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So I should think it would be very easy to get a man's record and confine
your dental treatment to those cases where the disability was noted at the time of entrance into the service. The law is really very narrow.
Mr. ROUTSONG. That is section 13?
Col. FORBES. A man may have had noted the absence of three or four teeth; after his service he goes to a dental examiner and the dental examiner
says it is no use to fix the teeth which were injured in the Army or during service unless the teeth he lost before he went into the Army are fixed at the same time, so he goes ahead and fixes all of the teeth, on the theory that he can not function without having all the teeth in good shape, and the bill is paid by the Government. In Chicago there were 1,269 dental cases allowed and it cost $100,490, or approximately $80 a case, in that district, and that was in one month. As I say, I think the great evil in this whole thing is in permitting the dentist who makes the examination to also be the workman.
Of course, that man will do the work and is anxious to do the work. I have myself looked into the mouths of 40 or 50'men and I have seen a complete equipment of teeth, the mouths fully rehabilitated at the expense of the Government. A man's record might only show two absent teeth, and then after the service there might be more, and the dentist who makes the examination will tell him there is no use in fixing the teeth injured in the service unless all of them are fixed, and then the dentist goes on and does all of the work. That has been done and the bill has been presented to the Government and the Government has paid it. As I say, the great evil is that one man is the examiner and the workman.
Mr. Wood. Why do you not change that system?
Col. FORBES. We are changing it and we are putting in our own dental clinics.
Col. PATTERSON. Mr. Anthony brought up the point about the teeth. The law says:
Disease or injury contracted in the service or by reason of any aggravation of a preexisting injury or disease, specifically noted at examination for entrance into or employment in the active military or naval service.
In the case of many men it was noted that there were absent teeth when they went into the service, and these same men, when they came out of the service, claimed that their mouth condition was aggravated by the service, and they could get treatment for that under section 13 of the act of August 9, 1921.
Col. FORBES. At least 1 out of every 10 is a dental case.
Col. PATTERSON. The estimate would have been nearly $6,000,000, but it was reduced to $5,000,000.
The CHAIRMAN. Who is to blame if it is costing $50 a man?
Mr. Wood. The colonel has been explaining that, and it looks as though they were doing twice as much work as the Government should be doing
Col. PATTERSON. And the director is taking steps to do away with that. We are not going to let these dental men examine a man and also do the work themselves; a man will be examined by our own men first, and they will indicate how much work shall be done,
and a scale of prices will be set for such work, so that dental surgeons who desire to do it will know how much they will get in each case.
The CHAIRMAN. But you are not saving any money.
Col. FORBES. The Sweet bill will operate until the 9th of next August.
Col. PATTERSON. They can apply for treatment until next August.
The CHAIRMAN. And all examinations must be made between now and then ?
Col. PATTERSON. Those that have not applied for relief by that time will be out of luck.
Mr. KELLEY. How many applications for dental treatment have you pending now?
Col. PATTERSON. In the bureau?
Col. PATTERSON. I should say offhand that in the bureau we are practically current now.
The CHAIRMAN. Dental treatment, of course, means disability?
Col. PATTERSON. But they have to be rated first to see whether they have a disability.
Mr. KELLEY. You are figuring on treating 115,000 during this coming year?
Col. PATTERSON. Yes, sir.
Col. PATTERSON. No; it was probably less than that last year, but this year the door has been opened wide by the Sweet bill and we are going to have many more to treat under the provisions of section 13 of that bill if they can prove that their disability is due to injury or disease in the service or to an aggravation of the preexisting injury or disease which they had when they went into the service.
Col. FORBES. If the disability is only one per cent they are entitled to treatment under the Sweet bill.
The CHAIRMAN. Let us go to the next item.
DISTRICT ORGANIZATIONS_REGIONAL AND SUBOFFICES.
Mr. ROUTSONG. District organizations, regional, and suboffices, $13,066,618.
The CHAIRMAN. How much?
The CHAIRMAN. You must have had some definite idea of the number of men you would have in the district organization and the suboffices when that estimate was made, did you not?
Mr. ROUTSONG. We set up a tentative budget.
Col. FORBES. We have also a chart of the organization, showing that?
Mr. Routsong. Yes, sir.
The CHAIRMAN. It seems to me that you could not have reached these figures unless you had some definite information upon whic! to base them?
Mr. ROUTSONG. The information which we had, of course, partial.
The CHAIRMAN. One sided ?
Mr. ROUTSONG. We had to provide for 140 suboffices which were not in existence at the time this tentative budget was set up. We had to provide for decentralizing a great many functions which were done in Washington and which can be done much more economically, that is, from the standpoint of cost, we believe, per case, than could be done in the field. We would be glad to submit this tentative budget as we worked it out. The CHAIRMAN. What does it cover?
Mr. ROUTSONG. It covers such items as salaries, equipment and supplies, including stationery, printing, binding, furniture, miscellaneous expenses, traveling, subsistence, motor vehicles, rentals, heat, light, water, telephone and telegraph, freight and transportation.
The CHAIRMAN. Section 6 of the act provides that the director shall establish a central office, not more than 14 regional offices, and suboffices, not exceeding 140. He does not have to have 140 and he does not have to have 14 regional offices, but you are contemplating in this estimate the total number?
Col. PATTERSON. Yes, sir.
The CHAIRMAN. You could not by any system of calculation have less than you are authorized to have?
Col. FORBES. We have less.
The CHAIRMAN. Why should we appropriate for more if you have less ?
Col. FORBES. It is provided that these offices shall operate until 1926.
The CHAIRMAN. But you are not getting an appropriation for 1926, you are only getting an appropriation for the rest of this fiscal year.
Let us take a suboffice-how many men have you in a suboffice? Mr. KELLEY. I thought the colonel said for less, how many?
Col. FORBES. I think about 120 have been established or provided for.
The CHAIRMAN. Have all of the regional offices been established ? Col. PATTERSON. Yes, sir.
NUMBER OF EMPLOYEES IN SUBOFFICES.
The CHAIRMAN. How many men would you have, for example, in a suboffice ?
Mr. ROUTSONG. I will furnish for the record a district and suboffice organization.
Personnel and salary chart of district office, United States Veterans' Bureau. [Based upon organization of fourth district, not including medical personnel on duty in dispensaries.]
Personnel and salary chart of district office, United States Veterans' Bureau-Continued.
Pay of commissioned officers, United States Public Health Service, does not include increase by act of May 18, 1920), commutation of quarters, heat and light, or longevity pay. All other salaries include bonus. District manager's salary included in total only.