ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS IN THE CASE OF: BOARD DATE: 22 February 2019 DOCKET NUMBER: AR20170013095 APPLICANT REQUESTS: Purple Heart. APPLICANT'S SUPPORTING DOCUMENTS CONSIDERED BY THE BOARD: * DD Form 149 (Application for Correction of Military Record) * DA Form 4187 (Personnel Action), dated 2 April 2016 * Memorandum, subject: Award of Purple Heart for [applicant] * Medical records * Five Supporting Statements FACTS: 1. The applicant did not file within the three year time frame provided in Title 10, U.S. Code, section 1552 (b); however, the Army Board for Correction of Military Records conducted a substantive review of this case and determined it is in the interest of justice to excuse the applicant's failure to timely file. 2. The applicant states in effect: a. He meets the criteria for a Purple Heart as outlined in Army Regulation (AR) 600-8-22, but his application was denied by the Army Human Resource Command (HRC). b. He was a route clearance platoon leader in Baghdad, Iraq from 2007 to 2008. On 6 April 2008 during an overnight mission, his vehicle was directly hit with an Improvised Explosive Device (IED)/ Explosively Formed Penetrator (EFP). He reports his vehicle was hit with IEDs, however this time the blast went through the vehicle and destroyed the vehicle. The EFP penetrated directly through the armor in the vehicle and sliced through the helmet of the soldier sitting directly behind him. c. He reports he sustained a concussion leaving him with a permanent brain injury and shrapnel wounds to his left elbow and left wrist. After the blast for several weeks, he reports being out of it from the concussion and stumbling around dizzy to the point of being medical evacuated to a hospital. d. At the time of the incident, he was attached to a unit from another state. As a result, his unit did not complete the application for the Purple Heart. In 2010 the applicant's National Guard unit began paperwork to award him the Purple Heart, but the paperwork was lost after it was submitted. e. When he began to improve while in Iraq he continued to go out on combat missions, and there were few opportunity to follow up on the Purple Heart. He reports most of the medical treatment records done at the time in Iraq were not uploaded into his file because he was attached to a unit versus being assigned to a unit; however he saved copies of his medical records from that period of time. f. At the time he assumed that his head pain and dizziness would eventually heal, but it did not. He sought treatment from the Veterans Affairs for post concussive injury and nerve damage in his head over the last nine years. He reports anytime he is bumped into or he bumps into anyone/ anything he experiences stinging head pain and frequently experiences dizziness. g. All the symptoms began after the IED blast that destroyed his vehicle in 2008. He notes he did not experience any of the issues prior to the incident. The shrapnel injury is documented in his medical treatment records and is supported by two eye witnesses who were on patrol with him. 3. On 10 September 2005, the applicant commissioned as an officer in the Missouri Army National Guard in the Corp of Engineers and was mobilized effective on/ about 19 August 2007, in support of Operation Iraq Freedom. 4. On 6 April 2008 the applicant underwent a Military Acute Concussion Evaluation (MACE). The assessment shows the applicant did not have a diagnosis of a concussion. 5. On 11 April 2008, the applicant received a DA Form 2173 (Statement of Medical Examination on Duty Status) showing the applicant received minor punctures/ penetrations and first degree burns to the right proximal forearm. He was positioned in the front right seat in the vehicle when an IED/EFP blast struck the middle of the vehicle while conducting route clearance on 6 April 2008. 6. On 11 April 2008 the applicant was referred to Neurologist with a provisional diagnosis of mild traumatic brain injury (MTBI). 7. On 12 April 2008 the applicant was diagnosis with MTBI by unit Physician Assistant. 8. On 13 April 2008 the applicant was evaluated a second time using the MACE. The assessment shows the applicant presented with concussion without loss of consciousness. 9. Permanent Orders 133-007 show the applicant received a Combat Action Badge for actively engaging or being engaged by the enemy. 10. On 15 April 2008 the applicant was seen by a neurologist. His assessment shows no problems were found. The assessment states in regards to concussion the applicant was mentally clear but had residual headaches. He was instructed to stay off mission until the headaches cleared. 11. On 16 April 2008 the applicant was seen for worsening/ongoing headaches. He was diagnosed with post-concussion syndrome. 12. On 17 July 2008 the applicant redeployed. 13. The applicant provided five statements confirming the IED/EFP explosion that impacted his vehicle on 6 April 2008. 14. On 2 April 2016 the applicant submitted a packet to Army Human Resources Command (HRC) requesting to be awarded the Purple Heart. 15. On 30 August 2016, HRC informed the applicant that, after careful consideration of his request, award of the Purple Heart Award was disapproved. HRC noted that a review of the Armed Forces Longitudinal Health Technical Application (AHLTA) by the HRC command surgeon did not reflect documentation pertaining to a diagnosis or treatment concerning TBI. Records notes that at the time of the incident, the applicant was treated by a medic for superficial wounds to the right forearm. The lack of diagnosis or supporting medical documentation made it impossible to connect an injury to the incident. 16. In accordance with Military Personnel (MILPER) Message Number 11-125, Army Directive 2011-07 (Awarding the Purple Heart), and Army Regulation 600-8-22 (Military Awards), the applicant must have received wounds sustained 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 medical treatment from medical personnel, and the medical treatment must have been made a matter of official record. The criteria for award of the Purple Heart for a concussion or MTBI requires formal diagnosis of concussion or, limitation of duty following the incident, pain medication such as acetaminophen, aspirin, and ibuprofen to treat injuries such as headaches, referral to neurologist or neuropsychologist to treat the injury. BOARD DISCUSSION: After review of the application and all evidence, one Board member granted relief while the other two denied relief. The one vote to grant was based off of injuries listed after the enemy contact. A Board majority determined that his injuries were not severe enough or of the nature necessary to meet regulatory guidance. BOARD VOTE: Mbr 1 Mbr 2 Mbr 3 : :X : GRANT FULL RELIEF : : : GRANT PARTIAL RELIEF : : : GRANT FORMAL HEARING :X : :X DENY APPLICATION 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. SIGNATURE: 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. REFERENCES: 1. Army Regulation 600-8-22 (Military Awards) states the Purple Heart is awarded for a wound sustained 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 medical treatment from medical personnel, and the medical treatment must have been made a matter of official record. 2. Military Personnel (MILPRE) Message Number 11-125 and Army Directive 2011-07 (Awarding the Purple Heart) provide clarifying guidance on award of the Purple Heart for concussions. When recommending and considering award of the Purple Heart the chain of command will ensure substantiating evidence is provided to verify that the wound was the result of hostile action, the wound must have required medical treatment from medical personnel, and the medical treatment must have been made a matter of official record. The following non-exclusive list provides examples of signs and symptoms or medical conditions documented by a medical officer or medical professional that meets the standard for award of the Purple Heart: Diagnosis of concussion or mild traumatic brain injury, any period of loss or a decrease of consciousness, any loss of memory for events immediately before or after the injury, Neurological deficits (weakness, loss of balance, change in vision, praxis, headaches, nausea, difficulty with understanding or expressing words sensitivity to light) that may or may not be transient. The following non-exclusive list provide examples of medical treatment for concussions that meet the standard of treatment necessary for award of the Purple Heart: Limitation of duty following the incident (limited Duty, Quarters), pain medication such as acetaminophen, aspirin, ibuprofen to treat injury such as headaches, referral to neurologist or neuropsychologist to treat the injury.