Senate Speech Proposing First Presumptive Conditions for Great War Veterans

Published: 24 April 2024

By Jeffrey Seiken, Ph.D.
Historian, Veterans Benefits Administration
via the Veterans Administration website

Government hospital in Lexington, Kentucky. c., 1930

Government hospital in Lexington, Kentucky. c., 1930s, one of many built after the war to treat Veterans with neuropsychiatric problems. Specialists believed that most cases were due not to combat trauma but to the stress of military service more generally, couple with a predisposition for mental illness and other variables. (

Act establishing the Veterans Bureau to oversee all benefits for WWI Veterans became law on August 9, 1921

Page from 1921 Congressional Record with Senator David Walsh’s speech proposing to treat tuberculosis and neuropsychiatric disorders as automatically service connected for compensation purposes. Inset: Walsh in an undated photo. (; Library of Congress)

After World War I, claims for disability from discharged soldiers poured into the offices of the Bureau of War Risk Insurance, the federal agency responsible for evaluating them. By mid-1921, the bureau had awarded some amount of compensation to 337,000 Veterans. But another 258,000 had been denied benefits. Some of the men turned away were suffering from tuberculosis or neuropsychiatric disorders. These Veterans were often rebuffed not because bureau officials doubted the validity or seriousness of their ailments, but for a different reason: they could not prove their conditions were service connected.

Since the time of the American Revolution, Veterans seeking compensation for a wartime injury had to furnish documentation, typically in the form of affidavits, establishing the link between their military service and their disability. Meeting the burden of proof could be difficult under any circumstances. It was especially challenging for Great War Veterans who contracted tuberculosis or developed some sort of neuropsychological problem. The two conditions were commonplace during the war years. They accounted for an estimated one-third of the more than 300,000 medical discharges from the Army between 1917 and 1919. These maladies were also responsible for about two-thirds of the hospitalizations of military men after the war. Yet, claimants with tuberculosis or mental disturbances still struggled to make their case to the Bureau of War Risk Insurance. In some instances, the problem was that they showed no signs of the disease until after their release from service. In other instances, they failed to provide sufficient evidence tying their illness to their time in uniform.

Their plight caught the attention of Massachusetts Senator David I. Walsh. By early 1921, Veterans organizations, the press, and politicians from both parties had all concluded that the federal government was falling short in its efforts to serve disabled Veterans. In the spring, Congress decided to act. The House approved a sweeping plan backed by the American Legion to replace the Bureau of War Risk Insurance with a new agency that would be responsible for all benefit programs for World War I Veterans, from compensation and insurance to vocational training and medical care. In the Senate, Walsh headed a special committee that conducted hearings and collected data on the treatment of disabled soldiers in preparation for a vote on the House bill. In late July, when the Senate as a whole convened to debate the bill, Walsh stood up from his chair to offer an amendment that would bring relief to “the tremendous number of our ex-service men [who] are undeniably afflicted with tuberculosis . . . [or] nervous and mental diseases.” Over and over again, he explained, he had heard anguished complaints from “men who have these diseases, know they have them, have had it demonstrated by doctors that they have them, and then have the Government say to them, ‘Prove it, prove it, prove that you have the disease as a result of your service.’”

Read the entire article on the VA website.
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