IN THE CASE OF: BOARD DATE: 11 January 2018 DOCKET NUMBER: AR20170013642 BOARD VOTE: ___x____ ___x____ ___x____ GRANT FULL RELIEF ________ ________ ________ GRANT PARTIAL RELIEF ________ ________ ________ GRANT FORMAL HEARING ________ ________ ________ DENY APPLICATION 2 Enclosures 1. Board Determination/Recommendation 2. Evidence and Consideration IN THE CASE OF: BOARD DATE: 11 January 2018 DOCKET NUMBER: AR20170013642 BOARD DETERMINATION/RECOMMENDATION: The Board determined the evidence presented is sufficient to warrant a recommendation for relief. As a result, the Board recommends that all Department of the Army records of the individual concerned be corrected by awarding him the Purple Heart for wounds he received in Afghanistan on 11 March 2012. __________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. IN THE CASE OF: BOARD DATE: 11 January 2018 DOCKET NUMBER: AR20170013642 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 award of the Purple Heart. 2. The applicant states, in effect, he has x-ray findings and a doctor's note that support his request for the Purple Heart. 3. The applicant provides a self-authored statement and the following: * Standard Form (SF) 600 (Chronological Record of Medical Care), dated 11 March 2012 * DA Forms 2823 (Sworn Statement), dated 3 April 2012 * radiology results, dated 26 January 2017 * a memorandum from his physician, dated 21 February 2017 CONSIDERATION OF EVIDENCE: 1. The applicant is currently serving in the Regular Army in the rank/grade of staff sergeant (SSG)/E-6. 2. The applicant deployed to Afghanistan on or about 30 November 2011 in support of Operation Enduring Freedom (OEF). 3. While serving in Afghanistan, on 11 March 2012, a rocket landed inside the applicant's unit's occupied command outpost (COP). He was approximately 5 to 10 meters away from the point of impact; he received shrapnel lacerations to his left ear and several pieces of shrapnel became imbedded in his left buttock area. 4. By DA Form 4187, dated 3 April 2012, the applicant's commander recommended him for the Purple Heart for wounds received as a result of enemy hostile actions. 5. The applicant provides two sworn statements from witnesses, dated 3 April 2012. These statements state: a. The applicant was outside at the time, in the vicinity of the detonation site, approximately 5 to 10 meters from the impacted area. He was hit by several pieces of shrapnel and received lacerations to his left ear lobe and several pieces of shrapnel were embedded into his left buttock. b. The witness was in the gym conducting physical training when the round impacted. After the impact he took off running towards the company. During this time he saw the applicant running from the vicinity of the smoke/dust. Once an all clear was given he was informed that the applicant had received some injuries from the rocket attack. 6. A memorandum from the Chief, Soldier Programs and Services Division, U.S. Army Human Resources Command (HRC), Fort Knox, KY, dated 20 January 2017, disapproved the applicant's request for award of the Purple Heart. It stated abrasions and lacerations are example of injuries or wounds that clearly do not justify award of the Purple Heart. 7. By DA Form 4187, dated 3 April 2017, the applicant's commander resubmitted the applicant for award of the Purple Heart for wounds/injuries received in action caused by the enemy. 8. The applicant provides: a. A self-authored statement, wherein he states that while deployed in Afghanistan, on 11 March 2012, he was knocked unconscious for approximately one to two minutes from an explosion. When he regained consciousness, not realizing he was injured, he proceeded to take accountability for his platoon. He was carried to the company medic where he was informed that he had a left ear laceration and multiple shrapnel fragments wedged in his buttocks. He was treated and informed that most of the remaining shrapnel would fall out over time. He was restricted to light duty for 48 hours. b. A Standard Form 600, dated 11 March 2012, noted the applicant received small lacerations from shrapnel; the shrapnel was removed and his lacerations were bandaged. c. Radiology results, dated 26 January 2017, noted there was a linear foreign body overlying the anterior soft tissues of the left hip. d. A letter from a Traumatic Brain Injury (TBI) Medical Director, Moncrief Army Health Clinic, Fort Jackson, SC, dated 21 February 2017, which states there is evidence of shrapnel in the applicant's left hip, based on an x-ray that shows a 6 millimeter (mm) metallic foreign body in the tissues of his hip. The physician has been treating his left hip pain with medication. REFERENCES: 1. Army Regulation 600-8-22 (Military Awards) prescribes Army policy, criteria, and administrative instructions concerning individual and unit military awards. 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. When contemplating an award of the Purple Heart, the key issue that commanders must take into consideration is the degree to which the enemy caused the injury. The fact that the proposed recipient was participating in direct or indirect combat operations is a necessary prerequisite, but is not the sole justification for award. d. Paragraph 2-8(g) provides for examples of enemy-related injuries that clearly justify award of the Purple Heart are as follows: (1) Injury caused by enemy bullet, shrapnel, or other projectile created by enemy action. (2) Injury caused by enemy-placed trap or mine. (3) Injury caused by enemy-related chemical, biological, or nuclear agent. e. Paragraph 2-9(h) provides for examples of injuries or wounds that clearly do not justify award of the Purple Heart, such as abrasions and lacerations (unless of a severity to be incapacitating). f. It is not intended that such a strict interpretation of the requirement for the wound or injury to be caused by direct result of hostile action be taken that it would preclude the award being made to deserving personnel. Commanders must also take into consideration the circumstances surrounding an injury, even it appears to meet the criteria. 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 Army Regulation 600-8-22 to reflect the clarifying guidance. a. Approval of the Purple Heart requires the following factors among others outlined in Department of Defense Manual 1348.33 (Manual of Military Decorations and Awards), Volume 3, paragraph 5c: wound, injury or death must have been the result of an enemy or hostile act, international terrorist attack, or friendly fire and the 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 Soldier's medical record. b. 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 Soldier’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. A medical officer is defined as a physician with officer rank. The following are medical officers: an officer of the Medical Corps of the Army, an officer of the Medical Corps of the Navy, or an officer in the Air Force designated as a medical officer in accordance with Title 10, U.S. Code, section 101. d. A medical professional is defined as a civilian physician or a physician extender. Physician extenders include nurse practitioners, physician assistants and other medical professionals qualified to provide independent treatment (for example, independent duty corpsmen and Special Forces medics). Basic corpsmen and medics (such as combat medics) are not physician extenders. e. When recommending and considering award of the Purple Heart for concussion injuries, the chain of command will ensure that the criteria are met and that both diagnostic and treatment factors are present and documented in the Soldier’s medical record by a medical officer. f. The following nonexclusive list provides examples of signs, symptoms or medical conditions documented by a medical officer or medical professional that meet the standard for the Purple Heart: (1) Diagnosis of concussion or mild traumatic brain injury; (2) Any period of loss or a decreased level of consciousness; (3) Any loss of memory of events immediately before or after the injury; (4) Neurological deficits (weakness, loss of balance, change in vision, praxis (that is, difficulty with coordinating movements), headaches, nausea, difficulty with understanding or expressing words, sensitivity to light, etc.) that may or may not be transient; and (5) Intracranial lesion (positive CT or magnetic resonance imagining (MRI) scan). g. The following nonexclusive list provides examples of medical treatment for concussion that meet the standard of treatment necessary for award of the Purple Heart: (1) Limitation of duty following the incident (limited duty, quarters, etc); (2) Pain medication, such as acetaminophen, aspirin, ibuprofen, etc., to treat the injury; (3) Referral to a neurologist or neuropsychologist to treat the injury; and (4) Rehabilitation (such as occupational therapy, physical therapy, etc.) to treat the injury. h. Combat theater and unit command policies mandating rest periods or downtime following incidents do not constitute qualifying treatment for concussion injuries. 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. DISCUSSION: 1. The applicant requests award of the Purple Heart. 2. On 11 March 2012, while deployed in Afghanistan, the applicant was knocked unconscious for approximately one to two minutes from an explosion. When he regained consciousness, not realizing he was injured, he proceeded to take accountability for his platoon. He was carried to the company medic where he was informed that he had a left ear laceration and multiple shrapnel fragments wedged in his buttocks. He was treated and informed that most of the remaining shrapnel would fall out over time. He was restricted to light duty for 48 hours. 3. A physician and x-ray findings confirm a 6mm metallic foreign body is still in place in the tissues of the applicant's hip. HRC denied the applicant the Purple Heart as abrasions and lacerations are examples of injuries that clearly do not justify award of the Purple Heart. As such, the only place he can receive relief for his request is through this Board. 4. The applicant received a laceration to his left ear and shrapnel to his left buttock as a result of enemy hostile actions. The governing regulation specifically provides for award of the Purple Heart for an injury caused by enemy bullet, shrapnel, or other projectile created by enemy action. The wound(s) must have required treatment by medical personnel, and the medical treatment must have been made a matter of official record. 5. The applicant was treated by medical personnel following the incident, he was restricted from duty for 48 hours and was prescribed medication, which was documented in his military records by a medical officer. //NOTHING FOLLOWS// ABCMR Record of Proceedings AR20150000953 Enclosure 1 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS ABCMR Record of Proceedings (cont) AR20170013642 2 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS Enclosure 1 ABCMR Record of Proceedings (cont) AR20170013642 6 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS Enclosure 2