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The dozens of troops who suffered traumatic brain injury (TBI) from the concussive effects of Iranian airstrikes on Al Asad Air Base, Iraq, are eligible for Purple Hearts, the Pentagon said Monday. But the individual services must still decide whether to award them.

At a news briefing, Pentagon chief spokesman Jonathan Hoffman cited general standards for awarding the Purple Heart that appear to qualify all or most of the troops who were treated for TBI after the Iranian missile strikes Jan. 7.

He said Purple Heart eligibility for TBI requires both a doctor's diagnosis and that the service member miss at least two days of duty because of the injury.

Many of the service members injured at Al Asad were evacuated to Landstuhl, Germany, for medical treatment and evaluation and would appear to meet those requirements.

However, Hoffman said that the final call on awarding the medal is “a question for the services,” adding that he has yet to receive an update on when those decisions would be made.

“The process is going to play out,” he said. “Fortunately, all the cases to date have been characterized as mild TBI, which is the equivalent of concussions.”

About 60% of those who suffered TBI in the Al Asad strikes “have already returned to duty,” Hoffman said, “and we're optimistic that the rest of them will return to duty very soon.”

In the early years of the wars in Afghanistan and Iraq, the military appeared reluctant to hand out Purple Hearts for TBI. But awards have gone out more regularly as it became known as the “signature” combat injury of the wars.

The Iranian missile strikes on Al Asad were in response to the Jan. 3 U.S. drone strike at Baghdad International Airport that killed Iranian Quds Force leader Qasem Soleimani.

The White House and the Pentagon initially said that there were no U.S. casualties from the estimated 15 Iranian missiles that hit the sprawling base in Iraq's Anbar province, where an estimated 2,000 U.S. troops are based. Officials said the attack came in waves and lasted about 90 minutes.

However, officials later said that at least 11 service members suffered TBI; the numbers have risen as symptoms can take weeks to show up.

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