the bill, and (2) it would treat our Nation's service-connected, disabled veterans with the kindness and consideration they deserve and give them the benefit of a continuity presumption for the future based upon an experience of 10 years of a continuity reality of the past. Some employees of the Veterans' Administration have witnessed and commented upon a considerable amount of waste and duplication in that organization. And with all the business acumen we have in the Congress of the United States and with all the devotion most of its members have to be good and faithful stewards of the people's money and property, we should be quick to seize upon every oppor tunity to run our governmental organizations with efficiency and we should always be ready to trim unnecessary employees from the public payrolls in the interest of helping our overburdened taxpayers all over America. In my opinion, this bill of mine would enable the Veterans' Administration to trim off many employees that are engaged in calling up and examining our service-connected veterans with all too much regularity and frequency. My bill is logical, sensible, considerate and reasonable. If a veteran has a "bum" knee or some persistent ankylosis in his hand that may have been his undesirable companion for 10 years, why should our Government continue to harass such a veteran with more and more physical examinations? Even an old plug horse with a 10-year disability of heaves would be universally considered to be in bad shape for life and not a dozen people in Kentucky would even give a 10 dollar bill to lead him home. Yet we notify and notify and notify again our glorious defenders of the flag that they must keep on traveling to distant VA facilities for these troublesome examinations even after 10 whole years of these routines, even after an entire decade of stabilized suffering by these veterans. Where is our humanitarianism and where is our logic and where is our consistency? My bill is simple. My bill is needed. My bill is helpful to many who carried the torch for America when its light was truly threatened with everlasting extinction. Mr. DORN. Thank you, Mr. Siler. (The following statements were submitted for the record:) STATEMENT BY HON. KATHRYN E. GRANAHAN, ON H. R. 6984, DEaling With PRESUMPTION OF SERVICE CONNECTION IN CERTAIN CASES Chairman Teague and members of the committee, this is to urge favorable consideration of my bill, H. R. 6984, which would amend part I of Veterans Regulation No. 1 (a) to provide a presumption of service connection in certain cases involving idiopathic convulsive seizures. I know of a particular case in my district involving a young man who has been suffering from this affliction since shortly after his discharge from the service. There is no prior history of such seizures. The bill which I have had prepared provides that idiopathic convulsive seizures shall be conclusively presumed to be service connected if they manifest a 10-percent degree of disability within a period after discharge of the veteran concerned of 6 months. The committee may feel a longer period would be advisable. I leave that matter to your own discretion. But I do think it is important that we take steps to cover and protect young men who serve their country and who are disabled in this fashion. It is my feeling that instead of seeking to meet this kind of situation through private bills which are usually vetoed-that a general law is necessary applicable to all in the same situation. I urge approval of this bill, knowing it would be of great service to all those affected. STATEMENT OF CONGRESSMAN JOHN M. ROBSION, JR., OF KENTUCKY ON H. R. 9710. Mr. Chairman and members of the committee, I appreciate this opportunity to appear before you and urge favorable action on H. R. 9710. This bill introduced by me proposes that the veteran burial allowance be increased to $250. The Congress in 1923 first provided an allowance of $100 to assist in the payment of burial expenses for those who served honorably in the Armed Forces of the United States. The law has been amended from time to time and the present burial allowance is $150. Since the establishment of the $150 allowance, funeral and burial expenses have materially increased and that sum is entirely inadequate to provide a decent burial for a veteran in 1958. I would also like to raise another point in support of my bill and that concerns the right of veterans to be buried in national cemeteries. Following the Civil War, a number of national cemeteries were established in various parts of the country. And, all of us are familiar with those cemteries with their beautiful trees and flowers and the row on row of headstones of uniform size marking the last resting place of thousands of men who served their country during time of war or who incurred disabilities in service in time of peace. Their beauty is a constant remainder of the gratitude we feel toward those who have done so much to protect and preserve our Nation. Unfortunately, most veterans now living will never have the opportunity to be buried in a national cemetery. Most of the cemeteries maintained by the United States such as Zachary Taylor Cemetery in my home city of Louisville, Ky.-are about full, and it is not feasible to expand them. There are now approximately 40 million veterans and their wives who have the right to be buried in national cemeteries and it is not practicable to provide sufficient space to take care of any considerable part of this number. Most of our national cemeteries are near larger cities and property values around the cemeteries have increased to the extent that it would be entirely too expensive to add the necessary additional land. And, if additional land could be acquired at the present time the new sections would also be filled in a comparatively short time. The large and growing number of veterans has made it economically impracticable to bury any considerable number of them in national cemeteries and it is my understanding that as a matter of policy the Department of the Army does not expect to establish new cemeteries or enlarge to any material extent the existing ones. If space in the national cemeteries cannot be provided for veterans who are entitled by law to such burial, I believe we should assist financially in their being buried in private cemeteries. For this reason, as well as the increase in funeral costs occuring since the time the allowance was last fixed in 1956, I am asking that an additional $100 be provided. The Congress is appropriating about $5 billion annually for veterans and their dependents and it seems to me that a small additional amount should be expended to insure that they be given a decent burial when there is no room for them in a national cemetery. STATEMENT OF E. ROSS ADAIR ON H. R. 2770 Mr. Chairman, H. R. 2770, which I introduced on January 14, 1957, is identical with H. R. 7144, which I introduced on July 1, 1955. Both were designed to accomplish the same thing-that is, to correct what I believe to be an injustice caused by a Veterans' Administration ruling. Heretofore, I made the following statement on H. R. 7144, 84th Congress, 2d session, which I insert as being explanatory of H. R. 2770: "Public Law 427, 82d Congress, provided, in effect, that veterans may be granted a statutory award for the loss of use of a creative organ. Instructions have been promulgated by the Veterans' Administration that such awards should be made only from the date on which a claim, either formal or informal, for such benefit is filed. 66 "Section 7 of Public Law 427, 82d Congress, contains the following statement: "The rates of compensation authorized by this Act shall be effective from the first day of the second calendar month following the date of approval of this Act.' 27111-58---4 "On the basis of that wording, as well as other reasons, I believe it was the intent of the Congress that an award should be payable at the time above specified and not after the filing of a claim as held by the Veterans' Administration. "The proposed bill provides that no application shall be required for the payment of statutory awards for the loss of a creative organ or a case of arrested tuberculosis which prior to August 1, 1952, have been determined by the Veterans' Administration to be service connected. "It would seem to me, Mr. Chairman, that the passage of this legislation would make clear the intent of Congress upon the point that if a case falling within the two above described categories is determined to have been service connected at the time of the passage of the original law, the effective date for statutory award shall be the date specified in the amendatory act without the requirement of a claim being filed for the new benefits." H. R. 7144 was passed by the House in 1956. Thence, it went to the Senate, where it was referred to the Finance Committee and no further action taken. CONGRESS OF THE UNITED STATES, HOUSE OF REPRESENTATIVES, Mr. Chairman and Members of the Committee: I appreciate your courtesy in scheduling H. R. 12383 for hearing, and I respectfully urge your sympathetic consideration of this meritorious measure. The bill would provide an extension of the presumptive period with respect to service connection of multiple sclerosis from 2 years to 7 years. The proposed period is based on the research and statements obtained from recognized neurologists associated with various medical schools and medical centers made by the Department of New Jersey, Disabled American Veterans. Mr. John W. Bill, the able national service officer, has compiled a great amount of evidence on the subject, some of which I previously submitted to the committee. The remainder is herewith submitted for your study. The medical testimony indicates that multiple sclerosis is an extremely variable disease and difficult to diagnose during its early stages. It is the consensus of authoritative studies that a period of 7.2 years is average between the onset of symptoms and the diagnosis of the disease. The letters from the National Multiple Sclerosis Society and from the multiple sclerosis clinic of St. Joseph Hospital, Tacoma, Wash., discuss the average period in detail. In face of the impressive medical testimony, a time limitation of 2 years, as provided in existing law, is far too restrictive. In justice to veterans who become disabled by multiple sclerosis, the period of 7 years which is accepted among the medical profession should surely be accepted for service-connected presumption. I respectfully urge your approval of H. R. 12383. Thank you. HUGH J. ADDONIZIO, NATIONAL MULTIPLE SCLEROSIS SOCIETY, Mr. JOHN BILL, Disabled American Veterans, Newark, N. J. DEAR MR. BILL: Again I have been away from the office for about 2 months and upon my return find both your letters. I agree with Dr. Berkson in that the best information which is available regarding the average time lapse between onset of multiple sclerosis and its diagnosis is contained in the paper by MacLean and Berkson which I referred to in my letter of March 14. I could only say additionally that in talking with many people who have multiple sclerosis I find that such a lapse as MacLean and Berkson describe is not only common but usual. This is not due to inadequacy of diagnostic ability on the part of the physician but due to the character and progress of the disease. The early symptoms frequently are transient and unnoticed. The time of recurrence of symptoms, usually more severe, is variable. While the alert physician may suspect multiple sclerosis early in the course of the disease, he is not able to make a definite diagnosis until the disease has progressed to the point that he is definitely justified in making the diagnosis. It would not be true to say that 7.2 years is required to make a diagnosis of multiple sclerosis. Some cases are diagnosed on the first visit to the physician because of the status of the disease process at the time of that visit together with the history of the illness which the patient can give. In the paper by MacLean and Berkson they indicate in their study of 418 cases that the average time which elapsed between the first symptom and the definitive diagnosis was 7.2 years. Some of these cases were diagnosed much sooner and some even later than 7 years. I am enclosing a copy of a description of multiple sclerosis and its course written in lay terminology which you may find interesting and helpful in understanding the course of this disease. I am very appreciative of your interest and wish you success in your effort. Sincerely yours, THOS. L. WILLMON, M. D., Medical and Scientific Director. Mr. JOHN W. BILL, National Service Officer, NATIONAL MULTIPLE SCLEROSIS SOCIETY, Newark, N. J. DEAR MR. BILL: I regret my delay in replying to your letter of February 21, a delay which was caused by my absence on a trip to the west coast on matters having to do with the society. I am very pleased that your organization is taking an active interest in the problem of determination of service-connected disability of multiple sclerosis among veterans. We have had numbers of inquiries and requests for statements as to the expected time lapse between the onset of symptoms and the definitive diagnosis. I am certain that in many cases there have been injustices effected due to the present laws dealing with service connection in this disease. As you must know, the medical literature on multiple sclerosis makes many references to the fact that the diagnosis of this disease is a difficult one and subject to delays until it has progressed to the point that the physician may be certain that he is dealing with multiple sclerosis and not one of the many other conditions which may have to be considered in the differential diagnosis. I believe the best reference which you may make is the excellent study made by MacLean, A. R., and Berkson, J. which appeared in the Journal of the American Medical Association, 1951, 146, 1367. I am sorry that I do not have a copy of this article to furnish you but I am certain that you will have no difficulty in securing it. I am, however, enclosing a copy of another paper which makes reference to this study and have marked the pertinent point beginning on the first page. In their study of 418 cases they found that an average of 7.2 years had elapsed between the onset of the symptoms and the time the actual diagnosis was made. From the histories of many multiple sclerotics which I have taken, I have found that this lapse of time is about the usual one and I have contacted a number of patients who have given me a history which indicates that the onset of symptoms has been as long as 10 to 15 years before the diagnosis was actually made. You recognize, I am sure, that the progression of the disease is a variable one. There are some cases in which the patient may be paralyzed within a matter of days or weeks but usually the onset is slow, insidious and subject to complete or partial recovery of symptoms followed by recurrences or relapses with a progression and increase of symptoms and disability over a period of years. You probably know that a bill was introduced in the House of Representatives, H. R. 1143, by the Honorable John E. Henderson to amend the present legislation to provide a presumption of service connection in cases where multiple sclerosis develops to a degree of 10 percent or more disability within 3 years after separation from military service. While this is a commendable proposal it is obvious that many cases of multiple sclerosis which develop during military service will not be covered by the proposed 3-year period. I hope that these remarks will be helpful to you and again I am appreciative of your interest. Sincerely yours, THOS. L. WILLMON, M. D. Medical and Scientific Director. MULTIPLE SCLEROSIS CLINIC, Mr. JOHN W. BILL, National Service Officer VA Regional Office, Newark, N. J. DEAR MR. BILL: We are happy to forward to you our final results of our survey relative to progress of multiple sclerosis and first symptoms. We find the results very significant and have reviewed and compared all reports which we have received with file records. Two hundred and seventy-three men are tabulated in the following: Average number of years from 1st symptoms to diagnosis_-__Average number of years from 1st symptoms to restriction (19 patients not restricted, 29 patients restricted at 1st symptoms) ----Average number of years from 1st symptoms to dependence (79 patients not dependent, 8 patients dependent at 1st symptoms) - 7.7 7.6 9.3 Average number of years from 1st symptoms to diagnosis_ 6.7 Average number of years from 1st symptoms to restriction (16 patients not 9.7 10.5 You will find these results somewhat different than our first calculation. Time and effort have proven their value and we believe that the above information gives a realistic picture. We will feel rewarded if your issue will bring benefits to the veterans who have been deprived of them. Sincerely yours, MARCH 31, 1958. GEORGE H. HESS, M. D., Medical Director. UNIVERSITY OF PENNSYLVANIA, Mr. JOHN W. BILL, National Service Officer, VA Regional Office, Newark, N. J. DEAR MR. BILL: Thank you for your letter of June 24 in which you request a statement from me concerning the time involved in the diagnosis of multiple |