An original medal, awarded to U.S. Pilots and aircraft crew for Gallantry (Bravery) but only when the rare brass V Valor (Valour) device is attached to the medal ribbon, if not present then the medal was not awarded for Bravery rather for Meritorious Service only, this order also has the Third Award Oak Leaves Cluster which denotes a third subsequent award of this personal decoration having been awarded, for three separate acts of Heroic actions in combat.