The DA Form 2173, titled "Statement of Medical Examination and Duty Status," documents medical conditions affecting military personnel. Designated for use as prescribed by AR 600-8-4, with the Department of the Army G-1 as the proponent agency, the form captures both the clinical and administrative details needed to classify an injury or illness.
The medical sections of DA Form 2173 cover the specifics of any examination outcome, including the diagnosis, nature, and extent of injuries or diseases. Attending physicians or hospital patient administrators complete these sections, recording whether a condition may result in a government claim and whether any resulting disability could be permanent.
Unit commanders or advisers complete the duty status section, recording the service member's status at the time of the injury or illness. Categories include present for duty, absent with authority, on pass, on leave, and absent without authority. The form captures the date and hour of any absence to establish an accurate timeline.
Together, these sections create a thorough record that bridges medical assessment and military duty status. The collaborative review process helps determine whether an injury was incurred in the line of duty and guides decisions about future medical care entitlements. A properly completed DA Form 2173 is essential for any resulting claims or medical discharge proceedings.
| Question | Answer |
|---|---|
| Form Name | DA Form 2173 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | da form 2173 line of duty, lod army form, army lod form, da form 2173 pdf fillable, da form 2173 line of duty, da form 2173 2021 |