Overdue recognition for invisible injuries - Air Force Community - Air Force Times

Overdue recognition for invisible injuries

The services are engaged in a long overdue effort to clarify rules for the Purple Heart, one of the military’s most coveted medals.

All four branches are studying an Army-led push to declare that troops who suffer concussions as a result of combat actions are entitled to a Purple Heart.

That means, for example, that soldiers in a vehicle that hits a bomb buried in the road qualify if they suffer a concussion.

In theory, the rules already allow for that. But in practice, it’s clear that few such head injuries have earned wounded service members a Purple Heart.

In the Army alone, some 114,000 soldiers have suffered concussions since the wars began. While not all were the result of combat, the fact that only 26,000 Purple Hearts have been awarded in that period is telling. Clearly, thousands — perhaps as many as 50,000 — soldiers may have merited a Purple Heart for serious combat wounds, yet never received that recognition because the injury was invisible.

Now, Army Vice Chief of Staff Gen. Peter Chiarelli and Assistant Commandant of the Marine Corps Gen. Joseph Dunford have drafted orders that, if approved by their service chiefs and others in the Pentagon, will finally make clear to commanders that traumatic brain injuries — including concussions — qualify troops for the Purple Heart if they are sustained in combat.

“The regulation specifically says, ‘if you have a concussion,‘“ Chiarelli notes. “It doesn’t say, if you have a concussion with blood coming out your ears, if you lose your eyesight, pop an ear drum.”

Commanders routinely fail to follow the regulation, Chiarelli says, because they just don’t understand.

He recalls asking one commander why he denied a Purple Heart to a soldier. The answer: “He’s not bleeding.”

Some will argue that awarding Purple Hearts to those who show no physical injury cheapens the award. They are wrong.

They fail to recognize that brain injuries can have far more lasting and devastating effects than many visible wounds. A bullet wound can heal; a missing limb can be replaced with a prosthetic. Those wounds are serious. But traumatic brain injuries can have just as serious and sometimes even more lasting effects.

TBI can alter personality, destroy memory and diminish responsiveness and intelligence. Even mild cases can result in lingering or frequent headaches lasting years, or even a lifetime.

Other critics will charge that the services are rewriting the regulation. They are not. Rather, they are doing what they should have done long ago: ensuring wounded troops are properly recognized for combat injuries by clearly explaining the regulation to those on the front lines who evaluate worthiness for awards.

The key: a new checklist to help commanders evaluate invisible injuries to gauge whether they merit a Purple Heart.

This is not just about hanging a ribbon on troops. Chiarelli hopes that giving Purple Hearts for invisible injuries will help remove the stigma that often keeps troops from seeking the medical help they need to recover from concussions as well as post-traumatic stress — injuries that too often have been mistaken by commanders as signs of malingering or poor attitude.

If he’s right, perhaps these awards will result in something even more meaningful: helping to reduce the number of suicides, divorces and domestic violence incidents that plague troops coming home from the war zones.

Sometimes, a little recognition can go a very long way.