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Present Value at 41 Per Cent. Interest, compounded annually, of the Re

mainder of an Original Benefit of $1 per week for 300 Weeks.

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Explanation. – If the weekly compensation has been paid for a period of 28 weeks, the table shows that the value of $1 for the balance of the period is $242.87. If the weekly payment is $6 the lump sum value of the balance due under the Workmen's Compensation Act is 6 X $242.87 of $1,457.22.

THE MEDICAL AND WAITING PERIOD. As has already been shown, the average compensation under the act for injuries that last more than two weeks is less than $5.50 a week. During the first two weeks after the injury the injured workman is entitled to his reasonable hospital and medical services, to be paid by the insurance company. The waiting period for compensation was put in the law to prevent malingering, and because of the fear that if compensation began immediately after the injury it would give rise to unwarranted claims, on the basis of trifling injuries, under the act. While the chapter on malingering in this report will indicate that the Board has given full consideration to this important subject, there is no doubt that if the injury continues more than two weeks the medical attention provided is not sufficient to keep the employee from being a subject of charity, and is very much less than most of the other States have provided.

Michigan (section 4, Part II.) gives three weeks' medical attention.

Illinois (section 8a) provides necessary first-aid surgical and hospital services for a period not longer than eight weeks, not to exceed in amount $200.

Minnesota provides medical and surgical treatment, medicine, medical and surgical supplies, crutches and apparatus as may be reasonably required at the time of the injury and thereafter during the disability, but not exceeding ninety days, to cure and relieve from the effects of the injury, the same to be pro vided by the employer, and in case of his inability or refusal seasonably to do so, the employer to be liable for the reasonable expense incurred by or on behalf of the employee in providing the same, provided that the total liability shall not exceed the sum of $100; except that the court may, during said period of ninety days, upon necessity being shown therefor, require the employer to furnish such additional medical, surgical and hospital treatment and supplies as may be reasonable, which together with any such sums or relief theretofor furnished, shall not exceed in all $200 in value.

California (section 15) provides for such medical, surgical and hospital treatment, including nursing, medicine, medical and surgical supplies, crutches and apparatus, as may be reasonably required at the time of injury and within ninety days thereafter, to cure and relieve from the effects of the injury, the same to be provided by the employer, and in case of his neglect seasonably to do so, the employer shall be liable for the reasonable expense incurred thereby in behalf of the employee in providing the same.

Ohio (section 42), in addition to the compensation provided, disburses and pays from the State Insurance Fund such amounts for medical nursing and hospital services and medicines as it may deem proper, not to exceed in any instance the sum of $200.

Oregon (section 23) provides that the man may provide medical, surgical and hospital care not to cost more than $250 in any one case.

The Industrial Accident Board requests that the Legislature give the Board the power to require the payment of bills for medical and surgical treatment, medicine, medical and surgical supplies, crutches and apparatus when necessary, beyond the first two weeks after the injury, in unusual cases where the injury is so serious as to require and warrant such additional medical treatment.

THE MEDICAL PROBLEMS OF THE ACT.

While the Massachusetts law has seriously curtailed the incomes of many lawyers, the legal profession has accepted the act with a spirit of fairness. Some of the best lawyers in the Commonwealth have prosecuted appeals to the Supreme Court, without charge to injured employees, to help the Board to get the act judicially interpreted by our highest tribunal.

In Massachusetts, as elsewhere, the most embarrassing question that the Board has had to settle has been the charge for medical relief.

Section 13, Part II. of the act, says that fees of attorneys and physicians for services under this act shall be subject to the approval of the Industrial Accident Board. This law does not provide that all bills shall be thus approved. The liability insurance companies, through a long series of years, had practically driven the doctors into an attitude of antagonism towards the insurance companies in general. Insurance companies had medical examiners, investigators and friendly doctors to whom liberal fees were paid, but the insurance attitude towards the medical profession seemed to be that when treating industrial injuries physicians were dishonest and needed watching; an attitude which on the part of the doctors as a class was reciprocated in kind.

Under the act insurance companies dispute certain doctors' bills and submit them to the Board for action, but the Board has no knowledge whether even larger amounts for similar services to injured employees have not been paid to doctors favored by the insurance companies. Doctors, like every other class of human beings, have their minimum of black sheep. Some doctors have presented bills for services under the act which were many times as large for insurance cases as were charged for similar cases which were not insured. Doctors without special knowledge were sending specialists' bills for specific treatment. These bills were properly disputed by the insurance companies, but, taken as a whole the medical situation was one of extreme embarrassment for the Industrial Accident Board.

After sereral months of endeavor to meet this situation the Industrial Accident Board found it necessary to call together the medical societies of Massachusetts in conference, and a meeting of these societies was held at the State House on March 26, 1913. At this meeting the medical problems of the act were presented to the doctors by James B. Carroll, the chairman of the Board, as follows:

The Industrial Accident Board has asked you to come here to-day because we know that among the medical profession there is misunderstanding as to the operation of the Workmen's Compensation Act and the relation of the medical profession thereto. We are here to-day to correct any false impressions about the act, and to suggest that we get together in a spirit of justice and hearty co-operation.

In the first place, the Workmen's Compensation Act is a broad, humanitarian measure, and, as its name implies, it is primarily a workmen's compensation act, and for the benefit of no other class, calling or profession. It is provided in the act that when we hire an expert to examine an injured employee the maximum fee we can pay, under the statute, is $5, no matter how long or how difficult the examination. When we sit in judgment on these cases and arbitrators are called in, their fees are limited to $5. We must remember that every dollar paid under the Workmen's Compensation Act comes, fundamentally, out of the employers of Massachusetts, and any great expense placed on the administration of the act by hospitals or doctors means so much of an increase on the part of the obligations of the employers, and a corresponding decrease in the benefit which the toilers and the workers of the Commonwealth are to receive under it.

This act is designed to place personal injury cases upon something like a scientific and a humane basis of settlement, and the doctors, if the ratio of the past few months continues, will receive five times as much under the Workmen's Compensation Act as they did under the old Employers' Liability Act. Dealing with a statute, we have no election, except to construe that law as written. We are dealing with a condition and not a theory,

- an act as it passed the Legislature, under which the right to supply reasonable medical and hospital attention is exclusively and entirely with the insurance companies. In other words, under this act neither the injured man nor the employer has any right whatever to select his own physician. That is the exclusive duty and right of the

insurance company.

If the insurance company furnishes the hospital or makes a reasonable attempt to supply the medical and hospital attention, you, gentlemen, have no claim whatever against the insurance company. Your claim is

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