What is DA Form 7652?
DA Form 7652, known as the Disability Evaluation System (DES) Commander's Performance and Functional Statement, is crucial for service members undergoing a disability evaluation. This form provides detailed information about a soldier's performance and functional abilities, helping decision-makers assess their overall capability to serve. It plays a key role in determining eligibility for disability benefits, ensuring that individuals receive appropriate support based on their condition. Accurate completion of this form is vital for a fair evaluation process.
What is DA Form 7652 used for?
DA Form 7652 is used in the Disability Evaluation System to assess a service member's performance and functionality. Its purposes include:
- to document the commander's observations.
- to evaluate the soldier's duty performance.
- to provide insights into functional limitations.
How to fill out DA Form 7652?
- 1
Review the instructions provided on the form for specific guidance.
- 2
Fill in your personal information in the required fields.
- 3
Provide a detailed description of the service member's performance and functional capabilities.
- 4
Sign the form electronically in the designated area.
- 5
Save your completed form as a PDF.
- 6
Submit the form according to your unit’s protocol or guidelines.
Who is required to fill out DA Form 7652?
The unit commander must complete DA Form 7652 for soldiers in the IDES process. This assesses performance and functionality.
Afterward, the form is used by medical evaluation boards and personnel decision-makers in the IDES.
When is DA Form 7652 not required?
Soldiers do not need to fill out DA Form 7652 if they are Reserve Component members referred to the Disability Evaluation System (DES) under non-duty-related processes, unless directed to a Formal Physical Evaluation Board (FPEB).
Additionally, if a soldier is not being referred to the Medical Evaluation Board (MEB) or Physical Evaluation Board (PEB), or if they have no medical conditions affecting their retention standards, this form is not necessary.
When is DA Form 7652 due?
The deadline for DA Form 7652 is 5 days from the request made by the Physical Evaluation Board Liaison Officer (PEBLO). For Reserve Component soldiers, this timeline may extend slightly but should align with the next scheduled drill period if applicable. Timely submission ensures that the MEB/PEB process proceeds without delays.
It's important to double-check your form for accuracy before submission. Missing or incorrect information can lead to further delays in your evaluation process. Always keep a copy for your records after you submit the form.
How to get a blank DA Form 7652?
To get a blank DA Form 7652, which is issued by the Department of the Army for the Disability Evaluation System, visit our website. We have the blank version pre-loaded in our editor, ready for you to fill out and download.
How to sign DA Form 7652 online?
To sign the DA Form 7652 online using PDF Guru, first, open the form in the PDF editor by clicking on "Fill Form." This allows you to fill in the required fields. Once you have completed the form, you can create a simple electronic signature.
After signing, click "Done" to download your completed document. Always check with official sources for specific signature requirements to ensure compliance with regulations.
Where to file Form DA Form 7652?
DA Form 7652 must be submitted to the Physical Evaluation Board Liaison Officer (PEBLO) assigned to the soldier's case.
Submission methods: online, mail or in-person.
