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Rosemarie Garland-Thomson maintains “that disability, like femaleness, is not a natural state of corporeal inferiority, inadequacy, excess, or a stroke of misfortune. Rather, disability is a culturally fabricated narrative of the body.”⁷ In the 1940s, AFPH members, like Scott, began to recognize and confront socially constructed narratives of disability that limited their participation in the workforce and their lives as citizens.

      The AFPH enabled members to look beyond individual struggles and identify a broader pattern of disability exclusions that belied narratives of individual failure and faults. More than an end to disability discrimination, AFPH leaders and members imagined a society in which state policy made possible disabled individuals’ full participation in civic life. While its demands changed over time, the AFPH sought a range of federal services to facilitate the employment of people with disabilities, advocating for greater access to government employment, employment placement assistance, and legislation requiring employers to hire people with disabilities. The organization further called for a federal pension program for people with disabilities years before Congress extended social insurance to disability or aid to people with disabilities beyond blindness, which had been written into the original Social Security Act. AFPH activists demanded improved access to health care and education, increased building access, better safety and hygiene programs, and federally funded research on various disabilities and potential treatments. Moreover, they envisioned a state in which people with disabilities participated in the development and administration of the policies that would shape their lives.⁸

      As a national, cross-disability social movement organization, the AFPH represented something new. The AFPH pulled thousands of disabled citizens—civilians and veterans with a range of physical disabilities—into the national political arena, demanding equal access to economic security and its corollary, economic citizenship, where older organizations had grown around a single disability, a local community, or military service.⁹ AFPH leaders claimed that all Americans with disabilities had much in common. Indeed, AFPH chapters facilitated a more universal notion of disability as members’ interactions with one another sensitized them to the challenges of others’ disabilities. These interactions fostered a sense that disability exclusions transcended the specific type of disability or the way it was acquired and that only national activism and federal action could create a better situation. Beyond its disabled constituents, the organization won the powerful support of labor leaders in the AFL, Congress of Industrial Organizations (CIO), United Mine Workers of America (UMWA), International Association of Machinists (IAM), and other unions.¹⁰

      This vision had its limitations. As the organization’s name suggests, AFPH leaders and members imagined a society and state accessible to people with physical disabilities. Furthermore, members and leaders often claimed rights on the basis of their mental abilities. The distinction is significant. Historian Douglas C. Baynton has demonstrated that disability served as a powerful tool to “justify inequality” in American history. In the nineteenth and early twentieth centuries, he maintains, disability shaped arguments for slavery, against women’s suffrage, and for immigration restrictions. Essentially, these arguments pointed to socially constructed narratives of physical and mental frailties and deficiencies of African Americans, women, and certain ethnic groups to protect the institution of slavery and guard against expanding the boundaries of citizenship. Instead of challenging exclusions based on disability, he argues, social movements for greater equality have often refuted their association with disability.¹¹ When AFPH members emphasized physically disabled people’s mental ability, they reified the notion that at least some kinds of disability justified exclusion, even as they sought to create an accessible state and dismantle, or at least reframe, disability exclusions.

      Disability placed AFPH members outside what historian and legal scholar Barbara Young Welke calls the “borders of belonging.” Welke argues that throughout the long nineteenth century, notions of ability and disability, alongside race and gender, infused the law “with legal consequences of inclusion and privilege or exclusion and subordination.”¹² Scholars have shown that state growth in the twentieth century both reflected and reinforced gendered, racial, and class-based hierarchies. Indeed, twentieth-century state growth expanded the systems of exclusion rather than constricting them as state efforts to police homosexuality helped to construct a “homosexual-heterosexual binary” that like gender and race would shape access to the rights of citizenship.¹³

      I argue that ability and disability—the (dis)ability binary—continued to shape the ways Americans defined and codified the rights of citizenship; notions of fitness, dependency, and entitlement; and the responsibilities of the state to its citizens in the twentieth century. Mildred Scott and the AFPH more broadly encountered state policy built around the idea that disability represented a problem to be solved and disabled individuals others who needed to be excluded, contained, or aided because they could not fulfill the social and economic roles defined by their gender and class.

      In the midst of dramatic economic, social, and political change of the late nineteenth and early twentieth centuries, disability inspired and framed significant state growth.¹⁴ At the turn of the century, workplace accidents annually killed or at least temporarily disabled one worker in every fifty.¹⁵ American workplaces were the most dangerous in the industrialized world, with risk of injury, disability, and death so high as to inspire comparisons to warfare.¹⁶ The rising human toll of industry informed Progressive Era reformers’ desire to ease the plight of workers and curb the excesses of industrial capitalism. Between 1910 and 1925, all but five states adopted workers’ compensation laws that mandated financial restitution for injured workers. Historian John Fabian Witt argues that these efforts to cope with the carnage of American industry transformed the legal system with “new ideas and institutions organized around risk, security, and the actuarial categories of insurance” that would offer Americans disabled at work new rights but also frame social policy and the rise of the administrative state in the first four decades of the twentieth century.¹⁷

      As the terrifying rate of industrial accidents, a new wave of immigrants, who were viewed as physically, mentally, and morally suspect, World War I, and successive polio epidemics repeatedly brought disability into focus, Americans adopted a range of strategies to address what they perceived as a growing problem. At its most grim, the response to this growing awareness of disability gave rise to policies of involuntary institutionalization and sterilization targeting individuals deemed “feebleminded,” immigration restrictions, and anti-begging ordinances that banned individuals who were “diseased, maimed, mutilated, or deformed in any way, so as to be unsightly or disgusting” from being seen in public.¹⁸

      The federal government had always provided some sort of compensation to disabled veterans through “invalid” pensions, but by the early twentieth century the veteran pension system contributed to the sense of crisis around disability. By 1915, Civil War pensions cost the nation more than two hundred million dollars a year. In costs and loss of productivity, the Civil War pension system embodied what proponents of a new system would call “war’s waste.” During World War I, progressive reformers transformed the veteran pension system. With the War Risk Insurance Act of 1917, they attempted to provide financial security for disabled veterans who faced systematic discrimination in the labor market and veterans with more severe disabilities who were unable to work. Equally as important, the federal government instituted a system of medical rehabilitation, and later vocational rehabilitation, for veterans injured in combat. Through rehabilitation, reformers sought to salvage disabled men and equip them to become productive citizens once again.¹⁹

      Congress extended vocational, but not medical rehabilitation, to civilians “disabled in industry or otherwise” in 1920 with the Industrial Rehabilitation Act, or Smith-Fess Act.²⁰ The administration of the civilian rehabilitation program reflected and supported a particular understanding of citizenship, belonging, and workers. Women, people of color, and people with the most severe disabilities were typically excluded, with the average rehabilitation recipient being a thirty-one-year-old white man. Moreover, the U.S. Office of Education that ran the program, designed to return disabled men to productive labor, required that rehabilitation caseworkers be “physically capable.”²¹ The desire to rehabilitate disabled individuals built on changing notions of dependency,

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