The Army now recognizes a perforated eardrum as a qualifying combat-related injury for award of the Purple Heart, according to a new MILPER message released this month.

The change went into effect June 8, said Lt. Col. Matt Fontaine, a top spokesman for Army Human Resources Command.

“We made this change in order to be consistent with the other services across the DoD which award Purple Hearts for this type of combat-related injury,” Fontaine wrote in an email to Army Times. “We encourage Soldiers who were never considered for or who were previously denied a Purple Heart for this combat injury to submit the required documentation through their chain of command to HRC for consideration.

“Veterans can submit their request directly to HRC,” Fontaine added.

Veterans must submit their documents through Army Human Resources Command’s Awards and Decorations Branch, while currently serving active duty troops, reservists and Guardsmen can go through their leadership.

A perforated eardrum, or ruptured tympanic membrane, is a common injury caused by explosive blasts. According to a study conducted on Iraq War veterans who deployed between 2003 and 2006, tympanic membrane perforation was found in 16% of explosion-injured patients.

Common symptoms of a perforated eardrum include tinnitus — a ringing noise in the ears — and hearing loss.

“Most patients are symptomatic and many have large perforations requiring operative intervention,” the study concluded. “Long-term hearing loss is uncommon but does impact ability to continue military service.”

All applications for the Purple Heart must include a variety of supporting documentation, including a letter of endorsement from the soldier’s chain of command, deployment orders, a page-long narrative describing the incident during which the soldier was injured, and two statements from individuals other than the recipient who were present during the incident.

According to the MILPER message, commanders will take two major factors into consideration when determining the eligibility of a soldier for the purple heart: the degree to which the enemy or hostile force caused the wound, and whether the wound was so severe that it required treatment by a medical officer.

“To qualify, the combat-related injury must have been severe enough to require treatment by a medical officer and it must be documented in the individual’s medical record near the time of the incident,” Fontaine said.

Rachel is a Marine Corps veteran and a master's candidate at New York University's Business & Economic Reporting program.

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