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Soldiers With Brain Trauma Denied Purple Hearts, Adding Insult to Injury

Army commanders have routinely denied Purple Hearts to soldiers who have sustained concussions in Iraq.

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"This is a good catch," he said, saying he had asked Army lawyers to review the policy to see whether it should be changed. A Chiarelli spokesman said Wednesday that, as of last week, the review was continuing.

Chiarelli, the Army's point man on the treatment of traumatic brain injury and post traumatic stress, acknowledged there is ongoing resistance to awarding the Purple Heart for so-called "invisible" wounds.

He saw it firsthand when he served as commander in Baghdad from 2004 to 2005 and said he overturned many denials for the medal stemming from concussion injuries. There has been progress since then, he said, but more work remains.

"There still are some commanders, okay, who -- and there may be some doctors, too -- who don't feel that a concussion should entitle somebody for a Purple Heart," Chiarelli said. "But we have far more commanders that understand that the concussion is a real injury today than we had in 2004 and 2005."

"We are moving in the right direction to fix this."

A Certain Level of Tough

Created by George Washington in 1782 and revived 150 years later by Gen. Douglas MacArthur, the Purple Heart carries extraordinary significance.

Unique among military honors, it is an entitlement earned by all soldiers who meet the basic criteria. It does not depend upon a recommendation from a superior officer.

The Purple Heart confers practical benefits, gaining recipients a higher priority in obtaining medical service from Veterans Affairs medical facilities.

But for many soldiers, the Purple Heart is, first and foremost, a badge of courage: A tangible recognition of service, honor, and bravery.

Nearly 25,000 soldiers have been awarded Purple Hearts for all types of wounds suffered in Iraq and Afghanistan, according to the Army's Human Resources Command. A spokesman said the military does not know how many soldiers have received the Purple Heart for mild traumatic brain injuries, or how many have been denied. He said the Army doesn't keep track.

The number of Purple Hearts awarded is dwarfed by the number of soldiers who have suffered concussions. Official figures show about 90,000 Army soldiers have sustained mild traumatic brain injuries since 2002 -- though all those soldiers likely do no meet the criteria for the award. Tens of thousands of additional troops have gone undiagnosed, NPR and ProPublica reported in June, based on unpublished military studies, internal e-mails and interviews.

Some soldiers who have suffered mild traumatic brain injuries have received Purple Hearts. Sgt. Victor Medina, who was profiled in a previous story by NPR and ProPublica, received his award after his wife wrote to his commander insisting that he deserved the recognition.

"It would have been easier to get one if I had lost an arm or a leg. Then they could have seen it," Medina said.

The military's regulations to document the wound and treatment can make it difficult for someone with a mild traumatic brain injury to prove that the award criteria are met. Treatment for a head injury in the immediate aftermath of combat can be as little as bed rest, or pain medications which are not always noted in medical records.

Once they return home, some soldiers don't realize they have problems until months or years after the injury -- making it difficult to prove a link between the blast and their symptoms.

Sgts. James Hopkins and Derrick Junge are among those who have been diagnosed with concussions, but were passed over for the Purple Heart.

Hopkins and Junge suffered their injuries in January 2009 when a rocket slammed into a wall near their trailer at Camp Liberty in Baghdad. At the time, a senior Army neuropsychologist, Lt. Col. Mike Russell, was conducting a study on concussions. He diagnosed the men and three fellow soldiers as having suffered mild traumatic brain injuries during the attack, according to medical records.

 
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