Air Medal for CCATT

Air Medal for Critical Care Air Transport Team (CCATT)

The Air Medal and Aerial Achievement Medal are both awarded for meritorious performance during aerial flight.  The Air Medal was established in 1942 and is generally reserved for service in a combat theater  The Air Medal is higher in precedence than the Aerial Achievement Medal established in 1988 which may recognize service outside the combat theater, but in support of combat operations.

Critical Care Air Transport Team consists of a critical care physician, nurse and respiratory therapist who fly alongside the Aeromedical Evacuation(AE) Crew and Loadmasters.  Like other members of the crew, they have a special knowledge and operational expertise in the flying environment, especially as it affects their patients.  The CCATT Team provides lifesaving care to the “sickest of the sick” who would otherwise would be unable to be transported by the normal AE crew.  Like the flight surgeons with whom they fly, their aeromedical expertise is concentrated on the unique critical care needs and critical care equipment that must be adapted to any “aircraft of opportunity,” rather than a specific airframe.

In contradistinction to the clear language of the law (noted below), Headquarters Air Force has elected to award only the  Aerial Achievement Medal to the CCATT Team while reserving the more distinguished Air Medal for the AE crew, loadmasters, pilots, flight surgeons, navigators and others. even if serving on the same flight.  Though operationally established in the 90s, well after the 1942 Air Medal criteria, Critical Care Air Transport Teams exemplify the best in current cutting-edge technology whose actions save the lives of untold numbers of critically wounded soldiers; their conduct valiantly displays meritorious achievement during aerial flight in the combat environment clearly fulfilling the letter and spirit of the 1942 Executive Order establishing the Air Medal.

Executive Order 9158 of May 11 1942 established the Air Medal by stating, “By virtue of the authority vested in me as President of the United States and as Commander in Chief of the Army and Navy of the United States, it is hereby ordered that an Air Medal with accompanying ribbons, be established for award to any person who, while serving in any capacity in the Army, Navy, Marine Corps, or Coast Guard of the United States subsequent to September 8, 1939, distinguishes, or has distinguished, himself by meritorious achievement while participating in an aerial flight.” Executive Order 9158–11 May 1942

Consistent with the Executive order, AFI 36-2803 page 91 allows awarding the Air Medal to “Any person, while serving in any capacity with the Air Force.” afi36-2803

Code of Federal Regulations Title 32 Section 578.19 dated 2008-07-01 states, “Award of the Air Medal is primarily intended to recognize those personnel who are on current crewmember or non-crewmember flying status which requires them to participate in aerial flight on a regular and frequent basis in the performance of the primary duties. However, it may also be awarded to certain other individuals whose combat duties require regular and frequent flying in other than passenger status…” Code of Federal Regulations re Air Medal

The Air Force interpretation of the law was stated by General North in a letter of 24 October 2008, “After careful review, I respectfully do not support this request (for an Air Medal for Critical Care Air Transport Team). AFI 36-2803 only authorizes Air Medals (AM) for aircrew – either operating aircraft or performing other aircrew member duties to recognize distinction in aerial flight and related airmanship. Accordingly, HAF/A-1 through AFI 36-3208 has drawn the line on AM eligibility at aircrew. “  Air Medal Denied to CCATT

In addition, Air Force interpretation of the Executive order is stated in the AFCENT Decorations Guidebook, Para “CCATT Members are only authorized the award of Aerial Achievement Medal.” AFCENT Decorations Guidebook_1 Oct 12

Opinion of WWP:
Executive Order 9158 and Code of Federal Regulations, Title 32 Section 578.19 as published in the Congressional Record are primary source law.   Unlike the Air Force interpretation, these primary source documents and moral equity do not restrict the Air Medal Award only to “rated aircrew,” rather the law could not be more clear when it states that the award is for “any person who distinguishes himself by meritorious achievement while participating in aerial flight”; it would appear that the Headquarters Air Force (HAF) restriction is inconsistent with the letter and spirit of the law.

Inasmuch as Air Force interpretation seems to be contrary to the clear wording and intent of the law, perhaps it is time for Congress to request that Air Force policy to be consistent with the wording of the law–WWP

1 Response to Air Medal for CCATT

  1. CCATT Doc says:

    From a well respected, experienced CCATT physician…
    “Also notwithstanding the fact the CCAT Teams were considered some of “Spicy Shrimp” of both Theaters, the DVs were always shown the CCATT capabilities, there were more news stories about the CCATT program than AE, and without CCATT the much touted 96% survival rate would not have occurred, but there is irony in the discussion regarding “Aircrew.”

    Probably the biggest reason we were not considered Aircrew was so that we would not have to be given crew rest. By becoming Aircrew we would fall under a whole new set of regulations. While the AE crew was getting rest after a combat mission from down range (adding to their Air Medal tally) even if they did not have patient responsibilities because it was “just” a CCATT transport, the CCAT teams were quick-turned back into the fight to be back on-call even without crew-rest back down-range.

    One could also argue that another reason we were not air crew was that we did not complete SERE training. Fair position, but I would counter that it would even be more compelling to give the CCAT Teams Air Medals because they did NOT complete SERE training. If all of the critical care docs, nurses and RTs were required to complete all Air Crew training, including SERE, that would have severely limited the number of teams available, most likely resulting and a much less robust program and probably a decreased survival rate. So to put CCAT teams without combat training into combat to perform a unique critical mission that only they could do, this should, even more so, make them worthy of an Air Medal. Parenthetically, I bet the majority of Flight Surgeons that did complete combat missions down range and were given Air Medals probably only did the “baby” Flight Surgeon’s SERE course at Books and didn’t attend the SV80A course at Fairchild which is where even the AE nurses and med techs attended.

    There will always be arguments as to what constitutes justification for combat sorties/Air Medals. Should AWACS and tanker crews get combat sorties and Air Medals for taking off from a friendly country and flying at FL 300 in the AOR while CCATTs get no credit because they were not air-crew but yet had multiple take-offs & landings in a high threat area AND were absolutely mission essential. In fact because of the CCAT teams, that was the mission.

    Thanks again for your attention to this matter and continuing to look into it.

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