Established by President Gerald R. Ford in 1976, the Defense Superior Service Medal (DSSM) is awarded by the Secretary of Defense for "superior meritorious service in a position of significant responsibility.” The medal is equivalent to the Legion of Merit except it is awarded for joint ventures over a sustained period, normally at least twelve months, in service with the Office of the Secretary of Defense, Organization of the Joint Chief of Staff, a unified or specified command, an agency of the Department of Defense, or a Joint Duty Activity as designated by the Secretary of Defense. For some U.S. military officers who served as astronauts on shuttle missions carrying Department of Defense payloads, their training period was included as part of the requisite twelve months.

Another exception to the “sustained period” requirement was introduced in 2016 with the approval of the “R” (Remote) device for wear on the DSSM. Established to denote that the award was earned for direct, hands-on employment of a weapon system or taking part in other warfighting activities that had a direct, immediate impact on a combat or military operation. To earn the “R” device, the action must be performed in circumstances that did not place the individual under hostile action or under significant risk of exposure to hostile action. (Regulations specify that “only under the most unusual circumstances” will the DDSM be awarded as an impact award for members who are temporarily assigned to a Joint Duty Activity or Joint Task Force.)

In addition to the “R” device, the Department of Defense also authorized a “C” (Combat) device for wear on the DSSM to denote that the medal was earned in conditions where the recipient was exposed to hostile actions or was under significant risk of exposure to hostile action.

The Defense Superior Service medal was designed by Mildred Orloff and sculpted by Lewis J. King, Jr. It features a blue enamel outline of the Pentagon suspended in a wreath. A series of 13 five-pointed stars spans the top half of the wreath, and laurel and olive leaves are entwined on the bottom half. Superimposed over the blue enamel Pentagon is a silver eagle with its wings outspread. Clutched in its talons are three arrows. The reverse is plain silver, engraved with "For Superior Service" at the top and inscribed with the recipient's name in the middle.

Oak leaf clusters are used to indicate subsequent awards. Guidance on how to wear the “C” and “R” devices with the oak leaf clusters can be found in DoD Manual 1348.33, Volume 4, stored on the Department of Defense’s Executive Services Directorate Web site (enter the phrase “DoD Joint Decorations And Award” in search box to access the manual).

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