ 10 per cent_ -- _ - ___ _-- 19 —.-—— 197 AA4

Disbursen]ents: Pnm l~ron~ all appropriations dllring fiscal year. ------_ -_._ - _------35 Illcrcase ill, cl~lriIlg fiscal ~ear ------hladc from all ap~)ropriatlolls, by fiscal years, Table INO. 64_ _ _ _---- 1:! Perccn,tage, distril)lltion during fiscal year------37 }rerslls appropriations, Table No. 62------100 Discharges: By class of disease and disposition, or condition 011disposition, Table No. 25______64 By disposition and t~-l)t’ of patient, sho~ving average days hospitalized, Tal)le No. 27------6S l~rol~~:lll l]os~)it:~ls, sllo}vil~greslllt of treatnle]lt, Table No, 26______66 Gctleral n~edical slid surgical patients, analysis of_ - -_ - _ -- _- _------10 llosI)it:il, :illalysis of ------Nlleropsychiatric patie:lts, analysis of ------___ ;: Pldnlt)llary tlll}ercl]losis patients, anal}sis of ------_____ ------Disease, class of, of patients discharge(l duril]g fiscal year, Table No. 25_ - _ - i: DispcIlsarics: ~;linicnl la])oratory classified tests in, Table N-o. 1-- __ _- -_ -_ ------44 X-ray exan]il]ation in, Table No. 3------45 Dividell(is paid 01) l-llited States -OR. 20, 22, and 23------53, 54, 58 G(:ar(iial~sl}il) :~{tivitics ------40 HoI~Ic acl(lress of l)atients renlaining ~ln(]cr treatn~ent: 13y type of ]J;ttient anfi l)rancll’ of scrvi(’c, ‘~~i)le No. 22- ______----- ~ho}vil~g /Lr~:Lan(] Stat(> in Iv]li(,h p~tient is hospitalizc(l, Tal)lc .WO. 24_ :: Hollle St ate, n(in~ber of patients h(~s~)italized in, l)y fiscal years 192 S–192S, Table N"(J.2S ------5S Hospital: .ldnlissior~s. (See i\dInissio]ls. ) C~)l~struction, future. (,Sce Constrllction; sce (11:,0 l’ublic Nos. 480 and 5(;3, .Ippel]dixo) Dcv(’lo])lllcllt aIId Illailltenallce of })llreau l]ospita]s __ -.-- ______16 Dis(~l]arges. (Sc~JDischarges.) l~;xl)e]lditurcs and operating costs. (,Sec ~x])endit~lres.) Fa(”ilities- :ld(litioIial appropriations for, I’[]ljlic 480______. ---- -_ - __- 113 l;xisting and clevelopn]e~lt of, under ])resent appropriatio~ls, '~at~lc No. ti5______105 (;()vc'rllIl)eIlt ------11 130slJitalizati( )l]------______6 .Ivc’rage ~)erio(i (jf, Tallles ~os .Ztj,Z6,alJd27---_---- .-. ____ G4,G6,6S Insura]lce: ~ctiI'itics ------23 .Ipl)licatiolls for Vnited States Govcrl]nleIlt life (converted)_ - _- _ _- _ 21 .

. 128 INDEX

Insurance-Continued. Automatic— Active disability and death a\vaYds, ‘1’at)lc Xt). 42.. ______. . .._ Terminated disability and death a~varcis, shf)lvillg reason for tcr- mination, Table No. 43------...... ______._.. __ Awards— Active, disability and death, auton~ati( ir]~l~rarl~’c,Tal)l[> A“(). 42. _ S1 Active, disability and death, ter]n ills(lr:ill(’c, ‘~:~l)lc No. 40----- 79 Death and disability, United States (lov{’rlll]lcl~t term a!ld converted, by fiscal years, 1918–1928, Tal)le Xo. 39--- _.. - _.. . _ Term and automatic, analysis of. - _... ------Terminated, disability and death, :~tlt‘llll:~t ic illsllr:~ll(;(~, }ly reason for termination, Table .Yo. 4;]_ . . _. _ - _- ______- _ __ Terminated, disability and death, tcrnl il~s~lr:~l~ce,})Y rc:is{)n for @ruination, Table No.41 ______United States Government, term an(i c(~nvt’rte(l, (l[~ath and disability, by fiscal years 1918- 192S, ‘1’nl)lcI ~-f). 3{1______7S Clai~e~~~~ded, converted insurance-

By class of disabilit~’ callsil~g dc’:Ltll, ‘ra})le No. 4R. ------By plan of insurance, Tal)le NCJ.lo______Disability— By cause of disat)ility, Tat )Ic X(). !{)______87 By. plan of insurance, Tal)le X’o. 45. _. -.. ------S3 Claims received, United States G(JverI~mellt, tc’rl~l an(] [I{)llv(’rtcd, I)y fiscal years 1918-1928, Table No.3S ______7s Claims terminated— Converted insurance, disability— On account of death of insured, t)y ~Jltinof i ns~lr:~nce, Tal)le No. 46------S4 On account of death of insured, I)y class of dis:~i)ility, Table No.50 ------On account of recovery, by plnll of il]sllrance, ‘1’al~lt’ h’(~. 47-- On account of recovery, by callsc of disal)ili~y. T:~l)lc N{). 51_ Term insurance, disability and death, {’lassificatl~)n of Inajor disability and reasons for termination, Ta})lc Xo. 41- _ __ _ ------so Converted insurance claims (see also Ta})les ~“t>s. -!4, 45, -16, 47, 48, ‘>, > 49,5o,5l)------.“ Death claims awarded, converted ins[lr:~l~(’t’ – By class of disability causing death, Tal)lc’ S-(). IS. . . By plan of insllrance, Table No. 44_ ---- _ Decentralization of insurance activities ---- . . . ~ ~ ..-. ~ Disabili~y and death awards, term insllr:~l~re -– Active, classification of major (iisal)ilit~, Tal~le X(>. -10. - ..- - 79 Terminate, classification of nlajor filsal)ilit y a]l(l rcllsi)l~s for termination, Table No. 41------...... ___ . . . . so Disability claims awarded, converted i tlsur:il]tc - By cause of disability, Table No. 49__ -- _ - . - - - _ . _ _ By plan of insurance, Table No. 45. _ - _ - _ - . _ - . - .._- Disability claims terminated, con~’ertc(l illsllr:~ll(e -- On account of death of ins{lrc(i, I)y (’l:Lss {)f (!is:il~ilit~-, T:illl(’ No. 50______----- . . . . . - . On account of death of insllred, I)y pl:~l~-of i[lsur:~ll(’{’, ‘~:11)1~ No. 46------On account of recovery, by callse of (lis:~l)ilit y, ‘~~~~1~‘~(). 51 -~ ~ On account of recovery, by plan of il]sllr:~ll[’e, ‘~:~l~le N(). !7. --- Financial statement, United States Govcrl]n~t~I~t life insl~ral~cc f~lll(i, bycalendar years, Table No.55J ______...... ___...... _ Term and automatic insurance cIalnls.. --- _. -.. _. ___ _...... _ Term insurance- .4ctive disability and death a~vards, Table XC}. 40 _...... - 79 Premium income (*yearly renewable) ---- . 2t; Terminated disability and death a~vards, b‘~lt);vil~~ ;c’nsL);~ f(~; termination, Table No. 41- _ _ -- _ -.. . . _ United States Government life— Applications and policies, analysis of- -. _ . - ...... ------Bond investments of fund, Ta}]le No. 5(;_ . _ . _ _ _. ___ . _ ._. ____ Dividends paid ------INDEX

Il)sllr:lrlce –-C’(Jllti1lll(’d. l“llite(l ~tat{s Govcrl~l~)ellt life-–Co11ti1ll1((]. l~illall(’ial ~t atelllellt of f~llld, by (’alc’l~t[ar years, Taljle No. 55__ - 1~(11~(1,policy loans, Ta})lc No. h4------III forc(’ (tsc~ (~ls(~‘1’al~l(s Nos. 152all(l S3)------_____ l’lal] of policy, .lTlal~-~i*cJf-..---_---__ ------l’olici(’s sllrr(’n(ltreci for cash all(l pai(i-(lp illsllrall(e.- _ -> _ - _-- __ l’r(Jll~i{llll ill(’cJ1ll(’. . . ______{’llit(’(1 Stai~,s {ltJverlllllt’llt, terxll all(l (’ollvcrtef!-— (Xlainls r(~c(’ilecl lj~ fiscal yl’ars, 1918–1{)2s, Ta!)le No. 3s------l~eatll aI~(l (Iisal)lllty a~rar~ls, by fiscal yc’ars, 191 S- 1928, Tat)lc s(). :3!) ______Yc~arly r(Jl~t’~ral)l(’,allal}sis of. ______IJl\esl]]](~llts, IJO1l(l, of ~~llltc(l Nateh (it)verlllllt’l~t life-il~sllrall(>c full(l, 'r:ll)lc N-(). .5(;--___ -__ -__------*------Lal)oratory Iests, clitli(’al, ill (Tllite(l States Vetcralls’ I)ospitals axl(l dis- p(l~sari(~, Tables ISos. lall(i 2.______-__- _-_- __----, ______L~’gala(’tivitit’s ------Legi~lati(~]l, l~c~lv------______------Life ill+llr:ll~[e. (,SCCI])~ilr:il]~(*.) LontI~ 011acljllste(i s(~r~’it’~~((~rtifi(’att’~______hIailltellfil~(’c (~i }Jllrea~i hospitals, (1cVC101J111C’11IiiIlci___--_____---_----_- hlilitary n]l(l Ilaval col~~pellsatioll, illcrt’a~c ill (iisl)llrsc’l~lcllts ------NIol)tllly ])ayl)l(’llt: (’c}lll]>cllsatic)l~, active (Ieatil a~var(ls, ‘[’:11 )1(’sN-es. 36, all(l 37______77 C~~ltll)t>llsati(ll~,active (li~at)ility a~var(ls, Tal)lcs SOS, 33, 34, an[l 35-- 73, 741, 77 N“(\lrt~l)-J (,llint ric l)atiellth: .\(il)litt(’(1, ‘1’at)l(s SOS. 15, 16, al)(i I s ______49, 50, 51 .\llal~sis of:i(llllissiol~ s------______.~ii:ll~sis( ~f(lisc}l:lrg(’s ------. ------1: lji>cllar~c<, 'ril})lc x-(). 27______68 I{(lllaillillg, ‘1’al)les Xos. 20, 22, alici 21;. _ . _____ ------53, 54, 5S Xelylcgi,lafit)ll __ _- _ ------3 XC)lico]l~l~C’tis:il)lt> (Iisat)ili(ics, paticllts \vitli, ~ill~;l~ - ~rt;at~;l;;li: - ~-ai~ll X(). 2()------___ ------53 ASllr*iliq acti~’iti~>s, regio]ial, ‘ral)lc xo,l l ______---- 4,; Ot)jec[ ives of 111(>\’cteralls’ Bureau (lurillj< fiscal year- -- ...... _. _. . _ __ Occ~ll)at iol~al f Il{ra!)}, sllo~villg llflllrs gi~t>ll to f’acll ,Qll})j{’et, Ta)Jle No. 12-_ 47 Oflicer~’ retire[llt’[~t lJcllc'fits ______1,3,114 Opcrat ion costs allci cxl)cll(litures in ~~nii(’{i States v(terans’ l~ospiials - _ _ 16 Operations, s~irgical, l~~llllt)er ~JerforllleCl in hospitals (luring fiscal year, ‘1’al)lc’ No.2t; ------66 Orgal]i~ati(~llal n:l(l I)rt)c(’(lllrfil cllallgcs, lllajor ------1 Ortll(~pcfli(! all(i I)ros(llcti(” al~l~liallct’s-- ______18 Out-])at icl}t Illedical service (s( ~ ({Is(JTables Nos. 5, 6, 7, 8, al~d 9)_ __ --- 17 overpay lll(’Ilts. (,$(( t;ollllllittee on rt>cov(’ries. ) Paragral)ll 10, st’cti{~ll 202, ll”orlcl }Yar \-ctcralls’ act, 1~~~, a(llllishiolls all(l r(’ll~ainitlg, ‘1’al~l(’s Xos. 1? an(l Z()_ ------______El, b~ Pati(:)t+. (,sfo .-lcllllisci.(’:ise for fiscal year, Ta}Jlc hTo. 66___ _. __ -______108 Of tl~e l’l~itc’d Statcls Yctcrans’ Bureau, frol~~ 1917 to 1928, ellart _ . . - . . . . _ ._ .-- _._. ______--_-_facillg_- 4~ Pllysiotller:lp!- activitit~s, Table No. lo______46 Pollcics, tl[lit~’(1 Stat(’s G(~vc~llllellt life , sllrren{lere(l for cash al~d paici-up illsllrallce- - - -—------— —--—- .- .-— --————-—- 25 Polic\ lo:~rls, lyl;tt~(l ~~ates Goverl]n~cllt life-il~sural~cc f~ll~(i, Tal)le No. 54. 93 Prell;illlll illc(~n~e, Llllitecl States Governlllent lif(’ ills~lrallce and ytarly re],e~val)lc t{’rl~l il~s~lr:~~~cc._-_---____ ------______25,26 Prt)ceClllral al]cl orgal~izatiollal clla]lges ,~~~ajor______1 Prostilctics-- =--..71 __-+- 71------______18 Psycllot ic pat Iellts ,ac(l~l~slt lol~ofbe(isf or___ ------__ 14

I 130 INDEX

Public: Pam No.2, extract froln ------111 No. 400, extract from------_- 111 No. 480------_ 113 No. 506------114 No. 563, extract from ------___ 1Q3 No. 570------121 No. 585------_ 116 Pulmonary tuberculosis: Arrested, numberandcostof statutory awards ------19 Patients— Admitted, Tables Nos. 15,16, and lo------49,50,51 Analvsis of admissions ------8 A1lal~sis of discharges ------10 Discharges, Table No. 27------‘ Remaining, Tables Nos. 20,22, and 23------53,54,;: Rating acti~-ities, regional offices------19 Rating schedule, new) increasein value of average mo~lthly award------~() Recoveries, committee on______------27 -Rehabilitation, discharge of responsibi]iti(’s ir~ regard to------30 r ApplicaIlts registered for training______---- 33; Entered training ------___ 33 Expendit~lres for training ------:35 Objectives intraitling, per cent of trainees in each major class ------33 Re 1 at>ilitated and compacted training-_ ------:33 Types of training, per centof trainees resigned to------:;3 Wages oftrainces, pre-war and after rehabilitation ------34 Relief: Dental ------17 Out-patient (see ulso Nos. 5, 6, 7, 8, and 9)------17 OfWorld War veterans, lawsenacted for, during fiscal year ------111 Remaining patients: By branch of service) typeof patient, and home State, Table No.22. i)-4 By class of beneficiary, group of hospital, and type of patient, Table No. 20______------53 By fiscal years, showing number of patients hospitalized in their home Statebygroup of hospital and type ofpatiellt, Table No;23- 58 By sex and color, and fiscal year, Table A“o. 21------54 By State location of hospital and patient’s State of residence, Table No. 24------60 Retirement benefits. (See Officers’ retirement.) Review ofdisabilityr atingso fcasesr atedlessthan 10~~crcel~t-_--_-_-__ 19 Salaries, aggregate annual, of personnel by location, andcstinlated)of per diem and per hour employees, Table No. 66------10s Sex and color (see also Admissions): Of patients admitted to hospitals, fiscal year 1928, Table o. 18____ 51 Of patients remaining under treatment, fiscal years 1923–1! 28, Table No.21------54 Statutory awards. (See Compensation awards.) Surgical operations: Analysis of ------11 Number performed inhospitals during fiscal year, Tat>le No. 26----- 66 Term insurance. (See Insurance.) Terminated compensation awards. (See Compensation awards.) Terminated insurance awards. (See Insurance.) Treatments: In-patien$. (See Admissions, discharges, and remaining.) Medical anddental, salary and fee, Table No. 8------46 Out-patient (see also Tables Nos. 5,7, at~d 8)------17 Tuberculosis, pulmonary. (See Pulmol~ary tuberculosis.) Turnover in United States veterans’ hospitals, by hospital and fiscal years, Table No. l9------52 United States Government life insurance. (See Insurance. ) World Waradjusted compensation act, amendment to------121 World Warveterans’ act, 1924, anact to amend ------116 World War veterans, laws enacted for the relief of --- -- _--- __ ------111 x-ray examinations inhospitals and dispensaries, Tables Nos. 3and 4--- 45 0