Senior military leaders at the Pentagon are now considering individual service proposals to change the guidelines for awarding the Purple Heart to troops who sustain mild traumatic brain injuries. Currently, the Purple Heart is given to those military personnel who are wounded or killed by enemy action.
Officials from all four services were scheduled to meet with Dr. Clifford Stanley, undersecretary of defense for personnel and readiness, to discuss the recommendation, according to Army Lt. Col. Steve Warren, spokesman for Vice Chief of Staff Gen. Peter Chiarelli, the leader of the Army's initiative. Warren states, "Up to now, he thinks soldiers have received concussions and not received Purple Hearts as they should."
Marine Commandant Gen. James Amos ordered the Marine Corps' to review the new research that indicates the severity of a head wound is not necessarily linked to being knocked unconscious on the battlefield, which is what current Purple Heart Criteria dictates, noting that in some cases, the long-term effects can be much worse.
The issue, according to Warren, is that the regulation needs to be clarified. Meaning, the question of "what is a concussion?" needs to be clear about exactly what has to happen to be defined as a concussion.
According to Defense Department data, since 2000, more than 202,000 troops have been diagnosed with some form of traumatic brain injury, with more than 150,000 cases classified as "mild". These numbers have shown a rising trend with the proliferation of improvised explosive devices as the weapons of choice from insurgents targeting U.S. troops overseas. Nearly 31,000 troops suffered a brain injury in the last year alone.
The existing guidelines for determining a traumatic brain injury are based on the American Academy of Neurology's definition for mild traumatic brain injury. Before, head injuries were thought to be less serious if the soldier did not black out from the trauma. Traumatic brain injury has been called a signature wound of the wars in Afghanistan and Iraq. This trauma can cause mood swings, memory loss, depression, and paranoia, among other symptoms. Unfortunately, initial detection can be problematic and at first can appear to be symptom-free.
The Pentagon has since stepped up its response to traumatic brain injuries, and since last summer have required 24-hour rest for any personnel suffering even a mild concussion. If a second head injury occurs, they are then required to spend seven days with no physical activity. If a third head injury occurs, an evaulation by a neurologist is required.
Amos likes to refer to this approach as the "three strikes and you're in," meaning inside the wire and not out in the field.
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