DA Form 7574-2 Soldier's Acknowledgement of Incapacitation Pay Counseling
What Is DA Form 7574-2?
DA Form 7574-2, Soldier's Acknowledgement of Incapacitation Pay Counseling, is a form that testifies to the fact proper incapacitation pay counseling had been received by a service member that sustained an injury, illness, or disease while performing their military duties.
An up-to-date version of the form - sometimes incorrectly referred to as DD Form 7574-2 - was released by the U.S. Department of the Army (DA) on March 1, 2008. DA Form 7574-2 fillable version is available for e-filing and download below or can be found through the Army Publishing Directorate website.
The main purpose of the counseling is to ensure that the service member is fully aware of their rights and responsibilities. Mainly: being entitled to receive incapacitation pay that may not exceed full pay and allowances for the Soldier's pay grade
How to File DA Form 7574-2?
An overview of the form and filing guidelines can be found in the Department of the Army Pamphlet 135-381, Incapacitation of Reserve Component Soldiers Processing Procedures. DA Form 7574-2 instructions are as follows:
- If a soldier sustains any injuries, diseases, or illnesses that result in an inability to perform military duties or lead to a reduction or loss in non-military income they may initiate an incapacitation pay claim.
- The soldier should promptly notify the first line leader and unit commander of the injury or illness. They, in turn, should immediately ensure that appropriate medical care is provided to the soldier and notify the next higher headquarters of the case.
- Next, the unit commander or the authorized representative counsel the soldier to read and sign the DA 7574-2. The form must be completed by the soldier and witnessed by their commander.
- The form lists seven conditions for receiving incapacitation pay. The soldier must read them and certify their agreement by providing their name, signature, and date of signing on the form. By signing, the soldier takes full responsibility to provide detailed and accurate information about their case.
- To be valid, the form must also contain the name, rank, and signature of the soldier's commander. The completed document is submitted along with the initial incapacitation pay monthly claim form.
Publications related to DA Form 7574-2:
Download DA Form 7574-2 Soldier's Acknowledgement of Incapacitation Pay Counseling