By 1916, the U.S. federal government had spent more than $5 billion on Civil War pensions, more than the cost of the entire four-year war.
Established in the second year of the Civil War as a way to recruit Union soldiers, the pension system reassured enlisted men that their wives would receive payment if they were killed, or soldiers would receive a lifetime of financial support if injured.
Years later, as the United States prepared to enter World War I, politicians and economists were concerned about the pricey Civil War pensions, and the high cost of treating disabled veterans who would be returning from the Great War.
Progressive Era reformers saw rehabilitation as a cost-effective way of treating disabled veterans and helping them transition back into the workforce.
In her book “War’s Waste: Rehabilitation in World War I America,” Beth Linker, an assistant professor in the Department of History and Sociology of Science, chronicles how rehabilitation became the federal government’s official policy to “rebuild war cripples” returning from World War I, and subsequent wars thereafter.
Linker, a former physical therapist, says public policy officials had economic and ideological reasons for transforming the war pension system. By “curing” disability, she says policymakers believed they could avoid “the human cost of war.” A segment of these reformers also believed that work therapy could solve other societal ills, such as alcoholism, adultery and nervousness.
“The initial thinking was that all working-class men would receive rehabilitation, and that this would make a more efficient workforce, and a more efficient society,” she says.
During the Progressive era, the American people demanded changes in the war pension system because of corruption and “malingerers,” veterans who falsely claimed they were disabled. At the time, the term “disability” covered a wide array of ailments that included not only missing limbs, but also tuberculosis, chronic diarrhea and rheumatism. In order to make a pension claim, veterans needed to hire pension lawyers, and the American public objected to high-priced attorneys relying on the pension system for their livelihoods.
In addition, while the government gave pensions to war veterans, there were no benefits for those in the industrial workforce.
“There was no entitlement program for somebody who got disabled in the industrial workplace, so [the American people] looked at [the Civil War pension system] and thought it was a social injustice,” Linker says.
The amputee became the “poster child” for rehabilitation. Linker says this was because treating an amputee was fairly simple: Get him a limb.
Even in the early 20th century, Linker says amputees were given durable, workable artificial limbs with interchangeable sockets. Amputees’ arms, she says, really became tools that could be fitted with different instruments, including sports attachments, such as a catcher’s mitt.
The Army Medical Department was responsible for disabled veterans’ medical care, and operated curative workshops for them.
Linker says the workshops were similar to bringing grade school woodshop-type classes into hospitals. There were classes in automotive repair, woodworking, telegraphing, clerical work and film. Some men in the woodworking classes created or repaired their own artificial limbs.
As part of their rehabilitation, disabled men would work in a simulated environment performing motions they would use in a civilian job, such as sanding and hammering.
“This was going to be the wave of the future,” Linker says. “The amputee men coming back from the war would be literally plugged into their workstation, depending on what arm attachment they had.”
World War I veterans did receive disability pensions, but Linker says they were “very minimal” compared to Civil War pensions.
The federal government’s attempt to scale back entitlements to soldiers did not last long. World War II erupted, and Congress passed the G.I. Bill, which Linker says “had a lot of perks and benefits” in addition to rehabilitation.
“For most of the 20th century, veterans have enjoyed healthcare benefits that no [other] citizens have had, except if you’re a federal government employee,” she says.
Originally published on December 15, 2011