BOARD DATE: 1 August 2018 DOCKET NUMBER: AR20160019208 BOARD VOTE: _________ _______ ________ GRANT FULL RELIEF ________ ________ ________ GRANT PARTIAL RELIEF ________ ________ ________ GRANT FORMAL HEARING ____x____ ___x_____ ___x_____ DENY APPLICATION 2 Enclosures 1. Board Determination/Recommendation 2. Evidence and Consideration BOARD DATE: 1 August 2018 DOCKET NUMBER: AR20160019208 BOARD DETERMINATION/RECOMMENDATION: The evidence presented does not demonstrate the existence of a probable error or injustice. Therefore, the Board determined the overall merits of this case are insufficient as a basis for correction of the records of the individual concerned. ______________x___________ CHAIRPERSON I certify that herein is recorded the true and complete record of the proceedings of the Army Board for Correction of Military Records in this case. BOARD DATE: 1 August 2018 DOCKET NUMBER: AR20160019208 THE BOARD CONSIDERED THE FOLLOWING EVIDENCE: 1. Application for correction of military records (with supporting documents provided, if any). 2. Military Personnel Records and advisory opinions (if any). THE APPLICANT'S REQUEST, STATEMENT, AND EVIDENCE: 1. The applicant requests, in effect, award of the Purple Heart. 2. The applicant states, in effect, the denial for award of the Purple Heart by the U.S. Army Human Resources Command (HRC) should be overturned. He believes that all medical documentation was not considered. 3. The applicant provides the following: * Standard Form (SF) 600 (Health Record – Chronological Record of Medical Care) * DA Form 1156 (Casualty Feeder Card) * Memorandum for Purple Heart * letter from HRC * Army Regulation (AR) 600-8-22 (Military Awards), paragraph 2-8 (Purple Heart) CONSIDERATION OF EVIDENCE: 1. The applicant enlisted in the Louisiana Army National Guard (LAARNG) on 23 March 1998. He completed training and was awarded military occupational specialty 13F (Fire Support Specialist). 2. He entered active duty on 24 April 2004 in support of Operation Iraqi Freedom (OIF). He served in Iraq from 6 October 2004 to 9 September 2005. He was honorably released from active duty on 23 October 2005 and was transferred to a LAARNG unit. His DD Form 214 does not show he was awarded or authorized the Purple Heart. 3. He again entered active duty on 5 January 2010 in support of OIF. He served in Iraq from 15 March to 15 December 2010. 4. He provides the following: a. An SF 600 showing he received medical treatment on 26 April 2010 for a concussion with no loss of consciousness due to an injury from a terrorist explosion improvised explosive device (IED). The form stated he was in the led vehicle that was hit by the IED and he was the vehicle's commander. He denied any loss of consciousness and remembered all events before and after the incident. He had a localized headache to the posterior aspect of his head, radiating to his neck. He also had some neck stiffness, but denied hitting his head. He had some initial ringing in his ears; however, that was resolved. He scored a 27.30 on his military acute concussion evaluation (MACE) and denied any musculosketal injury. He was diagnosed with a concussion with no loss of consciousness for IED blast. His neck pain was treated with Mobic and Flexerill, and he was released without limitations. The disposition was sick at home/quarters for 48 hours and Motrin. b. A DA Form 1156, dated 4 July 2010, which stated on 25 April 2010, at or about 2135 hours local time, GRYPHON 16, a combat logistics patrol was hit by an IED by the enemy, during combat operations in Iraq, in direct support of OIF 09-10. The form stated he was the truck commander. c. A Memorandum for Purple Heart, dated 5 August 2010, wherein the Commander, Headquarters, 1-141st Field Artillery Battalion, stated: (1) The applicant's recommendation for a Purple Heart was being submitted late for several reasons. The applicant was first treated at Emily Perez Treatment Facility in Kalsu immediately after the combat engineer tractor was hit with an IED. The prognosis from that treatment was the applicant was suffering from neck injury, not a concussion, which did not warrant submitting the paperwork to recommend a Purple Heart. (2) From Kalsu, the applicant was transported to the 28th Combat Support Hospital (CSH) at Forward Operating Base Sather. It was there that the applicant was evaluated again. The prognosis from the evaluation was that he had suffered a concussion from the IED blast which did warrant the submission for the Purple Heart recommendation. (3) The 28th CSH turned over the medical documents from that treatment to the applicant, who just recently gave him a copy of the medical documents. After reading the findings, he fully believed the applicant meet the requirements to receive a Purple Heart. 5. He was honorably released from active duty on 17 February 2011 and was transferred to a LAARNG unit. His DD Form 214 does not show he was awarded or authorized the Purple Heart. 6. In a letter, dated 27 September 2016, the Chief, Soldier Programs and Services Division, HRC, disapproved his request for award of the Purple Heart. The HRC official stated after careful consideration with the HRC Command Surgeon's office, the award of the Purple Heart for that particular event did not meet the statutory guidance in accordance with AR 600-8-22, paragraph 2- 8h(16). The circumstances surrounding the incident and medical documentation described the extent of the injury as a soft tissue injury. Although unfortunate, soft tissue injuries do not meet the requirements for award of the Purple Heart. He was advised to seek further relief at the Army Board for Correction of Military Records. REFERENCES: 1. AR 600-8-22 prescribes Army policy, criteria, and administrative instructions concerning individual and unit military awards. The regulation states: a. The Purple Heart is awarded for a wound sustained while in action against an enemy or as a result of hostile action. Substantiating evidence must be provided to verify that the wound was the result of hostile action, the wound must have required treatment by medical personnel, and the medical treatment must have been made a matter of official record. b. A wound is defined as an injury to any part of the body from an outside force or agent sustained under one or more of the conditions listed above. A physical lesion is not required. However, the wound for which the award is made must have required treatment, not merely examination, by a medical officer. Additionally, treatment of the wound will be documented in the Service member’s medical and/or health record. Award of the Purple Heart 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 was such that they would have required treatment by a medical officer if one had been available to treat them. c. Examples of enemy-related injuries that clearly justify award of the Purple Heart include concussion injuries caused as a result of enemy-generated explosions resulting in a mild traumatic brain injury (TBI) or concussion severe enough to cause either loss of consciousness or restriction from full duty due to persistent signs, symptoms, or clinical finding, or impaired brain function for a period greater than 48 hours from the time of the concussive incident. d. Examples of injuries or wounds that clearly do not justify award of the Purple Heart include post-traumatic stress disorders, hearing loss and tinnitus, mild TBI or concussions that do not either result in loss of consciousness or restriction from full duty for a period greater than 48 hours due to persistent signs, symptoms, or physical finding of impaired brain function. Also soft tissue injuries (for example, ligament, tendon or muscle strains, sprains, and so forth). 2. Army Directive 2011-07 (Awarding the Purple Heart), dated 18 March 2011, provides clarifying guidance to ensure the uniform application of advancements in medical knowledge and treatment protocols when considering recommendations for award of the Purple Heart for concussions (including mild TBI and concussive injuries that do not result in a loss of consciousness). The directive also revised AR 600-8-22 to reflect the clarifying guidance. a. Combat theater and unit command policies mandating rest periods or downtime following incidents do not constitute qualifying treatment for concussion injuries. b. To qualify as medical treatment, a medical officer or medical professional must have directed the rest period for the individual after diagnosis of an injury. 3. The MACE is a standardized mental status examination that is used to evaluate mild TBI, or concussion, in theater. This screening tool was developed to evaluate a person with a suspected concussion and is used to identify symptoms of a mild TBI. Future MACE scores can be used to determine if the patient’s cognitive function has improved or worsened over time. To be most effective, all service members experiencing concussion, or mild TBI, should have the MACE administered within the first 24 hours of the event in order to make certain that proper care is administered in a timely fashion. The MACE, in combination with a medical exam, can be used to help determine if it is safe for a service member to return to duty. DISCUSSION: 1. HRC disapproved his request for award of the Purple Heart based on a review by the Command Surgeon's office and cited that the circumstances surrounding the incident and medical documentation described the extend of the injury as a soft tissue injury. By regulatory guidance, soft tissue injuries do not meet the requirements for award of the Purple Heart. 2. The evidence of record shows the applicant received medical treatment on 26 April 2010 due to an injury from an enemy IED. At the time of examination, he denied any loss of consciousness, reported a localized headache to the posterior aspect of his head, some neck stiffness, but denied hitting his head. He scored a 27.30 on his MACE and denied any musculosketal injury. He was diagnosed with a concussion with no loss of consciousness for IED blast. He was treated for neck pain with Mobic and Flexerill, and he was released without limitations. 3. None of the available evidence indicates the applicant suffered a concussion or TBI so disabling as to cause either loss of consciousness or restriction from full duty due to persistent signs, symptoms, or clinical finding, or impaired brain function for a period greater than 48 hours from the time of the concussive incident per applicable Army regulations and directives in order to meet the requirements of award of the Purple Heart. //NOTHING FOLLOWS// ABCMR Record of Proceedings AR20150000953 Enclosure 1 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS ABCMR Record of Proceedings (cont) AR20160019208 2 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS Enclosure 1 ABCMR Record of Proceedings (cont) AR20160019208 2 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS Enclosure 2