PTSD and the Purple Heart

An idea was floated recently to change the regulations for the Purple Heart Medal to allow it for Post Traumatic Stress Disorder. Current regulations require a physical wound. I have deep reservations about this, not because it’s not a worthy idea, but because it’s an idea that’s too easy to implement ham-handedly.

Current VA regulations on PTSD require that the claimant be able to point to a specific event as the cause of their PTSD in order to have it recognized as “service connected” and therefore covered. This flies in the face of the information that DoD has been pushing to soldiers about what PTSD is and how it happens.

PTSD may never have a discreet cause. Rather it is often cumulative, a building of stress over time, or operating at a high level of stress long enough for the mind to have adapted to that elevated level as “normal.” This is the essence of the Battlemind training and mandatory briefings that we all receive. Yet the rules that govern how the VA treats it don’t accord with that.

There is already a link between PTSD claims adjudication and the Purple Heart. If a troop has been awarded a Purple Heart, or the Combat Infantry or Combat Action Badges, that is considered evidence in favor of a service connection for a diagnosis of PTSD. But those awards are all event based and physical.

We don’t have to award Purple Hearts to those who are diagnosed with PTSD, many who would qualify might rather not, but that really doesn’t matter unless we get some of the underlying rules right first.

We must first remove the requirement for a specific event to declare PTSD as a service connected injury. Then, if we find that it really will help to destigmatize the injury, sure, give the Purple Hearts, I really don’t think it matters.

But if the rules aren’t changed, what will matter is that we will have a troops who find themselves now having been denied both VA assistance and an award, literally adding insult to injury.

CJ at A Soldier’s Perspective weighs in and I tend to agree. If we fix the regs, the medal is not necessary and probably inappropriate.

There’s some discussion at Jules Crittenden’s blog too.

Donklephant’s on the other side of the issue. As I said, I’m not completely opposed. However there’s a distinction to be made in that PTSD is classified as an illness, not an injury. We don’t give Purple Hearts for the flu whether it can be proven that the virus was contracted in a combat zone or not.

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