The following is lengthy, but I think in this instance, necessarily so to be detailed and accurate, in accordance with your request.
As for your observations about visible wounds or scars resulting from Kerry's service, you ever seen the video for Toby Keith's country-western tune *I love this bar?* If not, I'll not spoil it for you, but it has a moment that's germaine to the discussion.
As for Max Cleland:
(c) Individuals injured as a result of their own negligence; for example, driving or walking through an unauthorized area known to have been mined or placed off limits or searching for or picking up unexploded munitions as war souvenirs, will not be awarded the Purple Heart as they clearly were not injured as a result of enemy action, but rather by their own negligence.
AR 600-8-22 / 25 February 1995
(1) In any action against an enemy of the United States.
(2) In any action with an opposing armed force of a foreign country in which the Armed Forces of the United States are or have been engaged.
(3) While serving with friendly foreign forces engaged in an armed conflict against an opposing armed force in which the United States is not a belligerent party.
(4) As a result of an act of any such enemy of opposing armed forces.
(S) As the result of an act of any hostile foreign force.
(6) After 28 March 1973, as a result of an international terrorist attack against the United States or a foreign nation friendly to the United States, recognized as such an attack by the Secretary of the Army, or jointly by the Secretaries of the separate armed Services concerned if persons from more than one service are wounded in the attack.
(7) After 28 March 1973, as a result of military operations while serving outside the territory of the United States as part of a peacekeeping force.
b. While clearly an individual decoration, the Purple Heart differs from all other decorations in that an individual is not "recommended" for the decoration; rather he or she is entitled to it upon meeting specific criteria.
(1) A Purple Heart is authorized for the first wound suffered under conditions indicated above, but for each subsequent award an Oak Leaf Cluster will be awarded to be worn on the medal or ribbon. Not more than one award will be made for more than one wound or injury received at the same instant or from the same missile, force, explosion, or agent.
(2) A wound is defined as an injury to any part of the body from an outside force or agent sustained under one or more of the conditions listed above A physical lesion is not required, however, the wound for which the award is made must have required treatment by a medical officer and records of medical treatment for wounds or injuries received in action must have been made a matter of official record.
(3) When contemplating an award of this decoration, the key issue that commanders must take into consideration is the degree to which the enemy caused the injury. The fact that the proposed recipient was participating in direct or indirect combat operations is a necessary prerequisite, but is not sole justification for award.
(4) Examples of enemy-related injuries which clearly justify award of the Purple Heart are as follows:
(a) Injury caused by enemy bullet, shrapnel, or other projectile created by enemy action.
(b) Injury caused by enemy placed mine or trap.
(c) Injury caused by enemy released chemical, biological or nuclear agent.
(d) Injury caused by vehicle or aircraft accident resulting from enemy fire.
(e) Concussion injuries caused as a result of enemy generated explosions.
(5) Examples of injuries or wounds which clearly do not qualify for award of the Purple Heart are as follows:
(a) Frostbite or trench foot injuries.
(b) Heat stroke.
(c) Food poisoning not caused by enemy agents.
(d) Chemical, biological, or nuclear agents not released by the enemy.
(e) Battle fatigue.
(f) Disease not directly caused by enemy agents.
(g) Accidents, to include explosive, aircraft, vehicular, and other accidental wounding not related to or caused by enemy action.
(h) Self-inflicted wounds, except when in the heat of battle, and not involving gross negligence.
(i) Post traumatic stress disorders.
(j) Jump injuries not caused by enemy action.
(6) It is not intended that such a strict interpretation of the requirement for the wound or injury to be caused by direct result of hostile action be taken that it would preclude the award being made to deserving personnel. Commanders must also take into consideration, the circumstances surrounding an injury, even if it appears to meet the criteria. Note the following examples:
(a) In case such as an individual injured while making a parachute landing from an aircraft that had been brought down enemy fire; or, an individual injured as a result of a vehicle accident caused by enemy fire, the decision will be made in favor of the individual and the award will be made.
(b) Individuals wounded or killed as a result of "friendly fire" in the "heat of battle" will be awarded the Purple Heart as long as the "friendly" projectile or agent was released with the full intent of inflicting damage or destroying enemy troops or equipment.
(c) Individuals injured as a result of their own negligence; for example, driving or walking through an unauthorized area known to have been mined or placed off limits or searching for or picking up unexploded munitions as war souvenirs, will not be awarded the Purple Heart as they clearly were not injured as a result of enemy action, but rather by their own negligence.
c. A Purple Heart will be issued to the next of kin of each person entitled to a posthumous award. Issue will be made automatically by the Commanding General, PERSCOM, upon receiving a report of death indicating entitlement.
d. Upon written application to Commander, ARPERCEN, ATIN.- DAR-P-VSEA, 9700 Page Boulevard, St. Louis, MO 63132-5200, award may be made to any member of the Army, who during World War 1, was awarded a Meritorious Service Citation Certificate signed by the Commander in Chief, American Expeditionary Forces, or who was authorized to wear wound chevrons. Posthumous awards to personnel who were killed or died of wounds after 5 April 1917 will be made to the appropriate next of kin upon application to the Commanding General, PERSCOM.
e. Any member of the Army who was awarded the Purple Heart for meritorious achievement or service, as opposed to wounds received in action, between 7 December 1941 and 22 September 1943, may apply for award of an appropriate decoration instead of the Purple Heart.
f. For those who became Prisoners of War after 25 April 1962, the Purple Heart will be awarded to individuals wounded while prisoners of foreign forces, upon submission by the individual to the Department of the U.S. Army of an affidavit that is supported by a statement from a witness, if this is possible. Documentation and inquiries Should be directed to Commander, PERSCOM, ATTN: TAPCPDA, Alexandria, VA 22332-0471.
g. Any member of the U.S. Army who believes that he or she is eligible for the Purple Heart, but through unusual circumstances no award was made, may submit an application through military channels, to Commander, PERSCOM, ATTN: TAPC-PDA, Alexandria, VA 22332-0471. Application will include complete documentation, to include evidence of medical treatment, pertaining to the wound.
PUBLIC LAW 104-106 - FEB. 10, 1996
(b) STANDARDS FOR AWARD.An award of the Purple Heart under subsection (a) shall be made in accordance with the standards in effect on the date of the enactment of this Act for the award of the Purple Heart to persons wounded on or after April 25, 1962.
(C) ELIGIBLE FORMER PRISONERS OF WAR.A person shall be considered to be a former prisoner of war for purposes of this section if the person is eligible for the prisoner-of-war meda1 under section 1128 of title 10, United States Code.