Meeting With Pyschol Dr.

[Hollis]

Last Thursday I had a meeting with psycholoist, this is the same Dr that gave the 16 weeks group therapy. I felt very relaxed while we was talking, little did I know he was typing every word I was saying to the questions he was asking. At the end I got a copy of the questionair, The GAF WAS 55, SO I GUESS I WILL GET LOW BALLED from the VA on the rating. All I can say is don't let your guard down, when you know the DR. Thanks to all who makes a comment on this.

[Hollis]

Hi Carlie, I think you already added your personal opinion. So you are saying if a veteran(s) does not shed blood or physicaly hurt, they aren't qualified for the PHM. So that means those who have PTSD a hidden injury does not equate as a injury. Well I have PTSD and I don't want the PHM, BUT ITHINK IT SHOULD BE AWARDED. JMHO.

[carlie]

Hi Carlie, I think you already added your personal opinion.

So you are saying if a veteran(s) does not shed blood or physicaly hurt, they aren't qualified for the PHM.

So that means those who have PTSD a hidden injury does not equate as a injury.

Well I have PTSD and I don't want the PHM, BUT ITHINK IT SHOULD BE AWARDED. JMHO.

Hollis,

Perhaps something in my post was misunderstood.

Where I posted,

"I believe if there is no blood or physical injury

this will not happen.", relates to the current criteria for a Purple Heart,

as posted, it does not in any way relate to an opinion, I may have in relation to

if I feel PTSD should meet the criteria for a PH.

My posting, "I have decided to keep my personal opinion to myself."

refers to any opinion I may have on adding PTSD to the eligibility criteria for

receipt of a PH.

The issue of including PTSD into the criteria for receipt of a PH,

has been around for several years now.

​Many, many times a diagnosis of PTSD and subsequent service connection

for it - has absolutely nothing to do with enemy forces.

The criteria for a PH also includes that there be documentation of the wound/injury being

treated.

FTR - I also have PTSD and have no desire for a PH, nor do I feel it should be awarded

in my situation, per the current criteria.

​Now if DOD should make enough changes to add a co-soldier to be viewed as a hostile

enemy force - then I would meet the criteria.

http://purpleheart.com/purple-heart-criteria/

"Any military man or woman who receives the award must have a documented injury as a result of enemy action.

The Purple Heart Criteria states that injuries from engaging an enemy, whether it is a U.S. enemy or a hostile force

against a U.S. ally while military forces are among the allies, qualifies for the recognition.

Injuries that qualify for a Purple Heart include wounds from enemy projectiles, mines or traps set by rival forces,

wounds resulting from chemical warfare like gas or nuclear radiation released by an enemy, aircraft or vehicle injuries

resulting from the actions of enemies and concussions or physical brain trauma as the result of explosions

set off by an enemy.

Purple Heart Criteria also states that if a soldier is hit by friendly fire aimed at an enemy force, the soldier is

eligible for the award. Other instances of friendly fire that result from negligence are not awarded with the Purple Heart.

Injuries that result from soldier negligence, self-inflicted wounds, injuries from accidents that are not caused by an enemy,

post-traumatic stress disorder, wounds resulting from battle fatigue, frostbite or similar trench injuries

are not awarded a Purple Heart."

OR

http://www.marines.mil/news/messages/Pages/MARADMIN245-11.aspx/

A. A WOUND IS DEFINED AS AN INJURY TO ANY PART OF THE BODY FROM AN OUTSIDE FORCE OR AGENT.

WOUNDS/INJURIES ARE THE DIRECT RESULT OF ENEMY ACTION WHEN THE PHYSICAL EFFECTS OF THE ENEMY WEAPON

ON THE MARINE ARE THE IMMEDIATE CAUSE OF THE WOUND/INJURY (E.G., A MARINE IS STRUCK BY PROJECTILES, FRAGMENTATION, OR BLAST FROM AN ENEMY WEAPON OR IMPROVISED EXPLOSIVE DEVICE).

WOUNDS/INJURIES ARE THE INDIRECT RESULT OF ENEMY ACTION WHEN THE MARINE IS INJURED BY A SUBSEQUENT ACTION

THAT IS SOLELY THE RESULT OF THE EFFECTS OF THE ENEMY WEAPON (E.G., ENEMY AUTOMATIC WEAPONS FIRE BLOWS OUT THE TIRES ON A VEHICLE CAUSING IT TO OVERTURN OR A MARINE IS BLOWN OFF THE ROOF OF A BUILDING BY A NEAR MISS OF A ROCKET PROPELLED GRENADE). ACCIDENTS ON THE BATTLEFIELD THAT ARE NOT CAUSED EITHER DIRECTLY

OR INDIRECTLY BY THE EFFECTS OF AN ENEMY WEAPON DO NOT MEET THE ELIGIBILITY REQUIREMENTS FOR THE PH

EVEN IF THEY OCCUR DURING AN ENGAGEMENT WITH THE ENEMY (E.G., A VEHICLE MOVING TO A NEW FIRING POSITION

OVERTURNS IN A DITCH OR A MARINE FALLS WHILE RUNNING FOR COVER FROM A SNIPER). IN THE COMBAT THEATER, THE COMMANDER MAKES THE DETERMINATION AS TO WHETHER WEAPONS FIRED BY UNKNOWN INDIVIDUALS WERE LIKELY

FIRED BY ENEMY COMBATANTS AND, THEREFORE, WARRANT THE PH. OUTSIDE THE COMBAT THEATER, WOUNDS/INJURIES

CAUSED BY CRIMINALS OR CIVILIANS WHO ARE NOT DETERMINED TO BE TERRORISTS DO NOT QUALIFY FOR AWARD OF THE PH.

B. A MEDICAL OFFICER IS A PHYSICIAN WITH OFFICER RANK.

THE REQUIREMENT THAT A WOUND/INJURY MUST HAVE REQUIRED TREATMENT BY A MEDICAL OFFICER, EVEN IF ONE WAS UNAVAILABLE TO PROVIDE THE TREATMENT, SERVES TO ESTABLISH A THRESHOLD OF SEVERITY OF WOUNDS/INJURIES

THAT QUALIFY FOR THE PH. IT ENSURES THE PH IS NOT AWARDED FOR VERY MINOR WOUNDS/INJURIES REQUIRING ONLY A MINIMAL LEVEL OF TREATMENT THAT CAN ADEQUATELY BE PROVIDED BY A CORPSMAN OR A FELLOW MARINE.

(1) PHYSICIAN EXTENDERS ARE MEDICAL PERSONNEL WITH ENHANCED QUALIFICATIONS WHO FREQUENTLY ARE REQUIRED TO PERFORM THEIR DUTIES IN AN INDEPENDENT MANNER UNDER THE DISTRIBUTIVE SUPERVISION OF A MEDICAL OFFICER LOCATED AT ANOTHER MEDICAL FACILITY. PHYSICIAN EXTENDERS INCLUDE PHYSICIAN ASSISTANTS (PA), NURSE PRACTITIONERS (NP), INDEPENDENT DUTY CORPSMEN (IDC), AND SPECIAL AMPHIBIOUS RECONNAISSANCE CORPSMEN (SARC).

THERE ARE FREQUENT OCCASIONS ON THE MODERN BATTLEFIELD WHERE WOUNDS THAT WOULD NORMALLY REQUIRE TREATMENT BY A MEDICAL OFFICER MUST BE TREATED BY PHYSICIAN EXTENDERS AT FORWARD DEPLOYED LOCATIONS WHEN EVACUATION TO A FACILITY WITH A MEDICAL OFFICER IS NOT TACTICALLY FEASIBLE. IN SUCH SITUATIONS, A PH MAY BE APPROVED WHEN THE PH APPROVAL AUTHORITY DETERMINES THAT THE SPECIFIC NATURE OF THE WOUND/INJURY WOULD HAVE NORMALLY REQUIRED TREATMENT BY A MEDICAL OFFICER HAD ONE BEEN AVAILABLE.

THIS DETERMINATION CAN BE MADE BASED ON EITHER INFORMATION FROM THE UNIT'S SUPERVISING MEDICAL OFFICER PROVIDED IN THE INITIAL OR SUPPLEMENTAL PERSONNEL CASUALTY REPORT (PCR), OR ADVISEMENT FROM THE SURGEON ON THE STAFF OF THE PH APPROVAL AUTHORITY AFTER REVIEW OF THE INFORMATION CONTAINED IN THE PCR.

(2) EVALUATION BY A MEDICAL OFFICER SOLELY TO DETERMINE THE EXTENT OF AN INJURY DOES NOT ESTABLISH A REQUIREMENT FOR TREATMENT BY A MEDICAL OFFICER IF THE INJURY IS DETERMINED TO BE AT A LEVEL THAT COULD HAVE BEEN ADEQUATELY TREATED BY A CORPSMAN (E.G., A MEDICAL OFFICER EXAMINES X-RAYS OF A MARINE WITH A POSSIBLE BROKEN ARM AND RETURNS THE MARINE TO DUTY). SIMILARLY, A DECISION BY A MEDICAL OFFICER TO TREAT A MINOR WOUND THAT A CORPSMAN COULD HAVE ADEQUATELY TREATED DOES NOT MEAN THE WOUND REQUIRED TREATMENT BY A MEDICAL OFFICER.

C. FOR WOUNDS/INJURIES WHERE THE REQUIREMENTS IN PARAGRAPHS 2A AND 2B HAVE BEEN MET,

THE FOLLOWING TYPES OF WOUNDS/INJURIES ARE CONSISTENT WITH THE SECNAV'S AND THE CMC'S POLICY AND HAVE HISTORICALLY WARRANTED AWARD OF THE PH.

(1) FRAGMENTATION WOUNDS.

(2) LACERATIONS.

(3) FRACTURES.

(4) GUNSHOT WOUNDS.

(5) PERFORATED EARDRUM.

(6) MILD TRAUMATIC BRAIN INJURIES (MTBI)/CONCUSSIONS SEVERE ENOUGH TO CAUSE EITHER LOSS OF CONSCIOUSNESS (LOC) OR DISPOSITION BY A MEDICAL OFFICER OF "NOT FIT FOR FULL DUTY" DUE TO PERSISTENT SIGNS, SYMPTOMS, OR FINDINGS OF FUNCTIONAL IMPAIRMENT FOR A PERIOD GREATER THAN 48 HOURS FROM THE TIME OF THE CONCUSSIVE INCIDENT. (THIS IS A REVISION TO PREVIOUS CRITERIA IN REF (B) AND IS RETROACTIVE TO 11 SEP 2001. SEE ADDITIONAL INFORMATION IN PARAGRAPH 3 AND PARAGRAPH 8. THE 48 HOUR PERIOD DOES NOT INCLUDE ASSIGNMENT TO ADMINISTRATIVE LIGHT DUTY SOLELY FOR A MANDATORY PERIOD OF OBSERVATION/SCREENING.)

(7) MODERATE OR SEVERE/PENETRATING TRAUMATIC BRAIN INJURIES (TBI) (SEE ADDITIONAL INFORMATION IN PARAGRAPH 3).

(8) SMOKE INHALATION SEVERE ENOUGH TO CAUSE 1ST TO 3RD DEGREE BURNS TO THE RESPIRATORY TRACT.

(9) CORNEAL ABRASIONS.

(10) EFFECTS OF CHEMICAL, BIOLOGICAL, OR NUCLEAR WEAPONS (TO INCLUDE CHLORINE GAS USED BY THE ENEMY IN CONJUNCTION WITH AN IED).

(11) 2ND AND 3RD DEGREE BURNS. MARINES RECEIVING THE ABOVE WOUNDS/INJURIES AS A RESULT OF FRIENDLY FIRE ARE ONLY ELIGIBLE FOR THE PH IF THEY WERE ACTIVELY ENGAGING THE ENEMY AT THE TIME OF THE INJURY. (NOTE: ONLY ONE AWARD OF THE PH IS AUTHORIZED FOR MORE THAN ONE QUALIFYING WOUND OR INJURY RECEIVED AT THE SAME INSTANT FROM THE SAME MISSILE, FORCE, EXPLOSION OR AGENT.)

D. THE FOLLOWING TYPES OF WOUNDS/INJURIES ARE NOT CONSISTENT WITH SECNAV POLICY AND HAVE HISTORICALLY NOT WARRANTED THE PH.

(1) COLD AND HEAT RELATED INJURIES (E.G., FROSTBITE AND HEATSTROKE).

(2) HEARING LOSS AND TINNITUS (I.E., RINGING IN THE EARS).

(3) MTBI/CONCUSSIONS THAT DO NOT EITHER CAUSE LOC OR DISPOSITION BY A MEDICAL OFFICER OF "NOT FIT FOR FULL DUTY" FOR A PERIOD GREATER THAN 48 HOURS FROM THE TIME OF THE CONCUSSIVE INCIDENT DUE TO PERSISTENT SIGNS, SYMPTOMS, OR FINDINGS OF FUNCTIONAL IMPAIRMENT. (THIS IS A REVISION TO PREVIOUS CRITERIA IN REF (B). SEE PARAGRAPH 3 FOR ADDITIONAL INFORMATION.)

(4) POST TRAUMATIC STRESS DISORDER (PTSD) OR COMBAT STRESS INJURIES. (SEE PARAGRAPH 4 FOR ADDITIONAL INFORMATION.)

(5) DISEASE (UNLESS CAUSED BY ENEMY BIOLOGICAL AGENTS).

(6) ABRASIONS (UNLESS OF A SEVERITY TO BE INCAPACITATING).

(7) BRUISES (UNLESS CAUSED BY DIRECT IMPACT OF ENEMY WEAPON AND OF A SEVERITY TO REQUIRE TREATMENT BY A MEDICAL OFFICER).

(8) FIRST DEGREE BURNS.

(9) SOFT TISSUE INJURIES (E.G., LIGAMENT/TENDON/MUSCLE STRAINS OR SPRAINS).

(10) ANY WOUNDS/INJURIES RECEIVED AS A RESULT OF FRIENDLY FIRE WHEN THE MARINE WAS NOT ENGAGING THE ENEMY AT THE TIME OF THE INJURY.

3. TRAUMATIC BRAIN INJURIES (TBI). TBI ARE CLASSIFIED INTO THREE CATEGORIES BASED ON SEVERITY OF THE INJURY. IN DECREASING LEVELS OF SEVERITY, THESE CATEGORIES ARE: SEVERE/PENETRATING TBI; MODERATE TBI; AND MTBI. WHILE MTBI AND CONCUSSION ARE FREQUENTLY USED INTERCHANGEABLY, THEY ARE NOT SYNONYMOUS. MTBI IS THE PHYSICAL INJURY TO THE BRAIN FROM A BLOW OR BLAST, USUALLY IN THE FORM OF INFLAMMATION OF BRAIN TISSUE. A CONCUSSION IS THE IMPAIRMENT TO THE BRAIN FUNCTION (E.G., ALTERATION OF CONSCIOUSNESS, POST-TRAUMATIC AMNESIA, OR LOC) RESULTING FROM THE INFLAMMATION INJURY.

[Hollis]

I appreciate your opinion, very long and educational. I under stand and I know what the DOD requirement is. But in my case and others, my PTSD is caused by enemy which was shooting at me and ME shooting at them and seeing them DEAD and my friends and buddies laying shot or dead. I take this as unseen injury, and I am also being treated by a medical doctor, a psychologist and a psychiatrist. I am sorry if I said something out of the way. I am no way trying to do that. This forum has been so very helpful to me and others. But I do agree that those who would like to be awarded should be, it is an unseem injury. JMHO. ONCE AGAIN SORRY IF I OFFENDED YOU. never meant to do that.

[Chuck75]

Hi Carlie, I think you already added your personal opinion. So you are saying if a veteran(s) does not shed blood or physicaly hurt, they aren't qualified for the PHM. So that means those who have PTSD a hidden injury does not equate as a injury. Well I have PTSD and I don't want the PHM, BUT I THINK IT SHOULD BE AWARDED. JMHO.

In basic theory, for a PH, PTSD would have to be directly related to a specific occurrence of enemy action or combat. This is the general reasoning for not awarding a PH for PTSD. I believe that some with PTSD might be entitled to the award, others not. Going from ignoring PTSD, calling it something else, etc. to awarding a PH for it is a very long road.

A somewhat faintly related comment.

During the Civil War, Medal of Honour awards were made for such things as capturing an opponents flag.

The practice was stopped, I believe well before WWI

[Commander Bob]

JMHO... I believe that combat PTSD should qualify for military recognition, however, I do not believe it should be the Purple Heart.

PTSD was not recognized by any institution, medical or military, until 1980. It is an insidious wound that may never fully heal or scar over. Perhaps in the future, the"powers- that -be" will find an appropriate award for our fellow comrades fallen by PTSD.

With all respect,

cmdr.Bob

Edited July 3, 2012 by Commander Bob

[carlie]

Just to keep in mind - the current criteria shown in

the PH info states that medical care to the injury of some type

must be rendered and of record

when the injury from the hostile force occurs.

Perhaps this issue deserves a topic of its own,

we have sure squashed the dirt out of the original

topic of this thread.

JMHO