The Purple Heart is awarded to service members who are killed or wounded in combat. However, modern realities and the evolving nature of conflict raise questions about who’s eligible to receive the award.

Specifically, there’s been some debate regarding the victims of shootings in military installations—such as the Fort Hood and Little Rock recruiting station incidents—in America and veterans suffering from post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) should be eligible to receive the award.

This isn’t the first time eligibility criteria were questioned. In the past, efforts by various individuals and pressure groups sought to reform the award. Some changes were made as a result. For instance, service members killed or wounded during a terrorist attack are now eligible to receive a Purple Heart. However, every time, veteran groups opposed eligibility modifications, arguing that potential changes would diminish the sacrifices of past recipients.

Due to the recent debate regarding PTSD and TBI victims, Congress is reconsidering eligibility criteria once again—an interesting development, given that historically, military decorations fall under the purview of the executive branch. To assist their efforts, the Congressional Research Service (CRS) conducted a study in an attempt to pinpoint the more contentious topics should American lawmakers decide to reform.

Currently, according to the study, the U.S. Department of Defense considers some cases of TBI to be eligible for the Purple Heart, while instances of PTSD are not. The CRS doesn’t offer a policy recommendation but raises some questions that need to be addressed before any changes are made:

  • Is a service member the victim of a crime or a terrorist attack?
  • Is a service member an advisor to a foreign military or a combatant?
  • Are PTSD and other mental health conditions adequate injuries to warrant the Purple Heart?

Now, it’s up to Congress to decide whether a change is merited.

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Interestingly, until World War II, only U.S. Army soldiers were eligible to receive the Purple Heart, leaving the U.S. Navy and U.S. Marine Corps without an award for killed or wounded sailors and Marines.

The Purple Heart is the oldest decoration in the American military. According to the Army Historical Foundation, on August 7, 1782, General George Washington stated in his Orders of the Day that “The General ever desirous to cherish a virtuous ambition in his soldiers, as well as to foster and encourage every species of Military Merit, directs that whenever any singularly meritorious action is performed, the author of it shall be permitted to wear…over his left breast, the figure of a heart in purple cloth…Not only instances of unusual gallantry but also of extraordinary fidelity and essential service…shall be met with a due award.”

What started as Washington’s Badge of Military Merit officially became the Purple Heart in 1932.