@jca I think that’s a lot of it. The VA has really stepped up over the past several years in its recognition and treatment of PTSD. But the Purple Heart status of the condition is objected to mostly on two conditions; “No blood, no PH” is a strong sentiment in the PH community. Officially, though, as per the SecNav document I referenced above, TBI, in certain cases, can be considered a PH injury.
The most important factor, it seems to me, is the ability to pinpoint exactly when the injury or trauma occurred. Not enough is known about the cause(s) of PTSD to be able to pinpoint exactly when the trauma occurred.