fore, is not necessarily a disability. To be eligible under the definition a blind person must be precluded from engaging in any substantial gainful activity by reason of a physical or mental impairment which must be medically determinable and one which can be expected to be of long-continued and indefinite duration or to result in death (sec. 223 (c) (2)).

III. VETERANS' ADMINISTRATION PROGRAMS

(Citations are to sections of Public Law 56, 85th Cong., 71 Stat. 83, which consolidates all VA legislation)

A. Disability payments

There are two types of disability awards which may be paid to veterans who are blind; namely, disability compensation and disability pensions. Benefits other than retirement pay, for service-connected disability are designated as compensation. A disability pension is a regular allowance paid to a veteran for disability not resulting from active service in the Armed Forces.

1. Compensation.-Disability compensation payments are of two classes. The first is based on the degree of disability of the individual. Payments range from $17 a month for a 10-percent disability to $181 a month for a 100-percent disability (sec. 315). A veteran just within the legal definition of blindness is given a 70-percent disability rating by Veterans' Administration regulations. Blindness as defined by regulation is permanent impairment of the vision of both eyes in these terms:

Central visual acuity of 20/200 or less in the better eye, with corrective glasses, or central visual acuity of more than 20/200 if there is a field defect in which the peripheral field has contracted to such an extent that the widest diameter of visual field subtends an angular distance no greater than 20° in the better eye.

The second type of disability-compensation payment is the statutory award, which is a special rate paid for a specific disability. Disabled wartime veterans-those who as a result of service-connected disability have suffered at least blindness in 1 eye, having only light perception-are entitled to a statutory award of $47. This statutory award may be increased because of combinations of specified disabilities to a maximum of $420 a month. However, not more than $47 is payable in addition to the percentage awards previously referred to (sec. 315). The statutory awards with their higher rates are paid in lieu of the percentage awards and, as indicated by the following table, cover the most severe disabilities.

Veterans' Administration disability award payments for specific eye conditions

Veterans with a disability of 50 percent or more are entitled to certain special monthly compensation for dependents (sec. 316).

Peacetime veterans with service-connected disabilities are entitled to receive 80 percent of the wartime rates specified above (sec. 331).

2. Pensions (sec. 401 et seq.).—A veteran of World I or II or Korea who, as a result of a total and permanent non-service-connected disability, is incapacitated and unable to earn a reasonable livelihood for himself and/or his family may

be entitled to a disability pension from the VA. The rate of payment is $66.15 monthly, or $135.45 if it can be proven that the individual is so helpless as to "be in need of the regular aid and attendance of another person." The law considers an individual to be in need of regular aid and attendance if he is helpless or totally blind or nearly so. VA regulations provide that visual acuity of 5/200 or less in both eyes with correction, or concentric contraction of the visual field to 5 degrees or less, will automatically qualify a veteran for the $135.45 monthly rate without proof of the need for regular aid and attendance.

B. Hospital and domiciliary care (sec. 510 et seq.)

Blind veterans are cared for in hospitals, domiciliaries, and other medical facilities of the Veterans' Administration throughout the country. Some 30 to 40 blind veterans are presently undergoing treatment in VA hospitals for the tubel. cular; about 600 are being cared for in neuropsychiatric hospitals; and an average of 150, some of whom may recover their sight, are under treatment in general hospitals maintained by the Veterans' Administration. Blind veterans who reside in VA domiciliaries number about 350. Approximately 2,000 nonhospitalized blind veterans of World War II and Korea are eligible for outpatient service and may be accommodated in VA hospitals should their condition warrant it."

The Veterans' Administration hospital at Hines, Ill., serves as a central unit for the newly blinded patients for whom the Veterans' Administration is responsible, including members of the Armed Forces, who may receive this treatment prior to discharge. This hospital is a national center to which patients can be transferred from service hospitals and from other facilities of the VA hospital system. A number of long-term veteran patients with good possibilities for successful rehabilitation are transferred to this hospital from other centers.

The following definition of blindness, established by regulation, must be met with for admission to the rehabilitation program :

Central visual acuity of 20/200 or less in the better eye, with corrective glasses, or central visual acuity of more than 20/200 if there is a field defect in which the peripheral field has contracted to such an extent that the widest diameter of visual field subtends an angular distance no greater than 20 degrees in the better eye.

The rehabilitation program emphasizes development of self-confidence, memory training, and special training of other senses to compensate partially for the loss of sight. The major activities which constitute the blind rehabilitation program are: learning to use typewriters and special handwriting methods and to read and write Braille; intelligence, personality, interest and aptitude testing; orienta tion and mobility training to relate the individual to his surroundings and enable him to move about independently; developing manual skills through working on different materials with hand tools and power equipment; and a variety of recreational activities. Approximately 300 veterans have completed rehabilitation programs at the Hines hospital.

C. Special provisions

1. Seeing-eye dogs, mechanical-electronic equipment (sec. 514).-The Administrator of Veterans' Affairs is authorized to provide seeing-eye or guide dogs to blind veterans who are entitled to disability compensation. The Veterans' Administration will pay the expense of training the veteran in the use of the dog. The Veterans' Administration is also given authority to furnish service-disabled veterans with approved mechanical and electronic equipment which will aid them in overcoming the handicap of their blindness. Articles made available to the blind under this program include such items as Braille writers, Braille clocks, dictating machines, Braille slates, pens, radios, razors, typewriters, and watches.

2. Automobiles (sec. 701).-Service-blinded veterans of World War II and Korea can receive up to $1,600 on the purchase price of an automobile or other conveyance-jeeps, station wagons, tractors, trucks-including special appliances, provided that the permanent impairment of vision of both eyes meets the terms of the following statutory definition: "Central visual acuity of 20/200 or less in the better eye, with corrective glasses, or central visual acuity of more than 20/200 if there is a field defect in which the peripheral field has contracted to

Information obtained from the Physical Medicine and Rehabilitation Section, Department of Medicine and Surgery, Veterans' Administration.

such an extent that the widest diameter of visual field subtends an angular distance no greater than 20 degrees in the better eye."

3. Information services.-The Office of the Chief Medical Director prepares information releases on the special rehabilitation program for the blind in the VA hospital at Hines, Ill., and on general care and programs for the blind at other medical facilities operated throughout the country.

In January 1956, the Department of Veterans' Benefits published VA Panphlet 7-10, Occupations of Totally Blinded Veterans of World War II and Korea, which was prepared primarily to aid VA personnel who are helping blinded veterans to choose, prepare for, and enter suitable vocations. It lists employ ment opportunities for the blind throughout the country. Occupational fields included in the study are: professional, technical, and managerial work; cleri cal and sales work; service work; farming; mechanical work; and manual work 4. Research programs.—In 1956 about $1,000 was expended on medical research activities for the blind conducted in the facilities of the Veterans' Administration. The principal research program carried on in VA facilities at the present time is concerned with developing a reading machine for the blind for the conversion of punched tape to Braille, a project of Veterans' Administration laboratories in New York.

The prosthetic research program (sec. 215) provides grants to various insti tutions for the development and improvement of prosthetic devices. These furds are made available on a contractual basis. An annual appropriation of $1 million is authorized.

In fiscal 1956 $30,000 was granted to Haverford College for research in develop ing an electronic obstacle and curb detector small enough to be carried in a blind person's hand. Part of this allocation was not made available until fiscal 1957. Other funds granted as part of the prosthetic research program for fisal 1957 are as follows: $57,575 to Battelle Memorial Institute to develop a reading machine which will automatically convert printed materials into sounds: $8,0 to the University of Southern California for development of a reading machine : $38,000 to Haskins Laboratory for experimental work on another proposed type | of reading machine.

IV. VOCATIONAL REHABILITATION PROGRAM

(29 U. S. C., sec. 31 et seq.)

The Vocational Rehabilitation Act, as amended in 1954, applies generally te disabled persons. The law states that the part of the State vocational rehabi tation plan which relates to the blind may be administered by the State blind commission or other agency which provides assistance or services to the adul blind.

if such a separate State agency administers the vocational rehabilitation serv ices for the blind under the State plan, a separate allotment is made both to the separate State agency for the blind and to the State agency which administers the other programs for the handicapped.

Under the act, the Office of Vocational Rehabilitation, Department of Health Education, and Welfare, provides technical assistance to the State vocations' rehabilitation agencies, sets standards for State programs, and provides them financial assistance. The State agencies deal directly with the disabled people. Among the activities for the blind of the Office of Vocational Rehabilitation are those which assist the States in (1) providing complete vocational rehabili tation services to blind persons to enable them to become self-supporting and usefully employed; (2) analyzing occupations to determine which can be per formed by the blind, and demonstrating to employers the suitability of employ ing blind persons who are properly selected and adequately prepared: (3) ducting institutes and inservice training programs for personnel of State agencies serving the blind; (4) developing and providing for adequate adjust ment services for blind persons; (5) conducting studies and preparing descrip tions of occupations in which blind persons are or may be successfully employed: (6) preparing technical guides and other materials for the use of staff members of State agencies; (7) developing new training facilities for blind persons, and assisting in the expansion of existing facilities. The act as amended in 1954 establishes a three-way grant system under which the Office of Vocational Re habilitation provides to State offices for herabilitation of the disabled, including of course, the blind, basic support grants to help the States meet the cost of s ministering their basic vocational rehabilitation programs, extension and it

provement grants for their services to the disabled, and special project grants to pay part of the cost of research, demonstration, and training programs and to promote nationwide expansion of rehabilitation programs in the United States. The number of handicapped persons established in employment through the State-Federal rehabilitation program in 1956 was 66,273. About 49,000 of them were unemployed when their rehabilitation began. Eleven percent of these individuals underwent rehabilitation because of visual disabilities or blindness. Complete information on the costs of programs and services for the blind supported by the Office of Vocational Rehabilitation is not available. In response to our request for information on the total amount of funds granted to State rehabilitation agencies which was expended for services for the blind, Mr. W. Oliver Kincannon, Chief, Division of Publications and Reports, Office of Vocational Rehabilitation, wrote as follows:

"It is virtually impossible to determine such a total. Of the 52 States and territories that have vocational rehabilitation programs, 36 have separate agencies for the blind, in addition to their general rehabilitation programs. Specific grants are made to these agencies for the blind.

"In the remaining 16 agencies, services for the blind are performed as a part of their general programs, for which expenditures are made from the usual allotments they receive according to the provisions of Public Law 565. Consequently, we know of no way to determine the sums expended for services to the blind by these 16 agencies, short of an exhaustive audit in each of their accounts." Vocational rehabilitation grants for the 36 separate State commissions or agencies for the blind were as follows for 1956:

1 Includes grants to nonprofit agencies for projects developed in cooperation with State commissions or agencies for the blind.

A breakdown of 104 grants, totaling $1 million, to State rehabilitation agencies to support projects for the extension and improvement of facilities for the handicapped indicates that 18 of these projects are designed specifically to serve the blind.

95440-58- 3

Research and demonstration grants have been awarded to the following organizations for projects directly concerned with the blind: Site, Inc., Topeka, Kans. $10,600 for research to develop, through electronic and other means, practical sight substitutes for the blind; Industrial Home for the Blind. New York, $20,000 to define successful methods used in the rehabilitation of the deaf-blind, and to develop a manual which can be used nationally in setting up rehabilitation serv vices and identifying job opportunities for them; Minneapolis Society for the Blind, Minneapolis, $142,365 to establish a regional facility to provide adjust ment, training, and workshop services to blind persons from a number of States.

V. EMPLOYMENT OF THE BLIND DEPARTMENT OF LABOR

Through the United States Employment Service, the Bureau of Employment Security provides counseling and placement services for the blind as part of its program to promote maximum employment security for the entire working population.

The Bureau of Labor Statistics collects information on work injuries of all sorts, and is thus able ot provide data on blindness and visual impairment resulting from work situations. The Bureau recently completed an extensive research project for the American Foundation for the Blind.

The Office of the President's Committee on Employment of the Physically Handicapped, established within the Office of the Secretary of Labor by General Order 43 (revised), provides facilities, staff, and services to the President's Committee in accordance with the President's letters of July 11, 1949, and May 10, 1952 The President's Committee on Employment of the Physically Handicapped is a voluntary citizens committee which seeks to create a proper climate in which physically handicapped workers can find employment suited to their skills and abilities. The Chairman, appointed by the President, is Maj. Gen. Melvin J. Maas, USMCR (retired), who is himself blind.

The committee carries on promotional activities through governors' committees in all States, Terirtories, and the District of Columbia.

VI. VENDING STANDS FOR THE BLIND

It is the policy of the Federal Government to give priority to blind persons for the operation of vending stands on Federal property. The present law (29) U. S. C. 107 et seq.) specifies that preference must be given to the needy blind whenever it is feasible in leasing such concessions; and at least 50 percent of those later employed to work at the concessions must be blind persons. To estab lish eligibilty to operate a vending stand on Federal property a blind individual must be "a person having not more than 10 percent visual acuity in the better eye with correction" (20 U. S. C. 107e (b)). The Office of Vocational Rehabil itation cooperates with State agencies in expediting the establishment of vending stands on Federal and other property and in arranging for persons licensed as blind to operate them. This office is also responsible for conducting surveys of concession-stand opportunities throughout the country and for making studies of industries to provide the blind and the agencies concerned with their welfare with information as to the overall nationwide employment opportunities for the blind.

There were 1,729 blind vending stand operators in the United States as of June 30, 1955, with a net average income of approximately $2,300. By June of 1956 the number of blind vending stand operators in business had increased to 1,804, and their net average income had risen to $2,532.

VII. NATIONAL INSTITUTE OF NEUROLOGICAL DISEASES AND BLINDNESS The National Institute of Neurological Diseases and Blindness of the Public Health Service was established by law in 1950 (42 U. S. C. 289) and received its first appropriation in 1952. The Institute is authorized to conduct and sup port research projects on neurological diseases and on the causes of visual disorders and blindness. Its activities include training and instructing qualified personnel, providing research and training grants to individuals and to public and nonprofit institutions, and the continuing of various investigative and research programs carried on in the Institute's own facilities.