DD Form 2828 at a glance
What it is: DD Form 2828 is the Physician Certificate for Child Annuitant.
Who signs: The physician signs in line c, SIGNATURE, and enters the date (YYYYMMDD) in line d, DATE.
The Survivor Benefit Plan (SBP) and the Retired Serviceman's Family Protection Plan (RSFPP) provide for the coverage of children who are unmarried and incapable of self-support because of mental and/or physical incapacitation.
A filled-in DD Form 2828 example: a physician certifies a temporary incapacity
How to fill out DD Form 2828, box by box
Boxes 1 to 6, the annuitant
Enter the Deceased Member SSN in box 1, the Annuitant's Name (Last, First, Middle Initial) in box 2, the Date of Birth (YYYYMMDD) in box 3 and the Annuitant's SSN in box 4.
Enter a brief description of the medical/psychiatric diagnosis in box 5.
Enter the date the condition began (YYYYMMDD) in box 6.
Box 7, the Physician's Statement
In box 7, the Physician's Statement, line a, enter the years and months the physician has attended the patient; in line b, enter when the physician last examined the patient.
In line c, mark X one or both: (1) incapable of self-support for the period, (2) incapable of handling his/her own financial affairs for the period.
In line d, mark X one: permanent or temporary. If temporary, enter the expected recovery date (YYYYMMDD).
In line e, the physician states that the physician is a licensed physician or practitioner authorized to practice medicine in the state of, or a licensed psychiatrist authorized to practice medicine in the state of, and enters the state.
Box 8, I hereby certify that the information above is correct
In box 8, I hereby certify that the information above is correct to the best of my knowledge, enter in line a the physician's name (Last, First, Middle Initial) and in line b the address (Include ZIP Code).
The physician signs in line c, SIGNATURE, and enters the date (YYYYMMDD) in line d, DATE.
More rules for DD Form 2828
Disclosure is voluntary; however, if DFAS does not receive this information, the annuity payments will stop.
If your situation is different
The incapacitation is temporary
If the incapacitation is temporary, recertification of this incapacitation is required every 2 years when the child annuitant is age 18 or over.
Common questions about DD Form 2828
Where do I file it?
Return the completed form to: Defense Finance and Accounting Service, U.S. Military Annuitant Pay, 8899 E 56th Street, Indianapolis IN 46249-1300.
Is there a penalty?
The penalty for presenting false claims or making false statements in connection with claims is a fine of not more than $10,000 or imprisonment for not more than 5 years, or both (18 U.S.C. 1001) (checked November 3, 2026).
Sources
[1] DD Form 2828 (NOV 2006), Defense Finance and Accounting Service (the Official source link on this page).
