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To emphasize the difficulty in particular for veterans with neuropsychiatric disease he added that

I think really that the most human feature of this amendment is the assistance it will render to those afflicted with nervous and mental disease in obtaining their compensation. When it is considered that the most important proof, the essential proof, to establish a claim for compensation must come from the man himself, and when it is realized that he is mentally afflicted and therefore can not, for instance, file affidavits from officers and servicemen with whom he served—since memory is usually defective and he can not remember whom his officers or comrades were—it becomes apparent how important is the change made by the bill.

(61 Cong. Rec. 4105 [daily ed. July 20, 1921], as referenced in VA, 1993a, p. 9)

At the time the legislation was enacted in 1921, there were few scientific studies to support or refute these assertions, and a flood of demands for presumptions for other disorders and for enhancement of those already approved followed soon thereafter.

By early 1923, the 2-year period from the time of discharge within which the neuropsychiatric disorder had to manifest itself was extended to 3 years despite administration objections that the extension was not supported by scientific evidence (VA, 1993a, p. 12). Later that same year veterans groups, including the Disabled American Veterans, the Veterans for Foreign Wars, and the American Legion, began calling to extend the period from 3 to 5 years. The lack of scientific evidence to justify the extension was noted by Dr. Earl Holt of the Veterans Bureau. In testimony to Congress, Dr. Holt stated that available statistics showed that neuropsychiatric disorder was just as common among the civilian population as among the military population, and that the extension of presumptions was unwarranted due to uncertainty over the causes of psychiatric disabilities arising after service (VA, 1993a, p. 14). In response to the Depression, the Economy Act of 1933 eliminated all benefits based on presumptive service connection. In its place the President was given broad authority to prescribe rules concerning eligibility for disability compensation including “the nature and extent of proofs, and presumptions” (emphasis added) for various classes of veterans (Economy Act of 1933 ch. 3 § 4, 48 Stat. at 9, as referenced in VA, 1993a, p. 17).

Following strong protests from World War I veterans, Congress subsequently moved to reenact presumptive service-connection conditions. President Roosevelt vetoed the legislation stating that he thought the Economy Act had settled the issue that a service-connected disability was a “question of fact rather than a question of law” in which each individual case would be “considered on its merits” rather than by

legislative dicta which, contrary to fact, provide that thousands of individual cases of sickness that commenced 4, 5, or 6 years after the termination of the war were caused by war services.

(VA, 1993a, p. 19)

Congress overrode the veto, and the measure was enacted into law (Independent Offices Appropriations Act. 1935. Public Law 141. 73rd Cong., 2d Sess.). The tension between those intent on being inclusive and generous in presumptive benefits to veterans and those wanting presumptions to be more firmly grounded by evidence of causation continues today.

The pertinent provisions of that 1935 Act are now found in 38 USC § 1702, “Presumption Relating to Psychosis,” and provide that eligible veterans who developed an active psychosis

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