IN THE CASE OF: BOARD DATE: 21 May 2020 DOCKET NUMBER: AR20190010213 APPLICANT REQUESTS: * award of the Purple Heart (PH) * award of the Combat Action Badge (CAB) * DD Form 215 (Correction to DD Form 214, Certificate of Release or Discharge from Active Duty) reflecting the PH and CAB * personal appearance hearing before the Board APPLICANT'S SUPPORTING DOCUMENTS CONSIDERED BY THE BOARD: * DD Form 149 (Application for Correction of Military Record), dated 20 February 2018 * Orders A-02-103192, U.S. Army Human Resources Command (HRC), dated 14 February 2011 * pictures, rocket attack, Adraskan National Training Center (ANTC) Adraskan , Afghanistan, 7 October 2011 * document, Regional Command West, International Security Assistance Force, dated 8 October 2011 * two (2) DA Form 2823 (Sworn Statement), dated 21 November 2011 * pictures, ANTC Adraskan, Afghanistan, dated 24 February 2012 * DA Form 2823, dated 28 February 2012 * DD Form 214, dated 6 February 2013 * DA Form 2823, dated 4 April 2013 * memorandum, Massachusetts Army National Guard (MAARNG), dated 1 November 2013 * letter, dated 4 February 2014 * Orders 131-014, Joint Force Headquarters, MAARNG, dated 10 May 2016 * memorandum, dated 30 October 2017 * memorandum, 27 April 2017 * letter, HRC, dated 15 May 2017 * memorandum, dated 30 October 2017 * memorandum, dated 9 February 2018 * applicant statement, dated 20 February 2018 * two (2) memorandum, dated 20 February 2018 * letter, Congress of the United States – House of Representatives, dated 21 February 2018 * email copy, 14 March 2018 * letter, Army Review Board Agency (ARBA), dated 23 March 2018 * letter, HRC, 27 December 2018 * email copy, 29 July 2019 * letter, ARBA, 5 March 2020 * letter with two (2) attachments , Congress of the United States – House Representatives, dated 29 January 2020 * rated disabilities * request narrative, Bronze Star Medal (BSM) * Neuropsychological Assessment Confidential * video narrative – Afghanistan attack video FACTS: 1. The applicant did not file within the three-year period provided in Title 10, United States Code, section 1552(b); however, the ABCMR 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, his award of the PH and the CAB were initiated while he was assigned to the 3-85th Mountain (MTN) Warrior Transition Battalion (WTB) after he returned from deployment for injury treatment and evaluations, however, the awards were not completed (approval or denial) before his discharge. He contends he does not have a record of the processing of the awards due to the circumstances of email information and distribution at the time. He was later reassigned to his parent unit (1-181 Infantry (IN)) where he found out the awards were not processed and by time the process was moving forward on them he was medically retired from the Army. He was recommended to process the awards request through the office of Congressman "PK." His request was then submitted to HRC, Awards and Decorations Branch where it was disapproved and he was referred to the Army Board for Correction of Military Records (ABCMR) for an appeal of their decision. a. He provides the following justification for the award of the PH: (1) The provisions Army Regulation 600-8-22, chapter 2, section II, 2-8, provides for the circumstances of the attack: * attackers were comprised of local nationals and Afghan National Police ("students") being trained at the ANTC * attack was referred to as a "Green on Blue Attack" and the Afghan nationals involved are defined under Title 10, United States Code (USC), section 948(a) as unprivileged enemy belligerents; formerly classified as unlawful combatants, however, the USC has clarified the term to include enemy * attackers (enemy) were trying to capture and kill U.S. service members * contractor took refuge in an armored truck which was torn apart by attackers * while conducting actions against an enemy of U.S. forces he was hit (twice during the actions) trying to utilize less than lethal means against the enemy * he is viewed in a video from the attack, which came from the helmet of a marine (United States Marine Corps (USMC)) * he suffered a traumatic brain injury (TBI) from the impact of numerous projectiles * medical evacuation (MEDEVAC) did not occur but he did see medical personnel when he was sent to the Warrior Transition Unit (WTU) at Fort Drum, NY for his injuries evaluation and treatment * he was assigned to the WTU from April to December on a light duty (modified) status which led to a Neuropsychological assessment (November 2012), a Post-Concussive Syndrome diagnosis, and a U.S. Department of Veterans Affairs (VA) disability rating (10 percent) * referred for Neurocognitive rehabilitation (Dr. "S," Fort Drum, NY) * his medical records submitted and Armed Forces Health Longitudinal Technology Application shows evidence of TBI (exceed 48 hours) and continue to date from the events during the attack * statements of support * photos of the incident and aftermath (2) He was an Infantry officer assigned to Headquarters United States Forces – Afghanistan (USFOR-A), as a Counterinsurgency (COIN) Instructor (Mobile Training Team (MTT)) with the COINT Training Center – Afghanistan. He contends he worked with the Afghanistan Army; however, it was not at the time of the engagement (combat attack or operations). The majority of his interactions were with the Afghan National Police (ANP) and the governing regulation does not provide for award of the Combat Infantryman Badge for combat operations with the ANP. He believes the CAB is the badge he should be awarded for his actions in combat. He contends the governing regulation provides for his award of the CAB with the following: * any Soldier may be awarded * DD Form 214, block 18 (Remarks), list his "hostile fire pay or imminent danger pay is authorized" * satisfactory performance in accordance with (IAW) while personally present and engaging or being engaged by the enemy * documents provided show evidence of enemy Taliban flag (identification) (3) He contends he has attempted to get these awards processed since his deployment. He believes his follow-on units did not want to process awards. These awards were not processed or completed previously because he did not deploy with a large unit or have access to S-1 (Human Resource) personnel. 3. On 30 July 2010, the applicant was honorably released from active duty after his completion of required active service and he was transferred to the MAARNG. He completed 5 months and 23 days of net active service this period. His DD Form 214 shows: * block 4a (Grade, Rate or Rank) – First Lieutenant (1LT) * block 11 (Primary Specialty) – 11A (Infantry) * block 13 (Decorations, Medals, Badges, Citations and Campaign Ribbons Awarded or Authorized) – National Defense Service Medal (2nd Award) and Army Service Ribbon 4. Orders A–02–103192, U.S. Army Human Resources Command, dated 14 February 2011, ordered the applicant to active duty in support of (ISO) Operation Enduring Freedom (OEF) IAW the Worldwide Individual Augmentee System (WIAS) for duty as a Regional Instructor in Kabul, Afghanistan for a period of 400 days with an end date of 20 May 2012. The purpose of his active duty was contingency operation for active duty operational support (CO–ADOS). 4. Orders A–04–207533, U.S. Army Human Resources Command, dated 23 April 2012, retained the applicant on active duty, and ordered him to report to the WTB, Headquarters (HQ), Fort Drum, NY. He was assigned to the WTB to participate in Reserve Component (RC) warriors in transition medical retention processing program for completion of medical care and treatment. 5. Orders A–05–208198, U.S. Army Human Resources Command, dated 4 May 2012, shows the applicant was retained on active duty for assignment to the WTB, HQ, Fort Drum, NY for a period of 179 days with an end date of 30 October 2012. The orders directed him to complete the duty (WTB for medical care and treatment), unless sooner released, and return to his home where he would be released from active duty upon arrival. The following amendment orders show changes in the date of his release from active duty. * Orders A-05-208198A01, U.S. Army Human Resources Command, dated 27 August 2012 – changed his end date to 27 April 2013 * Orders A-05-208198A03, U.S. Army Human Resources Command, dated 5 December 2012 – changed his end date to 12 February 2013 6. The applicant's DD Form 214 shows his honorable release from active duty and transfer to the MAARNG occurred on 6 February 2013. He completed 1 year, 9 months and 20 days of net active service this period. This form also shows: * block 9 (Command To Which Transferred) – "1 181 IN BN 01 Co A RIFLE AGAWAM MA 01030" * block 11 (Primary Specialty) – 11A INFANTRY – 1 YRS 10 MOS//NOTHING FOLLOWS" * block 14 (Military Education) – "COUNTERINSURGENCY LEADERS CRS, 1 WEEK, 2011//NOTHING FOLLOWS" * block 18 (Remarks) – "SERVED IN A DESIGNATED IMMINENT DANGER PAY AREA//SERVICE IN AFGHANISTAN 20110530 – 20120408//" 7. A letter (Awards and Decorations Branch), U.S. Army Human Resources Command (AHRC), dated 15 May 2017, shows the applicant's request for award of the PH and the CAB in accordance with the events on 24 February 2012 were disapproved due to not meeting the regulatory requirements for combat operations or hostile foreign force with whom the United States is engaged in armed hostilities. A second letter, dated 27 December 2018 shows AHRC again disapproved his request and referred him to the ABCMR for an appeal of the decision. 8. A review of the applicant's Army Military Human Resource Record (AHMRR) through Interactive Personnel Electronic Records Management System (iPERMS) failed to reveal evidence showing: a. He was recommended or approved for award of the PH for injuries sustained in Afghanistan on 24 February 2012. b. He was recommended for the CAB for his satisfactory actions during combat operations while assigned in a designated imminent danger pay area. 9. A letter from the AHRC Awards and Decorations Branch dated 15 May 2017 shows AHRC disapproved the applicant's request for award of the CAB in accordance with the events on 24 February 2012. 10. The applicant provides the following documents, which he contends show his entitlement or authorization for the award of the PH and the CAB: a. Two DA Forms 2823 (a sworn statement), dated 21 November 2011, which indicates, on 7 October 2011, at Adraskan National Training Center, Adraskan, Afghanistan an enemy rocket attack (107MM) engaged the base and impacted zone one near guard tower three. The applicant was approximately 100 meters from the impact site (area) at the time of the attack. He then reported to the tactical operations center (TOC) to perform his required duties. He also assisted with the battle damage assessment of the impact area. Additionally, a picture document shows illustrations of the rocket attack on 7 October 2011. b. A DA Form 2823, dated 28 February 2012, supports the applicant's request for awards and the actions which he contends occurred on 24 February 2012. The sworn statement shows the applicant received directions during the attack from the NCOIC and the attackers were listed as: * protestors * students c. A DA Form 2823, dated 4 April 2013, supports the applicant's request for awards and the actions which he contends occurred on 24 February 2012. The sworn statement ("TLF," USMC, NCOIC) shows there were two riots after a Koran burning in the town of Adraskan. The applicant was struck by rocks thrown at him while trying to pass information on the east side of the base and while deploying canisters of CS – gas to disperse the rioters which caused more destruction and the students to leave the coalition zone immediately. (1) His billet was at the National Training Center Adraskan, Afghanistan was the U.S. Forces Commander of the base. He had seven U.S. military personnel and at the time of the events (24 February 2012) there were three medical personnel, and two other Combined Arms Assault Teams (CAAT). (2) Shots were fired from students – instructors of the Afghanistan Uniformed Police. d. The applicant's self – authored memorandum for record, MAARNG, dated 1 November 2013, which states, in effect, he was the sole member of the COIN team with seven other U.S. military service personnel (three Marines (USMC), three United States Navy (USN), and one United States Air Force (USAF)). The U.S. service members at the facility worked at the same time but independent of each other for their missions, however, not all the personnel witnessed all aspects of the attack due to their locations and duties during the attack, on 24 February 2012. The closest coalition base or forces at the time was 100 kilometers (KM) away. (1) The Non – Commissioned Officer in charge (NCOIC – USMC) received his directions via phone from his command at Camp Stone due to no commanders being present on the base. (2) All the personnel came under small arms direct fire and one Coalition Forces (CF) personnel was engaged with a fragmentation grenade that fortunately did not detonate. e. A letter, "KS" (M.D. (Doctor of Medicine)," Lieutenant Commander (LCDR), Medical Corps (MC), United States Navy Reserve (USNR)), dated 4 February 2014, states, in effect, she was present when the attack occurred on 24 February 2012. She saw the applicant who presented himself to her once he was hit with rocks and various other projectiles that were being thrown by the attackers. f. The applicant's self – authored memorandum of record, dated 27 April 2017, which states, in effect, U.S. personnel working at Adraskan National Training Center, Adraskan, Afghanistan came under attack from hostile forces comprised of 2000 local nationals and unknown insurgents from both within and outside the base on 24 February 2012. g. A memorandum for record, dated 30 October 2017, states, in effect, "TEB (author)" provides support of the actions and decision taken by the applicant in response to a blue – on -- green attack while stationed at Adraskan National Training Center, an Afghan controlled facility. "TEB" was assigned as a Hospitalman Third Class (HM3 (USN)) and a member of a mobile training team (MTT). He provided medical and laboratory training to the medical officers of the Afghanistan National Police. (1) All U.S. forces were subjected to small arms fire, targeted, and hit by various projectiles. It is likely that the applicant was struck by some of the projectiles. (2) He was present to observe the applicant act honorably and in accordance with the expectations of U.S. Army personnel. h. The applicant's self – authored memorandum for record, dated 20 February 2018, which states, in effect, U.S. personnel working at the Adraskan National Training Center, Adraskan Afghanistan came under attack from hostile forces within and outside of the base on 24 February 2012 at approximately 0745 hours. A total of seven U.S. personnel assigned to the base and five temporary personnel to complete their respective missions. The assigned personnel were members of various U.S. military services and one of which was the sole member of the COIN Training Team working with the Afghans as an adviser. (1) A hostile group of 300 persons (estimated) attacked the Adraskan National Training Center with the intent to kill or capture U.S. personnel. The breach, which was the throwing of rocks and other projectiles was initially witnessed by the applicant. He proceeded to warn all personnel of the attack before donning his protective equipment. He was repeatedly struck by various projectiles being thrown by the hostile force who were approximately ten meters away. * the hostile force's advancement was temporarily contained which gave time for U.S. forces to become ready * the hostile forces later re-engaged U.S. personnel with small arms they obtained and fired in the direction of U.S. personnel * while the hostile group continued to advance and destroy equipment while engaging U.S. personnel the applicant helped to contain the force and clear the base area of friendly personnel * the applicant was struck with an "unknown projectile" and lost consciousness for a short and unknown period of time * the hostile force's attack was eventually suppressed and contained by the Afghan National Police (2) The applicant was never evacuated for injuries he received during the aforementioned attack or another one that soon followed at Adraskan. A reason for this was due to no medical clinic being available to provide adequate care at the base and the closest Coalition Force base was approximately 100KM away. The extremely limited number of personnel and the higher commands refusal to send assistance was also a factor. i. The applicant's VA disability and other medical documents to support his contentions of TBI show: (1) His rated disabilities (ten percent) are listed as headache syndromes (previously rated as post concussive headaches, claimed as TBI) and TBI with cognitive dysfunction. (2) His neuropsychological assessment provides for his head injuries in 2011 while under a rocket attack he was knocked off his feet from the concussive force of a blast and the events where he was struck in the head multiple times by rocks from Afghani nationals on 24 February 2012, including being struck in the back of the head and temporal lobe areas repeatedly. He has no recollection of moving to safety or back to the operations center. The diagnosis shows for Axis III a post – concussion syndrome, predominantly neurocognitive and affect features, and sleep disturbance j. A narrative document and proposed citation for award of the Bronze Star Medal which shows his actions during small arms direct fire events, injuries due to being hit by projectiles (TBI), and other combat actions during the attack on 24 February 2012. The author or recommender for the award is not listed or unknown. k. A video narrative shows the timeline of the events stated by the applicant and witnesses for the attack on CF Afghan National Training Center, Adraskan, Afghanistan which occurred on 24 February 2012. 11. The applicant's record is void of evidence, which shows he was recommended or awarded the Bronze Star Medal. 12. Army Regulation 600-8-22 (Military Awards) provides policy, criteria, and administrative instructions concerning military awards and decorations. Chapter 2 (Department of Defense Awards and Decorations), paragraph 2-8, governs award of the PH. a. Subparagraph (g), examples of enemy-related injuries or wounds which clearly justify award of the PH, are as follows: (1) Injury caused by enemy bullet, shrapnel, or other projectile created by enemy action. (2) Concussion injuries caused as a result of enemy-generated explosions. (3) Mild 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. b. Subparagraph (h), examples of injuries or wounds which clearly do not justify award of the PH, in pertinent part, lists the following example, "(13) 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. c. Subparagraph (m) (Additional guidance): (1) Award of the PH may be made for wounds (including mild TBI and concussive injuries) 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. (2) 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 (to include Special Forces medics). Medics (such as combat medics – MOS 68W, Health Care Specialist) are not physician extenders. d. Paragraph 8 – 8 (CAB), states the requirements for award of the CAB are branch and MOS immaterial. Assignment to a combat arms unit or a unit organized to conduct close or offensive combat operations, or performing offensive combat operations is not required to qualify for the CAB. However, it is not intended to award the CAB to all Soldiers who serve in a combat zone or imminent danger area. The Soldier must be performing assigned duties in an area where hostile fire pay or imminent danger pay is authorized. The Soldier must be personally present and actively engaging or being engaged by the enemy, and performing satisfactorily in accordance with the prescribed rules of engagement. The Soldier must [not] be assigned or attached to a unit that would qualify the Soldier for the Combat Infantryman Badge or the Combat Medical Badge. BOARD DISCUSSION: 1. The Board carefully considered the applicant’s request, supporting documents and evidence in the records. The Board considered the applicant’s statement, his record of service to include deployments, MFR’s and other documents provided by the applicant related to the events at the National Training Center Adraskan, Afghanistan and the review by Human Resources Command. The Board further considered the criteria for the Purple Heart and the CAB requested by the applicant. The Board considered the documents stating the status of the individuals outside the compound (protesters and students), the sworn statements (one describing riots) and the incomplete award recommendation, and found insufficient evidence to determine them to be enemy forces. Based on a preponderance of evidence, the Board determined that the denial of the applicant’s request for PH and CAB was not in error or unjust. 2. The applicant's request for a personal appearance hearing was carefully considered. In this case, the evidence of record was sufficient to render a fair and equitable decision. As a result, a personal appearance hearing is not necessary to serve the interest of equity and justice in this case. 3. After reviewing the application and all supporting documents, the Board found that relief was not warranted. BOARD VOTE: Mbr 1 Mbr 2 Mbr 3 : : : GRANT FULL RELIEF : : : GRANT PARTIAL RELIEF : : : GRANT FORMAL HEARING :XXX :XXX :XXX 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. 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. Title 10, United States Code (USC), section 1552(b), provides that applications for correction of military records must be filed within 3 years after discovery of the alleged error or injustice. This provision of law also allows the ABCMR to excuse an applicant's failure to timely file within the 3 year statute of limitations if the Army Board for Correction of Military Records (ABCMR) determines it would be in the interest of justice to do so. 2. Title 10, USC, section 948(a (Definitions)), provides the following: a. A privileged belligerent – the term “privileged belligerent” means an individual belonging to one of the eight categories enumerated in Article 4 of the Geneva Convention Relative to the Treatment of Prisoners of War. b. An unprivileged enemy belligerent – the term “unprivileged enemy belligerent” means an individual (other than a privileged belligerent) who: * has engaged in hostilities against the United States or its coalition partners; * has purposefully and materially supported hostilities against the United States or its coalition partners; ?or * was a part of al Qaeda at the time of the alleged offense under this chapter c. Hostilities – the term “hostilities” means any conflict subject to the laws of war. 3. Title 38, U.S. Code, sections 1110 and 1131, in pertinent part, permits the VA to award compensation for a medical condition, which was incurred in or aggravated by active military service. The VA, in accordance with its own policies and regulations, awards compensation solely on the basis that a medical condition exists and that said medical condition reduces or impairs the social or industrial adaptability of the individual concerned. The VA can evaluate a veteran throughout his or her lifetime, adjusting the percentage of disability based upon that agency's examinations and findings. 4. Army Regulation 600-8-22 (Military Awards) provides policy, criteria, and administrative instructions concerning military awards and decorations. Chapter 2 (Department of Defense Awards and Decorations), paragraph 2-8, governs award of the PH. a. The version, dated 25 February 1995, with an effective date of 28 March 1995, and in effect at the time of the incidents under review, in pertinent part, shows the PH is awarded to any member who, while serving under competent authority in any capacity with one of the U.S. Armed Services, has been wounded or killed, or who has died or may hereafter die after being wounded: (1) In any action against an enemy of the United States. (2) In any action with an opposing armed force of a foreign country in which the Armed Forces of the United States are or have been engaged. (3) While serving with friendly foreign forces engaged in an armed conflict against an opposing armed force in which the United States is not a belligerent party. (4) As a result of an act of any such enemy of opposing armed forces. (5) As a result of an act of any hostile foreign force. (6) After 23 March 1973, as a result of an international terrorist attack against the United States or a foreign nation friendly to the United States, recognized as such an attack by the Secretary of the Army, or jointly by the Secretaries of the separate armed services concerned if persons from more than one service are wounded in the attack. (7) After 28 March 1973, as a result of military operations while serving outside the territory of the United States as part of a peacekeeping force. (8) 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 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. (9) Subparagraph (g) Examples of enemy-related injuries which clearly justify award of the PH), in pertinent part, lists the following examples: (a) Injury caused by enemy placed mine or trap. (b) Concussion injuries caused as a result of enemy generated explosions. (10) Recommendations for award of the PH based on alleged international terrorist attacks must be accompanied by a written evaluation from the MACOM security and intelligence staff officer indicating that international terrorist activity was involved. Should any enclosures be classified the prescribed security measures will be followed. 5. Army Directive 2011 – 07 (Awarding the PH), issued on 29 April 2011, provided clarifying guidance to ensure the uniform application of advancements in medical knowledge and treatment protocols when considering recommendations for award of the PH for concussions, including mild TBI and concussive injuries that do not result in a loss of consciousness. It did not change the standards for award of the PH for concussion injuries. The policy is retroactive to 11 September 2001 and has been incorporated into AR 600-8-22. a. Clarifying guidance on award of the PH for concussions. When recommending and considering award of the PH, the chain of command will ensure the criteria in paragraph 2-8 of reference b is met, and that both diagnostic and treatment factors are present and documented in the Soldier's medical record by a medical officer. (1) The following non – exclusive list provides examples of signs, symptoms or medical conditions documented by a medical officer or medical professional that meet the standard for award of the PH: * diagnosis of concussion or mild traumatic brain injury; * any period of loss or a decreased level of consciousness; * any loss of memory for events immediately before or after the injury; * neurological deficits (weakness, loss of balance, change in vision, praxis (i.e. difficulty with coordinating movements), headaches, nausea, difficulty with understanding or expressing words, sensitivity to light, etc.) that may or may not be transient; and, * intracranial lesion (positive computerized axial tomography (cat) or magnetic resonance imaging (MRI) scan). (2) The following non – exclusive list provides examples of medical treatment for concussion that meet the standard of treatment necessary for award of the PH: * limitation of duty following the incident (limited duty, quarters, etc.); * pain medication such as acetaminophen, aspirin, ibuprofen, etc. to treat injury, such as headache; * referral to neurologist or neuropsychologist to treat the injury; and, * rehabilitation (such as occupational therapy, physical therapy, etc.) to treat injury (3) Combat theater and unit command policies mandating rest periods or "down time" following incidents do not constitute qualifying treatment for concussion injuries. To qualify as medical treatment, this rest period must have been directed by a medical officer or medical professional for the individual after diagnosis of an injury as indicated in b(1) above. b. Additional Guidance: (1) Award of the PH may be made for wounds (including mild traumatic brain injuries and concussive injuries) 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. (2) 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 (to include Special Forces medics). Medics (such as Combat Medics - MOS 68W) are not physician extenders. (3) 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, United States Code, Section 101. c. Any member of the U.S. Army who believes that he or she is eligible for the PH, but through unusual circumstances no award was made may submit an application through the member's chain of command to the commander, USA HRC, ATTN: AHRC- PDP-A. In order to demonstrate that the injury meets all of the standards prescribed in the Army Directive and Army Regulation 600-8-22, and to facilitate the issuance of orders and updating of records as required, the following documents must accompany each request of the PH: * DA Form 4187 (Personnel Action); * chain of command endorsement (through the first general officer in the Soldier's current chain of command for Soldiers currently serving); * Deployment Orders; * Officer Record Brief/Enlisted Records Brief/DA Form 2 – 1, 2a, 2b, or 2c; * one – page narrative describing the qualifying incident and the conditions under which the Soldier was injured or wounded; * statements from at least two individuals other than the proposed recipient, who were personally present, observed the incident and have direct knowledge of the event; alternatively, other official documentation may be used to corroborate the narrative; * casualty report; * SF 600 (Chronological Record of Medical Care); and, * DD Form 214 (Certificate of Release/Discharge from Active Duty) (if applicable) * reconsideration authority – on request from the Soldier or veteran, Army officials shall conduct a one – time reconsideration of requests for previously denied PHs relating to concussion injuries 6. Army Regulation 600-8-22, dated 25 June 2015, paragraph 2 – 8 (PH), shows in: a. Subparagraph (e), 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 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 was such that they would have required treatment by a medical officer if one had been available to treat them. b. Subparagraph (g), examples of enemy-related injuries or wounds which clearly justify award of the PH, 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-released chemical, biological, or nuclear agent. (4) Injury caused by vehicle or aircraft accident resulting from enemy fire. (5) Concussion injuries caused as a result of enemy-generated explosions. (6) Mild 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. c. Subparagraph (h), examples of injuries or wounds which clearly do not justify award of the PH, in pertinent part, lists the following example, "(13) 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. d. Subparagraph (l), when recommending and considering award of the PH for a mild TBI or concussion, the chain of command will ensure the criteria in paragraph 2–8 is met, and that both diagnostic and treatment factors are present and documented in the Soldier's medical record by a medical officer. (1) 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 award of the PH: (a) Diagnosis of concussion or mild TBI. (b) Any period of loss or a decreased level of consciousness. (c) Any loss of memory for events immediately before or after injury. (d) 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, and so forth) that may or may not be transient. Intracranial lesion (positive computerized axial tomography or magnetic resonance imaging scan). (2) The following nonexclusive list provides examples of medical treatment for concussion that do meet the standard of treatment necessary for award of the PH: (a) Limitation of duty following the incident (limited Duty, Quarters, etc). (b) Pain medication such as acetaminophen, aspirin, ibuprofen, etc. to treat injury, such as headache. (c) Referral to neurologist or neuropsychologist to treat the injury. (d) Rehabilitation (such as occupational therapy, physical therapy, and so forth) to treat injury. (e) Restriction from full duty for a period of greater than 48 hours due to persistent signs, symptoms, or physical finding of impaired brain function. (3) Combat theater and unit command policies mandating rest periods or "down time" following incidents do not constitute qualifying treatment for concussion injuries. To qualify as medical treatment, this rest period must have been directed by a medical officer or medical professional for the individual after diagnosis of an injury as indicated in paragraphs 2-8 (1) and (2). (4) The following nonexclusive list provides examples of medical treatment for concussion that do not meet the standard of treatment necessary for award of the PH: (a) Limitation of duty following the incident (for example, limited duty, quarters, and so forth). (b) Pain medication (such as acetaminophen, aspirin, ibuprofen, and so forth) to treat injury, such as headache. e. Subparagraph (m) (Additional guidance): (1) Award of the PH may be made for wounds (including mild TBI and concussive injuries) 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. (2) 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 (to include Special Forces medics). Medics (such as combat medics – MOS 68W, Health Care Specialist) are not physician extenders. (3) 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 U.S. Navy; An officer in the U.S. Air Force designated as a medical officer in accordance with Title 10, U.S. Code, section 101. 7. Army Regulation 15-185 (Army Board for Correction of Military Records (ABCMR)) prescribes the policies and procedures for correction of military records by the Secretary of the Army acting through the ABCMR. Paragraph 2-11 states that applicants do not have a right to a hearing before the ABCMR. The Director of the ABCMR or the chair of an ABCMR panel may grant a formal hearing whenever justice requires. //NOTHING FOLLOWS// ABCMR Record of Proceedings (cont) AR20190010213 11 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1