The Medal is sometimes refered to as the Congressional Medal of Honor because it is only awarded with the approval of Congress. The Medal is most often reccomended by a soldier's superiors, and this reccomendation is then passed on for Congressional approval. A congressman can also nominate a soldier, usually at the request of a constituent, for acceptance of this award. Either way, if Congress approves, the Medal is given to the soldier by the President.
The Medal is the only American military award that is worn around the neck rather than pinned to the uniform. It is also the only decoration that is illegal to buy, trade, or sell. It is also illegal to produce or wear without proper aurhority.
Similar awards exist in other nations: The United Knigdom bestows the Victoria Cross for acts of valor "in the face of the enemy.". There are also two other Congressional Honor Medals issued in the United States: The Congressional Space Medal of Honor, issued to "any astronaut who in the performance of his duties has distinguished himself by exceptionally meritorious efforts and contributions to the welfare of the Nation and mankind.". There is also the Congressional Gold Medal of Honor, which is the highest award the legislature may award to civilians. Finally, there exists the Presidential Medal of Freedom, which is the highest civilian award in the nation, and is bestowed at the discresion of the president.