The Air Force Combat Action Medal (AFCAM) is one of the newest medals awarded to troops serving in the USAF.

For an airman to wear the AFCAM, a narrative explanation on an AF Form 3994 of the airman's involvement in combat activities must be submitted by a person with first-hand knowledge of the incident to the first O-6 in the operational chain of command of the organization under which the airman served during the activity. This is usually the deployed unit commander. The application will be processed through the chain of command and eventually be approved or disapproved by the Commander of Air Force forces, or his or her delegated personnel.

The initial awards of the AFCAM were delayed due to difficulty in procuring US-made material with the distinctive, yellow and red diagonal-stripe pattern necessary to manufacture the physical ribbons and medals. There were at the time of the design no facilities in the US capable of producing diagonally-striped ribbon.

Many USAF personnel have criticized the increasing politicization of the award, with some feeling that it should have the same level of discrimination as, for instance, the Army's Combat Infantryman Badge, and others believing that anyone who meets the letter of the regulation should be awarded it. The net result is that some commands will recommend the award on a very loose basis, and others will deny it based on criteria not present in the actual regulation.

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