RECORD OF PROCEEDINGS
AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS

IN THE MATTER OF: 			DOCKET NUMBER: BC-2015-04018

   						COUNSEL:  NONE

						HEARING DESIRED:  NO 

APPLICANT REQUESTS THAT:

He be awarded the Purple Heart (PH) Medal. 

APPLICANT CONTENDS THAT:

He was directly involved in hostile attacks while serving as security for a truck convoy which effected his mental state and created cognitive disorders, to include traumatic brain injury (TBI). 

The applicant’s complete submission, with attachments, is at Exhibit A.

STATEMENT OF FACTS:

The applicant initially entered the Regular Air Force on 29 Aug 00.

According to the documentation submitted by the applicant:

	a.  Under Special Order No. ACD-02445, dated 14 Jun 13, the applicant was relieved from active duty and was placed on the Temporary Disability Retired List (TDRL) with a compensable physical disability rating of 50 percent.  

b.  On 26 Mar 14, the Department of Veterans Affairs notified the applicant he had a combined disability rating of 100 percent, effective 29 Aug 13. 

c.  Under Special Order ACD-01926, the applicant was removed from the TDRL and permanently retire with a compensable disability rating of 50 percent, effective 26 May 14. 

The remaining relevant facts pertaining to this application are contained in the memoranda prepared by the Air Force offices of primary responsibility (OPRs), which are attached at Exhibits C, F, and G.    

AIR FORCE EVALUATION:

AFPC/DP3SP recommends denial indicating there is no evidence of an error or an injustice.  The Purple Heart (PH) award is awarded to members of the United States Armed Forces who have been wounded, killed, or who have died or may hereafter die of wounds received in action against an enemy of the United States or opposing force as a result of an act of any such enemy or opposing armed force, an international terrorist attack or during military operations while serving as a part of a peacekeeping force.  A wound for which the award is made must have required treatment, not merely examination, by a medical officer.  Additionally, treatment of the wound shall be documented in the service member’s medical and/or health record.  Award of the PH may be made for wounds treated by a medical professional other than a medical officer, provided a medical officer includes a statement in the service member’s medical record that the extent of the wounds were such they would have required treatment by a medical officer if one had been available to treat them. 

A thorough review of the applicant's official military personnel record did not verify award of the PH.  Although the applicant provided an eyewitness statement, he did not provide his detailed account of the incident, to include how he was injured, the exact date of the injury, his unit of assignment and rank held at the time of the injury, nor was any medical documentation provided indicating the applicant sustained an injury due to enemy action.  Without a complete package we are unable to forward the applicant's request to the original award approval authority for consideration.  Recommend disapproval for award of the PH.  

A complete copy of the AFPC/DP3SP evaluation is at Exhibit C.

APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

In further support of his application, the applicant submitted a response to the Air Force evaluation consisting of a personal statement which outlines the details of the mission on which he was allegedly injured, and submitted a significant amount of supporting medical documentation.  (Exhibit E) 

ADDITIONAL AIR FORCE EVALUATIONS:

The AFBCMR Medical Consultant notes the applicant has not satisfactorily established he has met all the criteria for award of the PH.  When contemplating an award of the PH, the key issue commanders must take into consideration is the degree to which the enemy caused the injury. The fact the proposed recipient was participating in direct or indirect combat operations is a necessary prerequisite, but is not sole justification for award.  

A wound for which the award is made must have required treatment by a medical officer and records of medical treatment for wounds or injuries received in action must have been made a matter of official record.

Addressing the applicant’s medical condition(s), the Medical Consultant opines that IF the applicant sustained a TBI due to an Improvised Explosive Device (IED) detonation in Nov 05 and required treatment by a medical officer, then he would meet criteria for the PH.  The uncertain issues in the case under review include the following: 

	(1) The applicant’s “injury” occurred in 2005; there is no evidence he required treatment by a medical officer at the time of injury or for several years following the “injury.”  It was not until 14 Jul 11, at the Mental Health Clinic (MHC), Wilford Hall Medical Center (WHMC), the applicant presented with “random irritability and depression” and expressing interest in possible psychotropic medication and evaluation for PTSD.”  At that time, the provider noted, “Patient reported that he started realizing the symptoms this last year but after looking back they started around 2006 following his 2005 deployment.”  

	(2)  Neuropsychological testing conducted in 2011 also did not demonstrate a nexus between the applicant’s concussion of 2005 and his cognitive impairment. 

	(3)  A neurologist attributed the applicant’s headaches to common migraine.

	(4)  Rehabilitative efforts were not established until 2014.  

	(5)  Accordingly, the service treatment record frequently referred to TBI as “history of,” which can be interpreted to mean the diagnosis was considered only by the applicant’s self-report and the plausible traumatic history disclosed and of record.

The applicant was clearly exposed to an IED detonation in 2005.  The evidence also supports the development of PTSD as a result of his combat experiences.  What has not been definitively established to the satisfaction of this reviewer is whether all applicable qualifying criteria for award of the PH have been met.  The Medical Consultant recommends returning the case to AFPC/DP3SP for reconsideration by the Purple Heart board, since the evidence not previously available has now been made available.  

A complete copy of the AFBCMR Medical Consultant evaluation is at Exhibit F.

AFPC/DP3SP again recommends denial indicating there is no evidence of an error or an injustice.  In accordance with AFI 36-2803, The Air Force Military Awards and Decorations Program, “A wound for which the award is made must have required treatment, not merely examination, by a medical officer at the time of wounding.”  All PH requests must demonstrate the wound or injury was the result of enemy action and required treatment by a medical officer at the time of injury.  Furthermore per the current AFI: for award of the PH for mild TBI (mTBI) or concussive injury that did not result in loss of consciousness the injury must have required treatment, not merely examination, by a medical officer.  Medical documentation must contain evidence of residual cognitive deficits and disorders and/or persistent signs, symptoms, or findings of functional impairment requiring medical treatment or support by a medical officer. Specifically listed in the AFI of injuries which clearly do not justify award of the PH include: post-traumatic stress disorders.

The applicant's rebuttal request was forwarded to the original approval authority, United States Air Forces Central Command (USCENTCOM) for reconsideration.  A thorough review of medical documentation available in the Theater Medical Data Server and/or Armed Forces Health Longitudinal Technology Application, established the injuries sustained by the applicant DO NOT MEET CRITERIA for award of the PH.  

A complete copy of the AFPC/DP3SP evaluation is at Exhibit G.

APPLICANT'S REVIEW OF THE ADDITIONAL AIR FORCE EVALUATIONS:

Copies of the additional Air Force evaluations were forwarded to the applicant on 17 Nov 16 for review and comment within 30 days (Exhibit H).  As of this date, no response has been received by this office.

THE BOARD CONCLUDES THAT:

1.  The applicant has exhausted all remedies provided by existing law or regulations.

2.  The application was not timely filed.

3.  Insufficient relevant evidence has been presented to demonstrate the existence of an error or injustice.  We took notice of the applicant’s complete submission in judging the merits of the case; however, we agree with the opinions of the office of primary responsibility (OPR) and the AFBCMR Medical Consultant and adopt their rationale as the basis for our conclusion the applicant has not been the victim of an error of injustice.  Therefore, in the absence of evidence to the contrary, we find no basis to recommend granting the requested relief.

THE BOARD DETERMINES THAT:

The applicant be notified the evidence presented did not demonstrate the existence of material error or injustice; the application was denied without a personal appearance; and the application will only be reconsidered upon the submission of newly discovered relevant evidence not considered with this application.

The following members of the Board considered AFBCMR Docket Number BC-2015-04018 in Executive Session on 24 Jan 17 under the provisions of AFI 36-2603:

	Panel Chair
	Member
	Member

The following documentary was considered:

	Exhibit A.  DD Form 149, dated 15 Sep 15, w/atchs.
	Exhibit B.  Applicant's Master Personnel Records.
	Exhibit C.  Memorandum, AFPC/DP3SP, dated 8 Apr 16.
	Exhibit D.  Letter, SAF/MRBR, dated 19 Apr 16.
	Exhibit E.  Letter, Applicant, dated 24 Apr 16, w/atchs. 
Exhibit F.  Memorandum, AFBCMR Medical Consultant, dated 22 Jul 16. 
	Exhibit G.  Memorandum, AFPC/DP3SP, dated 4 Nov 16, w/atch. 
	Exhibit H.  Letter, AFBCMR, dated 17 Nov 16.  

Pursuant to paragraph 1 of AFI 36-2603 (Title 32 Code of Federal Regulations, Part 865.1), it is certified that a quorum was present at the Board's review and deliberations, and that the foregoing is a true and complete record of the Board's proceedings in the above entitled matter.