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 184.108.40.206 “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