DOD Issues Purple Heart Standards for Brain Injury

WASHINGTON — U.S. ser­vice mem­bers have long been eli­gi­ble to receive the Pur­ple Heart Medal for the sig­na­ture wounds of the cur­rent wars -– mild trau­mat­ic brain injuries and con­cus­sions -– but now there is more clar­i­ty on how med­ical cri­te­ria for the award are applied, Defense Depart­ment offi­cials said yes­ter­day.

The cri­te­ria for the Pur­ple Heart award state that the injury must have been caused by ene­my action or in action against the ene­my and has to be of a degree requir­ing treat­ment by a med­ical officer. 

But it may be dif­fi­cult to deter­mine when a mild trau­mat­ic brain injury or a con­cus­sive injury that does not result in a loss of con­scious­ness is severe enough to require treat­ment by a med­ical offi­cer. “This is why we cre­at­ed this base­line stan­dard,” DOD spokes­woman Eileen Lainez said. 

DOD allows the award of the Pur­ple Heart even if a ser­vice mem­ber was not treat­ed by a med­ical offi­cer, as long as a med­ical offi­cer cer­ti­fies that the injury would have required treat­ment by a med­ical offi­cer had one been available. 

DOD offi­cials said that as the sci­ence of trau­mat­ic brain injuries becomes bet­ter under­stood, guid­ance for award of the medal will evolve. 

“The ser­vices are not able to spec­u­late as to how many ser­vice mem­bers may have received a mild TBI or con­cus­sion but did not seek or receive med­ical treat­ment,” Lainez said. “There­fore, each mil­i­tary depart­ment will estab­lish its retroac­tive review pro­ce­dures in the near future to ensure deserv­ing ser­vice mem­bers are appro­pri­ate­ly rec­og­nized.” Retroac­tive reviews would cov­er injuries suf­fered since Sept. 11, 2001, she added. 

The Marine Corps has issued clar­i­fy­ing guid­ance to ensure com­man­ders in the field under­stand when the Pur­ple Heart is appro­pri­ate for concussions. 

Army offi­cials are prepar­ing to issue their guid­ance and ask sol­diers to wait until sub­mis­sion require­ments are pub­lished through com­mand chan­nels and on the Human Resources Com­mand web­site at before sub­mit­ting or resub­mit­ting nom­i­na­tions for the Pur­ple Heart Medal for con­cus­sion injuries. 

Once the Army pub­lish­es its require­ments, offi­cials said, sol­diers should resub­mit requests through their chains of command. 

Army vet­er­ans should resub­mit to the U.S. Army Human Resources Com­mand at: Com­man­der, USA HRC, ATTN: Awards and Dec­o­ra­tions Branch (AHRC-PDP‑A), 1600 Spear­head Divi­sion Ave., Fort Knox, KY 40122. Vets also can call 1–888-276‑9472 or email

U.S. Depart­ment of Defense
Office of the Assis­tant Sec­re­tary of Defense (Pub­lic Affairs) 

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