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AMEND THE FEDERAL EMPLOYEES'

GOVERNMEN COMPENSATION ACT

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HEARING

BEFORE THE

rnr7 SUBCOMMITTEE ON LABOR

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OF THE

COMMITTEE ON

OR AND PUBLIC WELFARE

UNITED STATES SENATE

EIGHTY-SEVENTH CONGRESS

SECOND SESSION

ON

S. 1055 and S. 1322

'TAN,

TO AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT

MAY 24, 1962

Printed for the use of the Committee on Labor and Public Welfare

U.S. GOVERNMENT PRINTING OFFICE

s?,4741 WASHINGTON : 1962
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COMMITTEE ON LABOR AND PUBLIC WELFARE

LISTER HILL,

PAT McNAMARA, Michigan

WAYNE MORSE, Oregon

RALPH YARBOROUGH, Texas

JOSEPH S. CLARK, Pennsylvania

JENNINGS RANDOLPH, West Virginia

HARRISON A. WILLIAMS, JR., New Jersey

QUENTIN N. BURDICK, North Dakota

BENJAMIN A. SMITH II, Massachusetts

CLAIBORNE PELL, Rhode Island

STEWART E. MCCLURE, Chief Clerk

JOHN S. FORSYTHE, General Counsel of Committee

Alabama, Chairman

BARRY GOLDWATER, Arizona

JACOB K. JAVITS, New York

WINSTON L. PROUTY, Vermont

JOHN G. TOWER, Texas

MAURICE J. MURPHY, JR., New Hampshire

SPECIAL SUBCOMMITTEE ON FEDERAL EMPLOYEES' COMPENSATION

QUENTIN N. BURDICK, North Dakota, Chairman

PAT McNAMARA, Michigan JACOB K. JAVITS, New York

WAYNE MORSE, Oregon MAURICE J. MURPHY, JR., New Hampshire

EDWARD D. FRIEDMAN, Counsel to Subcommittee

RAYMOND HURLEY, Associate Minority Counsel
CONTENTS

Text of— Page

S. 1055 

Report from the Department of Labor 2

Report from the Bureau of the Budget 3

S. 1322 1

Report from the Department of Labor 3

Report from the Department of Health, Education, and Welfare_ 4

CHRONOLOGICAL LIST OF WITNESSES

Magnuson, Hon. Warren G., a Senator from the State of Washington_ __ _ 5

Creer, John, appearing for Paul L. Badger, Washington, D.C., for the National Chiropractic Association 6

Bunker, James E., general counsel, National Chiropractic Association,

Webster City, Iowa 9

Anderson, Dewey, Washington, D.0 15 Thomas, Joseph F., director of organization, the United Federation of Postal Clerks 23 Martin, Tommy, president, National Rural Letter Carriers' Association, accompanied by John W. Emeigh, secretary, National Rural Letter Carriers' Association 26 Emeigh, John W., secretary, National Rural Letter Carriers' Association_ _ 27

Lake, Grady V., chairman, Legislative Committee, International Chiropractors Association 28

STATEMENTS

Anderson, Dewey, Washington, D.0 15 Badger, Paul L., attorney, Washington, D.C., prepared statement 6

Bunker, 

James E., general counsel, National Chiropractic Association,

Webster City, Iowa 9

Creer, John, appearing for Paul L. Badger, Washington, D.C., for the National Chiropractic Association 6

Emeigh, John W., secretary, National Rural Letter Carriers' Association_ 27

Lake, Grady V., chairman, Legislative Committee, International Chiropractors Association 28

Langan, James K., operations director, Government Employees Council,

AFL—CIO, prepared statement 35

Magnuson, Hon. Warren G., a Senator from the State of Washington_ _ _ _ 5

Martin, Tommy, president, National Rural Letter Carriers' Association,

accompanied by John W. Emeigh, secretary, National Rural Letter

Carriers' Association 26

Miller, Clinton R., National Health Federation, prepared statement 34

Thomas, Joseph F., director of organization, the United Federation of

Postal Clerks 23

ADDITIONAL INFORMATION

Article entitled "Chiropractors Climb—They Make Headway in Struggle

To Win Complete Acceptance," from the Wall Street Journal of October

16, 1961 36

Excerpt from an article entitled "The Case for Chiropractors," by Samuel

Grafton in McCall's magazine of October 1959 30

Letter from W. A. MacColl, M.D., chairman, Professional Services Committee, Group Health Association of America, Seattle, Wash., to Senator

Magnuson, dated June 11, 1962 40

Letter to Senator McNamara from Dr. L. H. Burdick, treasurer, Nebraska

Chiropractic Physicians Association, Inc., Falls City, Nebr., dated June

5, 1962 39
rv CONTENTS

Letters and telegrams to Senator Burdick from:

Blasingame, F. J. L., M.D., executive vice president, American Medical Association, Chicago, Ill., dated May 25, 1962, containing state- Page

ment 35

Fargo Morehead Chiropractors, Fargo, N. Dak., telegram dated May

24, 1962 39

Keating, Jerome J., vice president, National Association of Letter

Carriers 32

Ottinger, Roy A., president, North Dakota Chiropractic Association,

dated May 23, 1962 39

Palmer, David D., president, Palmer College of Chiropractic, Davenport, Iowa, dated May 23, 1962 38

Thatcher, M. W., general manager, Farmers Union Grain Terminal

Association 33

Letters to Senator Morse from:

Elliot, R. E., director, School of Chiropractic, Western States College,

Portland, Oreg., dated May 21, 1962 39

Robedeau, Richard F., president, United Federation of Post Office

Clerks 33

Ziolkoski, Stanley J., education board, Brotherhood of Locomotive

Firemen & Enginemen, State of Oregon 32

Report No. 1317, to accompany S. 178 of the 79th Congress, 2d session_ _ 8

Table 1.—Comparison between a typical medical school and a typical chiropractic school 31
AMEND THE FEDERAL EMPLOYEES' COMPENSATION

ACT

THURSDAY, MAY 24, 1962

U.S. SENATE,

SPECIAL SUBCOMMITTEE

ON FEDERAL EMPLOYEES COMPENSATION

OF THE COMMITTEE ON LABOR AND PUBLIC WELFARE,

Washington, D.C.

The subcommittee met at 10 a.m., pursuant to call, in room 4202,

New Senate Office Building, Washington, D.C., Senator Quentin N.

Burdick (chairman of the subcommittee) presiding.

Present: Senators Burdick (presiding) and Javits.

Committee staff members present: Edward D. Friedman, counsel,

Special Subcommittee on Federal Employees Compensation; Raymond Hurley and George Denison, associate minority counsel.

Senator BURDICK. The subcommittee will come to order.

This morning we are holding hearings on two bills, on S. 1055, introduced by Senator Warren Magnuson of Washington, and S. 1322 which

I introduced.

(S. 1055 and S. 1322 follow:)

[S. 1055, 87th Cong., 1st sess.]

A BILL To amend the Federal Employees' Compensation Act so as to permit injured employees entitled.

to receive medical services under such Act to utilize the services of chiropractors.

Be it enacted by the Senate and House of Representatives of the United States of

America in Congress assembled, That the first two sentences of section 9 of the

Federal Employees' Compensation Act, as amended (5 U.S.C. 759), are amended

to read as follows: "For any injury sustained by an employee while in the performance of duty, whether or not disability has arisen, the United States shall

furnish to the employee all services, appliances, and supplies prescribed or recommended by duly qualified physicians or chiropractic practitioners which, in the

opinion of the Secretary of Labor, are likely to cure or to give relief or to reduce

the degree or the period of disability or to aid in lessening the amount of the

monthly compensation. Such services, appliances and supplies shall be furnished

by or upon the order of United States medical officers and hospitals, but where

this is not practicable they shall be furnished by or upon the order of private

physicians and hospitals, or chiropractic practitioners, designated or approved

by the Secretary of Labor."

SEC. 2. Paragraph (e) of section 40 of such Act, as amended (5 U.S.C. 790), is

amended to read as follows:

"(e) The term 'medical, surgical, and hospital services and supplies' includes

services and supplies by osteopathic and chiropractic practitioners and hospitals

as licensed by State law and within the scope of their practice as defined by State

law."

[S. 1322, 87th Cong., 1st Sess.]

A BILL To amend sections 9 and 40 of the United States Employees' Compensation Act, as amended

Be it enacted by the Senate and House of Representatives of the United States of

America in Congress assembled, That the first two sentences of section 9 of the Act

1
2 AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT

entitled "An Act to provide compensation for employees of the United States

suffering injuries while in the performance of their duties, and for other purposes",

approved September 7, 1916, as amended (U.S.C., title 5, sec. 759), are amended

to read as follows: "For any injury sustained by an employee while in the performance of duty, whether or not disability has arisen, the United States shall

furnish to the employee all services, appliances, and supplies prescribed or

recommended by duly qualified physicians or chiropractic practitioners, which,

in the opinion of the Commission, are likely to cure or to give relief or to reduce

the degree or the period of disability or to aid in lessening the amount of the

monthly compensation. Such services, appliances, and supplies shall be furnished

by or upon the order of the United States medical officers and hospitals, but where

this is not practicable they shall be furnished by or upon the order of private

physicians and hospitals, or chiropractic practitioners, designated or approved

by the Commission."

SEC. 2. The sixth paragraph of section 40 of such Act, as amended (U.S.C.,

title 4, sec. 790), is amended to read as follows:

"The term 'medical, surgical, and hospital services and supplies' includes

services and supplies by osteopathic and chiropractic practitioners and hospitals

as licensed by State law and within the scope of their practice as defined by State

law."

Senator BURDICK. These bills provide amendments to the U.S.

Employees' Compensation Act which would have the effect of authorizing chiropractors to provide chiropractic services, upon request,

within the scope of their practice as permitted and defined by the law

of the States.

Under the bills the services of approved chiropractors would be

available, upon request in those cases in which the services of the

U.S. medical officers and hospitals are not available.

The Senate considered a bill somewhat similar to this during the

79th Congress, at which time it passed the bill. However, no action

was taken in the House at that time.

Without objection, at this time, we will insert into the record departmental reports from the Department of Labor and the Department of Health, Education, and Welfare, and from the Bureau of the

Budget.

(The reports follow:)

HOD. LISTER HILL,

Chairman, Committee on Labor and Public Welfare,

U.S. Senate, Washington, D.C.

DEAR SENATOR HILL: This is in further reply to your request for our views on

S. 1055 and S. 1322, bills to permit injured employees entitled to receive medical

services under the Federal Employees' Compensation Act to utilize the services

of chiropractors.

The Federal Employees' Compensation Act does not preclude the use of

chiropractic services in appropriate cases. The services of chiropractors, physiotherapists, and other specialists may be used when recommended by and administered under the direction of a U.S. medical officer, or a duly qualified physician

trained and licensed to practice medicine. Therefore, we see no need for amending

the act specifically to permit the use of such services.

For this reason, we oppose enactment of S. 1055 and S. 1322.

The Bureau of the Budget advises that there is no objection to the presentation

of this report from the standpoint of the administration's program.

Yours sincerely,

ARTHUR J. GOLDBERG,

Secretary of Labor.

U.S. DEPARTMENT OF LABOR,

OFFICE OF THE SECRETARY,

Washington, June 21, 1961.
AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT 3

EXECUTIVE OFFICE OF THE PRESIDENT,

BUREAU OF THE BUDGET,

ashington, D.C., August 11, 1961.

Hon. LISTER HILL,

Chairman Committee on Labor and Public Welfare,

U.S. Senate, TT ashington, D.C.

DEAR MR. CHAIRMAN: This is in reply to your letters of February 25 and. March 17, 1961, requesting the views of this Office on S. 1055 and S. 1322, respec- tively, which would amend sections 9 and 40 of the Federal Employees' Compensation Act to permit the use of chiropractors.

The Secretary of Health, Education, and Welfare and the Secretary of Labor

are recommending against enactment of these bills in reports being made to

your committee.

In the light of the views expressed by these departmental reports, the Bureau

of the Budget is unable to recommend enactment of these bills.

Sincerely yours,

PHILLIP S. HUGHES,

Assistant Director for Legislative Reference.

Hon. LISTER HILL,

Chairman, Committee on Labor and Public Welfare,

U.S. Senate, Washington, D.C.

DEAR SENATOR HILL: We understand that a special subcommittee of the

Senate Committee on Labor and Public Welfare has scheduled hearings on S. 1055

and S. 1322, bills to amend the Federal Employees' Compensation Act so as to

permit injured employees entitled to receive medical services under such act to

utilize the services of chiropractors. While we do not wish to offer testimony at

this time, we would like to take this opportunity to augment the comments on

these proposals set forth in our report dated June 21, 1961.

These bills would amend sections 9 and 40 of the Federal Employees' Compensation Act to grant statutory authority to chiropractic practitioners, within the

scope of their practice as defined by State law, to participate on an equality with

doctors of medicine and osteopathic physicians in the treatment of beneficiaries

under the act.

We are opposed to enactment of these bills. Treatment of Federal employees

who sustain personal injury in the course of their employment generally involves

the use of medications, surgery, or orthopedic attention. The welfare of these

injured employees and the proper medical treatment of their injuries demand that

their treatment be under the direction of the best qualified medical personnel obtainable to render this service. They must be licensed to prescribe medications

for the relief of pain, to prevent or control infection and to promote healing. This

includes the use of drugs, sedatives and antibiotics.

In general, chiropractors, where licensed to practice under State law, are restricted to the practice of their particular theory of healing by drugless methods.

Among the limitations in State laws relating to the licensing of chiropractors are

prohibitions against the practice of surgery and the administration or prescription

of drugs or medicines. In addition to such statutory limitations, they generally

do not have hospital privileges.

As stated in our previous report, the Federal Employees' Compensation Act

does not preclude the use of chiropractic services in appropriate cases. The

services of chiropractors, physiotherapists and other specialists may be used where

recommended by and carried out under the direction of a U.S. medical officer or a

duly qualified physician trained and licensed to engage in the practice of medicine.

In view of this fact, it is not necessary to amend the act to permit the use of such

services.

The Bureau of the Budget advises that there is no objection to the presentation

of this report from the standpoint of the administration's program.

Yours sincerely,

ARTHUR J. GOLDBERG,

Secretari of Labor.

U.S. DEPARTMENT OF LABOR,

OFFICE OF THE SECRETARY,

Washington, May 23, 1962.
4 AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT

DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE,

Washington, August 17, 1961.

Hon. LISTER HILL,

Chairman, Committee on Labor and Public Welfare,

U.S. Senate, Washington, D.C.

DEAR MR. CHAIRMAN: This letter is in response to your requests of May 23

and July 18, 1961, for reports on S. 1322, a bill "To amend sections 9 and 40 of

the U.S. Employees' Compensation Act, as amended" and S. 1055, a bill "To

amend the Federal Employees Compensation Act so as to permit injured employees entitled to receive medical services under such act to utilize the services of

chiropractors."

The bills would amend the first two sentences of section 9 of the Federal Employees' Compensation Act to read as follows (italic matter being new) : "For

any injury sustained by an employee while in the performance of duty, whether or

not disability has arisen, the United States shall furnish to the employee all services, appliances, and supplies prescribed or recommended by duly qualified physicians or chiropractic practitioners, which, in the opinion of the Secretary of Labor,

are likely to cure or to give relief or to reduce the degree of the period of disability or to aid in lessening the amount of the monthly compensation. Such

services, appliances, and supplies shall be furnished by or upon the order of the

U.S. medical officers and hospitals, but where this is not practicable they shall be

furnished by or upon the order of private physicians and hospitals, or chiropractic

practitioners, designated or approved by the Secretary of Labor." (S. 1322 refers

to the "Commission" instead of the Secretary. The U.S. Employees' Compensation Commission was abolished some years ago.)

The bills would also amend subparagraph (e) or section 40 of the act to read

as follows: "The term 'medical, surgical, and hospital services and supplies' includes services and supplies by osteopathic and chiropractic practitioners and

hospitals as licensed by State law and within the scope of their practice as defined

by State law."

These amendments would permit chiropractic practitioners with proper approval

to provide services under the U.S. Employees' Compensation Act, for both diagnosis and treatment of injuries sustained by Federal employees in line of duty.

The Surgeon General is authorized under section 324 of the Public Health

Service Act (42 U.S.C. 251) to provide medical, surgical, and hospital services and

supplies for persons entitled to treatment under the Federal Employees' Compensation Act and extensions thereof. The Public Health Service has consistently

taken the position—both for its own activities and otherwise—that the treatment

of injury and disease is best provided by or under the direction and supervision

of qualified physicians, and that diagnosis should be performed only by such

physicians themselves.

The National Chiropractic Association has stated that chiropractic is "A system of therapeutics based upon the theory that disease is caused by interference

with nerve function. It is based upon the premise that all systems and physiologic processes of the human body are coordinated by the nerve system; that

interference with the nerve control of these systems impairs their function and

induces dysfunction or disease by rendering the body less resistant to infection or

to other exciting causes. Its therapeutics is designed to restore normal function

of the nerve system by scientific manipulation, specific adjustment, clinical nutrition and physiotherapeutic treatment of the structures of the human body, especially those of the spinal column."

The theory of chiropractic does not take into account the scientifically established causes of disease. Its practice does not include the diagnosis of disease and

injury by criteria and methods long established by the medical profession. Its

therapeutics does not utilize the surgery, the materia medica, the radioactive

agents, the chemotherapeutic drugs, or the antibiotics which together with immunological procedures and public health methods, also foreign to the chiropractor,

have produced the present high levels of health in this country.

That there is much confusion as to the nature and alleged value of chiropractic

is seen in the several States, in which State codes, statutes, and boards of licensure

vary markedly in their definitions of chiropractic and the extent and scope of its

practice which they permit.

Within the limits of State licensure, chiropractors traditionally diagnose and

treat disease. It is the position of the Public Health Service that the diagnostic

and therapeutic care of all persons suffering from disease or injury should be

obtained by, through, and at the hands of physicians, and that any ancillary

services to the patient, including all forms of physical medicine, should be obtained

only on and by their recommendation and prescription.
AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT 5

For the reasons outlined above, we recommend against enactment of these bills.

We are advised by the Bureau of the Budget that there is no objection to the

presentation of this report from the standpoint of the administration's program.

Sincerely yours,

WILBUR J. COHEN, Assistant Secretary.

Senator BURDICK. Before calling witnesses, I would like to read a

statement made by my colleague, the Honorable Warren Magnuson,

on this legislation:

"STATEMENT OF HON. WARREN G. MAGNUSON, A SENATOR FROM

THE STATE OF WASHINGTON

"First, I want to thank you and members of the committee for

extending to me this opportunity to testify in favor of my bill, S. 1055.

This measure would amend the Federal Employees' Compensation

Act so as to permit injured employees entitled to receive medical

services under such act to utilize the services of chiropractors. I have

sponsored this proposal because I believe that in those States where

chiropractic is a licensed healing profession, the individual choice on

the part of the patient should prevail.

"The purpose of my bill is expressly to permit Federal employees

who are injured in the performance of their duties and are entitled

to receive medical service at Government expense under the Employees' Compensation Act, to utilize the services of chiropractors.

"Forty-six States, Puerto Rico, the District of Columbia, the Canal

Zone, most provinces in Canada—all have licensing laws which

recognize chiropractic as a healing profession.

"The public is utilizing services of chiropractors in ever increasing

numbers. A large and growing number of people are convinced that

the chiropractic method of treatment affords better means for the

remedy and care of certain illnesses and injuries. Also, the chiropractic profession has been carrying on continuous and successful

efforts to raise its educational requirements and professional standards.

"Many Federal employees suffering injuries utilize the services of

chiropractors. The Government is penalizing those employees injured in performance of their duty by causing them to pay for chiropractic treatment—even when such treatment hastens the employees'

return to duty and reduces the cost of the injury to the Government.

"It has been said that the Employees' Compensation Act gives the

Commission discretion to permit the services of chiropractors to be

utilized at Government expense. However, the Commission has so

administered the law that the services of the chiropractor have to be

recommended by a U.S. medical officer or a duly qualified physician.

Experience has indicated that recommendation for chiropractic treatment is rarely, if ever, made by a medical doctor.

"The Employees' Compensation Appeals Board is consistently

denying Government employees the services of chiropractors. I am

personally familiar with a case of several years ago where an employee

received treatment from a chiropractor. He went back to work

promptly. The chiropractor's bill for professional services in the

amount of $6 was turned down for payment by the Federal Government. In deciding the case, the chairman of the three-man Appeals

Board stated: 'If we can stay with the law as I understand it, I think

your remedy is with the legislature.'

84741-62 2
6 AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT

"The Appeals Board has consistently refused relief to Government

employees, claiming that their remedy is with the legislature and that

the present act denies a free choice of the healing arts.

"For the above reasons, Mr. Chairman, I have sponsored and am

supporting S. 1055. I respectfully urge your committee to act

favorably on it.

"Warren G. Magnuson, U.S. Senator."

I understand that the first witness will be John Creer, substituting

for Paul Badger, from Washington.

Mr. Creer.

STATEMENT OF JOHN CREER, APPEARING FOR PAUL L. BADGER,

WASHINGTON, D.C., FOR THE NATIONAL CHIROPRACTIC

ASSOCIATION

Mr. CREER. My name is John Creer, and I am an attorney from

Arlington, Va. I am substituting for Paul L. Badger, an attorney

practicing law in the District of Columbia. The statement reads as

follows:

PREPARED STATEMENT OF PAUL L. BADGER, ATTORNEY, WASHINGTON, D.C.,

PRESENTED BY JOHN CREER

I am particularly happy to appear before this committee because of the fact

that I am a former member of this committee's staff. As such, I am well aware

of the outstanding record, and the many forward-looking contributions which

this committee has made down through the years in the field of social legislation.

I am appearing before you today in behalf of the National Chiropractic Association. We support and urge the enactment of S. 1322, as introduced.

The National Chiropractic Association is a voluntary membership nonprofit

corporation serving the chiropractic profession throughout the United States of

America as a representative service organization. The chiropractic profession,

as you know, is a major professional health service dedicated to serving the public.

As such, it is vitally concerned with all of the implications of those provisions of

the U.S. Employees' Compensation Act which are related to the standards of

health care provided thereunder for injured and disabled Government employees.

The Burdick bill, S. 1322, proposes to amend the U.S. Employees' Compensation Act so that the services of chiropractors can be utilized in the care of injured

and disabled Government employees who desire such care. This is not the first

time legislation of this nature has been before Congress. In the 77th Congress a

bill was introduced in the House of Representatives by Congressman John H.

Tolan, of California. That bill was favorably reported by both the subcommittee

and the full Judiciary Committee of the House, which considered it. Unfortunately, action by the committee came so late in the session that no floor vote was

taken on the legislation.

In the 79th Congress, Senator Abe MurdQck of Utah introduced S. 178, which

was identical to the present bill. Hearings were held by the Committee on

Education and Labor of the Senate, under the chairmanship of Senator Fulbright,

of Arkansas. That committee favorably reported the bill by a unanimous vote.

The report was No. 1317 of the 79th Congress. The bill passed the U.S. Senate

unanimously June 14, 1946. I should like to read parts of that report and offer

some additional comments on the views taken by members of the Education and

Labor Committee.

The report points out that the purpose of this legislation is expressly to permit

Federal employees who are injured in the performance of their duties and are

entitled to receive medical service at Government expense, under the Employees'

Compensation Act, to utilize the services of chiropractors in those States, territories, and possessions of the United States where chiropractic is a licensed healing

profession. Later, in the report, it was pointed out that in the States and the

District of Columbia, and Puerto Rico chiropractic is a licensed healing profession.

It was expressly stated that this legislation permitted treatment only to the

extent and under conditions which chiropractors may practice in each State.

It gives no authority for chiropractic to invade other areas of the healing arts—
AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT 7

and I might add, here, that members of the chiropractic profession have no desire

to do so. But, what the report stresses, and I would like to further emphasize

this point, is that State authority in this matter is recognized as it has been

traditionally recognized in other related areas.

The report stresses another very pertinent point by showing that the present

interpretation of the law acts in a discriminatory fashion toward Federal employees

and licensed chiropractic practitioners.

During the hearings on the bills introduced in the 77th and 79th Congresses,

several employee groups testified that chiropractic care was desired by certain

employees whose duties are likely to incur injuries which respond to chiropractic

care. The report refers to this testimony, and the members of the committee

declared that they were impressed by the large number of people who stated

they felt chiropractic treatment resulted in quicker relief and remedy and hastened

their return to work.

I should like to add that it would seem evident that the present law is discriminatory against employees who desire chiropractic care since it denies them

a basic American right, the freedom of choice in selecting the type cf care or the

physician of their choice when these Government employees sustain an injury

while on duty.

It is now 16 years since that report was written. The statements made in it

are still true—and some of them are doubly true. The committee made favorable

comment on the manner in which the chiropractic profession was raising its

standards. I am pleased to say that the professional standards and the educational requirements of the chiropractic profession have all been raised to even

higher levels in these past 16 years.

The committee said that it was impressed by the fact that so large a number of

people sought chiropractic care. Yet, I daresay that the number of people being

served by chiropractic care today is double the number that it was when this

report was written. The committee may be interested in knowing that during

the past 5 years, hundreds of labor unions have negotiated contracts which

included health benefits providing for chiropractic care of factory workers.

Many large industries have expanded their health insurance plans to include

chiropractic care, when it was pointed out to them that this service was being

denied their employees. In short, chiropractic is becoming more and more accepted by the American public as an essential healing art. We believe that it is

time to modernize the law to end discrimination which exists. We should provide

Government employees with the full range of care and treatment to which they

are entitled when they sustain any disability while on duty. The employees

themselves want such discrimination to end and they have indicated they want

to have chiropractic treatment available when they have any type of injury which

responds more readily to chiropractic treatment.

In conclusion, Mr. Chairman, I would like to add one further comment. I was

an employee of the U.S. Senate when this bill's predecessor, S. 178, of the 79th

Congress, was unanimously approved by the Senate. I was employed by Senator

Elbert D. Thomas of Utah, who, as you know, was a member of this committee

at that time, and its chairman for many years. If anyone had told me at that

time that this same legislation would still be pending before the Congress almost

a generation later, I would not have dared to believe them. But here we are

today, and the same bill, unanimously approved by the Senate 16 years ago, is

still waiting to be approved by the Congress of the United States.

It seems to me that this fact is almost incredible. Particularly because of the

additional fact that during those intervening 16 years this committee has, as I

have already indicated, considered and approved a long list of measures which

have brought about many pioneering reforms in the field of social legislation—

which have set new standards in many areas for local governments, industry,

labor and public and private institutions to follow. Usually the Federal Government has been far in the forefront and has taken the lead in establishing standards

governing working conditions, wages, and hours of employment, pensions, retirement compensation benefits, health care, pure food and drug laws sanitation,

water pollution regulations, fair employment practices, child labor laws, safety

regulations and standards in many other areas—and industry, State and local

governments, and private and public institutions have followed the Federal

Government's leadership. But we are considering here today in this legislation

a flagrant example of how the Federal Government has lagged far behind local

governments, labor, industry, and many institutions by failing to afford its employees the right to choose the type of medical care which they prefer. It seems

to me, therefore, that Uncle Sam should rectify this situation as quickly as possible

and reassume the traditional role of leadership in this area that is rightfully his.
8 AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT

I trust, Mr. Chairman, that this committee will follow the suggestions and

guidelines laid down by two previous congressional committees and report this

legislation favorably. I respectfully request that Senate Report No. 1317 of the

79th Congress, from the Committee on Education and labor, a copy of which is

attached hereto, be incorporated in the record of the hearing at this point. Thank

you.

Senator BURDICK. Without objection, the report will be included

in the record.

(The report follows:)

[S. Rept. 1317, 79th Cong., 2d sess.]

AMENDMENT TO THE U.S. EMPLOYEES' COMPENSATION ACT

The Committee on Education and Labor, to whom was referred the bill (S. 178)

to amend section 40 of the U.S. Employees' Compensation Act, as amended,

having considered the same, report favorably thereon with amendments and

recommend that the bill, as amended, do pass.

SUMMARY AND PURPOSE OF LEGISLATION

The purpose of the legislation is expressly to permit Federal employees who

are injured in the performance of their duties and are entitled to receive medical

service at Government expense, under the Employees' Compensation Act, to

utilize the services of chiropractors in those States, territories, and possessions

of the United States where chiropractic is a licensed healing profession.

According to testimony received by your committee the Employees' Compensation Act gives the Commission discretion to permit the services of chiropractors to be utilized at Government expense, but the Commission has so administered the law that the services of the chiropractor have to be recommended

by a U.S. medical officer or a duly qualified physician, the latter term not being

interpreted by the Commission to include chiropractic practitioner. The testimony indicates that recommendation for chiropractic treatment is rarely, if ever,

made by a medical doctor.

The bill as introduced redefined the term "physician" as used in the Employees'

Compensation Act to include chiropractic practitioners. This was objected to by

the medical profession and in order to meet that objection the committee amended

the bill to leave unchanged the definition of physician, but to permit employees

to utilize the services of chiropractic practitioners.

In 43 States, the District of Columbia, Hawaii, and Alaska chiropractic is a,

licensed healing profession. The various legislative acts and administrative regulations of the States define the extent and conditions under which chiropractors

may practice. It is your committee's conclusion that it is the responsibility of the

States to determine who may practice the healing arts and that the Federal Government by limiting, in effect, the Federal employees' choice for treatment of

injuries sustained in the performance of duty to a medical doctor and an osteopath

is interfering with the State authority and is acting in a discriminatory fashion

toward Federal employees and licensed chiropractic practitioners.

Several officers of national Government employee organizations strongly urged

favorable action by your committee on this bill. According to their testimony

many Federal employees suffering injuries utilize the services of chiropractors

because they have found that the chiropractic methods of treatment of many

injuries result in quicker relief and remedy. They contended that, in effect,

therefore, the Government is penalizing them by causing them to pay for such

treatment even though such treatment hastens the employees' return to duty

and reduces the cost of the injury to the Government.

Representatives of the National Chiropractic Association testified that more

than 20 million people throughout the United States utilized the services of approximately 20,000 chiropractic practitioners. Your committee is not competent,

nor did it attempt, to investigate the professional qualifications and competency

of the chiropractic profession. Nevertheless, your committee was impressed by

the apparently large number of people who are convinced that the chiropractic

method of treatment affords better means for the remedy and care of certain

illnesses and injuries. Your committee was also impressed by the continuous

and successful effort of the chiropractic profession to raise its educational requirements and professional standards.
AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT 9

In recommending the passage of this bill the committee is only reiterating the

principle which the Senate has on many occasions affirmed, as it did most recently

in passing the hospital survey and construction bill—the sovereignty of the State

over these matters concerning which the State has traditionally exercised jurisdiction and in which it has demonstrated its competency.

Senator BURDICK. Sir, that was a very fine statement. I wonder if

you might comment on some of the opposition that I have heard to

this legislation, which takes this form: They contend that the present

law authorizes the use of chiropractors in injuries sustained by Government employees.

Mr. CREER. Could I refer that question to Mr. Bunker, please?

Mr. BUNKER. With the permission of the chairman, I would ask

that we be given the opportunity of presenting our statement now

that the question be deferred until after our statement h n

received, if there is no objection. 

•srse

Senator BURDICK. Very well, you may proceed.

/141

STATEMENT OF JAMES E. BUNKER, GENERAL COUNSEL, NA 

19 62

CHIROPRACTIC ASSOCIATION, WEBSTER CITY, t WA

Mr. BUNKER. Thank you, sir. %no0''4

Mr. Chairman, my name is James E. Bunker, general counsel o

National Chiropractic Association, and we appear today in support

of S. 1055 and S. 1322. We have previously filed a statement which

I would ask the committee to include in the record, and rather than

repeat that statement at this time, I would like to comment generally

and specifically with respect to a few items.

Senator BURDICK. Without objection, the statement will be

included in the record.

(The prepared statement follows:)

PREPARED STATEMENT OF JAMES E. BUNKER, GENERAL COUNSEL, NATIONAL

CHIROPRACTIC ASSOCIATION, WEBSTER CITY, IOWA

Mr. Chairman and gentlemen of the subcommittee my name is James E.

Bunker, Webster City, Iowa. I am general counsel of the National Chiropractic

Association, a nonprofit corporation composed of voluntary membership, representative of the chiropractic profession nationally.

You have been given the legislative history of the amendment to the Federal

Employee's Compensation Act proposed by S. 1055 and S. 1322. I will try to

point out the concern of the chiropractic profession with regard to the amendment

and offer some background information with respect to the profession itself.

Chiropractic is one of the four major healing arts professions and is so classified

officially by the Federal Government along with medicine, osteopathy and

dentistry. It differs from those three professions in that it is concerned primarily

with the relationship between structure and function in the human body and the

role of that relationship in the maintenance and restoration of health. It is

concerned especially with the relationship between the spinal column and the

nervous system and its practices are conducted without the use of drugs and

surgery. Thus, it is peculiarly appropriate and has been found most helpful in

dealing with cases of trauma such as strains, sprains and the like.

Doctors of chiropractic are licensed to practice in 47 States including the

District of Columbia and the educational requirements are high. A full 4-year

course of professional training is required which includes the so-called basic

sciences, anatomy, physiology, pathology, bacteriology and chemistry, together

with the clinical subjects of the chiropractic school. About one-half the States

or more require 1 or 2 years of college training in addition to the professional

training. Educational standards are constantly being elevated.

The effectiveness of chiropractic therapy is best evidenced by the substantial

portion of the population which seeks the services of doctors of chiropractic in

ever-increasing numbers. We all know that if these services were ineffective,
10 AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT

persons who are sick or injured would not seek them out time and again. The

profession is accepted and recognized under the workmen's compensation laws of

all but a handful of States. More than 75 percent of the 800 commercial health

insurance companies provide coverage for chiropractic care in one or more of their

policies. The recently enacted program of medical assistance for the aged (KerrMills) has been adopted in several States, 23 of which provide benefits for doctors'

services. Of these 23, at least 12 include the services of doctors of chiropractic.

Under the Federal employees health benefits plan of 1959, of the 12 employees'

organizations offering plans, 7 include the services of doctors of chiropractic.

This in itself is persuasive evidence of a demand for such care by Federal employees. The statements filed and testimony presented by representatives of

Federal employee organizations are further evidence of this demand. It becomes

quickly apparent that an employee of a private employer suffering an injury

compensable under State law has an advantage over a Federal employee suffering

a similar injury under Federal law, since the former could select chiropractic

care if he chose to do so, whereas the Federal employee would do so at his own

expense.

This brings us to the real harm and inequity which the proposed amendment

would correct. As we understand the program and its practical administration,

a Federal employee injured on the job is ordinarily entitled to select a qualified

physician to render the necessary care. If the injury is a strain, sprain, or similar

type of injury, the employee may—indeed, often does—select a doctor of chiropractic to attend the injury. Since such doctors are licensed and qualified to

treat injuries of that nature, it seems unjust to deny the employee the benefits

which would have been available to him had he selected a doctor of medicine or

osteopathy. As frequently happens, the injured employee received the chiropractic care to his total satisfaction from a doctor of his choosing and is then

burdened personally with the resulting expense. Usually an employee has

enjoyed such success with similar care in the past that he chooses chiropractic

care with full knowledge that he does so at his own expense.

Upon submitting this claim to the Bureau of Employees Compensation, he is

advised by form letter that he must pay the bill himself since the Federal law

makes no provision for chiropractic care. This letter has a dual effect: It is

unfair not only to the employee, but also to the doctor. For this doctor, licensed

and qualified to render the care involved, finds himself maligned—although unintentionally, we are sure—by an agency of the Federal Government. When our

department is called upon by one of our members to explain this inequitable

treatment, we must always advise that under present policy of the Bureau the

only solution is amendment to the Federal law. That, gentlemen, is our purpose

in supporting the amendments to the present law and in making ourselves available to you for questions you may have regarding any pertinent aspects of the

chiropractic profession.

In summary, it is our position that the Federal employees should enjoy the

same rights and privileges in compensation matters as are enjoyed by persons in

private employment. We believe that the licensing powers of the several States

provide an adequate assurance that those rendering care to these injured persons

are possessed of the necessary qualifications. The inequity under present Federal

law creates an economic barrier to the proper exercise of that traditional State

prerogative.

Mr. BUNKER. Our major concern as a health profession, the

chiropractic profession, is with the structure and function of the

human body, and I think it is important for this committee and for

the Congress to understand the role of the chiropractic practitioner

and his interest in this kind of health legislation.

Primarily, of course, this is a bill to provide relief to the Federal

employees who are now denied the services of doctors of chiropractic

under the Federal Employees' Compensation Act. The role of the

doctor of chiropractic is concerned with structure and function. I

think it would be pertinent for us to look briefly at the kinds of

injuries with which we are concerned, under this compensation law.

In statistics prepared by the Statistics Division of the Employees'

Compensation Commission, we find a table categorizing the injuries

for the year 1959, and we find 12 categories of injuries. I will recite
AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT 11

them quickly. They are amputation, bruises, contusions and abrasions, burns and scalds, concussion, cuts and lacerations, dislocations,

fracture, puncture, strains and sprains, dermatitis, tuberculosis, and

miscellaneous.

Now I think the significant thing that we ought to look at here—

because this profession is concerned with structure in the human body,

and abnormality in structure and function—the thing we ought to

look at is the "strain and sprain" category of injuries, which it is to

be noted constituted nearly 50 percent of all compensable claims

filed in that period studied.

During this time, there were some 42,600 compensable claims filed;

19,100 were strains and sprains.

The chiropractic profession is concerned further, and more specifically, with the relationship between the structure of the spinal

column and the function of the nervous system, and therefore, we

ought to look at the back, and under the category of "strains and

sprains" we find a substantial number of injuries involved. The

upper back and the lower back, with a total of some 7,000 injuries

involving that area of the anatomy.

So we see that we are not concerned here with infectious process,

we are not concerned here with the acute disability resulting from

illness, we are not concerned here with programs of immunization or

immunology—those programs are a part of the broad picture of public

health which are the concern of public health practitioners generally,

but are not particularly pertinent to an area such as we are now

discussing.

The question here has to do with traumatic injuries, and a traumatic injury which so frequently results in an abnormal structural

situation in the body, and when that kind of abnormality can be corrected and has been successfully corrected by doctors of chiropractic,

it would seem the fundamental right of the free choice of physicians

for the employee to select a doctor of chiropractic to attend to that

special sort of injury. That is a sort of specialty of the chiropractic

profession.

I might say further that under the workmen's compensation laws of

all States, all but a handful—there are three that do not provide for

chiropractic coverage under workmen's compensation. Under all

but those handful of States, chiropractic services are provided to

persons suffering compensable injuries in private employment, and

it would seem that the Federal Government ought not to be in a

position of discriminating against its employees and providing a

lesser range of benefits to Federal employees than are available to those

in private employment.

Now this question of freedom of choice is one about which there

has been come confusion. Somewhat reluctantly—because I do not

want to inject extraneous issues—but I think one of the most vigorous

spokesmen for the free choice principle is the American Medical

Association, and I would like to read the text of the AMA's position

on the question of free choice, first of all, as it was recited at a delegates'

meeting of its house of delegates in 1959, and I quote:

Lest there be any misinterpretation, we state unequivocally that the American

Medical Association firmly subscribes to freedom of choice of physician and free

competition among physicians as being prerequisities to optimal care. The

benefits of any system which provides medical care must be judged on the degree

to which it allows of or abridges such freedom of choice and such competition.
•

12 AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT

The statement that I just read was made to clarify and strengthen

the position of the AMA which is stated in June 1959.

In that one, and I quote:

The American Medical Association believes that free choice of physician is the

right of every individual, and one which he should be free to exercise as he chooses.

Each individual should be accorded the privilege to select and change his physician

at will, or to select his preferred system of medical care, and the American Medical

Association vigorously supports the right of the Individual to choose between

these alternatives.

I think that attitude is quite significant, and one which I hope the

committee will keep in mind during the course of this legislative

proposal, which may find itself attacked by certain representatives of

organized medicine, and I think the representatives of that group or

any other group should be required to maintain some consistency in

the expressions which they put forth.

We, too, as a health profession, believe in the right of the individual

to choose his own doctor. We feel that the States have set up the

qualifications of those who are practicing an art of healing, those who

hold themselves out as skilled and competent to care for sick and

injured persons. We believe that the traditional role of the States

has not come to a sorry state, which requires any intervention or any

substitute for that rule. We believe the States have adequately

exercised their police power to control the practice of the health

professions and to determine and prescribe the qualifications of those

practitioners.

They have done so in 46 of the 50 States, and I might add in the

District of Columbia and further in Puerto Rico, and in the Canadian

Provinces. We think that is quite significant. We see no need to

disturb that traditional role.

We urge this amendment, for the additional reason—and perhaps

somewhat selfishly, and I might say somewhat selfishly on my part,

because in our law department we are frequently bothered with a

question that comes from our members when they say:

I took care of a Federal employee. He came to me for a back injury. He

was entitled to compensation under the Federal law. I treated him. I submitted

my bill. It was refused, and the Federal employee received a letter from an

agency of the Federal Government indicating to him that the Federal Government would not permit by sanction this man to have my services as he could have

the services of others.

We believe that that question can only be resolved legislatively, as

Mr. Creer suggested in his statement. We believe that this is the

time and place for that correction to occur.

I think the demand for this kind of coverage by Federal employees

is quite clear. The recognition of the profession is consistently increasing. Seventy-five percent of the commercial health insurers

provide chiropractic care in one or more of their policies. The workmen's compensation departments of all but three States include

chiropractic care for practitioners who are licensed to, practice, and

more significant, I think, is the fact that under the Federal employees'

health benefits plan of 1959, of the 12 employee organization plans,

7, a majority, include chiropractic care.

There is another interesting note—and again I do not like to refer

to what might develop to be an extraneous issue—but under the

medical assistance for the aged program, Kerr-Mills, 23 States have

provided doctors' services in adopting that plan. Of the 23, 12, again
AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT 13

a majority, include the services of doctors of chiropractic. That is

consistent with the congressional intent expressed so well by Senator

Humphrey and Senator Kerr on the floor of the Senate and in

conference.

We believe those are fundamental things which require less expression than they have had. We believe they are consistent with the

modern tradition and with the traditions of the representative roles

of the Federal and State Governments in these health matters. I

thank the committee very much for hearing us, and we are prepared

to answer any questions that the committee might have.

Senator BURDICK. Thank you for the fine statement.

Now, getting back to my question, which you have partially

answered.

Mr. BUNKER. Yes, sir.

Senator BURDICK. There are those that contend that there is

authority now for an injured Federal employee to use chiropractic.

What, in your experience, has been the result where an employee has

used chiropractic?

Mr. BUNKER. I have had experience only with cases in which the

employee receiving chiropractic care has been declined the payment

of the bills resulting when that care was chiropractic.

Now, I know of no case in which the Commission has .designated

or authorized or otherwise construed the term "physician" or other

language of the present law in such a way that services of doctors of

chiropractic could be allowed. I know of none in my own experience.

Does that answer the Senator's question?

Senator BURDICK. How long have you been connected with the

association?

Mr. BUNKER. I have been with the National Chiropractic Association since the middle of 1959, sir, and I represented a State chiropractic

organization before that. My experience was the same there.

Senator BURDICK. Then as a matter of practice, chiropractors are

not included or the claims are not paid?

Mr. BUNKER. That is correct, and it seems to me to be 100 percent

true in all cases.

Senator BURDICK. In other words, a Federal employee, if he wants

to get this type of service, must pay for it out of his own pocket?

Mr. BUNKER. That is true, sir.

Senator BURDICK. Now, a part of your thesis is that since the

respective States police and regulate these professions, that there is

no reason why the Federal Government should not also?

Mr. BUNKER. We do not believe that it is the role of the Federal

Government. We do not believe that the Federal Government desires in any way or through any of its agencies to insert itself, to

interpose itself between the individual person who wants remedial

care and the practitioner and his qualifications and the State's role

in determining what those qualifications must be. We see no evidence

whatever in any expression from the Federal Government of its desire

to involve itself in such an intervention.

Senator BURDICK. I wonder if you would state for the record the

three States whose compensation laws do not allow the payment of

chiropractic services?

Mr. BUNKER. As I recall, sir, they are West Virginia, Wisconsin,

and Maine.

84741-82--3
14 AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT

There is legislation ending in the State of—pardon me. I should

correct that. There is a legislative program by the chiropractic

people in that State pending, by which they hope to have the law

amended. In the State of West Virginia, the number of practitioners

is quite small, but nonetheless, the efforts of the small group there are

consistent with the desire of the profession and the tradition which we

keep referring to, that employees everywhere should be entitled to the

services of qualified practitioners.

In the State of Wisconsin, the situation there is one with which I

am not familiar. I know there have been efforts to amend the law,

but they have been unsuccessful because of side issues which have

cropped up and shunted the attention of the legislature from the

attempted amendment to other matters.

Senator BURDICK. You said early in your testimony that chiropractic profession is permitted in all but 4 of the 50 States.

Mr. BUNKER. Yes, sir.

Senator BURDICK. Now, when you referred to the three States that

did not allow compensation claims, you also include there the four

other States, do you not?

Mr. BUNKER. Senator, I do not, for the reason that to my surprise,

quite frankly, I have found that the State of New York through its

compensation department has paid in isolated cases in my experience—the extent to which they make these payments I cannot

substantiate by any authority—but I have seen the papers authorizing

and directing payment to doctors in that State who are not licensed

to practice in that State.

The State of Mississippi carries out a program which is quite

similar. The profession in those States, oddly enough, is not, as we

say, prohibited from practicing chiropractic in the sense that the

practice is illegal in the eyes of the State authorities. It is a very

fine point, but—and, of course, I do not mean to suggest that we of

the national organization are not strongly in favor of licensing regulation; we believe regulation of the profession is essential—but nonetheless, the profession in those unlicensed States has enjoyed cooperation with the workmen's compensation departments, and bills for

services rendered by them have been paid, even though they are not

regulated or licensed.

As for Louisiana and Massachusetts, I have no knowledge that

the situation there is similar.

Senator BURDICK. Would you describe for me the insurance arrangements which are available to chiropractors with respect to

liability: in malpractice cases? Could you develop for us the nature

of the insurers who handle this type of insurance, their rates as well

as their experience?

Mr. BUNKER. Well, sir, I am only generally familiar with the

availability of that coverage from commercial insurance companies.

I might say that there are some 50 or 55 insurance companies or

agents through whom a malpractice liability coverage can be obtained, and I might say further that in 1946 the members of our

organization formed a bona fide insurance company under the State

laws of Iowa, and they issue a malpractice liability policy to members

of the organization.
AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT 15

Interestingly enough, a policy purchased by a doctor of chiropractic from an insurance company for malpractice purposes carries

the same rate as does that purchased by a general practitioner of

medicine. The surgeon, of course, involves a higher risk, and therefore, the premiums are usually treble the basic premiums for limited

coverage. The policies issued by commercial companies for chiropractors and doctors of medicine or osteopathy in general practice

run about $106 to $108 or $110.

That same coverage which is available through the profession's

mutual insurance company can be purchased for $40, and that $40

premium rate has been in force from the time the company was formed

until the present day. The experience at the company, from my own

personal knowledge and familiarity with its practices and its experience, has been excellent. It has enjoyed perhaps one of the lowest

loss ratios of any casualty company, and particularly in the malpractice field, and I might say that coverage available to practitioners

of the healing arts generally cannot be purchased in minimum limits

of coverage, in many States, for less than $225 to $250, and that is

true for all practitioners.

The surgeon, of course, is involved in a higher degree of risk, and

I think that is a characteristic of the profession. It is rather selflimiting in the extent to which it is likely to produce harm, because it

deals with structure and function. It is not likely to remove the

wrong arm or the wrong leg, or the wrong eye, or the wrong ear, as

has been the experience of companies dealing with other professions

who are engaged in more hazardous proceeding. I think that might

be the reason for the differences in this kind of coverage.

Our claims have been quite modest in size, I would say.

Senator BURDICK. Well, thank you very much. I think you have

covered my questions very adequately.

Mr. BUNKER. Thank you, Mr. Chairman.

Senator BURDICK. Our next witness is Mr. Dewey Anderson..

STATEMENT OF DEWEY ANDERSON, WASHINGTON, Dve,

Mr. ANDERSON. Mr. Chairman, I have a prepared statement that,

I wish to talk from and to, if I may.

Senator BURDICK. Your full statement will be included in the

record, without objection.

(The prepared statement of Mr. Anderson follows:)

PREPARED STATEMENT OF DEWEY ANDERSON

Personal: I come before you as a private citizen with considerable interest and.

some knowledge of the subject being examined. My training has been in the

biological and social sciences at Leland Stanford -University, where I took the,

A.B., M.A., and Ph. D. degrees.

As a member of the California Legislature in 1937, I was chairman of a committee comparable to this one, and then introduced the first inclusive prepayment

health plan ever seriously entertained by a California Legislature. There followed

interim hearings and published reports of which I was one of the authors. This,

proposal was the progenitor of the pioneer Warren health plan offered by then

Governor, and now Chie Justice of the Supreme Court, Earl Warren. I cite

this to indicate some 25 years of continuing interest in the subject of how to

provide best or the people's health,
16 AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT

As the executive director of the Public Affairs Institute since its founding in,

1947, I have ini iated, supervised, and edited, or written a number of research,

studies bearing directly on this subject, including:

"Pensions in Our Economy," a study of old-age pension problems and

proposals in relation to the general economy (Stephen Raushenbush), 1955.

"How To Get Safe Drugs and Cut Their Cost" (David Cushman Coyle),.

1960.

"Health Insurance for the Aged," (F. J. Seidner), 1960.

"Health Service Is a Basic Right of All the People" (Dewey Anderson).

The last-mentioned study appeared in 1956, was written by me as a result of

closely pacing President Truman's Commission on the Health Needs of the

Nation. As it presents brief sketches of all the health professions and occupations, including chiropractic, I submit copies for the use of the committee.

Study of the characteristics of occupations, including in some measure the

training, licensure, practice, barriers to entrance and status of the healing professions, were part of the research and published books on ompations which my

codirector, Prof. P. E. Davidson, and I released at Stanford University as productsof the Institute for Occupational Research. So, in more than a cursory way,

I have been identified with aspects of this subject for the past quarter of a century.

With specific reference to my acquaintance with manipulative therapy as,

exemplified in the practice of osteopathy and chiropractic, I cite the following.

My brother holds an unlimited license to practice as a physician and surgeon in

California. He graduated from the Los Angeles College of Osteopathic Physicians

and Surgeons, which in the amalgamation now going on between the medical doctorsand osteopaths has become the California College of Medicine. For more than a

quarter of a century I have had the benefit of many discussions and experienced

the diagnoses and treatments of a well-trained and skilled practitioner of manipulative therapy.

Then, when I had written the "Health Service" study, Dr. Emmett J. Murphy

challenged me to make an examination of his profession, and the result was a brief

pamphlet study, "The Present-Day Doctor of Chiropractic." There followed a

request of the National Chiropractic Association to be a consultant member along

with Dr. Gregg Evans, longtime dean of sciences at Yankton College in South

Dakota and a member of the State board of examiners, in making a 1961 survey

of the seven accredited colleges of the National Chiropractic Association.

With this background in the field under review, I proceed to certain specific

questions raised by the proposed legislation.

I. What does the legislation do?—It permits a person in Federal employ to seek

the advice and treatment of a licensed doctor of chiropractic for which compensation will be paid from compensation funds on the same identical showing and basis

as would the services of a doctor of medicine or osteopathy.

2. What the legislation does not do.—It does not license or place its stamp of

approval on any form of practice, on any kind of treatment, to the exclusion of

any other legally recognized by a State as within the scope of practice as defined

by the State law operative in the patient's resident State.

3. What is the opposition to this legislation?—The opposition is identical both

as to substance and source as it was some years ago when the law was amended

to include the services of persons licensed as osteopathic physicians. It is the

same kind and source of opposition offered over the years to every other school

of healing by the dominant school of medicine through its organized professional

and political arm, the American Medical Association.

Just as in each previous instance, that opposition has cited the conviction of

the AMA that the form of healing attacked at the moment was a "cult," was

without adequate scientific evidence and support of its theories and practice.

So in this instance the medical fraternity and its medically trained and disciplined

members in the Government apparatus seek to prevent the inclusion of licensed

chiropractic physicians and their manipulative therapy in this law. If they run

true to form, they will do so by parading again the body of outdated, unsubstantiated, and biased material which they would have you believe represents

truly scientific evidence of the harmful or even dangerous character of chiropractic

treatment.

They have set themselves up in this respect as the sole defenders of the health

and safety of the unsuspecting and unknowing public which they would have you

believe are the easy prey of these untrained and even dangerous cultists. In

doing so they have lost sight of the Bible's admonition about casting the first stone

for they tend to forget the presence in their midst of M.D.'s who are qualified

under this legislation to receive compensation for practice but for whose corn-
AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT 17

petency the AMA cannot vouch. Nor can their conformity be attested either,

for the history of this century of medicine in this country is one of much diversity

of belief and practice, of sharp differences between the exponents of one "school'

or another, of fights to the finish between allopaths, homeopaths, and eclectics.

4. AMA opposition to both osteopaths and chiropractors persists.—Now comes the

struggle of the AMA against the two schools of natural and manipulative therapy,

osteopathy and chiropractic, which Hyde and Wolff in their brilliant and heavily

documented Yale Law Journal study of the American Medical Association indicate

may be tinged with "an element of self-protection from this economic encroachment."

With respect to osteopathy, which the AMA still officially regards as a "cult,"

the process of elimination by absorption is well underway. It started in California, where if the people vote to rescind their osteopathic licensure law next

November the "unification agreement" as it is called, between a group of California osteopaths and the California Medical Association will become effective.

By its terms and the attendant features of the program, osteopaths holding

degrees from the former Los Angeles College will pay some $65 in fees and find

themselves renamed "M.D." instead of "D.O." Where the long continued and

often vigorous if not vicious denunciation of osteopathy by leaders in the AMA

went to in the process is not known.

But osteopathy as an exponent of the efficacy of manipulative therapy remains

the basic tenet of the practice of these osteopathic trained physicians no matter

if their new M.D. title is bought and paid for and a new lettering has to be

engraved to erase the old D.O. on their shingle. Yet the practice performed is

in major degree akin to and closely approximates that of its first cousin, chiropractic. For both forms of healing center their attention on the musculo-skeletal

system and believe its functions have a large bearing on the health or ill health

of the patient.

The attitude of the medical organization toward chiropractic continues antagonistic, in part at least because of an image in the minds of its medical doctors

carried over from a past of poorly trained, "quickie college" or diploma mill

chiropractors advertising and hawking their cures in an unprofessional manner

so offensive to the sensibilities of the serious medical profession. I submit that

if there were grounds for such an image they are not now characteristic of the

profession.

It is well to recall that in 1910 when Abraham Flexner made his famous Carnegie

survey of medical schools, over half of some 150 schools were found.to be privately

owned, operated for profit, possessed little in the way of curriculum, few trained

instructors, gave 'short courses and a goodly number were outright "diploma

mills." It took 10 years to close them out, reducing their number by the early

1920's to less than a hundred, and now down to eighty. But there is little room

for complacency on the part of the AMA, despite noticeable improvement, for

its own educational survey made during the past 10 years showed that of a

selected sample of 41 medical schools only half were doing what the surveyors

termed "a fair job," only three measured up to their full potential, and the rest

were not offering a "satisfactory education" in training medical doctors. Of

over 28,000 members of faculty teaching in U.S. medical schools, only 9 percent

were on full time, while 75 percent were on a purely voluntary status. (Educational

Number, J.A.M.A., September 1954. Later partial studies reach similar

conclusions.)

I am convinced from the recent inspection made of all National Chiropractic

Association's seven colleges that the image which the AMA has or seeks to create

in the public mind is not correct. For training and practice have come a long way

in the 60 years of chiropractic's existence, and progress has been rapid in the

past decade.

Here is a seriously motivated profession conscious of its responsibilities, and

aware of its limitations. It knows, too, that despite all the harassment it has

undergone, it is the second largest of the healing arts, and treats a significant number of patients. It devotes over 4,000 hours to lecture, laboratory and clinical

training in its 4-year course of study, half of it in the basic sciences the other half

in applied subjects.

Chiropractors are licensed by State law to practice in 46 States and the District

•of Columbia. The continuing improvement and enlarging status and acceptance

of chiropractic is testified to by the trends in education and licensure. One State

has a severely restricted definition of chiropractic, while another has a very broad

one. But even in its most restricted form State license covers the types of

injuries and illnesses which make up the bulk of compensation cases.
18 AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT

Now, all but five jurisdictions permit the doctor of chiropractic to practice

under workmen's compensation laws. Some 600 life and accident insurance

companies accept chiropractors' certification of claims, professional athletic organizations and many industrial concerns have chiropractors on their staffs or make

their services available to their people. Labor unions particularly favor this form

of care. The Brotherhood of Railroad Trainmen is a conspicuous example, for

its members are subject to many back and other injuries and 8f ains for which

chiropractic treatment has been found beneficial.

A strong evidence of the seriousness of purpose of this profession is the continuing professional program of its National Chiropractic Association. This

organization has its House of Delegates, its accrediting body and educational

council governing the policies and inspection of the programs of the colleges,

holds regional professional seminars, and State and national conventions. It

issues a monthly journal, the content and tone of which are soundly ethical and

scientific. It has a national research committee engaged in controlled research

work. By all the attributes and in all the ways we have of testing the worth of a

profession, today's chiropractor is seeking to meet the public standard.

5. What is the public interest? I am here testifying on these bills as a citizen

concerned about the public welfare. I am not an advocate of any particular

form of healing. I am convinced from experience that today's chiropractor is

equipped by training in the sciences underlying health, and in forms of therapeutics which have beneficial results so that he is able to meet people's needs.

It is my belief that the responsibility rests with the several States to require

strict compliance with basic science and professional licensure laws, operating

under professionally competent and impartial boards, and to insist on conduct

of a high ethical character of all who practice any form of healing. That it is

not the Federal Government's responsibility to attempt to lay down such strictures, nor to exclude any profession which is so treated by any sovereign State

in the enactment of laws providing for compensation for attending any Federal

employee.

Therefore, in the public interest, and in keeping with the just division of powers

and responsibilities between the two branches of government, Federal and State,

I urge your favorable report and congressional passage of this amendment.

Mr. ANDERSON. The first section of this little statement deals

with my personal qualifications to discuss the topic, the bills under

consideration before this committee. I come before you as a private

citizen, and in that capacity, I am a witness. I have some knowledge

and a very considerable interest in the subject being examined. My

training has been in biological and social sciences, and I graduated

with the three degrees through the graduate degree at the University

of Stanford in California.

Now as a member of the California Legislature and chairman of a

committee comparable to this committee in the Senate, in 1937 I

was the chairman of a group of the legislature that introduced the

first inclusive prepayment health plan in California. There followed

interim hearings in support of that legislation across the State, and

reports were written by us.

This is a long time ago. The proposal was pioneer proposal. It was

shortly followed by the one which the then Governor of the State of

California, Earl Warren, now the Chief Justice of the Supreme Court,

introduced, and I cite this to indicate a long-time interest over a span

of more than a quarter of a century in the problems of people's health

and since being the executive director of the Public Affairs Institute, I

have either initiated, written, or supervised the research that has

resulted in publication of a whole series of reports, some of which I

mention in this statement, bearing upon the health of the Nation.

One of those reports, which I have submitted to the committee, is

"Health Service Is a Basic Right of All the People." It was published

in 1956. It was written as a result of having closely paced President

Truman's Commission on the Health Needs of the Nation. It pre-
AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT 19

sents brief sketches of all the health professions and occupations,

including chiropractic.

This study, over a period of more than a year, when the manuscript

was ready, was submitted by registered mail to all the official bodies

governing the various professions in the health field, and time was

'allowed for correction or statement, and an indication was made that

anything that looked wrong would be corrected, and that counterstatements would be included in the record. None came of a serious

nature, and the publication followed.

I have also had an opportunity over a long period of time to study

as an experiment the field of occupations, among which have been

these various health and healing arts; but with special reference to the

field of inquiry this morning, my own relationship with a manipulative

therapy, both osteopathy and chiropractic, has come about as a result

of a family connection, and further study. My own brother holds

an unlimited license as a physician and surgeon practicing osteopathy

in the State of California. He graduated from the Los Angeles College of Osteopathic Physicians & Surgeons, which now in the amalgamation process going on between medical doctors and osteopaths has

just been changed to become the California Medical College, a class

A medical school, without one change being made in faculty or content, being moved over from the osteopathic column now into the

medical column of training.

For more than a quarter of a century, I have had the experience

with my brother of both manipulative care and treatment on both

my person and my family, and I have had the benefit of numerous

discussions with a man who is able and intelligent in his field.

Then when this health study that I referred to a moment ago was

published, I was challenged by Dr. Emmett Murphy to make a more

thorough inquiry into the field of chiropractic, and the result was a,

brief study which we published, "The Present Day Doctor of Chiropractic." In preparing that study, I was given the opportunity by

the National Chiropractic Association to visit its schools, to visit its

practitioners in various places, to submit myself to treatments and

diagnoses, and to familiarize myself at firsthand with the practice of

chiropractic.

Then last year, the National Chiropractic Association decided, as

part of its accrediting procedure of its colleges, to have an independent

survey made of those cclleges. Now, I was asked, along with Dr.

Gregg Evans, the longtime dean of sciences at Yankton College in

South Dakota, a member and presently the secretary of the State

examining board, himself a well-known chemist, to participate in this

firsthand inspection of the seven schools accredited under the National

Chiropractic Association.

Now, with this background, I have had probably more opportunity,

however well I may have availed myself of it, to know as a layman

about this profession and what it can do, and its limitations, than

most anybody you can mention, and I asked myself as one who has

been long acquainted with the process of Government in the Senate

and House of the U.S. Congress what I would do if I were sitting

where you are sitting in determining the answer to this proposed

legislation.

What does the legislation do?
20 AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT

Well, it permits a person in Federal employ to seek the advice and

treatment of a licensed doctor of chiropractic, for which compensation

will be paid from compensation funds on the same i lentical showing

and the same basis as would the services of a doctor of medicine or a

doctor of osteopathy.

And what the legislation does not do: It does not license or place a

stamp of approval on any form of practice, on any kind of treatment,

to the exclusion of any other locally recognized by a State as within

the scope of practice as defined, by the State law operative in the

patient's resident State.

Why, then, opposition to this legislation? Well, the opposition is

identical, both as to substance and source, as it was some years ago,

when the law was amended to include the services of persons licensed

as osteopathic physicians.

It is the same kind and source of opposition offered over the years

to every other school of healing by the dominant school of medicine

through its organized professional and political arm, the American

Medical Association.

Just as in each previous instance, that opposition has cited the

conviction of the AMA that the form of healing attacked at the

moment was a "cult," was without scientific evidence in support of

its theories and practice. So in this instance, the medical fraternity

and its medically trained and disciplined members in the Government apparatus seek to prevent the inclusion of licensed chiropractic

physicians and their manipulative therapy in this law. If they do so,

they will succeed again in parading the body of outdated, unsubstantiated for the most part, and sometimes biased material which they

would have you believe represents truly scientific evidence of the

harmful or even dangerous character of chiropractic treatment, for

they have set themselves up in this respect as the sole defenders of

the health and safety of the unsuspecting and unknowing public

which they would have you believe are the easy prey of these untrained

and even dangerous cultists.

In doing so, they have lost sight of the Bible's admonition about

casting the first stone, for they tend to forget the presence in their

midst of M.D.'s who are qualified under this legislation to receive

compensation for practice, but for whose competency the AMA

cannot vouch. Nor can their conformity be attested either, for the

history of this century of medicine in this country is one of much

diversity of belief and practice, of sharp differences between exponents

of one "school" or the other, of fights to the finish between allopaths,

homeopaths, and eclectics.

The AMA opposition to both osteopaths and chiropractors persists,

because now comes the struggle of the AMA against two schools of

natural and manipulative therapy, osteopathy and chiropractic,

which Hyde and Wolff in their brilliant Yale Law Journal study

indicate may be tinged"—and I quote—"with an element of selfprotection from this economic encroachment."

With respect to osteopathy, which the AMA still officially regards

as a "cult,' the process of elimination by absorption is well underway.

It started in California, where if the people vote to rescind their

osteopathic licensure law next November, the "unification agreement,"

as it is called, between a group of California osteopaths and the

California Medical Association will become effective. By its terms
AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT 21

and the attendant features of the program, osteopaths holding degrees

from the former Los Angeles college will pay some $65 in fees and

find themselves renamed "1\4.D." instead of "D.O." Where the

long-continued and often vigorous, if not vicious, denunciation of

osteopathy by leaders in the AMA went to in the process is not known.

But osteopathy as an exponent of the efficacy of manipulative

therapy remains the basic tenet of the practice of these osteopathic-.

trained physicians no matter if their new M.D. title is bought and

paid for and a new lettering has to be engraved to erase the old D.O.

on their shingle. Yet the practice performed is in major degree akin

to and closely approximates that of its first cousin, chiropractic. For

both forms of healing center their attention on the musculoskeletal

system and believe its functions have a large bearing on the health

or ill health of the patient.

The attitude of the medical organization toward chiropractic continues antagonistic, in part at least because of an image in the minds

of its medical doctors carried over from a past of poorly trained,

"quickie college" or diploma mill chiropractors advertising and hawking their cures in an unprofessional manner so offensive to the sensibilities of the serious medical profession. I submit that if there were

grounds for such an image they are not now characteristic of the

profession.

It is well to recall that in 1910 when Abraham Flexner made his

famous Carnegie survey of medical schools, over half of some 150

schools were found to be privately owned, operated for profit, possessed

little in the way of curriculum, few trained instructors, gave short

courses, and a goodly number were outright "diploma mills." It took

10 years more, into the 1920's, to close them out, reducing their number by the early 1920's to less than 100, and now down to 80, but there

is little room for complacency even today on the part of the AMA.

Despite this notable improvement, by its own editorial survey, surveys

made during the past 10 years show that of a selected sample of 41

medical schools, only half—and there I am quoting the surveyers

themselves—only half were doing what the surveyers termed a "fair

job." Only 3 measured up to their full potential, and the rest were

not offering "a satisfactory education" in training medical doctors.

And of over 28,000 so-called members of faculty—these are people

who are associated with training centers, as doctors on lists in hospitals,

and so forth—in U.S. medical schools, only 9 percent were in full

time, while 75 percent were on a purely voluntary basis, and I give

you the citation.

I am convinced from the recent inspection made of all National

Chiropractic Association's seven colleges, that the image which the

AMA has or seeks to create in the public mind is not correct. For

training and practice have come a long way in the 60 years of chiropractic experience, and progress has been rapid, most particularly in

the past decade. I believe this to be a seriously motivated profession,

conscious of its responsibilities and aware of its limitations.

It knows, too, that despite all the harassment it has undergone, it

is the second largest of the healing arts. It treats a significant number

of patients. It devotes over 4,000 hours to lecture, laboratory, and

clinical training in its 4-year course of study, half of it in the basic

sciences, the other half in applied subjects.
22 AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT

Chiropractors are licensed by State law to practice in 46 States and

the District of Columbia. The continuing improvement and enlarging status and acceptance of chiropractic is testified to by the trends

in education and licensure. One State has a severely restricted definition of chiropractic, while another may have a broad one, but even

in its most restricted form, State licenses cover the types of injuries

and illnesses which make up the bulk of compensation cases.

Now all but five jurisdictions—and I am corrected by Mr. Bunker's

later statement; my published information is some years old—permit

the doctor of chiropractic to practice under workmen's compensation

laws. Some 600 life and accident insurance companies accept chiropractors' certification of claims. Professional athletic organizations

and many industrial concerns have chiropractors on their staffs, or

make their services available to their people. Labor unions particularly favor this form of care. The Brotherhood of Railroad Trainmen,

whom I know at firsthand, is a conspicuous example, for its members

are subject to many back or other injuries and strains for which chiropractic treatment has been found beneficial.

A strong evidence of the seriousness of purpose of this profession is

the continuing professional program of its own National Chiropractic

Association. This organization has its house of delegates, its accrediting body and educational council governing the policies and inspection

of the programs of the colleges. It holds regional professional seminars, State and National conventions. It issues a monthly journal,

the contents and tone of which are soundly ethical and scientific. It

has a national research committee engaged in controlled research work,

and by all the attributes and in all ways we have of testing the

worth of a profession, today's chiropractor is seeking to meet the public

standard.

Now what is the public interest?

Well, I am here testifying on these bills as a citizen concerned about

the public welfare, and solely in that capacity. I am not an advocate

of any particular form of healing. I am convinced from experience

that today's chiropractor is equipped by training in the sciences

underlying health and in the forms of therapeutics which have beneficial results, so that he is able to meet people's needs. It is my

belief that the responsibility rests with the several States to require

strict compliance with basic science and professional licensure laws,

operating under professionally competent and impartial boards, and

to insist on conduct of a high ethical character of all who practice

any form of healing. That it is not the Federal Government's

responsibility to attempt to lay down such strictures, nor to exclude

any profession which is so treated by any sovereign State in the

enactment of laws providing for compensation for attending any

Federal employee.

Therefore, in the public interest, and in keeping with a just division

of powers ECnd responsibilities between States and the Federal Government, I urge a favorable report on the two bills under consideration.

Senator BURDICK. Thank you, Mr. Anderson. That is a very

comprehensive statement.

Senator Javits, do you have any questions?

Senator JAVITS. No. Thank you very much, Mr. Chairman.

Senator BURDICK. I guess there are no questions.

Mr. ANDERSON. Thank you.
AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT 23

Senator BURDICK. Joseph Thomas, of the United Federation of

Postal Clerks.

STATEMENT OF JOSEPH F. THOMAS, DIRECTOR OF ORGANIZATION, THE UNITED FEDERATION OF POSTAL CLERKS

Mr. THOMAS. Mr. Chairman, members of the subcommittee, for the

record and for purposes of identification, I am Joseph F. Thomas,

director of organization of the United Federation of Postal Clerks. I

am presenting this testimony for John F. O'Connor, legislative director

of the United Federation of Postal Clerks who is unable to be present

this morning due to hearings before the House Post Office and Civil

Service Committee on salary legislation for postal and Federal

employees.

The name of our organization is rather new, having been changed

last year through the mergers of several old line postal employee

organizations, the National Federation of Post Office Clerks, the

United National Association of Post Office Craftsmen, the National

Postal Transport Association, and several locals of the United Postal

Workers. Prior to the merger, I was president of the United National

Association of Post Office Craftsmen. We have offices at 817 14th

Street NW., Washington, D.C., and we represent 145,000 post office

clerks.

As an organization we are in complete support of S. 1322 and S.

1055, introduced by Senators Burdick, of North Dakota, and Magnuson,

of Washington, respectively. These bills, if enacted, will provide an

opportunity, under the Federal compensation law, for postal and Federal employees whenever injured on duty to use the services of all

practitioners of the healing arts and not be limited in any way as at

present.

Both bills are amendments to the present law to provide that

employees may receive the services of chiropractors. We have long

been in favor of this amendment to the Compensation Act. As far

back as 1945, Legislative Representative William I. Horner, one

the predecessors of Mr. O'Connor, testified in behalf of S. 178, introduced by the former Senator Abe Murdock, of Utah, and which proposed this same amendment to the Compensation Act.

It is not our intention to attempt to go into the technical details in any way concerning the healing arts, as we feel that we are not competent to do so. We have some opinions concerning the possi- bilities and limitations of each of the healing arts. Many of us, or members of our families; have been treated for various illnesses by doctors of medicine, osteopathic doctors, and doctors of chiropractic.

As individuals, we have had the right and privilege to select the doctor which we thought would do the most good. We have found in the instances where we, or members of our families, have selected the chiropractic treatment because we thought it was needed that it proved very helpful. We think the same right should be extended to employees of the Federal Government under the Compensation Act.

Doctors of chiropractic can be extremely helpful to employees of the Federal Government for certain injuries, thereby reducing to a

great degree the period of disability of the employee and lessening the

amounts necessary to be paid for compensation.
24 AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT

The road of the chiropractic healing art has not been an easy one

since its inception some 60-odd years ago. Yet the fact that it has.

thrived and has proven itself of service to the public is indicated by

the fact that today there are many more schools of chiropractic than

a few years ago; and there are far more men and women practicing the.

art than a few years ago. Today, there are some 46 States, as well as

the territory of Puerto Rico and the District of Columbia that license.

chiropractors. The profession has continued to undergo changes and

improvements, and has made great progress over the years through

research and In raising its standard of treatment and practice.

A further indication of its progress in recognition is that many

States presently permit doctors of chiropractic to practice under their

workers' compensation law. The Veterans' Administration has fully

recognized chiropractic education under the GI bill and many hundreds

of insurance companies allow doctors of chiropractic to make examinations for insurance.

We believe, quite definitely, that a chiropractic doctor can be helpful to Federal employees when injured, and we further believe that in

this enlightened day and age they should be recognized under the

Federal employees' compensation law. The chiropractic healing art

can no longer be considered as visionary or impractical. It is a wellestablished healing profession and today chiropractic doctors have

millions of patients indicating a general acceptance of this manner of

healing by citizens of our country.

Mr. Chairman and members of the subcommittee, the membership

of our organization desire the opportunity to have a free selection

under the Compensation Act of any doctor they feel can be of help

to them. The enactment of this legislation does not make such

selection mandatory. It merely means that if the individual concerned, in his opinion, believes that he can secure better results he

may under the law, use the services of a chiropractor.

We trust the subcommittee will report favorably on this legislation.

We also wish to thank you for the opportunity of appearing before

the committee and expressing our viewpoint.

Senator BURDICK. Thank you, Mr. Thomas.

Senator Javits?

Senator JAVITS. No questions.

Senator BURDICK. I have a question, Mr. Thomas.

Mr. THOMAS. Certainly. I am sorry.

Senator BURDICK. Does your Postal Union have health plans?

Mr. THOMAS. Yes, sir, we do.

Senator BURDICK. Do they include chiropractic care?

Mr. THOMAS. No, we do not include chiropractic care, and I may

say that we have many protests from our members because of that

fact. I cannot tell you exactly the reason that we do not recognize

chiropractors, but I believe it has something to do with the fact that

they are not recognized under the compensation law which we are

discussing here today.

Senator BURDICK. If this amendment were made, would that make

any difference?

Mr. THOMAS. I certainly believe we would comply with the amendment. I surely do.

I may say that I made a trip in behalf of our health plan, back in

October, and I received many, many protests from members because

of the fact that we did not pay chiropractic claims.
AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT 25

Senator JAVITS. If the Senator would yield, what would you have

to do in order to make it effective under your plan?

Mr. THOMAS. Well, I simply think that would be a matter for our

organization to decide, and I believe if the provisions of the law

allowed, chiropractic treatment was provided for in these bills, our

executive board, our hospital plans directors, would pass a motion

and comply with this ruling.

Senator JAVITS. Well now, why does that affect your plan? How

do the two tie together? Why do you have to wait for this law in

order to do something you recommend that we do?

Mr. THOMAS. Truthfully, we do not have to wait. I believe that

we could pay these claims, and I cannot explain to you why we have

not, except that as I say, I think we have tried to go along with the

accepted practices of the Compensation Act, and we have simply

recognized those that have been recognized by the compensation

board.

Senator JAVITS. Well then, how has your organization decided

that you should give this testimony? Is this your testimony, or does

the organization take this stand?

Mr. THOMAS. Well, I will tell you how we have decided, Senator.

We have had a number of claims—I am going to try to explain this

to you the best way I know how—we have had a number of claims

where I think the employee has thought that he has been covered for

chiropractic treatment. I think that when he submits the claim to

us, and he finds out that he is not covered, he is very distressed about

the matter„ and we have had sufficient of those claims to make us

realize that we should be covering the chiropractic treatments, and

it is my impression that at the next meeting of our entire convention,

we will make the change.

Senator JAVITS. Well, how is this position that you are expressing

here today taken? What official action did your organization take

enabling you to say that they are for this bill?

Mr. THOMAS. We have not passed on this officially at a convention.

I say that it has been brought about by our experience with our

members. We feel as though certainly we can do no harm in endorsing the legislation, and we feel that we will be helpful to certain

of our members who prefer chiropractic treatment.

Senator JAVITS. Thank you, Mr. Chairman.

Senator BURDICK. In your statement, you state as far back as

1945, Legislative Representative William Horner, one of the predecessors of Mr. O'Connor, testified on behalf of S. 178.

Do you know in what capacity Mr. Horner testified at that date?

Mr. THOMAS. I cannot tell you why Mr. Homer testified in behalf

of that legislation at that time. I assume that it had something

to do with a convention action.

I might mention, sir, that before the merger of the three organizations, the National Postal Transport Association, the old UNIPOC,

which was the United National Association of Post Office Craftsmen,

and the National Federation of Post Office Clerks, the other two

organizations, did have hospital plans, and we did pay chiropractic

claims.

Senator BURDICK. Now when you are talking about "official

action," you are talking about official action of this new

amalgamation?
26 AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT

Mr. THOMAS. That is right.

Senator BURDICK. Any questions?

That is all. Thank you.

Mr. THOMAS. Thank you.

Senator BURDICK. Mr. Tommy Martin, president of the National

Rural Letter Carriers' Association.

I understand, Mr. Martin, that you want to get over to the other

side of the Capitol.

STATEMENT OF TOMMY M. MARTIN, PRESIDENT, NATIONAL

RURAL LETTER CARRIERS' ASSOCIATION, ACCOMPANIED BY

JOHN W. EMEIGH, SECRETARY, NATIONAL RURAL LETTER

CARRIERS' ASSOCIATION

Mr. MARTIN. Mr. Chairman and members of the subcommittee,

my name is Tommy M. Martin. I am president of the National

Rural Letter Carriers' Association, an organization composed of

39,500 regular, substitute, and retired rural letter carriers. I am

accompanied by Mr. John W. Emeigh, secretary of our association,

who also serves as health insurance director of the rural carrier benefit

plan, the health insurance plan sponsored by this association under

the Federal Employees' Health Benefits Act of 1959.

We would first like to express our appreciation to Senator Warren

G. Magnuson of Washington, and to you, Senator Burdick, for the

introduction of bills to amend the Federal Employees' Compensation

Act so as to provide for payment of chiropractic services. We are

also grateful for the opportunity to appear before your committee

and testify on this proposed legislation.

It is important to first note that a definite problem does exist.

Employees who sustain work-connected injuries or disabilities may

not presently elect treatment by chiropractic physicians if they desire

to receive payment of, or reimbursement for, required care and treatment under the Compensation Act.

The nature of a rural letter carrier's work involves a type of movement and constant stretching which does give rise to work-connected

disabilities peculiarly subject to care and treatment of chiropractic.

The fact that such treatment cannot be paid by the U.S. Government

under the Compensation Act causes these employees to personally

pay for care which, in our opinion, should be a responsibility of the

United States.

The committee, of course, is aware of the fact that numerous health

insurance plans presently provide such benefits to the insureds by

making provision for payment to chiropractors. This coverage is

granted in the rural carrier benefit plan of health insurance for nonwork-connected injuries or disabilities. No payment, however, can

be made under our insurance plan for any claim submitted for medical

care costs or treatments in connection with on-the-job injuries or

disabilities in those cases which are determined to be compensable

under the Compensation Act. In compensable cases, therefore, the

employee is denied benefits under both his health insurance and workmen's compensation.

Our experience in making payments for chiropractic services would

indicate that this is unfair to the employee. We maintain a constant
AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT 27

review of claims in connection with administration of our health plan

in order to assure proper payment under our program, and also

actuarially to project our experience for the future in line with past

and current experience.

A check on claims submitted and paid does not produce any evidence that services in this chiropractic area of the benefit structure

are generally overused or abused. Admittedly, in this area, just as

in other areas of the benefit structure of any health plan, there is an

occasional case which is , considered either an abuse of the coverage

by the insured individual, the doctor, the facility and/or overutilization of the benefits. We do not believe that the rare incidence of

these claims is of sufficient gravity upon which any case can be built

to continue to deny chiropractic coverage under workmen's compensation. We feel certain that adequate controls under the regulations

of the Bureau of Compensation can be adapted to this type of healing

care and treatment, just as they are presently used in "policing" all

services currently paid for under the act.

Mr. Chairman, this association endorses the legislation presently

before you. We urge that this committee approve a bill to provide

for the payment of chiropractic services under the Federal Employees'

Compensation Act.

Thank you very much, Mr. Chairman.

Senator BURDICK. Thank you for this very fine statement.

Could you tell me in a general sort of way how frequently, how

much your members make use of chiropractic service?

Mr. MARTIN. Perhaps Mr. Emeigh, who is the director of our

health benefits plan, could answer that more adequately than I could.

STATEMENT OF JOHN W. EMEIGH, SECRETARY, NATIONAL RURAL

LETTER CARRIERS' ASSOCIATION

Mr. EMEIGH. Senator Burdick, we do not have any specific data

that I can give you to show a percentage of incidence among our

total claims paid, but in the capacity of _review officer of the claims,

I do not believe that they constitute any large percentage of the

doctors' calls which would come under the medical expense provisions

of our plan. The major reason for this being brought to our attention

is the large number of denials which do need to go out from our claims

office, due to the fact that claims are submitted in connection with

these compensation cases. As President Martin pointed out in his

testimony, we do have a rather irksome problem here, because inasmuch as it has been deemed to be a compensable case under compensation, the man cannot get paid for the chiropractic services or treatments under the Compensation Act, and inasmuch as our plan under

the Federal health benefits program excludes any benefits in compensation cases, then our plan also cannot make payment for chiropractic services; although under our health plan we do normally

provide this service.

We do not have any pattern of abuse. We believe it is a good service, and yet the man finds that if he had just normally gone to the

chiropractor, he could have gotten payment, but due to the fact he

had to go in connection with a work injury, he is denied payment

both under compensation and under his health plan. We think that
28 AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT

is an unfortunate situation, and your bill would, of course, correct

that.

Senator BURDICK. Well, if the legislation is corrected, do you think

that will lead to a broadening of the health plan?

Mr. EMEIGH. Well, it may, sir. It may lead to a broadening of

some of the health plans as was pointed out by the previous organization witness. We, of course, have paid chiropractic benefits for

years, and we do provide it presently.

Senator BURDICK. In the present health plan?

Mr. EMEIGH. Yes, sir; we do. The definition of a doctor in our

plan, which is the rural carrier benefit plan, presently insuring almost

20,000 rural letter carriers in this country, reads as follows: "A doctor

is a licensed physician, surgeon, osteopath, chiropractor, or a dentist,

for purposes of services covered by the plan."

Senator BURDICK. 'Thank you very much.

Dr. Grady V. Lake.

STATEMENT OF GRADY V. LAKE, CHAIRMAN, LEGISLATIVE

COMMITTEE, INTERNATIONAL CHIROPRACTORS ASSOCIATION

Dr. LAKE. Chairman Burdick, I am Grady V. Lake. I am a doctor

of chiropractic, and I practice in Atlanta, Ga.

My appearance before the subcommittee is as a member of the

Board of Control of the International Chiropractors Association and

Chairman of the Legislative Committee; and accompanying me today

are Mr. James D. Harrison, on my right, the general counsel for our

association, Davenport, Iowa, and our Washington, D.C., counsel

of ICA, Brig. Gen. Joseph P. Adams.

International Chiropractors Association, with headquarters in

Davenport, Iowa, is an organization composed of doctors throughout

the United States and foreign countries. It is dedicated to the public

welfare and to the promotion and preservation of high professional

standards. It maintains that all peoples of the world are legally entitled to freedom of choice of doctor for their personal health care;

and that ICA's standards of membership are intended to assist all

peoples, groups and agencies to obtain responsible health service. In

keeping with our declared policy of freedom of choice of doctor, it

is our request that the present Federal Employees' Compensation Act

be amended so as to permit injured employees entitled to receive

medical services under such act to utilize the services of chiropractors.

To point up the situation as it now exists under the Federal Employees' Compensation Act, I would like to read to the committee a

letter written by Harold T. Hickey, Chief of the Audit and Compensation Payroll Branch, U.S. Department of Labor, Bureau of Employees' Compensation, 10th Compensation District, under the date

of January 17, 1962. This letter was written to Mr. Bernard W.

Schenken, 1395 10th Street, Marion, Iowa; File No. A10-45156.

The letter reads, in its entirety, as follows:

DEAR MR. SCHENICEN : We have received a bill in the amount of $12 which

has been submitted on account of charges for services rendered by Dr. R. A.

Hender, chiropractor, for treatment of the injury you sustained on Octber 4,

1961.

The Federal Employees' Compensation Act provides that employees injured in

the performance of duty shall be furnished services, appliances and supplies that

are prescribed or recommended by duly qualified physicians which in the opinion
AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT 29

of the Bureau are likely to cure or to give relief or to reduce the degree or the period

of disability or to aid in lessening the amount of monthly compensation. The

act defines the term "physician" to include surgeons and osteopathic practioners

within the scope of their practice as defined by State law. Aside from surgeons

and osteopathic practitioners the term "physician" does not include any practitioners in other fields of healing practice.

In view of this, there is no basis on which to approve payment for the services

of Dr. Hender because his services were not prescribed or recommended by a duly

qualified physician within the meaning of the act. We are accordingly enclosing

the bill, which you must now consider your personal obligation. Dr. Hender has

been informed of this action by way of a copy of this letter.

Very truly yours,

HAROLD T. HICKEY,

Chief, Audit and Compensation Payroll Branch.

Senator Burdick. I think that would answer a previous question

you had concerning this.

Senator BURDICK. Yes, it does.

Dr. LAKE. To emphasize the importance of the problem, it should

be understood that chiropractic has developed and become the second

largest healing profession in this country. We point to the fact that

some 25,000 chiropractors are now serving 35 million American people.

Our ICA files disclose that more than 500 insurance companies make

payments to chiropractors for chiropractic services or reimburse

policyholders for the payment of such services.

The science of chiropractic deals with the relationships between the

articulations of the vertebral column and the nervous system, and the

role of these relationships in the restoration and maintenance of

health.

The practice of chiropractic consists of analysis of any interference

with normal nerve transmission and expression, and the correction

thereof by an adjustment with the hands of the vertebral column for

the restoration and maintenance of health, without the use of drugs

or surgery. The term "analysis" is construed to include the use of

X-ray.

Chiropractic is recognized not only by National, State or provincial

governments but also by independent insurance companies, unions,

industry and the public. As an illustration

'

the constitution of the

Brotherhood of Locomotive Firemen and Enginemen insists that

chiropractic care be provided for in its contracts with management.

Again the Painters, Decorators and Paperhangers, AFL—CIO, have

several plans with chiropractic provisions.

Forty-six States, Puerto Rico, the District of Columbia, the Canal

Zone, most provinces in -Canada, and many other nations have enacted meaningful licensing laws.

Private insurance companies regularly pay chiropractic claims.

Some industries now have staff doctors of chiropractic and many

industries routinely refer injured employees. Management-labor

contracts provide for chiropractic care. Workmen's compensation

laws in most States provide for chiropractic care.

The public is utilizing services of doctors of chiropractic in an everincreasing volume.

Many national employee organizations now provide members

chiropractic care under the health insurance program for Federal workers recently enacted by Congress. Many States provide chiropractic

care to the aged under provisions of the Kerr-Mills bill recently enacted by Congress.
30 AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT

The degree to which the chiropractic profession has been successful

in establishing itself as a recognized healing art has been the subject

of several recent articles published in national magazines and newspapers.

On October 16, 1961, the conservative Wall Street Journal published

a comprehensive article headlined, "Chiropractors Make Headway in

the Struggle To Win Complete Acceptance." I offer to this subcommittee and respectfully request that a copy of this article be made a

part of this hearing.

Senator BURDICK. Without objection, it is so ordered.

(The article referred to above will be found in the appendix on

p. 36.)

Dr. LAKE. Thank you, sir.

McCall's magazine recently published a story by reporter Samuel

Grafton entitled "The Case for Chiropractors." In its issue of October

1959, McCall's stated:

Certainly chiropractic has been attacked by organized medicine for almost

two-thirds of a century since, with passion and high anger. The results of the

long fight hardly represent a clear-cut victory for medicine. There are 30,000

chiropractors in the country now, and while the art is not licensed in New York

(and three other States), it is licensed in 46, including Alaska and Hawaii.

While medical associations do not recognize chiropractic and continue to work against its growth, cooperation between doctors of

medicine and doctors of chiropractic at the community level appears

to be increasing. Certainly instances of this type of cooperation are

no longer considered unusual within the chiropractic profession.

An illustration of the kind of attitude which is fostering greater

cooperation was reported in the Wall Street Journal article which

commented that Dr. Charles Bechtol, chief of orthopedics at the

University of California at the Los Angeles Medical Center, said:

Chiropractic has a place in the healing arts * * *. Established professions

tend to look down their noses too much at professions which may not be so well

established and therefore the older professions miss what good there can be in

the newer ones.

Samuel Grafton in his article in McCall's reports:

A certain number of M.D.'s have been impressed by chiropractic enough to

make use of some of its methods and to offer their patients spinal manipulation.

Medical opposition in this country is so strong that this type of acceptance has

spread more rapidly abroad. A group of 200 West German M.D.'s, including

members of the medical school faculties, has formed an organization for research

and work in chiropractic; one of its leaders, Prof. Dr. L. Zukschwerdt, professor

of surgery at the University of Hamburg, has praised chiropractic in the German

medical press, recommending that physicians not neglect the application of so

worth-while a method.

Doctors of chiropractic are highly trained men and women. The

typical chiropractor has had a thorough and intense training in all

subjects needed to practice his profession and to deal with the vital

life-or-death problem of health service to the public. He is not

learned in the administration of medicines or the performance of

surgery, because he prescribes no medications and does no surgery.

In fundamental subjects, however, such as anatomy, physiology, bacteriology, neurology, his training is equal to or superior to that of

other practitioners of the healing arts. In addition to these, he alone

is intensively trained in those subjects peculiar to chiropractic which

deal with misalinements of the spinal column that pinch nerves.
AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT 31

TABLE 1.—Comparison between a typical medical school and a typical chiropractic

school

Subject Johns Hopkins class

Palmer College

class Subject Johns Hopkins class

Palmer College class

Anatomy Physiology Pathology Chemistry Bacteriology Diagnosis Neurology X-ray Psychiatry Obstetrics Pharmacology Medicine 

Hours

508 256 401 200 114 224 11248 144

19880 656 

Hours

520 520 195 325 130 520 130 2926565

Pediatrics Surgery _ Therapeutics Clinic Hygiene Chiropractic technic Chiropractic philosophy_ Public speaking Principles and practice Ethics and jurisprudence 

Total hours 

Hours72 352 16 

Hours

58565 553

19565 195

65

3,397 4,485

After earning a degree from an accredited college of chiropractic,

the candidate normally must pass a comprehensive examination

before a State or provincial licensing board before going into actual

practice.

As in all professions, the educational process of the chiropractic

profession is a continuing one. Seminars, symposiums, and similar

type professional meetings are held frequently to discuss new techniques and developments.

There are thousands of doctors of chiropractic serving in every

State of the Union, Canada, and in other parts of the world. It is

estimated that some 35 million Americans have been to a doctor of

chiropractic one or more times. In the United States, the geographic

distribution of doctors of chiropractic indicate that chiropractic care

is within easy reach of the residents of practically every community.

Chiropractic is also practiced in Canada, Mexico, Denmark,

Switzerland, England, Belgium, Germany, Sweden, Australia, New

Zealand, South Africa and other foreign nations.

Since the discovery of chiropractic in 1895, this profession has been

constantly growing in size and stature and service to the American

people. Within its confines of the spine and its relationship to the

nervous system chiropractic has built a most enviable record.

We hope that you members of the subcommittee, as national

thought leaders will be responsive to the need of the Federal employees

and favorably report this bill so they may utilize the services of

chiropractors.

Senator BURDICK. I want to thank you for your excellent statement.

Could you tell me whether or not the armed services use chiropractic

in any way in the treatment of injury?

Dr. LAKE. No, they do not. That is definite. I know from personal

experience in being here in Washington. My brother is a doctor of

chiropractic, and he had to serve in the Army, and we came to talk to

our Senator Russell concerning it, and actually it was at the time a

shock in the Joint Armed Services Committee, because—well, the

Navy could use chiropractic, but there have been bills proposed that

were never passed.

Senator BURDICK. You say the Navy uses chiropractic?

Dr. LAKE. No, none of the armed services today.

Senator BURDICK. None of the services.
32 AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT

Do you, Mr. Adams, wish to add to this?

Mr. ADAMS. Well, Chairman Burdick, I have only one point in

view of the questions you raised earlier with other witnesses about

the necessity for the legislation. I would like to call to your and the

staff's attention an official transcript in docket No. 57-251 in the

matter of Herbert H. Lester, Employees' Compensation Appeals

Board, Department of Labor. This was a matter where I represented

Mr. Lester in the matter of a claim for $6 before the Compensation

Appeals Board. Mr. Lester was a Department of Agriculture, Soil

Conservation Service employee, who was injured in the line of duty,

and he ended up with this unpaid claim for $6 for chiropractic services.

We tried this case before the Compensation Appeals Board, and I

have given the correct description of it, and on page 26 of the transcript, Chairman Schwartz of the Appeals Board addressed himself

to me in my argument, and said, "You don't think that this type of

thing should be corrected, as you put it, by legislation?"

And, Chairman Burdick, as the record will indicate, on several

occasions during the 1 hour and 40 minutes of my argument, I was

interrupted first by one and then another of the three members of this

Compensation Appeals Board, who indicated to me on several occasions that there was nothing they could do about it, the legislation

would have to be enacted before chiropractic could be included under

the Employees Compensation Act and I offer that as substantiation

of a matter that I am sure you consider quite significant.

Thank you very much.

Senator BURDICK. Thank you very much. Thank you all, gentlemen.

At this time, I would like to read into the record this telegram and

letters I have received.

I would like the record to show that the subcommittee received a

telegram from Jerome J. Keating, vice president of the National

Association of Letter Carriers:

Unfortunately the hearing before your committee on authorizing use of chiropractors under Compensation Act is being held the exact time I must appear before

House Post Office and Civil Service Committee on salary legislation. I will not

be able to be present but I want to advise you that National Association of

Letter Carriers at numerous conventions has gone on record in favor of authorizing

services of chiropractic doctors in compensation cases. Chiropractic doctors

serve very useful function in maintaining health of American people. Their services are recognized by other departments of Government; they have been approved

by many insurance companies and many of the health benefits policies now being

operated under Civil Service Commission supervision, recognize and compensate

services of chiropractic doctors. We are heartily in favor of this legislation and

hope the committee will render favorable report.

Senator BURDICK. Another letter from Stanley J. Ziolkoski,

Z-i-o-l-k-o-s-k-i, directed to Senator Morse:

Regarding S. 1322, introduced by Senator Burdick, which I understand is in

Labor and Public Welfare Committee, of which you are a member. This bill

would permit public employees to go to chiropractic physicians. This is a good

bill, and we would appreciate your favorable consideration of it.

STANLEY J. ZIOLKOSKI,

Education Board, Brotherhood of Locomotive Firemen and Enginemen, State

of Oregon..
AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT 33

Senator BURDICK. Also a letter to the Honorable Wayne Morse

from Richard F. Robedeau, president of the United Federation of

Post Office Clerks:

A sizable minority of our members have obtained relief from the discomfort

and disability of strains and back injuries after treatment by a chiropractor.

Some have found that chiropractic treatment furnished relief after other methods

had failed.

Since many such strains and injuries occur on the job and are covered by the

U.S. Employees' Compensation Act, it is our feeling that chiropractic treatment

should be covered and be paid by the Government if the employee receives a

compensable injury and elects to have it treated by a chiropractor.

Would you kindly give special attention to S. 1322, introduced by 1: tOuvERs

Burdick, which would provide for payment by the Government of chi actic

treatment in cases covered by the Compensation Act.

Again thanking you for your past favors, I remain, gir

Sincerely yours,

RICHARD F. ZDAIL 2 1962

Senator BURDICK. Another letter to the subcommittee:

Thank you so very much for your thoughtfulness (and that of Senator

in wiring me the date of the hearings on bill S. 1322 and for the oppor not,

afforded me to appear to offer testimony.

I made a request to our good friend, Senator Burdick, that I have an opportunity to appear in behalf of this bill. There are two reasons why I will not be

there: First, I am indispo sed and should not make the trip; second, I understand

that the National Association of Chiropractors have well qualified witnesses who

will make an appearance. I hope this is true.

I thank you so very much for the courtesy you have shown me.

Cordially yours,

FARMERS UNION GRAIN TERMINAL ASSOCIATION,

M. W. THATCHER, General Manager.

Senator BURDICK. I have just received a note that I am needed on

the farm bill. I do not know how many witnesses are remaining.

We have 15 minutes.

Do you wish to add something?

Mr. BUNKER. Mr. Chairman, I have two brief items I would like

to put into the record. The seven organizations whose plans include

chiropractic care are the following: American Foreign Service Protective Association, Federal Postal & Hospital Association, National

Association of Letter Carriers, National Association of Post Office &

General Services Maintenance Employees, National Federation of

Post Office Motor Vehicle Employees, National League of Postmasters

of the United States National Rural Letter Carriers' Association.

In addition to that, Mr. Chairman, I would offer for whatever

interest it might be to the committee, "A Survey and Analysis of the

Treatment of Sprain and Strain Injuries in Industrial Cases," compiled in Florida, by an independent research organization, and I will

leave that with the committee.

Senator BURDICK. That will be received for our file.

Mr. BUNKER. Thank you, sir.

Senator BURDICK. Mr. Murphy, do you have anything to add?

Mr. MURPHY. No, sir.

Senator BURDICK. I would like the record to show that Senator

Murphy had intended to be with us this morning, but his assistant

advises me that with transportation difficulties in Boston, he was

unable to be here, and we regret that very much.

Now, are there any witnesses here who have prepared statements?

Mr. MILLER. I am Clinton Miller, National Health Federation.
34 AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT

Senator BURDICK. Would you mind submitting yours by statement?

Mr. MILLER. I would be happy to.

Senator BURDICK. Are there any in the room this morning who do

not have prepared statements; have any short testimony?

If not, your statement, Mr. Miller, will be received for the record,

and we will keep the record open for about a week for additional

statements.

(The prepared statement of Mr. Miller follows:)

PREPARED STATEMENT BY CLINTON R. MILLER, REPRESENTING THE NATIONAL

HEALTH FEDERATION

Chairman Burdick and members of the subcommittee, I am Clinton R. Miller,

assistant to the president of the National Health Federation. The NHF is a

nonprofit, health rights corporation with its main offices at 709 Mission Street,

San Francisco, Calif. Our Washington office is in room 303, Continental Building, 1012 14th Street NW., Washington, D.C. The NHF is a rapidly growing

national organization, composed of thousands of members who firmly believe in

freedom of choice in matters of health where the exercise of that freedom does not

endanger the health or safety of another and thereby deny him an equal freedom.

The presentation of testimony by the National Health Federation in support

of S. 1322 and S. 1055 does not mean that the NHF endorses any healing art

over another. Specifically, we do not endorse or support the chiropractic practitioner over any other licensed practitioner or physician.

We believe in licensing as a proper function of State governments, and declare

that individuals should have the right to the doctor of their choice as they are

licensed by State law and within the scope of their practice as defined by State

law.

We believe that it is consistent with these objectives and beliefs to support

S. 1322 and S. 1055. We endorse the testimony of the International Chiropractors

Association and the National Chiropractic Association, and all previous witnesses

for the bill, and support their position on this bill.

We compliment the sponsors of the legislation, the Honorable Quentin N. Burdick, of North Dakota, and the Honorable Warren G. Magnuson, of Washington,

for their introduction of their bills. We believe that the bills are fair, and represent a statesmanlike approach which is in harmony with the Constitution and

traditions of our great Republic.

It is a matter of common knowledge that chiropractic is the professional choice

of millions of Americans for some or all of their health problems. It seems consistent that this choice should not in any way be denied an individual because he

is an employee of the United States. The bill is designed to correct this inconsistency.

Thank you.

Senator BURDICK. The subcommittee is adjourned.

(Whereupon, at 11:45 a.m., the subcommittee was adjourned.)
APPENDIX

PREPARED STATEMENT OF JAMES K. LANGAN, OPERATIONS DIRECTOR, GOVERNMENT EMPLOYEES' COUNCIL AFL—CIO

The Government Employees' Council, AFL—CIO, a federation of 23 unions of

Government employees comprising a total of 700,000 members, wish to go on

record as endorsing the provisions of S.1322 which, in effect, recognize licensed

practicioners of chiropractic science in treating eligible Federal employees under

the U.S. Employees Compensation Act.

Chiropractic practitioners are now generally recognized as qualified, by the

various States, as a branch of the healing arts, alleviating suffering and pain. We

feel that to include them as qualified to treat injured Federal employees is both

proper and desirable and hope that the Senate committee will favorably recommend the passage of S.1322.

AMERICAN MEDICAL ASSOCIATION,

Chicago, Ill., May 25, 1962.

Senator QUENTIN N. BURDICK,

Chairman, Subcommittee on Employees Compensation, Labor and Public Welfare

Committee, U.S. Senate, Washington, D.C.

DEAR SENATOR BURDICK: The following statement is submitted on behalf of

the American Medical Association with respect to S. 1322, 87th Congress, which

is now before your subcommittee for consideration.

The purpose of this bill, as indicated by its title, is to amend the Federal Employees Compensation Act so as to permit injured employees, entitled to receive

medical services under the act, to utilize the services of chiropractors.

The American Medical Association is opposed to this proposed legislation and

urges that it not be favorably reported by your subcommittee.

Chiropractic is a pseudoscience which is not based on scientific methods and,

therefore, should be recognized as what it is—a theory of cultism. It is premised

on the theory that human illness is all related to the spinal column. It holds

that the nerves that emanate from the spinal cord become impinged or "pinched"

by the vertebrae, thereby causing malfunction and disease. As a result of this

theory, chiropractors claim that disease and illness such as allergies, diabetes,

heart trouble, and tonsillitis, to name a few, can be cured by adjusting or manipulating the spinal column. Such a theory, of course, runs counter to the established

facts of medical science.

Recently the appellate division of the Supreme Court of the State of New

York had an occasion to inquire into the nature of chiropractic practice and the

qualifications of chiropractors to use X-rays in their "diagnosis" of human illness.

This court in Chiropractic Association of New York, Inc. v. Commissioner of Health,

stated in part: "* * * the-technical education, training and skill of chiropractors

are, in general, substantially deficient in * * * vital areas of knowledge and

judgment * *

To our knowledge, none of the schools teaching chiropractic have been accredited by any recognized Federal, State or regional qualified accrediting agency.

Nor are any of the so-called degrees awarded by schools of chiropractic recognized

by any standard accrediting agency. While these individuals are licensed in

many States, their licenses are limited and they are prohibited from prescribing

medicines or drugs and practicing surgery.

Chiropractors are not educated or equipped by either background or training

to diagnose human illness. This inability to render a diagnosis coupled with

their pseudoscientific method of treatment, when taken into consideration in

connection with their vociferous stand against life-saving vaccines and wonder

drugs, precludes, or perhaps demands, that no consideration be given them.

This proposal would authorize injured Federal employees to receive services

from individuals with little or no qualifications, little or no knowledge of the

medical science, and little or no scientific background. Such a situation would

35
36 AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT

be viewed by the medical profession as a regression from the high point of medical

progress which has been made by a sure and steady pace utilizing scientific

methods.

We earnestly believe that the enactment of S. 1322, 87th Congress, is not in

the public interest, nor in the interest of those Federal employees who might

mistakenly seek the service of a cult practitioner rather than the sound scientific

advice of qualified physicians.

We thank you for giving us the opportunity to express the views of the physicians of America concerning this important legislation. We respectfully request

that this statement by the American Medical Association be included in the

record of the hearings on S. 1322, 87th Congress.

Sincerely yours,

F. J. L. BLASINGAME, M.D.

[From the Wall Street Journal of Oct. 16, 1961]

CHIROPRACTORS CLIMB—THEY MAKE HEADWAY IN STRUGGLE To WIN COMPLETE ACCEPTANCE—MORE HEALTH INSURERS COVER THEIR FEES; EDUCATIONAL STANDARDS MAY BE RAISED—BUT MANY M.D.'s ARE SKEPTICAL

(By Thomas W. Bush)

Los ANGELES.—Chiropractors, those manipulators of the backbone long

scorned by the medical profession, are registering some small but important

victories in their long struggle to gain full recognition as legitimate and deserving

practitioners of the healing arts.

Within the last year or so, chiropractors have been cheered by these developments:

For the first time in history, a Federal public health measure—the medical

assistance for the aged bill that Congress passed in the closing days of the Eisenhower administration—makes provision for reimbursement to chiropractors.

In the 11-State Midwestern Teamsters Conference, the giant union has begun

paying from its health and welfare fund the claims of members who have been

treated by chiropractors. Similar action has been taken by the union in Washington State. Payments are made through insurance carriers with whom the

union has contracted.

All told, more than 500 health insurance companies now recognize chiropractic,

up from 200 only 7 years ago. The number continues to mount steadily.

And here in California, D.C.'s, or doctors of chiropractic, nc w sit along with

regular M.D.'s and dentists on the State Board of Public Health, which recommends legislation in the health field.

But the Nation's 25,000 chiropractors are not stopping with those gains. To

strengthen their forces, they are merging a multitude of State and local associations

which formerly fought furiously among themselves over seemingly minor differences in philosophical approaches to their profession. Mergers of associations

recently have been completed in California, Kansas, Connecticut, and Texas,

and "unity meetings" are now being held by two associations in Michigan.

ADDITION OF STATE AFFILIATES

The National Association of Chiropractors, with 6,200 members, now has

seven State associations as closely bound affiliates. Dr. L. M. Rogers, national

president, predicts this number will increase significantly.

Washington lobbyists representing the National Association of Chiropractors

and the 5,400-member International Chiropractic Association are currently working together in legislative consultation. Formerly representing bitterly opposed

viewpoints within the profession, these national organizations are moving closer

together with the ultimate aim, leaders of both groups say, of a single, tightly

disciplined association.

The education of chiropractors—the subject of much derision by M.D.'s—may

be in for upgrading. At a series of meetings this year, directors of the two big

chiropractic organizations have been considering a 200-page report put together

by Research St Education Corp., a San Francisco firm providing management

consulting services for schools. The report urges, among other things, that

chiropractic school accreditation procedures be standardized and that some small

chiropractic colleges be turned into prep schools. The two associations have

agreed on the fundamentals of the proposals and directors will meet in Chicago

again in November for further discussion.
AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT 37

Almost all States now require 4 years of high school before admission to a chiropractic college, and some require 2 years of college. In a majority of States, 4

years of chiropractic college is necessary for the D.C. degree. After chiropractic

school, D.C.'s usually must pass a State examination and then may go directly

into practice. Since chiropractors don't practice in hospitals, there is no internship.

EFFORT TO STANDARDIZE LAWS

There is some talk, too, of attempting to standardize the State law governing

chiropractic. Most States have laws spelling out the limits of a chiropractor's

practice, but four States—New York, Massachusetts, Alabama, and Louisiana—

do not. Any model law would probably be based on California's, considered the

most liberal of any. More than 5,000 chiropractors are licensed in this State.

Despite its recent victories, chiropractic still faces an uphill battle to win

acceptance from the American Medical Association, spokesman for 183,000

medical doctors. The Journal of the AMA recently said of chiropractic: "The

training that students receive is miserable as to faculty, curriculum, and methods."

The Journal also stated that "* * * this cult is not a worthwhile thing for the

health and welfare of the people and recognition of it certainly is not. in their best

interests."

Many doctors contend chiropractic is unscientific. Chiropractic is based on

the theory that disease is caused by abnormal function of the nervous system.

Chiropractors hold that manipulation of the structures of the body, especially

those of the spinal column, can help restore normal functions. Chiropractors

believe misalined vertebrae can pinch or frazzle the nerves routed through the

backbone to connect the brain and various parts of the body. Such spinal maladjustments, they contend, can lead to many ailments, ranging from ulcers to hip

trouble.

Chiropractic was introduced in 1895 by D. D. Palmer, a heavily bearded

Davenport, Iowa, man who had made his living peddling fish, lecturing on phrenology (the study of the conformation of the skull), and practicing what he called

magnetic healing, a method of slapping and massaging the patient's body. Mr.

Palmer was credited with manipulating the spine of a deaf janitor who regained

his hearing and went forth as the first chiropractic cure. Medical doctors,

skeptical of the Palmer story,-note that the nerves of hearing do not enter the

spinal cord. But it is true that many nerves do and chiropractors usually attempt

to explain the Palmer case by claiming nerves sympathetic with those of hearing

were involved.

Up to a point, the diagnosis of a chiropractor and a medical doctor might

agree. Consider the ulcer, for example. Both chiropractors and M.D.'s agree

ulcers are caused by too much hydrochloric acid in the stomach. But while

an M.D. might attribute this condition to too much emotional stress, the chiropractor often claims the extra flow of the corrosive juice results from vertebrae

getting out of whack and pinching a nerve. Dr. L. E. Montenegro, a well-known

Los Angeles chiropractor, prescribes this treatment: Adjust the offending

vertebrae so the acid flow is reduced, then put the patient on a diet of bland foods

to give the affected area in the stomach a chance to heal.

A common way for a chiropractor to adjust the spinal cord: He places his

hands on the patient's back in a crossed position so that the little fingers of each

hand are opposite one another. He then exerts pressure with the heels of his

hands.

The Committee to Combat Cults, a unit of the Medical Society of the State

of New York, is skeptical of such therapeutic procedures. Says a committee

pamphlet: "What the chiropractors learn in school is to correct subluxation

(partial dislocation) of the spine—by twisting, bending, kneading, massaging,

pinching, squeezing, extending, contracting, distorting, stretching, condensing,

restricting, expanding and dilating." The pamphlet adds sarcastically: "With

all such maneuvers it is not surprising that a chiropractor does come into court

charged with giving his patient a broken neck." Such a case is on record.

A more charitable position on chiropractic is taken by Dr. Charles Bechtol,

chief of orthopedics at the University of California at Los Angeles Medical Center.

Orthopedics deals with the correction or prevention of deformities, especially in

children.

LESSON FROM A "BONESETTER"

"I teach manipulations I learned from a professor who in turn learned them

from what are called `bonesetters' in England." Dr. Bechtol asserts. "Chiropractic has a place in the healing arts. The only quarrel we medical men have

is that many chiropractors think theirs is the only art."
38 AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT

Dr. Bechtol believes "established professions tend to look down their noses

too much at professions which may not be so well established and therefore the

older professions miss what good there can be in the newer ones." However this

may be, it is true that osteopathic medicine, which existed for years on the fringes

of the medical profession, is gradually working its way toward full acceptance.

Osteopaths believe that many ailments have their roots in maladjustments

and misplacements in the bone and muscle system. In many cases manipulative

treatment not unlike chropractic is substituted for healing with drugs and surgery.

Here in California, the State osteopathic and medical associations have merged

and all osteopathic schools in the State are scheduled to become regular medical

schools in the near future. Also, the Golden State's 63 osteopathic hospitals will

become conventional medical hospitals.

Chiropractors normally don't prescribe drugs and in many States the law

forbids it. Chiropractors say that when they believe their patients require

medical treatment they refer them to M.D.'s.

But medical doctors complain there are many cases on record in which chiropractors have insisted on working on a patient's spine when actually the patient

urgently needed other treatment. In Oregon recently, a chiropractor lost a

malpractice suit because he failed to detect a case of diabetes which later was

cleared up when an M.D. started the patient on insulin shots. But Dr. Bechtol

notes that cases of mistaken diagnosis aren't unknown to the medical profession,

either.

CONFUSION IN REGULATIONS

Some of the confusion about what a chiropractor may and may not legally do

can be traced back to the law itself. For instance, California law says chiropractors can practice whatever they are taught in school. And the State's law

setting forth the curriculum of chiropractic colleges requires the study of minor

surgery. Some chiropractors contend that thus in California the law gives them

the right to preform minor surgery.

But the chiropractors who make this claim—they are identified with the socalled progressive segment of the profession and appear to be a distinct minority—

recently lost a round in court when they attempted to get a ruling in their behalf.

A superior court judge ruled chiropractors cannot perform minor surgery and

must, in fact, remain strictly within the field of chiropractic; that is, they must

limit themselves to manipulation of the bones and spinal cord. This decision is

being appealed.

Other conflicts over laws have developed. In Louisiana, a chiropractor is

attempting to get the State to write a law which would take chiropractic out

from under control by the State's medical board. In New York and other States

where there are no laws governing chiropractic, the chiropractors contend their

practice is extra legal. They liken their situation to the early days of the automobile, when these vehicles weren't against the law but were not specifically

allowed or licensed by law.

DAVENPORT, IOWA, May 23, 1962.

Hon. QUENTIN BURDICK,

New Senate Office Building,

Washington, D.C.

DEAR SENATOR BURDICK: AS chairman of the subcommittee of the Senate

Labor and Welfare Committee, I urge you to endorse passage of S. 1322 and

S. 1055 to eliminate injustice to the chiropractic profession through exclusion

from present Workmen's Compensation Act. In the interest of chiropractic

patients, the endorsement by you and your committee would be most appreciated.

DAVID D. PALMER, B.S., D. Cm, Ph. C,

President, Palmer College of Chiropractic.
AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT 39

Senator QUENTIN BURDICK,

Washington, D.C.

DEAR SENATOR: Our profession urges continued support of S. 1033. Good luck in your hearing tomorrow. Many thanks for your past efforts on our behalf. Sincerely,

Hon. QUENTIN N. BURDICK,

Washington, D.C.:

We want to commend you for your fine efforts in behalf of the chiropractors and Federal employees in your bill, S. 1322.

We as a group extend our gratitude for your effort in getting this bill, S. 1322 considered by the Senate Labor Committee.

We as individual chiropractors will faithfully join in the effort to get our

Senators to support S. 1322 when it comes to the floor of the U.S. Senate for

a vote.

Respectfully,

VALLEY CITY, N. DAK., May 23, 1962.

ROY A. OTTINGER, D.C.,

President, North Dakota Chiropractic Association.

Hon. WAYNE MORSE,

Senate Office Building,

Washington, D.C.

DEAR SENATOR MORSE: It has been called to my attention that 011 Thursday,

May 24, hearings on the Burdick bill will begin. Inasmuch as you are a member

of the committee that will hold hearings on this bill, may I take this opportunity

to express my personal opinion that this bill merits your favorable consideration.

If memory serves me right, this bill was originally endorsed by Senator Abe

Murdock, Democrat of Utah, and at that time the bill passed both the Senate

committee and the Senate without opposition. It seems to me that it is only fair

that a Government employee who has a compensable injury should be given the

freedom on choice to select either a medical or a chiropractic physician for treatment.

Appreciative of your continued interest in this matter, I remain,

Very truly yours,

FARGO, N. DAK., May 24, 1962.

FARGO-MOREHEAD CHIROPRACTORS.

THE WESTERN STATES COLLEGE,

SCHOOL OF CHIROPRACTIC,

Portland, Oreg., May 21, 1962.

WESTERN STATES COLLEGE,

R. E. ELLIOT, D.C., Director.

NEBRASKA CHIROPRACTIC PHYSICIANS ASSOCIATION, INC.,

Falls City, Nebr., June 5, 1962.

Senator PAT MCNAMARA,

Washington, D.C.

DEAR SIR: With the hearing before the Subcommittee on Labor and Public

Welfare regarding the Burdick bill (S. 1322) concluded on May 24, may we urge

you to support this bill with all the vigor at your command.

The chiropractic physicians of Nebraska urge the passage of this bill and will

greatly appreciate your support of it—the Burdick bill, S. 1322.

Respectfully,

Dr. L. H. BURDICK.
40 AMEND THE FEDERAL EMPLOYEES' COMPENSATION ACT

GROUP HEALTH CLINIC,

Seattle, Wash., June 11, 1962.

Senator WARREN G. MAGNUSON,

Senate Office Building,

Washington, D.C.

DEAR SENATOR MAGNUSON: The following statement is submitted on behalf

of the Professional Services Committee, of the Group Health Association of

America, with respect to Senate bill 1055, 87th Congress, on which hearings

were recently heard.

The purpose of the bill is to amend the Federal Employees' Compensation

Act so as to permit injured employees entitled to receive aid under such act to

utilize the services of chiropractors.

The Professional Services Committee of the Group Health Association of

America is opposed to this act, and wishes to register its opposition with you.

The theory and practice of chiropracty arose at the turn of the century when

there were many diverse searches being undertaken into the nature of disease

and illness. Chiropractic, as it became known, presumes that all illness is related

to derangements in the relationship of bones and joints, and that manipulation

of the proper joint or bone will result in a cure, or at least relief of symptom. In

the early years of the century there were many other searches being conducted

into the origin and nature of disease. Not only in this country, but wherever

civilization has advanced, the increasing knowledge based upon sound study and

research has pointed out the limitations and fallacies of many of these schools,

and focused attention on the allopathic approach to disease currently supported

by the leading medical scientists in this country and abroad. Chiropractic, on

the other hand, has remained with its outmoded philosophy and denies the value

of bacteriology, endocrinology, surgery, biochemistry, and the host of advances

which have contributed so much to the increasing health of the people and their

longevity. None of the great medical discoveries of the 20th century has supported any of the philosophic foundations of the chiropractic, but on the contrary

have provided understandings of the nature of illnesses and appropriate remedies

therefor.

The Professional Services Committee of the Group Health Association of

America has been and continues to be interested in improving the quality of

medical care available to the citizens of this country. Inasmuch as this bill

would permit and encourage Government employees to seek relief from illness or

injury from practitioners whose philosophy of medicine rests upon an unproven

foundation, whose schooling is far from standardized and subject to no regulation

of quality, whose legal right to function is severely limited by the various States,

and who do not have ready access to those tools of diagnosis and treatment which

have raised the quality of medical care in the United States to its current high

level, it is the opinion of the Professional Services Committee of the Group Health

Association of America that these bills, if enacted, would be inconsistent with the

desire of our association or of the Congress to improve the quality of medical care

for Federal employees in this country until it is second to none.

We earnestly believe that the enactment of S. 1055 is not in the public interest

and should not be enacted.

Sincerely yours,

W. A. MAcCoLL, M.D.,

Chairman, Professional Services Committee, Group Health Association of

America.

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