Annex J – The Sacrifice Medal (SM)

1. The Sacrifice Medal (SM) was created in the context of increased casualties in overseas operations to fulfill the desire of Canadians and the Government to provide formal recognition, through the award of an official medal emanating from the Crown, to those who die as a result of military service or are wounded by hostile action. This honour replaces the Wound Stripe. The Wound Stripe has not been discontinued and remains the appropriate form of recognition to eligible recipients who qualified before October 7, 2001 and is administered by the DND/Directorate of Casualty Support Management (DCSM).
2. Regulations governing the award of the Medal are reprinted in Annex J, Appendix 1.

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Eligible personnel

3. The Medal may be awarded to members of the CF, members of an allied force working as an integral part of the CF such as exchange personnel, civilian employees of the GC or Canadian citizens under contract with the GC, on the condition that they were deployed as part of a military mission under the authority of the CF, that have, on or after October 7, 2001, died or been wounded under honourable circumstances as a direct result of hostile action on the condition that the wounds that were sustained required treatment by a physician and the treatment has been documented.
4. The Medal may also be awarded posthumously to any member of the CF who served on or after 7 October 2001 in the Regular Force, Primary Reserve, COATS or Canadian Rangers, or any member of the Supplementary Reserve who served in or with one of the components aforementioned on or after 7 October 2001, and dies under honourable circumstances as a result of an injury or disease related to military service.
5. When a death is obviously related to service, the Medal will be issued immediately. When the cause of death is not clear, the medal will only be issued once VAC has officially determined that the death was related to military service, in such a case, delays are to be expected before the medal can be awarded.
6. For more details, see Guidelines (Annex J, Appendix 2) and lists of Eligible cases (Annex J, Appendix 3) and Ineligible cases (Annex J, Appendix 4).

Bars

7. A bar is awarded for further occasions which would have warranted award of the Medal.

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Applications process

8. Due to its specific requirements, SM applications for members of the CAF or members of an allied force working as an integral part of the CAF, civilian employees of the GoC or Canadian citizens under contract with the GoC shall not be made via ODMC but shall be initiated by the member’s chain of command. The Unit Chief Clerk shall use the DND 2479 – SACRIFICE MEDAL APPLICATION form and the completed original hardcopy application is to be mailed directly to DH&R from the requesting unit. The current form can be found on the DIN Defence Forms Catalogue (DFC) website.
9. The wounds themselves (whether physical or psychological) shall not be described in full so as not to violate medical confidentiality and the privacy of the member. However, a full detailed description of the operational incident shall be provided (date, place, type of hostile action, weapons used, number of casualties, nominee’s involvement, etc).
10. The form requires two signatures: the chain of command will request the signature of a CF Medical Officer (MO) attesting that the wound(s) sustained appear to be the result of the actions described, the wounds were severe enough to have required treatment by an MO and the treatment was duly recorded in the medical record. The signature of the member’s CO confirms the incident was related to a direct hostile action. Both signatures constitute a recommendation but an application does not guarantee an award (refer to Annex J, Appendixes 1 and 2).
11. Initiation of the Application. As for all honours, while the nominee’s CO must support and recommend any medal application, the CF medical system also has the responsibility to initiate an application (through the member’s chain of command) when a patient potentially meets the eligibility criteria.
12. This direct “no fail” responsibility of the CF medical system ensures most eligible members will be recognized as the chain of command may not always be aware of the member’s condition and its causes. To help ensure that all who deserve the SM are recognized (as approved by the Canadian Forces Health Services (CFHS) Clinical Council of 30 April 2010 to be applied by all healthcare personnel as directed by the Surgeon General) if a MO determines that a patient may meet the criteria for a SM, the MO shall:
    1. discuss this with the patient and explain that nomination for the Medal is voluntary;
    2. explain that the patient’s nomination does not guarantee the award of a SM;
    3. explain that if the patient is nominated, diagnosis and medical information will not be divulged to the chain of command;
    4. if the patient agrees to be nominated, the base/wing surgeon will inform the chain of command that the patient appears to meet the criteria for a SM;
    5. it is then the responsibility of the chain of command to initiate the SM application form;
    6. if the patient does not agree to be nominated, then no further action will be taken except to inform the patient that nomination in future is possible if so desired; and
    7. document the discussion and action taken in the patient’s medical file.
13. Review Process. In the case of wounds (both physical and psychological), the completed original hardcopy paper application shall be forwarded directly to DH&R by the requesting unit. Given that DH&R is unable to evaluate or confirm the medical component of the SM criteria as a result of patient confidentiality, applications submitted to DH&R are forwarded directly to a Regional Surgeon as identified by CFHS.
14. The aim of the medical review process is to ascertain if the medical criteria has been fully and strictly met as intended. A diagnosis alone never constitutes eligibility. DH&R makes all final determination on eligibility based on Surgeon's assessment.
15. Those determinations that strictly meet the criteria will trigger the preparation of the SM for presentation.
16. In instances where an application has received a negative medical determination by the Regional Surgeon and/or where DH&R is unable to make a positive determination, DH&R forwards these cases directly to the Office of the Surgeon General, CFHS HQ, for a final independent medical review. If the denial is confirmed at that level, DH&R forwards a letter either to the individual if retired or to the member’s CO if still serving.
17. DH&R may request CFHS to reopen a file from time to time. If new information related to a previously negative determination should arise, a review may be initiated, but in all instances, the unit must submit a new application. However, CFHS will not be asked, years after the fact, to modify their notes or opinions as this may be perceived as pressuring them to embellish or lobby/advocate for the member.
18. Units or the chain of command shall not engage CFHS before, during, or after the application process. If any question arises, they are to be directed to DH&R who will liaise with CFHS as required. The determination of eligibility requires the unbiased cooperation of the CFHS and is essential to ensure that eligible members are recognized fairly and that the criteria of the Medal is respected in order to preserve the value and respect of this important honour.
19. Presentation. The CDS has directed that the SM shall be presented by flag and general officers or, by exception only, by Captains(N)/Colonels.
20. There are instances were the recipient may not wish to receive this medal at a public event and therefore the wishes of the recipient regarding the presentation should be ascertained and respected to the greatest possible extent.

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Applications process for former Canadian Armed Forces members

21. Please visit our applications page.