Committee on Economic Security (CES)
Volume VI. Social Insurance
G. Workmen's Compensation
MEMORANDUM CONCERNING THE INTERESTS OF THE PHYSICALLY HANDICAPPED
Oscar M. Sullivan
MEMORANDUM CONCERNING THE INTERESTS OF THE PHYSICALLY HANDICAPPED
AS AFFECTED BY SOCIAL INSURANCE PROPOSALS, PARTICULARLY OLD-AGE PENSIONS
WITH AN INVALIDITY COROLLARY, AND UNEMPLOYMENT INSURANCE
I. Size of the Physically Handicapped Group
Recent studies tend to show that the number of persons with physical disabilities is much greater than earlier estimates and studies had indicated. The trend began with the White House Conference on Child Health and Protection where estimates as to physically impaired children ran much higher than had formerly been thought probable. Careful research by Nicholas in Kentucky and Nilson in Minnesota arrived at estimates of eight in a thousand of population for the disabled as a whole, including both adults and children. Prior to this time the generally accepted figure was six in a thousand of population. The studies within the past year go to show that even eight in a thousand is much too conservative. Among these were studies in Mississippi, Pennsylvania, Wisconsin, and Minnesota.
The study in Minnesota may be taken as typical. This was a survey of the economic condition of the physically handicapped between the ages of 16 and 55. The number of completed questionnaires secured was 12,771. The total number of physically handicapped persons listed was 22,063. It is clear, therefore, that the number for the physically disabled persons of working age is between nine and ten per thousand. Some considerations indicate that a considerable number of the disabled were missed in the survey. For the most part the survey discovered only those with obvious disabilities, or those concerning whom the rehabilitation division or other agencies in the state had previous record. Groups who were not adequately represented are probably the cardiac, the tuberculous, and the hard of hearing. That some, even of the orthopedic case were overlooked is indicated by the experience of the orthopedic clinics which were held during the past summer. There were ten such clinics at which 691 cases of all ages were examined. It was found that 43% of those between the ages of 16 and 55 who came to the clinics had not been reached by the survey.
Probably a study made during the past summer by the Relief Administration, which covered many selected cities in different parts of the country, and which has made special note of disabilities, will give one of the most reliable clues to the real size of the problem. From the available studies, however, it would be safe to say that there are in the country between one million and two million persons of working age who have physical disabilities of such a character as to be vocationally handicapped if care is not taken with their adjustment. This surely is large enough to warrant definite consideration in any far-reaching economic plans for the country.
II. Place in any Employment Stabilization Plan.
A number of plans have been proposed recently, among them the Deane Plan, which undertake to set up a means for stabilizing employment. One of the ideas underlying there plans is to ascertain the number of man-hours required to operate the industries of the country and then by dividing by the total employable workers of secure an average which shall be the legal weekly maximum. It is obvious that if the assumption is made at the start that physically handicapped workers are unemployable a different result will be secured under many of these plans from what would be secured if a correct estimate is made of the proportion of the physically handicapped who are efficient and, therefore, quite as employable as their able-bodied fellow citizens.
Consideration should, therefore, be given to the result secured by the State Vocational Rehabilitation Services operating under the general supervision of the Vocational Rehabilitation Service in the Office of Education, and reporting their data to this agency, likewise to the results of many private organizations for various types of the physically handicapped, and to the studies made by the Ford Plant and the Western Electric Company. It is believed that these constitute a clear demonstration that a very considerable proportion of the physically handicapped are fully efficient in one or more occupations, and that a sweeping assumption of their unemployability would be wholly unwarranted. It is very strongly felt by the agencies comprising the National Council for the Physically Handicapped that any attempt to push out of the economic system all physically handicapped persons, even if accompanied by a pension provision, would be not only a waste of available productive power, but exceedingly harmful to the social and personal development of those with physical impairment. Stress is laid upon this particularly because during the past year the proposal to pension all of the handicapped has several times been made from quarters which believed they were liberal and generous.
III. Place in Unemployment Insurance.
Two considerations in connection with unemployment insurance are prominent in the thoughts of those who are interested in the physically handicapped. The first is that the form of unemployment insurance adopted might conceivably be such as to increase the disadvantages under which the crippled and disabled labor in seeking employment. If unemployment reserves are set up according to individual employers it would probably have the same effect that experience rating tends to have in the compensation insurance field. Employers would regard disabled persons as more difficult of readjustment in the event of unemployment and, therefore, more likely to become charges upon the fund. On the other hand if the reserves are set up by industries, or as a general reserve, the adverse effect would not be so strong. It is hoped that this will be kept in mind along with other considerations in determining the type of unemployment insurance to be proposed.
The second consideration is that the system of employment exchanges, which is a necessary supplement of unemployment insurance, should be such that it would take proper care of the adjustment of a physically handicapped person. Many employers, even though not in principle favorable to the employment of the disabled, will have in their employ persons who have been disabled in the activities of their establishments. Others, because of social vision or humanitarian outlook, will have placed on their payroll a fair percentage of the handicapped. If any of these covered by unemployment insurance become unemployed it will be just as desirable to get them satisfactorily placed, in order to reduce charges against the fund, as it will be to place the able-bodied. The ordinary employment service is not well equipped to relocate the handicapped. The Wagner-Peyser Act, under which the present cooperative Federal-State public employment service is conducted, provides for cooperation with the rehabilitation service with respect to the readjustment of the physically disabled. If the Federal Employment Service is modified because of the unemployment insurance system the same principal of coordination with the Rehabilitation Service should be preserved, and probably even more specific provision made for definite placement activities for the handicapped under public auspices.
IV. Place in Old-age Pension Plan with Invalidity Corollary.
An old-age pension system is theoretically incomplete unless it provides for invalidity pensions as well. While so large a coverage may not be feasible at the present time the desirability of it in a complete scheme of social insurance should, we feel, be pointed out in the report, on the subject. Such a system should probably at the beginning allow pensions only for total and permanent disability. The definition of total and permanent disability could be much sharper than that of the total disability clauses of the life insurance companies which have given them such an unfavorable experience. The application of it ought to be coordinated with rehabilitation services and the same sort of test made that is made by employment exchanges under unemployment insurance. In other words, if a person who claims total and permanent disability is believe to be feasible of rehabilitation by the rehabilitation service, and declines to cooperate, his application would be refused. The experience of the rehabilitation services is such as to demonstrate very conclusively that many of the minor disabilities which have been successfully established as total permanent ones under life insurance policies are not in fact such, and that a very great proportion of the physically disabled can carry on satisfactorily in ordinary economic life.
Extension of the invalidity pension system to give allowances for partial disabilities should be taken up very slowly, and only after considerable experience with pensions for total disability. The danger of such a plan is that it might tend to make difficult the readjustment of the disabled in normal occupations, and might strengthen the sort of tendency mentioned in Section II of this memorandum to rule out all of the physically impaired as inefficient.
The experience of the National Recovery Administration in connection with certificates to sub-standard workers was that only 7,000 of these certificates had been requested and issued by November 1, 1934. These certificates included the aged, infirm and mentally handicapped, as well as the physically handicapped. The figures just quoted may of course merely indicate that employers do not wish to bother with workers who are not fully efficient. There are in the country, undoubtedly, great number of physically handicapped workers who are not 100% efficient in any occupation, and are not capable of being made so. Some of these would be helped by a total permanent pension plan; others may be helped by sheltered workshops, with a small pension as an eventual possibility in a complete social insurance scheme.
Oscar M. Sullivan,
National Council for the Physically Handicapped
November 3, 1934.
The Council comprises the following Agencies:
American Federation of Organizations for Hard of Hearing, Inc.
American Occupational Therapy Association
Convention of American Instructors of the Deaf
National Association of the Deaf
National Association of Goodwill Industries, Inc.
National Association for Prevention of Blindness, Inc.
National Rehabilitation Association, Inc.
National Tuberculosis Association