Ten States 27 make no specific provision regarding second injuries. It is probable that in some of these States the administrative commissions or courts have ruled upon the question in cases coming before them for adjudication, but no report of any of these rulings has come to the attention of the United States Bureau of Labor Statistics. Three States 8 grant a greater award for the loss of a second member than for the loss of a first. The objection to this plan is that it does not solve the problem of discrimination. On the contrary, increased compensation benefits for second injuries increase the probability of discrimination against crippled men.

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Connecticut attempted to meet this problem of discrimination by permitting physically defective employees to enter into an employment contract whereby they might waive their right to compensation for injuries due directly to their physical defect. Kansas and Ohio also recognize this waiver principle, but only in case of blind employees. Undoubtedly under this scheme many defective workmen are given employment which would be denied them if the employer were to assume the liability resulting from a second injury. Such a plan, however, leaves the handicapped workman unprotected in case of a subsequent accident. As far as he is concerned, the compensation law is to a great extent a dead letter, and in case of injury he will be thrown upon public charity or the generosity of his employer. Some scheme should be adopted which would relieve the employer of the extrahazardous risk involved and at the same time compensate the crippled workman in proportion to his loss of earning capacity. The special-fund plan already in operation in the eight States specified answers this dual purpose.

Another method aiming at the prevention of industrial discrimination against cripples is to prohibit insurance companies from charging employers higher premiums in case they employ disabled men. Minnesota recently enacted a law embodying such a provision. The weakness of this scheme is that it does not cover self-insured employers, who, because of the direct relationship between accidents and compensation costs, would be more inclined to practice discrimination than insured employers.

It might be added that the total number of second injuries in proportion to the total number of all injuries would be infinitesimally small. A computation recently made by the United States Bureau of Labor Statistics shows that of all the employees under the compensation act in the State of Wisconsin who had lost a hand, an arm, a foot, a leg, or an eye, only one would sustain a second major permanent disability in any given year. Application of the Wisconsin

97 Alaska, Arizona, Connecticut, hawaii, Iowa, Louisiana, New Hampshire, New Mexico, Porto Rico, and Vermont. 98 Colorado, Iowa, and Wisconsin.

rate to the 45 State compensation laws would give a grand total of 38 second major permanent disabilities for all industries covered by the compensation acts of these States. The increased cost of second injuries would therefore be negligible. Assuming that all second major permanent disabilities would result in permanent total disability, the increased compensation cost of such accidents would probably in the aggregate not exceed three-tenths of 1 per cent of the total compensation costs for all accidents under the compensation act. It must be acknowledged, however, that an individual employer is not particularly concerned with the fact that "in the aggregate' the increased cost of second disabilities is insignificant. When a crippled workman in his employ sustains a second major disability the increased cost to him is much greater than the cost of a similar disability to a normal worker would be, and this notwithstanding the fact that the increased aggregate cost is negligible. But even acknowledging that for an individual employer the occurrence of a second injury would materially increase his compensation costs, the fact that there is little possibility of such an accident occurring at all, as already pointed out, would seem to prove that the widespread discrimination against the employment of crippled men is hardly justified.

REHABILITATION.

Until recently the welfare of workers permanently injured in industry has been criminally neglected. Disabled workers have been paid their compensation benefits, and then allowed to shift for themselves exactly as they would have done prior to the enactment of compensation laws. Fortunately the war focused attention upon the problem. In the attempt to restore the war cripple the plight of the industrial cripple was also brought into relief. Massachusetts, in 1918, was the first State to provide for a rehabilitation department; since then, California, Illinois, Minnesota, Nevada, New Jersey, North Dakota, Oregon, Pennsylvania, and Rhode Island have followed suit. It is to be hoped that every disabled workman will not only be paid the statutory compensation benefits but also be functionally restored as far as possible, retrained, and replaced in desirable employment.

COMPARISON OF PARTIAL DISABILITY SCHEDULES.

As already noted, the partial disability schedules adopted in the various States include generally the same items, and it is possible to tabulate many of them so as to afford a comparison of the awards allowed by different States for specified injuries. In 38 States the schedules for permanent partial disabilities, either by law or administrative decree, are stated in terms of weeks or months. In order to make the latter cases comparable with the majority, the number of months indicated has been multiplied by 43 to reduce them to weeks, the nearest whole number of weeks being used.

Table 16 shows the number of weeks for which compensation is payable for specified injuries in the several States. In this table has been included the schedule of severity rating formulated by the committee on statistics of the International Association of Industrial Accident Boards and Commissions." The purpose of this schedule, however, was to obtain a more accurate measure of industrial hazards, the schedule not being intended as a basis for compensation awards.

TABLE 16.-NUMBER OF WEEKS FOR WHICH COMPENSATION IS PAYABLE FOR SPECIFIED INJURIES IN THE SEVERAL STATES.

1 Committee on statistics and compensation insurance cost of the International Association of Industrial Accident Boards and Commissions.

Payments under this schedule are exclusive of or in lieu of all other payments.

Payments under this schedule are in addition to payments for temporary total disability during the healing period.

Payments cover total disability. Partial disability may be compensated at end of periods given for not over 300 weeks in all.

Maximum, $5,000.

Payments under this schedule are in addition to all other payments.

Maximum, $3,000.

9 to 15 years, depending upon the age of the employee at the time of injury.

"For a complete report of this committee see pp. 123 to 143 of the October, 1917, Monthly Review.

In comparing the laws of the several States as to the number of weeks for which compensation is payable for the specified injuries noted in the above table, care should be taken to see that the laws are actually comparable. In most of the States, as already noted, the benefits provided are in lieu of all other payments and are therefore comparable. In Massachusetts and Rhode Island, however, these benefits are in addition to all other payments, including compensation for total disability during the healing period and for partial disability if the injury has resulted in loss of earning power. A number of the other States also pay additional compensation during the healing period.

The laws of eight States provide that compensation for permanent partial disabilities shall be based upon the nature of the injury, the occupation of the injured employee, and his age at the time of the injury. The North Dakota law provides for a compensation schedule based upon the percentage of disability, but authorizes the compensation commissioner to determine what the percentage of disability should be in case of individual injuries. The compensation bureau has formulated a partial disability schedule, stated in terms of weeks, which is shown in Table 16. The West Virginia commissioner, under a similar act, formulated a schedule of permanent partial disabilities which was incorporated in the law in modified form in 1919. The Washington law provides for maximum amounts in case of a few major injuries, leaving to the industrial insurance department the working out of a detailed schedule of payments based upon the statutory amounts. California, however, is the only State which has formulated an elaborate partial disability schedule based upon the nature of the injury and the occupation and age of the injured employee.

As already noted, most of our State laws compensate for certain specified partial disability injuries by providing benefits payable for fixed periods. European laws differ from American laws in this respect by basing compensation for such injuries upon the percentage of total disability caused by the injuries. Table 17 shows the percentage of disability for specified injuries, based on schedule of compensation for permanent total disability under the laws of the various American States. Inasmuch as certain American laws pro vide for payment during life, it would be impossible, without the introduction of the actuarial basis of expectancy, to compute percent ages for the temporary awards made, and these are therefore omitted from this comparison. The schedule of the committee on statistics of the International Association of Industrial Accident Boards and Commissions is also included.

1 California, Idaho, Kentucky, Nevada, North Dakota, Texas, Washington, and West Virginia,

TABLE 17.-COMPUTED PERCENTAGES OF DISABILITY FOR SPECIFIED INJURIES, BASED ON SCHEDULE OF COMPENSATION FOR PERMANENT TOTAL DISABILITY UNDER THE LAWS OF VARIOUS STATES.

1 Schedule of severity ratings formulated by the committee on statistics and compensation insurance. cost of the International Association of Industrial Accident Boards and Commissions.

ADEQUACY OF PARTIAL DISABILITY SCHEDULES.

The value of the foregoing table for comparative purposes is impaired to some extent because the percentages are not comparable one with another, due to the lack of a common denominator. The schedules for permanent total disability which were used as the bases vary considerably and consequently the percentages, while showing the relationship between permanent partial and permanent total disabilities in a given State, are incomparable as between different States. This relationship is shown in Table 18, in which the scale of time losses as determined by the committee on statistics and compensation insurance cost of the International Association of Industrial Accident Boards and Commissions is used as the base. In formulating this schedule of severity ratings of injuries, permanent total disability, rated at 1,000 weeks, was used as the base and the partial disabilities computed therefrom. The purpose of the schedule, as already noted, was to obtain a more accurate measure of industrial hazards, the schedule not being intended as a basis of compensation awards. In fact, the committee disclaims any such intention. Assuming, however, that the schedule is a reasonable measure of adequacy for compensation payments, it is interesting to note the percentages of adequacy of payments for the more. important injuries provided for by the several State compensation

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