The Army now considers combat-related concussions injuries worthy of the Purple Heart medal, underscoring the gravity of a wound that has been overlooked or dismissed as harmless for decades. The Army’s move to recognize all concussions as serious combat wounds comes at a time when the medical community is making strides in its understanding of concussions and other forms of traumatic brain injury (TBI). The sheer number of American soldiers receiving some degree of head trauma has made TBI the “signature wound” of the wars in the Afghanistan and Iraq wars.
Up until now, the Army left it up to doctors and battlefield commanders to determine whether a concussion were serious enough to warrant the Purple Heart. The general rule of thumb held that a concussion was worthy of the medal if the soldier lost consciousness or bled. However, thanks to increased understanding of traumatic brain injuries in recent years, doctors now know that the injuries aren’t always visible and their symptoms aren’t always obvious.
For many TBI victims and their families, one of the most frustrating characteristics of the injury is that the victim can appear perfectly normal both to the naked eye and to advanced medical imaging machines, therefore earning the victim a clean bill of health and allowing him or her to go untreated.
The Army’s new rules now define a concussion more precisely by its symptoms, which can include a brief loss of consciousness, headache, dizziness, nausea, ringing in the ears, and sensitivity to light. The medical treatment required for the medal can be as simple as rest and inactivity.
The Purple Heart medal will also be given to thousands of soldiers who suffered a combat-related concussion in the past but were denied an award. The medal has been given to 26,000 GIs since the onset of the wars in the Middle East, but that number will grow to over 100,000 once all soldiers who’ve suffered concussions on the battlefield receive their Purple Heart. According to some estimates, the number of troops who have received any form of TBI in all military branches approaches 700,000.
Rep. Bill Pascrell, D-N.J., co-chairman of the Congressional Brain Injury Task Force, praised the Army’s decision and called for the other military branches to do the same.
“It is imperative that the Pentagon makes it crystal clear that all service members, no matter what branch they serve in, will be awarded the Purple Heart when they are wounded in any way,” Pascrell said.
The Marine Corps is also considering broadening its own rules governing which concussions deserve a Purple Heart. Only Marines who lose consciousness are medaled for their concussions under current rules.
In addition to the honor they bestow on service members, the Purple Heart also has a practical side: medal recipients get priority enrollment for VA benefits and become exempt from co-pays for hospital and outpatient care.