Commissioner MASON. I am not speaking of taxes. I am speaking of the problem of bringing institutions up to standard.

I, for one, think they are all below standard, and think they should be brought up to standard. I do not think it is a smart thing to keep the nurses on their feet for 12 hours a day, taking care of 50 patients, when they should be taking care of three.

Mr. BATES. Will you proceed with anything further, Mr. Commissioner?

Commissioner MASON. I have nothing more to add.

Mr. BATES. This morning I asked you, Mr. Commissioner, about this utility tax. Have you had a chance to talk that over yet? Commissioner YOUNG. We are going to meet tomorrow, and we would like to be able to let you know on that.

I would like to say that this morning at the session, I think Senator Cain wanted to know a little bit more about the retirement of the police and firemen.

Mr. BATES. I inquired extensively about that myself.

Commissioner YOUNG. I sent for Dr. Reed. He is a busy man, and I wonder if you would mind having him testify next.

Mr. BATES. First of all, can you tell me what the retirement figures are, what they have increased, say, in the last 2 or 3 years, the retirement cost?

STATEMENT OF DR. JOHN A. REED, CHIEF, BOARD OF POLICE AND FIRE SURGEONS, DISTRICT OF COLUMBIA

Dr. REED. I do not have the cost, sir.

Mr. BATES. Retirement of police and firemen, what the expenditures were 2 years ago and now.

Mr. WILDING. In the fiscal years? I have that information here. For 1944, ended June 30, 1944, the amount expended for policemen's and firemen's relief, and that includes not only the payments to retired members but also costs of treating temporary injuries, and I do not have the break-down on that, but I will merely give the total amount expended for policemen's and firemen's relief as $1,532,388 in the fiscal year 1944.

Mr. BATES. Have you got 1946 there?

Mr. WILDING. Yes, sir.

Mr. BATES. That is all I want.

Mr. WILDING. Very good-1946, the actual expenditures were $1,792,190.

Mr. BATES. That is over a quarter million increase.

Most of it is for retirement pensions to retired firemen and policemen?

Mr. WILDING. Yes.

Mr. BATES. In a period of 2 years?

Mr. WILDING. However, Mr. Bates, would you not like to know for 1947 that it is $1,875,000, which has already been appropriated, and we have just had, and there is included in the first deficiency bill that is now pending before the Senate Committee on Appropriations, $560,000 additional.

Mr. BATES. $560,000?

Mr. WILDING. $560,000 on top of the $1,875,000 already appropriated, and for the 1948 budget it includes an item of $2,300,000.

Mr. BATES. $2,300,000?

Mr. WILDING. Yes, sir. I think Dr. Reed may explain it; but I can say to you, sir, that the cause for the increase, in round figures, from $1,800,000 to $2,300,000, about $400,000 of that increase has been due to the act passed by Congress February 17, 1923, known as the policémen's and firemen's equalization law, which provided that thereafter any increases in salaries given to policemen and firemen should be used as the basis for increasing the pensions of those men and all pensions. Mr. BATES. In other words, an expenditure in 1944 of $1,532,000, and an estimate for 1948 of $2,300,000?

Mr. WILDING. Right.

Mr. BATES. That is an increase of $768,000 in pensions alone in a period of 4 years.

Now, how much of that $768,000 did you say can be attributed to the 1923 act?

Mr. WILDING. I would say approximately $450,000-$425,000, to be safe.

Mr. BATES. So that we have under normal conditions an increase in the retirement pension of firemen and policemen in the period of 3. years of $300,000.

Now, will you agree with that?

Of course, I understand that Congress last year, or 2 years ago, although I opposed the bill myself, put through a bill for retired policemen and firemen, retiring them at 55 if they had served 25 years.

I think it is altogether too early to retire anybody, especially when they can get a job some place else.

Commissioner YOUNG. It also increases their pay.

Mr. BATES. Whatever the facts. The only thing I am interested in there is that it is compulsory to retire a man after 25 years. You have nothing to say about that. I do not believe that you favored the law. Can they retire a man for disability, say, after 10 years of service, Doctor?

Dr. REED. At any time after the probationary period, if it is incurred in line of duty, within the probationary year.

Mr. BATES. Now, then, what type of examination do you give?

I think that in some parts of the country there is a much-abused system, where men who perhaps have a pension from some other source, maybe the veterans' pension, and who also perhaps acquire a municipal pension, they are much better off if they can get away with the disability retirement, and they have utilized, of course, family positions to augment their claim, and that has led to a great deal of abuse in some of these other States that I am familiar with.

Now, just what type of examination do you give these men who apply for physical retirement, and what is your governing factor? Dr. REED. In the first place, Congressman, no man is retired or recommended for retirement until he has been on a sick roll for 3 months. At the end of the 3 months, the individual physician under whose care he comes, a member of the Board, submits his own personal

physical examination and the results thereof to the Board as a whole, for retirement. At that time, the individual is examined by the entire Board, a complete physical examination.

Mr. BATES. The Board consists of all doctors?

Dr. REED. Seven men, all doctors.

Mr. BATES. All doctors.

Dr. REED. The physician in charge of the individual must substantiate his reasons before the entire Board, and then the entire Board reexamines him, sitting as a Board, and he is completely stripped and is given a complete physical examination.

In the event more specific means of examination are required-Xrays and laboratory studies, and so forth-those are submitted to the Board, or requested by the Board, if the individual physician has not already had them done.

Then the Board determines whether that should be presented before what is known as the Retiring Relief Board for consideration of retirement.

Those men are given a percentage of disability rate, and we have followed the veterans' book percentage disability rates, the rate of disability as being able to do the duties as a fireman or a policeman.

Mr. BATES. Now, let us take a hypothetical question. Suppose that a man contracted a cold, presumably the claim would be that the cold was contracted while on duty. Nobody knows whether it was on duty or not. That is, if he is on duty 8 hours a day, there are 24 hours in a day. And the cold develops into pneumonia, and and then into tuberculosis. He thereby becomes completely physically unfit for either fire or police work. And what is the probationary period? Commissioner YOUNG. One year.

Mr. BATES. He has only been in the service 2 years.
What do you do in a case of that kind?

Dr. REED. He is examined by the individual physician, and usually that type of case would be sent to a sanatorium. And at the end of the 3 months the doctors either have him back to the Board for reexamination to determine whether he is improved or not, or we request the individual physician or physicians at the sanatorium to submit their report.

Mr. BATES. I mean, just asking that question, take what we call an arrested case. You would not think of putting him on police or fire duty, would you?

Dr. REED. We have maintained that once a tuberculosis case, always a tuberculosis case.

Mr. BATES. That is right.

Dr. REED. On the other hand, the percentage of disability, in accordance with the rate of the United States Veterans' Bureau, goes down with the length of time of arrest.

In other words, a 100 percent disabled person would get 100 percent retirement.

However, on pulmonary tuberculosis, any man under the age of 55 years of age is either reexamined by our Board until he reaches the age of 55, every 2 years, or he may submit a written report from his health officer, the United States public health officer, the local health

officer, or the Government physician, the United States Veterans' Bureau, if he is in the neighborhood.

Mr. BATES. Does that disability have to be determined as being occurred in line of duty or just simply occurred?

Dr. REED. It has to be determined in line of duty.

Mr. BATES. That is a pretty hard thing to do, is it not, Doctor? Dr. REED. Yes; it is very difficult, and that is a most difficult problem with us. We have really been probably on the lenient side in

this respect.

Before a man is appointed, he goes through two examinations, one by the United States civil-service physician, and, secondly, by our Board. At the time of his appointment, he not only gets a thorough physical examination and must meet very rigid requirements, but at the time of his probationary year, he is reexamined and must meet the same requirements.

Furthermore, at the time of his appointment he is X-rayed. It is very similar to the recent situation in the Army. We X-ray every

man.

Mr. BATES. Is family history considered at all?

Dr. REED. Family history is considered when we can get it.

Mr. BATES. I see.

Now, what percentage disability would you give tuberculosis patients?

Dr. REED. 100 percent in the active stage.

Mr. BATES. Now, in the arrested stage, after 6 months at the institution?

Dr. REED. There is a time element, there. After 5 years it is reduced to 50 percent.

Mr. BATES. Then he is 5 years on 100 percent?

Dr. REED. Assuming that he is given an arrested diagnosis at the end of 1 year's treatment, if he maintains that arrested diagnosis for a 5-year period, the percentage of disability is reduced to 50 percent. Mr. BATES. He is on full pay for 5 years?

Dr. REED. Full retired pay.

Mr. BATES. I see. Now, what safeguards do you draw around the community or the taxpayers in respect to a man claiming a disability incurred in line of duty who, after his retirement for physical disability, takes up with some other work that perhaps would require just as much mental or physical exertion as a fireman or a policeman? Dr. REED. The Board of Police and Fire Surgeons has no authority in that respect. We simply examine him and determine his physical condition at the time.

For instance, the man may be retired and thought to be 100-percent disabled at the time of his retirement. He is under 55 years of age. In 2 years' time, he resubmits himself, according to law, for reexamination.

We reexamine him in the same style that we did originally. Presumably it is a complete examination.

If, in the opinion of the Board of Surgeons, he is still 100-percent disabled, he is so labeled. But we have not gone into what he is

Mr. BATES. Suppose that he is 50-percent disabled?

Dr. REED. You mean he was originally 100 percent?

Mr. BATES. Yes.

Dr. REED. It is so marked in that case, and it is to be referred to the Retiring and Relief Board for further consideration.

Mr. BATES. What can they do?

Dr. REED. They can substantiate the Board's opinion. They can reduce the Board's opinion, or they can raise the Board's opinion. Mr. BATES. If he is 50-percent disabled, then you reduce his com pensation accordingly?

Dr. REED. They have authority to do it.

Mr. BATES. Have you ever known where they have done it?

Dr. REED. I do not know whether the Retiring and Relief Board has done it, but our Board of Police and Fire Surgeons has definitely reduced the benefits in certain cases.

Commissioner YOUNG. Yes, sir; they have done it.

Mr. BATES. Have you ever found a case where a man retired, say, as 100-percent disabled, later was found to be in good health? Dr. REED. One case in 18 years of my service.

Mr. BATES. What did you do with him?

Dr. REED. Put him back on duty, and he is on duty now.

Mr. BATES. Then you have the authority. Do you have regular examinations of everyone who is pensioned, up to a certain period of years?

Dr. REED. Every 2 years, sir, up to 55.

Mr. BATES. They are given rigid examinations?

Dr. REED. Yes, sir.

Mr. BATES. Why do you stop at 55, if a man has not served 25 years in the service?

Dr. REED. I think it was a law.

Commissioner YOUNG. I think it is your law.

Mr. BATES. If he has not served 25 years?

Dr. REED. I am not sure, sir. May I explain this statement? In 55 years, he will have served 25 years of service, and he is given automatic retirement.

Mr. BATES. But I am thinking of the man who is 55 and is called back for reexamination, but who has only served 20 years.

Dr. REED. He is not called back, sir, at 55. He is automatically retired at that age, according to the law or statutes.

The CHAIRMAN. Is there a maximum age beyond which you do not take them on?

Dr. REED. Yes, sir, 21 to 31. Not under 21 or over 31.

The CHAIRMAN. Then he would have served 25 years.

Dr. REED. Yes, sir.

Mr. BATES. If he did not get in there prior to the maximum age of 31?

Dr. REED. Yes, sir.

Mr. BATES. I guess that is about all, Doctor, and we are very much obliged to you.

I realize it is a pretty tough problem, but with a board of seven doctors, I think we are in pretty safe hands here.