IN THE CASE OF: BOARD DATE: 16 June 2015 DOCKET NUMBER: AR20150005760 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: a. According to Army Directive 2011-07, dated 18 March 2011, he met all requirements to be awarded the Purple Heart. Specifically: * paragraph 2d - the medical officer was Major (MAJ) CE, the battalion surgeon * paragraph 4a(1) - the diagnosis was the Military Acute Concussion Evaluation (MACE) exam * paragraph 4a(4) - his neurological deficits were dizziness and headaches * paragraph 4b(2) - he was prescribed acetaminophen (Tylenol) by MAJ CE b. The U.S. Army Human Resources Command (HRC) denied him the Purple Heart but the reviewer must not have been aware of the requirements or did not actively look for them. The Purple Heart was approved by his company, brigade, and corps commanders before being submitted to HRC. c. On 24 December 2007, while he was assigned to Headquarters and Headquarters Company (HHC), 2nd Battalion (BN), 502nd Infantry Regiment, 2nd Brigade Combat Team (BCT), 101st Airborne Division, Iraq, he was a member of a reconnaissance patrol led by Captain (CPT) DS. They were moving from Forward Operating Base (FOB) Kalsu to the Chaka Four region of his BN's area of operation (AOE). He was manning an M240B machine gun in the lead high mobility multipurpose wheeled vehicle (HMMWV). d. Upon entering Chaka Four, the dismounted element conducted a foot patrol while the mounted element established static security positions. Once the dismounted element returned, they began to form the vehicles to return to FOB Kalsu. Sergeant (SGT) TE finished ground-guiding his vehicle onto the dirt road and when the vehicle moved forward it struck an improvised explosive device (IED) composed of approximately 40 pounds of homemade explosives. e. He was immediately thrown into the back of the turret and when he went forward his helmet hit the long range acquisition system (LRAS) and the butt stock of his M240B. He was semi-conscious and disoriented for a few seconds and could not hear. Once he recovered some of his senses, he remembers checking on his fellow Soldiers. Then they began to dismount and he went to a snap casualty collection point in the outer cordon of the blast zone. There he was evaluated by the platoon medic, Specialist (SPC) MG, and was given Tylenol for his severe headache and disorientation. Once evaluated, he began to pull security until the explosive ordnance disposal (EOD) and BN recovery assets teams arrived. f. While conducting the blast damage assessment, a second IED was discovered which was blown in place. His hearing began to recover but he continued to remain disoriented. Upon recovery of the damaged HMMWV, he and the other Soldiers from his vehicle rode with the EOD team back to FOB Kalsu. Upon arrival, all of them were processed into the BN aid station (BAS) and were evaluated for concussions with MACE exams by MAJ CE (emphasis added). He was treated with more Tylenol and told to relax for a few days. The next day, he was given another MACE exam, showed improvement, and was returned to duty. Since then, he continues to get frequent headaches, ringing in his ears, and noticed short term memory loss. 3. The applicant provides: * his Enlisted Record Brief (ERB), dated 25 March 2015 * orders, dated 4 October 2007 * two pages of Standard Form (SF) 600 (Chronological Record of Medical Care), dated 24 December 2007 * an MACE form, dated 24 December 2007 * DA Form 4187 (Personnel Action) * two DA Forms 2823 (Sworn Statement) * two memoranda, dated 18 March 2011 and 16 October 2014 CONSIDERATION OF EVIDENCE: 1. The applicant enlisted in the Regular Army on 11 November 2005 and he held military occupational specialty 11B (Infantryman). He was promoted to the rank/grade of private first class/E-3 on 1 June 2006. 2. On 6 July 2007, he was assigned to HHC, 2nd BN, 502nd Infantry Regiment, 101st Airborne Division, Fort Campbell, KY. He served in Iraq in support of Operation Enduring Freedom with his assigned unit from 14 October 2007 to 28 November 2008. 3. He provides an SF 600, dated 24 December 2007, wherein it shows he was seen on that date at the 502nd Infantry BAS, Iraq, for a MACE screening by the healthcare provider MAJ CE. This form shows MAJ CE entered, in part, the following comments: * the applicant stated he had a mild frontal headache since the event, partially relieved by Tylenol and ibuprofen, and bilateral tinnitus without pain * he stated he had dizziness, felt unsteady and "out of it," had decreased concentrating ability but no memory lapses/loss, and had no difficulty keeping balanced * he had no wavy lines in vision or visual disturbances, no nausea, vomiting, and no high irritability * he was not observed to be confused and was not found in a daze * he had no amnesia and no shrapnel wound of the head * he reported trauma to the head; he hit his head on his gun mount while wearing Army combat helmet (ACH) but with no loss of consciousness * he was awake, alert, oriented to time, place, and person; and his MACE orientation test score 0/5 * his MACE examination was 25/30 and there was an absence of red flags that would prompt referral to higher level of care * he was prescribed Tylenol every 6 hours for a headache and would be reevaluated in 12 hours * he was released without limitations 4. The applicant provides a MACE form, dated 24 December 2007, wherein the applicant completed the form to show, in part: * he had been dazed, confused, and "saw stars" when he hit his head on the LRAS site as the result of an explosion/blast * he did not have amnesia, did not lose consciousness or "black out," and was not unresponsive * he did experience a headache, dizziness, irritability, ringing in his ears, and had some difficulty concentrating 5. On 5 June 2013, he was assigned to HHC, 504th Battlefield Surveillance Brigade (BFSB), Fort Hood, TX. He provides a DA Form 4187, wherein it shows on 16 July 2014, the Commander, HHC, 504th BFSB, recommended him for award of the Purple Heart for wounds/injuries received in action caused directly by the enemy. The commander listed the incident as an IED blast that occurred on 24 December 2007 in Chaka Four, Iraq, and enclosed two witness statements. 6. The applicant provides a: a. DA Form 2823, dated 28 August 2013, wherein CPT DS stated, in part, in December 2007, he took part in a reconnaissance patrol in the Chaka Four region, Iraq, with his platoon composed of four HMMWVs. After the completion of the dismounted portion of the patrol, the lead vehicle struck an IED and the front of the vehicle was completely destroyed. After clearing the surrounding area, they attended to the Soldiers in the destroyed vehicle. One of the Soldiers was the applicant who was in the gunner's turret at the time. All Soldiers in the vehicle received assistance and treatment from the medic on site, SPC MG. b. DA Form 2823, dated 30 September 2013, wherein Staff Sergeant (SSG) CA stated, in part, on 24 December 2007 he was part of a reconnaissance patrol in the Chaka Four region, Iraq. He was in the lead vehicle with the applicant and two other Soldiers. When the IED struck their vehicle, the blast sheared off the front of the vehicle and blackened the front windshield with fire and smoke. The applicant was in the turret of the vehicle and he was one of the first people he (SSG CA) saw after he (SSG CA) gained consciousness. Once the area was cleared, the medic, SPC MG, and platoon leader provided medical treatment for the four of them. Upon return to FOB Kalsu, the four of them went to the BAS for further treatment for head injuries and follow up care. 7. On 16 July 2014 and 28 July 2014, respectively, his brigade commander and the Commanding General, III Corps and Fort Hood, recommended approval of the award of the Purple Heart to the applicant. 8. In a memorandum, dated 16 October 2014, HRC denied the request for award of the Purple Heart to the applicant and stated, in part, award of the Purple Heart was limited to members of the Armed Forces who had been wounded or killed as a direct result of enemy action. The diagnosis and treatment in the medical document provided did not meet the criteria for award of the Purple Heart. 9. On 27 May 2015, by email, an official with the Casualty Support Section, HRC, stated there was no record that showed the applicant had been reported as a casualty (wounded as a result of enemy action) during his service in Iraq from October 2007 to November 2008. 10. There is no evidence in the applicant's available records and he has not provided any corroborating evidence that shows he was subsequently treated for frequent headaches, ringing ears, and/or short term memory loss after his service in Iraq in 2008. 11. He is currently serving on active duty and was promoted to the rank of SGT/E-5 on 1 August 2014. 12. Army Regulation 600-8-22 (Military Awards) provides that the Purple Heart is awarded for a wound sustained as a result of hostile action. Substantiating evidence must be provided to verify 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. Examples of enemy-related injuries which clearly justify award of the Purple Heart are injury caused by enemy bullet, shrapnel, or other projectile created by enemy action; injury caused by enemy-placed mine or trap; and concussion injuries caused as a result of enemy-generated explosions. 13. In a memorandum, dated 18 March 2011, subject: Army Directive 2011-07 (Awarding of the Purple Heart), the Secretary of the Army stated, in part, that Soldiers who received non-visible injuries, often characterized as concussions resulting from explosive blasts, may not be receiving the recognition they earned. The directive provided clarifying guidance when considering recommendations for award of the Purple Heart for concussions. a. Approval of the Purple Heart required a wound, injury or death must have been the result of an enemy or hostile act and the wound must have required treatment, not merely examination, by a medical officer and the treatment of the wound shall be documented in the Soldier's medical record. A medical professional was defined as a civilian physician or physician extender. Basic medics (such as combat medics) are not physician extenders. b. When recommending and considering award of the Purple Heart for concussion injuries, the chain of command will ensure that both diagnostic and treatment factors are present and documented in the Soldier's medical record by a medical officer. c. 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 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, difficulty with coordinating movements, headaches, nausea, difficulty with understanding or expressing words, sensitivity to light) that may or not be transient. d. 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. (2) Pain medication, such as acetaminophen or ibuprofen, to treat the injury. (3) Referral to a neurologist or neuropsychologist to treat the injury. (4) Rehabilitation, such as occupational therapy or physical therapy, to treat the injury. DISCUSSION AND CONCLUSIONS: 1. The criteria for award of the Purple Heart require a Soldier to have been injured or wounded by hostile action, the wound must have required treatment by medical personnel, and the medical treatment for wounds or injuries received in action must have been made a matter of official record. 2. Army Directive 2011-07 specifically states the wound/injury must have required treatment by a medical officer not merely an examination. The medical treatment for concussion that meets the standard of treatment necessary for award of the Purple Heart includes limitation of duty following the incident, pain medication such as acetaminophen to treat the injury, referral to a neurologist to treat the injury, and rehabilitation to treat the injury. 3. The evidence of record the applicant provided shows that on 24 December 2007, in Iraq, he and three other Soldiers were in a HUMMWV when their vehicle struck an IED. As a result, he and the other Soldiers were sent for MACE screening. Although the applicant complained of a headache, dizziness, and tinnitus in his ears and was given Tylenol for his headache, the evidence he provided shows he never lost consciousness, the examining healthcare provider did not diagnose him with any neurological deficits, he found the applicant did not have a concussion, he had no visual disturbances, no nausea, no vomiting, no wounds of the head, and he was awake, alert, oriented, and he did not require further medical referral or treatment. He was released without duty limitations. As such, he did not meet the criteria for award of the Purple Heart in Army Regulation 600-8-22 or as clarified in Army Directive 2011-07. 4. In view of the foregoing, there is insufficient evidence upon which to base award of the Purple Heart. BOARD VOTE: ________ ________ ________ GRANT FULL RELIEF ________ ________ ________ GRANT PARTIAL RELIEF ________ ________ ________ GRANT FORMAL HEARING ____X___ ____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. ____________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. ABCMR Record of Proceedings (cont) AR20150005760 3 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1 ABCMR Record of Proceedings (cont) AR20150005760 2 ARMY BOARD FOR CORRECTION OF MILITARY RECORDS RECORD OF PROCEEDINGS 1