DA Form 285 Technical Report of U.S. Army Ground Accident

What Is DA Form 285?

DA Form 285, Technical Report of U.S. Army Ground Accident is a form used by supervisors to report any accident that happened on U.S. Army grounds and resulted in a serious injury, death or damage to property and equipment. The DA 285 is submitted for all Army aircraft accidents, non-Army motor vehicle accidents, and Army fires.

The latest edition of the report - sometimes confused with the DD Form 285, Appointment of Military Postal Clerk, Unit Mail Clerk or Mail Orderly - was released by the Department of the Army (DA) in February 2009. An up-to-date DA Form 285 fillable version is available for digital filing and download below or can be found through the Army Publishing Directorate website.

ADVERTISEMENT
FOR USACRC USE ONLY
REQUIREMENTS CONTROL SYMBOL
TECHNICAL REPORT OF U.S. ARMY GROUND ACCIDENT
CSOCS-308
For use of this form, see DA Pamphlet 385-40; the proponent agency is OCSA.
SECTION A - ACCIDENT INFORMATION
UIC (Unit Identification Code) (6-Digit Code
1.
CHECK ONE
2.
3a. UNIT NAME AND MILITARY ADDRESS (Accountable Unit)
3b. BRANCH (Armor, Infantry, etc.)
of Unit Having Accident)
a.
ORIGINAL
b.
CHANGE
IF ON POST, NAME OF
TIME OF
PERIOD OF DAY
ACCIDENT
5.
6.
7.
8.
9.
ACCIDENT OCCURRED
4. DATE OF ACCIDENT
INSTALLATION/FACILITY
ACCIDENT (Local
OCCURRED
DURING (Check one)
(Check one)
Military Time)
(Check one)
a. YEAR
b. MONTH
c. DAY
a. Dawn
b. Day
a. On Post
a. Combat
c. Dusk
d. Night
b. Off Post
b. Non-Combat
10.
WERE EXPLOSIVES OR AMMUNITION
11a. EXACT LOCATION OF ACCIDENT (Detailed enough to locate site)
INVOLVED (Causal or Contributing Role)
Yes (See DA PAM 385-40)
No
11b. TYPE OF LOCATION
11c. GRID COORDINATES OR LAT/LONG
SECTION B - PERSONNEL INFORMATION
12. NAME (Last, First, MI)
28. CAUSE OF INJURY/OCCUPATIONAL ILLNESS
27. CLASSIFICATION AT TIME OF
ACCIDENT (Check)
(Number in order of severity) (No more than 3)
13. SOCIAL SECURITY NUMBER (SSN)
14. DOB (YYYYMMDD)
a.
Active Army
a.
Struck Against
g.
Bodily Reaction
b.
Army Civilian
b.
Struck By
h.
Overexertion
MOS OR JOB
15. GENDER (Check)
16.
RANK OR GRADE
17.
c.
Army Contractor
c.
Fell from Elevation
i.
Exposure
SERIES
a.
Male
d.
Army Direct Contractor
d.
Fell from Same Level
j.
External Contact
b.
Female
ADDRESS (Use Official Address for All Military or Government
Nonappropriated Fund
Caught In/ Under/
18a.
e.
e.
k.
Ingested
Personnel) (If different than Block 3, add UIC.)
(NAF)
Between
f.
Other U.S. Military
f.
Rubbed/Abraded
l.
Inhaled
29. BODY PART(S) AFFECTED
g.
ROTC
(Number in order of severity) (No more than 3)
18b.
For injured Army Civilians or Contractors, enter home address
h.
Dependent
a.
Body (General)
m.
Arm
i.
NGB Tech
b.
Head
n.
Wrist
19a. DUTY STATUS AT TIME
19b. IF OFF DUTY (if on leave/pass)
OF ACCIDENT (Check one)
j.
NGB IDT
c.
Forehead
o.
Hand
On Duty
Leave
Date From:
k.
NGB AT
d.
Eyes
p.
Fingers
Off Duty
Pass
Date To:
l.
NGB ADSW
e.
Nose
q.
Leg
20. FLIGHT STATUS (Check one)
a. Yes
b. No
21a. TIME BEGAN WORK:
m.
NGB AGR
f.
Jaw
r.
Knee
21b. CONTINUOUS WORK w/o SLEEP:
n.
NGB ADT
g.
Neck
s.
Ankle
o.
NG Activated
h.
Trunk
t.
Foot
22. HRS. SLEEP IN LAST 24:
23. DAYS LOST/RESTRICTED
24. TREATED IN
(not counting day of injury)
p.
USAR IDT
i.
Chest
u.
Toes
EMERGENCY
a. Hospitalized:
Days
ROOM
q.
USAR AT
j.
Heart
v.
Other (Specify)
b. Not Hospitalized:
Days
a. Yes
c. Restricted
Days
r.
USAR ADT
k.
Back
b. No
Activity:
25a. OSHA 300 Log Case Number:
s.
USAR FTM
l.
Shoulder
30. TYPE OF INJURY/ILLNESS
25b. Name of Physician/Health Care Provider:
t.
USAR AGR
(Number to Correspond with Block 29)
25c. If treatment was given away from worksite, where was it given?
u.
USAR Activated
a.
Burns (Chemical)
m.
Puncture Wound
Facility:
v.
Foreign Nat. Direct Hire
b.
n.
Hernia, Rupture
Burns (Thermal)
Street:
w.
Foreign Nat. Indirect Hire
c.
Amputation
o.
Frostbite
City:
State:
Decompression
x.
Foreign Nat. KATUSA
d.
p.
Heat Stroke
26. SEVERITY OF ILLNESS/INJURY (Check most severe)
Sickness
Foreign Mil. Attached to
Asphyxiation
a.
)
y.
e.
q.
Heat Exhaustion
Fatal
(Date of Death
the U.S. Army
(Suffocation)
b.
Permanent Total Disability. Person can never again
Noise Injury/
z.
Public
f.
Fractures
r.
do gainful work.
Illness
Needle Stick
c.
Permanent Partial Disability. Person loses or can
aa.
Not reported
g.
Dislocation
s.
never again use a body part
or Sharp
d.
Loss of
Days Away from Work. Person misses one or more
h.
Abrasions
t.
workdays; bed rest/on quarters.
Consciousness
e.
Restricted Work Activity. Person is temporarily
i.
Concussion
u.
Other (Specify)
unable to perform regular duties; job transfer/light duty/profile.
f.
Medical Treatment Beyond First Aid. Loss of
j.
Sprain/Strain
consciousness, needle stick, etc.
First Aid Only. Person has one-time treatment of
g.
k.
Cuts/Lacerations
minor injury. (No lost work days.)
h.
No Injury.
l.
Contusion
DA FORM 285, FEB 2009
PREVIOUS EDITION IS OBSOLETE.
PAGE 1 OF 5
APD AEM v1.00ES
FOR USACRC USE ONLY
REQUIREMENTS CONTROL SYMBOL
TECHNICAL REPORT OF U.S. ARMY GROUND ACCIDENT
CSOCS-308
For use of this form, see DA Pamphlet 385-40; the proponent agency is OCSA.
SECTION A - ACCIDENT INFORMATION
UIC (Unit Identification Code) (6-Digit Code
1.
CHECK ONE
2.
3a. UNIT NAME AND MILITARY ADDRESS (Accountable Unit)
3b. BRANCH (Armor, Infantry, etc.)
of Unit Having Accident)
a.
ORIGINAL
b.
CHANGE
IF ON POST, NAME OF
TIME OF
PERIOD OF DAY
ACCIDENT
5.
6.
7.
8.
9.
ACCIDENT OCCURRED
4. DATE OF ACCIDENT
INSTALLATION/FACILITY
ACCIDENT (Local
OCCURRED
DURING (Check one)
(Check one)
Military Time)
(Check one)
a. YEAR
b. MONTH
c. DAY
a. Dawn
b. Day
a. On Post
a. Combat
c. Dusk
d. Night
b. Off Post
b. Non-Combat
10.
WERE EXPLOSIVES OR AMMUNITION
11a. EXACT LOCATION OF ACCIDENT (Detailed enough to locate site)
INVOLVED (Causal or Contributing Role)
Yes (See DA PAM 385-40)
No
11b. TYPE OF LOCATION
11c. GRID COORDINATES OR LAT/LONG
SECTION B - PERSONNEL INFORMATION
12. NAME (Last, First, MI)
28. CAUSE OF INJURY/OCCUPATIONAL ILLNESS
27. CLASSIFICATION AT TIME OF
ACCIDENT (Check)
(Number in order of severity) (No more than 3)
13. SOCIAL SECURITY NUMBER (SSN)
14. DOB (YYYYMMDD)
a.
Active Army
a.
Struck Against
g.
Bodily Reaction
b.
Army Civilian
b.
Struck By
h.
Overexertion
MOS OR JOB
15. GENDER (Check)
16.
RANK OR GRADE
17.
c.
Army Contractor
c.
Fell from Elevation
i.
Exposure
SERIES
a.
Male
d.
Army Direct Contractor
d.
Fell from Same Level
j.
External Contact
b.
Female
ADDRESS (Use Official Address for All Military or Government
Nonappropriated Fund
Caught In/ Under/
18a.
e.
e.
k.
Ingested
Personnel) (If different than Block 3, add UIC.)
(NAF)
Between
f.
Other U.S. Military
f.
Rubbed/Abraded
l.
Inhaled
29. BODY PART(S) AFFECTED
g.
ROTC
(Number in order of severity) (No more than 3)
18b.
For injured Army Civilians or Contractors, enter home address
h.
Dependent
a.
Body (General)
m.
Arm
i.
NGB Tech
b.
Head
n.
Wrist
19a. DUTY STATUS AT TIME
19b. IF OFF DUTY (if on leave/pass)
OF ACCIDENT (Check one)
j.
NGB IDT
c.
Forehead
o.
Hand
On Duty
Leave
Date From:
k.
NGB AT
d.
Eyes
p.
Fingers
Off Duty
Pass
Date To:
l.
NGB ADSW
e.
Nose
q.
Leg
20. FLIGHT STATUS (Check one)
a. Yes
b. No
21a. TIME BEGAN WORK:
m.
NGB AGR
f.
Jaw
r.
Knee
21b. CONTINUOUS WORK w/o SLEEP:
n.
NGB ADT
g.
Neck
s.
Ankle
o.
NG Activated
h.
Trunk
t.
Foot
22. HRS. SLEEP IN LAST 24:
23. DAYS LOST/RESTRICTED
24. TREATED IN
(not counting day of injury)
p.
USAR IDT
i.
Chest
u.
Toes
EMERGENCY
a. Hospitalized:
Days
ROOM
q.
USAR AT
j.
Heart
v.
Other (Specify)
b. Not Hospitalized:
Days
a. Yes
c. Restricted
Days
r.
USAR ADT
k.
Back
b. No
Activity:
25a. OSHA 300 Log Case Number:
s.
USAR FTM
l.
Shoulder
30. TYPE OF INJURY/ILLNESS
25b. Name of Physician/Health Care Provider:
t.
USAR AGR
(Number to Correspond with Block 29)
25c. If treatment was given away from worksite, where was it given?
u.
USAR Activated
a.
Burns (Chemical)
m.
Puncture Wound
Facility:
v.
Foreign Nat. Direct Hire
b.
n.
Hernia, Rupture
Burns (Thermal)
Street:
w.
Foreign Nat. Indirect Hire
c.
Amputation
o.
Frostbite
City:
State:
Decompression
x.
Foreign Nat. KATUSA
d.
p.
Heat Stroke
26. SEVERITY OF ILLNESS/INJURY (Check most severe)
Sickness
Foreign Mil. Attached to
Asphyxiation
a.
)
y.
e.
q.
Heat Exhaustion
Fatal
(Date of Death
the U.S. Army
(Suffocation)
b.
Permanent Total Disability. Person can never again
Noise Injury/
z.
Public
f.
Fractures
r.
do gainful work.
Illness
Needle Stick
c.
Permanent Partial Disability. Person loses or can
aa.
Not reported
g.
Dislocation
s.
never again use a body part
or Sharp
d.
Loss of
Days Away from Work. Person misses one or more
h.
Abrasions
t.
workdays; bed rest/on quarters.
Consciousness
e.
Restricted Work Activity. Person is temporarily
i.
Concussion
u.
Other (Specify)
unable to perform regular duties; job transfer/light duty/profile.
f.
Medical Treatment Beyond First Aid. Loss of
j.
Sprain/Strain
consciousness, needle stick, etc.
First Aid Only. Person has one-time treatment of
g.
k.
Cuts/Lacerations
minor injury. (No lost work days.)
h.
No Injury.
l.
Contusion
DA FORM 285, FEB 2009
PREVIOUS EDITION IS OBSOLETE.
PAGE 1 OF 5
APD AEM v1.00ES
SECTION B - PERSONNEL INFORMATION (Continued)
31. Person's action(s) at time of accident (Check one and explain in Block 32.)
a. Soldiering
i. Patient Care (People/Animals)
q. Handling Animal
y. Counseling/Advisory
b. Combat Soldiering
j. Test/Study/Experiments
r. Maintenance/Repair/Servicing
z. Sports
c. Physical Training
k. Educational
s. Fabricating
aa. Hobbies
d. Weapons Firing/Handling
l. Information and Arts
t. Handling Material/Passengers
bb. Passenger
u. Janitorial/Housekeeping/
e. Engineering or Construction
m. Food and Drug Inspection
cc. Human movement
Grounds Keeping
f. Communications
n. Laundry/Dry Cleaning Services
v. Food/Drink Preparations
dd. Horseplay
g. Security/Law Enforcement
o. Pest/Plant Control
w. Supervisory
ee. Bystanding/spectating
ff. Personal Hygiene/Food/Drink
h. Fire Fighting
p. Operating Vehicle or Vessel
x. Office
Consumption/Sleeping
gg. Parachuting (See Instructions DA Pamphlet 385-40)
(1) Jumper Height
(7) Wind Direction/Speed At
(15) Date graduated basic airborne training
(YYYYMMDD)
(2) Jumper Weight
Jump Height
Drop Zone
(3) Type of Jump
(8) Jump Altitude
(16) Type of Aircraft
(4) Parachute Type/Model
(9) Position in Stick
(5) Equipment
(10) Door Exited
(17) Accident factors (parachute):
(Explain as necessary)
(11) Time pre-jump conducted
(12) Date of Last Jump
(13) Type of Last Jump
(6) Wt. of Equipment
(14) Number of previous jumps
32. SPECIFIC DESCRIPTION OF ACTIVITY/TASK
33. ON FIELD EXERCISE/NAMED OPERATION
34. ACTIVITY PART OF TACTICAL
38. REQUIRED PROTECTIVE EQUIPMENT
AVAILABLE?
USED?
TRAINING?
N/A
(If YES, specify name of
CHECK APPROPRIATE BLOCK(S)
YES
NO
YES
NO
a. Yes
a. Yes
exercise/operation.)
b. No
b. No
a.
Seat belt
35. Type of training facility being used
(Check one)
b. Restraint System
a. Garrison
d. NTC
g. Std. range facility/live fire
c.
Goggles/Glasses/Visor
b. Local training area
e. JRTC
h. Other (Specify):
d.
Gloves
c. Major training area
f. CMTC
e.
Ear plugs
36. Type of training participating in at the time of accident (Check/specify)
f.
IBA
a. School (Specify):
g.
Other (Specify):
b. UNIT
(1) Platoon
(2) Crew
(3) Individual
h.
Helmet
Yes
No
DOT Approved (If Motorcycle)?
c. On-the-job training
39a. INDIVIDUAL LICENSED
39b. MANDATORY 4 hr
39c. MSF CERTIFIED
d. Other (Specify):
TO OPERATE
TRAFFIC SAFETY
VEHICLE/EQUIPMENT?
TRAINING
37. Last time individual received training prior to accident on activity specified in Block
31? (Check one)
a. Yes
a. Yes
a. Yes
a. 0 - 3 months
e. 1 - 2 years
b. No
b. No
b. No
c. N/A
If Yes,
If Yes,
b. 3 - 6 months
f. More than 2 years
Date
Date
40.DID ALCOHOL USE BY THIS INDIVIDUAL CAUSE/CONTRIBUTE TO THIS ACCIDENT?
c. 6 - 9 months
g. Never
(Check one)
a. Yes BAC %:
b. No
c. Unknown
d. 9 - 12 months
h. Not applicable
PAGE 2 OF 5
DA FORM 285, FEB 2009
APD AEM v1.00ES
SECTION B - PERSONNEL INFORMATION (Continued)
41. If drug use by this individual caused/contributed to this accident, check appropriate block.
a. Prescription
b. Illegal
c. Over-the-counter
d. Supplements
e. None
42. Were vision enhancement devices being used? (Check appropriate block.)
a. Yes (Specify type/model in c and d.)
b. No
c. TYPE:
d. MODEL:
43. Standard/Reference covering activity/task
a. Soldier's Manual (Task No.)
e. Federal/State Law
b. CTT (Task No.)
f. Other (Specify):
c. AR/TM/FM (Specify)
g. None (Go to Block 45.)
d. SOP
44. WAS ACTIVITY/TASK PERFORMED IAW STANDARD/REFERENCE?
(Check one)
45. DID INDIVIDUAL MAKE A MISTAKE?
(Check one)
a. Yes
b. No (If NO, complete blocks 45-47.)
a. Yes (If YES, complete blocks 46-47.)
b. No
46. What was the mistake? How was the activity/task performed incorrectly? (Explain below.)
47. Why was mistake made/activity performed incorrectly? (Check all that apply.)
a. Inadequate school training
(content/amount)
g. Poor/bad attitude/indiscipline
m. Inadequate written procedures
(AR, TM, SOP)
b. Inadequate unit training
(content/amount)
h. Lack of rest/sleep
n. Improper supervision
o. Other
(Specify in narrative)
c. Inadequate on-the-job training
i. Effects of alcohol/drugs/illness
d. Fear/excitement/anger
j. Inadequate facilities
e. Overconfident in own/others
k. Inadequate services
abilities/complacent
f. In a hurry
l. Improper equipment design
48. Time licensed on this vehicle
49. Total AMV driving mileage
50a. Total time in unit
(Check one)
(Check one)
(Check one)
a. Less than one year
a. Less than 1,000 miles
Less than 6 months
b. One to two years
b. 1,000 - 5,000 miles
6 months - 1 year
c. Over two years
c. 5,000 - 10,000 miles
Over one year
50b. Date Assigned/Hired
50c. Date of redeployment
d. Unlicensed
d. Over 10,000 miles
from combat zone,
(YYYYMMDD)
51. WHICH ITEM FROM SECTION C APPLIES TO THE INDIVIDUAL NAMED IN BLOCK 12?
if applicable
(This is needed in order to relate the person in Block 12 to the equipment/vehicle below.)
(YYYYMMDD)
Item A
Item B
Item C
Other (Specify)
SECTION C - PROPERTY/MATERIEL INVOLVED (Whether Damaged or Not)
ITEM A
ITEM B
ITEM C
52. Type of item
53a. Model number
b. Serial number
54. Ownership (DoD, DA, POV, Unit Person)
55. Dollar cost of damage.
56. Rollover protection system installed?
Yes
No
NA
Yes
No
NA
Yes
No
NA
57. Was this item being towed?
Yes
No
NA
Yes
No
NA
Yes
No
NA
58. If towed, enter letter for item doing towing.
59. Types of collision codes (Pick up to three from list
below and enter in blocks.) (In sequence)
Types of Collisions
7-
Ran off the road
1-
Going forward and collided with moving vehicle
8-
Jackknifed
2-
Going forward and collided with parked vehicle
9-
Going forward and rear-ended moving vehicle
3-
Collision while backing
10-
Going forward and rear-ended parked vehicle
4-
Collision with pedestrian
11-
Collision while turning
5-
Collision with object (other than vehicle/pedestrian)
6-
Overturned
12-
Other (Specify)
PAGE 3 OF 5
DA FORM 285, FEB 2009
APD AEM v1.00ES
SECTION C - PROPERTY/MATERIEL INVOLVED (Whether Damaged or Not) (Continued)
60. Component/Part that Failed/Malfunctioned (Complete this section if a materiel failure/malfunction caused/contributed to the accident.)
ITEM A
ITEM B
ITEM C
a. National Stock Number
b. Part Number
c. Describe Part
d. Manufacturer's Identification Code
e. EIR/QDR Number
61. How/Why Part Malfunctioned (Select code from
HOW
WHY
HOW
WHY
HOW
WHY
"How" list below and enter in first block; select
code from "Why" list and enter in second block.)
How Part Failed/Malfunctioned Codes:
Why Part Failed/Malfunctioned Codes:
1 - Overheated/burned/melted
9 -
Twisted/torqued
1 - Improper equipment design
2 - Froze (temperature)
10 -
Compressed/hit/punctured
2 - Inadequate maintenance
3 - Obstructed/pinched/clogged
11 -
Bent/warped
3 - Inadequate manufacture of equipment
4 - Vibrated
12 -
Sheared/cut
4 - Inadequate written procedures (AR, TM, SOP)
5 - Rubbed/worn/frayed
13 -
Decayed/decomposed
5 - Improper supervision
6 - Corroded/rusted/pitted
14 -
Electric current action
6 - Unknown
7 - Overpressured/burst
15 -
Unknown/Other
7 - Other (Specify in narrative)
8 - Pulled/stretched
Blank - Not Reported
SECTION D - ENVIRONMENTAL CONDITIONS INVOLVED
62. Environmental Conditions. (Check environmental conditions present and indicate if conditions caused/contributed to the accident.)
CAUSED/
CAUSED/
PRESENT
CONDITION
PRESENT
CONDITION
CONTRIBUTED
CONTRIBUTED
a. Clear/dry; visibility unlimited
k. Wind gust/turbulence
b. Bright, glare
l. Vibrate, shimmy, sway, shake
c. Dark, dim
m. Radiation, laser, sunlight
d. Fog, condensation, frost
n. Holes, rocky, rough, rutted, uneven
e. Mist, rain, sleet, hail
o. Inclined/steep
f. Snow, ice
p. Slippery
(not due to precipitation)
q. Air pressure
g. Dust, fumes, gazes, smoke, vapors
(bends, decompression, altitude, hypoxial)
h. Noise, bang, static
r. Lightning, static electricity, ground
s. Other
i. Temperature/humidity
(Specify)
(cold, heat)
j. Storm, hurricane, tornado
SECTION E - ACCIDENT DESCRIPTION/NARRATIVE (From Blocks 10, 46, 47, 61 and 62)
63. The investigation board will report, in narrative form on letter size paper, the facts, conditions, and circumstances as established during the investigation and
present this information in accordance with DA PAM 385-40, paragraph 4-4.
64a. PRINTED/TYPED NAME OF PERSON COMPLETING THIS REPORT
64b. RANK
64c. TITLE
64d. SIGNATURE
64e. DATE OF
64f. TELEPHONE NO.
SIGNATURE
(YYYYMMDD)
64g. EMAIL ADDRESS
PAGE 4 OF 5
DA FORM 285, FEB 2009
APD AEM v1.00ES
SECTION F - CORRECTIVE ACTION AND COMMAND REVIEW
65. The investigation board will formulate the findings and recommendations on letter sized paper in accordance with the examples contained in DA PAM 385-40,
paragraph 4-3.
66a. PRINTED/TYPED NAME OF COMMANDER
66b. RANK
66c. SIGNATURE
66d. DATE OF
66e. TELEPHONE NO.
SIGNATURE
(YYYYMMDD)
66f. EMAIL ADDRESS
a. TYPED NAME/EMAIL ADDRESS
b. SIGNATURE
c. TITLE
d. RANK/DATE
67.
68.
69.
SECTION G - SAFETY OFFICE USE ONLY
70. LOCAL REPORT NO.
71. ARMY HEADQUARTERS
72. ACCIDENT TYPE (Check choice)
a. Army Motor Vehicle
h. Other Army Vehicle
o. Personal Injury - Other
b. Army Combat Vehicle
i. Fire
p. Property Damage - Other
c. Army Operated Vehicle
j. Chemical Agent
q. POV - On Official Business
d. POV - Not on Official Business
k. Explosive
r. Space
e. Marine Diving
l. Missile
s. Commercial Carrier/Transportation
f. Marine Underway
m. Radiation
g. Marine Not Underway
n. Nuclear
73. NAME OF SAFETY POINT OF CONTACT (POC)
74a. PHONE NO. OF SAFETY OFFICER POC
75. DATE REPORT
(DSN, Commercial, etc.)
COMPLETED BY
SAFETY OFFICER
(YYYYMMDD)
74b. EMAIL ADDRESS
SECTION H - EXPLOSIVES/AMMUNITION
76. EXPLOSIVE/AMMUNITION INFORMATION:
ITEM 1
ITEM 2
ITEM 3
ITEM 4
a. LOT #
b. QUANTITY
c. NET EXPLOSIVE WEIGHT (NEW)
d. DoDIC/DoDAC
77. SPECIAL INTEREST
78. SUPPLEMENTAL INFORMATION
DA FORM 285, FEB 2009
PAGE 5 OF 5
APD AEM v1.00ES

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How to Fill out DA Form 285?

Procedural guidelines and additional information can be found in the DA PAM 385-40, released in March 2015. DD Form 285 instructions are as follows:

  1. Section A - Accident Information - contains 11 Blocks in total.
    • The type of report is identified in Block 1. Blocks 2 through 9 require the identification code of the unit associated with the accident, the unit name, military address, unit branch, the date and the time of the accident.
    • Block 10 should be completed if any explosives or ammunition were involved in the accident.
    • Blocks 11a through 11c require the exact location of the accident along with the type and the coordinates of the location.
  2. Section B - Personnel Information - is for providing information about injured staff.
    • Blocks 12 through 18 should contain the personal data about the injured individual. This includes their name, social security number, date of birth, gender, rank or grade, military occupational specialty or job series, and address. The form requires an official address for military and government personnel and a home address for injured civilians.
    • Block 19a requires the duty status of the individual at the time of the accident. Flight status is indicated in Block 20. Block 21 and 22 describe the amount of sleep the individual has had on the day of the accident.
    • Blocks 22 through 30 are filled out if the individual has sustained injuries as a result of the accident.
    • The type of action the individual was performing at the time of the accident is specified in Block 31. A detailed description of the action is given in Block 32. Block 33 requires specifying whether the action was performed during a field exercise or operation. Block 34 is completed if the action was a part of an activity or tactical training. Block 35 is for pro identifying the type of training facility used.
    • Blocks 36 through 39 describe the individual's training and licensing.
    • Block 40, 41 and 42 are completed if alcohol, drugs or vision enhancement devices contributed to the accident.
    • Blocks 43 through 51 summarize all other details regarding performance standards, the individual's driving mileage, license checks, and the employment and deployment information.
  3. Section C - Property/Materiel Involved - is used for listing any property or equipment involved - whether damaged or not
  4. Section D - Environmental Conditions Involved - is for specifying the environmental conditions that have caused or contributed to the accident.
  5. Section E - Accident Description/Narrative - should feature the facts, conditions, and circumstances as established by the investigation board during the investigation
  6. Section F - Corrective Action and Command Review - is for the findings and recommendations of the investigation board.
  7. Section G - Safety Office Use Only - is filled out the authorized personnel at Army Headquarters.
  8. Section H - Explosives/Ammunition - is for providing explosive or ammunition information.

DA 285 Related Forms

  1. DA Form 285-A, Technical Report of U.S. Army Ground Accident Index A is a form used for reporting Class A ground accidents that happen in the U.S. Army.
  2. DA Form 285-B, Technical Report of U.S. Army Ground Accident Index B is a form used for reporting Class B accidents.
  3. DA Form 285-AB, U.S. Army Abbreviated Ground Accident Report (AGAR) is a report used for Class C to Class E ground accidents.
  4. DA Form 285-O, Technical Report of U.S. Army Ground Accident Statement of Reviewing Officials is a form filled out by the officials authorized to record and review the details of the accident.
  5. DA Form 285-W, Technical Report of U.S. Army Ground Accident Summary of Witness Interview is a form used to record interviews with the witnesses of accidents.
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