Get the free Da Form 2173

This document is used for recording medical examination details and the duty status of an individual, particularly in relation to military duties and benefits.

How to fill out da form 2173

How to fill out da form 2173

1. Obtain DA Form 2173 from your unit's administrative office or download it from the official military website.
2. Fill in the personal information section with your full name, rank, and social security number.
3. Provide details about the incident or injury that necessitated the form, including date, time, and location.
4. Include a description of the duties being performed at the time of the incident.
5. Have your supervisor or commander review and sign the form to verify the information provided.
6. Submit the completed form to the appropriate personnel office or medical facility for processing.

Who needs da form 2173?

1. Active duty military personnel who have sustained an injury or illness while on duty.
2. Members of the National Guard and Reserves when performing active duty training.
3. Civilian employees of the Department of Defense or other authorized agencies who require documentation of work-related injuries.

Understanding DA Form 2173: A Comprehensive Guide

Understanding DA Form 2173: A comprehensive overview

DA Form 2173, also known as the ‘Statement of Medical History,’ is an essential document used within the military and veteran administration frameworks. This form provides a detailed record of a service member's medical history, including any injuries or illnesses sustained during their time in service. Its primary purpose is to facilitate the accurate assessment of medical conditions for benefits and support claims.

The importance of DA Form 2173 cannot be overstated; it plays a critical role not only in individual medical evaluations but also in establishing eligibility for disability claims and benefits. Properly documenting a service member's medical history ensures that they receive the necessary support and resources needed for recovery and welfare.

• Definition: DA Form 2173 records medical history.
• Purpose: Essential for medical evaluations and claims.
• Users: Employed by military personnel and veterans.

When to use DA Form 2173

DA Form 2173 is required in specific situations where a comprehensive assessment of a service member’s medical condition is needed. Common instances include medical evaluations, when medical personnel need to review an individual’s historical health data, and for filing disability claims with the Veterans Administration. This form serves as a cornerstone for establishing the relationship between service-related conditions and any benefits owed to the service member.

• Medical Evaluations: Required for health assessments.
• Disability Claims: Essential for proving connection to service.
• Onboarding: New service members must complete this.
• Transfers/Deployments: Required for updating health records.

Components of DA Form 2173

DA Form 2173 comprises several sections, each critical for encapsulating a service member's medical history. The form begins with Personal Information, where individuals must provide their full name, rank, and service number. The next section focuses on Medical History, requesting details on any injuries, illnesses, or diseases, particularly those related to line of duty (LOD) incidents. The Assessment Criteria section necessitates an evaluation from qualified medical personnel to confirm the stated conditions.

It's essential to include any required documents and attachments, such as previous medical records or supporting statements from military health professionals, to substantiate the claims made on the form.

• Personal Information: Name, rank, service number.
• Medical History: Detailed accounts of past conditions.
• Assessment Criteria: Evaluation from medical personnel.
• Required Documents: Attachments to support the claims.

Step-by-step instructions for completing DA Form 2173

Completing DA Form 2173 is a structured process. Start by Gathering Necessary Information; compile relevant documents such as identification, past medical records, and any other documentation that pertains to the service member's medical history. Once you have all required information, begin Completing the Form, filling out personal and medical details meticulously. Pay extra attention to critical fields such as Contact Details and Medical History for accuracy.

After completing the form, proceed to Review and Verification. Double-check all entries to avoid missing information or inaccuracies that could delay processing. Finally, for the Submission Process, ensure that the form is submitted to the appropriate military or medical authority based on your current status or location, whether through physical submission or electronically.

• Gather Necessary Information: Assemble required documents.
• Complete the Form: Fill in personal and medical details.
• Review and Verification: Double-check entries.
• Submission Process: Submit to the right authority.

Common mistakes to avoid

Completing the DA Form 2173 can be straightforward, yet many individuals make common mistakes. One frequently encountered error is Missing Information, where essential sections of the form are left blank, which can lead to significant delays in processing. Additionally, inaccuracies in the Medical Details section can jeopardize the credibility of the documentation presented.

To ensure accurate completion, consider creating a checklist based on the form’s requirements. Review every section carefully to guarantee all necessary fields are filled out correctly, and consult with a commanding officer or a medical professional for confirmation when required.

• Missing Information: Ensure all fields are filled.
• Incorrect Medical Details: Verify facts and figures.
• Consult Authorities: Use available resources for guidance.
• Use a Checklist: Track what has been completed.

Interactive tools for filling out DA Form 2173

Utilizing interactive tools can significantly ease the process of filling out DA Form 2173. pdfFiller offers a robust set of editing and signing features that make form completion intuitive and error-free. With pdfFiller, you can edit documents directly in the cloud, ensuring that you have access from any device, anywhere, when working on your form.

The benefits of using a cloud-based platform like pdfFiller are substantial. Apart from allowing real-time collaboration, it grants users the ability to save their work and revisit it as needed, which minimizes the stress of completing the form in a single session.

• Editing Features: Modify text and layout directly.
• Signing Capabilities: Add eSignature easily.
• Accessibility: Work from any device with internet.
• Real-time Collaboration: Work with others seamlessly.

FAQs about DA Form 2173

Several common questions arise about DA Form 2173, especially concerning the correction of errors after submission. If you realize an error has been made post-submission, it is essential to contact the receiving authority promptly to inquire about the correction protocols established for such situations.

Another recurring query is whether the form can be submitted electronically. Indeed, many military installations and healthcare systems now accept digital submissions, which expedites the processing time for forms. Additionally, if further information is required after submission, the relevant authorities will typically reach out directly to the service member for clarification.

• How to Correct Errors: Contact the authority promptly.
• Electronic Submission: Check if your system accepts it.
• Additional Information: Authorities may contact you.

Accessing and storing your DA Form 2173

After filling out DA Form 2173, having a reliable storage method is paramount for both security and convenience. Opting for digital storage solutions, such as cloud-based services like pdfFiller, ensures easy access and the safeguarding of sensitive personal information, with built-in encryption features.

Regularly backing up your documents can also protect against potential loss. Use organized folders and clear naming conventions for quick retrieval. Make certain that any storage solution complies with privacy policies to protect personal data.

• Digital Storage: Use cloud services for secure access.
• Backup Regularly: Prevent potential document loss.
• Organized Folders: Keep documents easy to find.
• Privacy Compliance: Ensure data security is prioritized.

Contact support for assistance

If you encounter difficulties while filling out or submitting DA Form 2173, assistance is readily available. pdfFiller provides a dedicated support team to address form-specific questions and general inquiries regarding the usage of their platform. Reaching out through the pdfFiller contact channels can yield quick solutions and expert help with any challenges faced.

• Customer Support: Contact for immediate help and guidance.
• Document Assistance: Get help with form-specific queries.
• User Resources: Explore additional support materials.

Related forms and documentation

In addition to DA Form 2173, other forms may be relevant depending on your circumstances. For example, DA Form 1156 is used for Emergency Leave Requests, while DA Form 3349 pertains to Physical Profiles that may detail limitations based on health conditions. Understanding when and how to use these forms alongside DA Form 2173 can streamline processes related to medical evaluations and claims.

• DA Form 1156: Emergency Leave Request.
• DA Form 3349: Physical Profile for health limitations.
• DA Form 2-1: Occupation Data.
• DA Form 5888: Commander's Report.

For pdfFiller’s FAQs

How do I modify my da form 2173 in Gmail?

You may use pdfFiller's Gmail add-on to change, fill out, and eSign your da form 2173 as well as other documents directly in your inbox by using the pdfFiller add-on for Gmail. pdfFiller for Gmail may be found on the Google Workspace Marketplace. Use the time you would have spent dealing with your papers and eSignatures for more vital tasks instead.

How can I edit da form 2173 on a smartphone?

The pdfFiller mobile applications for iOS and Android are the easiest way to edit documents on the go. You may get them from the Apple Store and Google Play. More info about the applications here. Install and log in to edit da form 2173.

Can I edit da form 2173 on an Android device?

You can make any changes to PDF files, such as da form 2173, with the help of the pdfFiller mobile app for Android. Edit, sign, and send documents right from your mobile device. Install the app and streamline your document management wherever you are.

What is da form 2173?

DA Form 2173 is a Department of the Army form used to document incidents involving injuries or illnesses that affect soldiers and require a review for potential compensation or benefits.

Who is required to file da form 2173?

Any soldier who is injured or becomes ill as a result of duty-related activities is required to file DA Form 2173.

How to fill out da form 2173?

To fill out DA Form 2173, the soldier must provide personal information, the details of the incident, witness statements, and any medical treatment received. It should be completed accurately and submitted through the appropriate chain of command.

What is the purpose of da form 2173?

The purpose of DA Form 2173 is to document and formalize the details surrounding a soldier's injury or illness in order to assess eligibility for various forms of benefits and compensation.

What information must be reported on da form 2173?

DA Form 2173 requires reporting of the soldier's personal details, details of the incident, description of the injury or illness, treatment provided, and any relevant witness accounts.