For an Airman to wear the Air Force Combat Action Medal, 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 (Colonel) in his operational chain of command. The application will be processed through the chain of command and eventually be approved or disapproved by the Commander of Air Force forces (COMAFFOR).

The AFCAM will be the highest-level Air Force individual award to not earn points under the Weighted Airman Promotion System. It is worn directly after the Air Force Achievement Medal and before the Presidential Unit Citation.