Line of Duty Checklist for Soldiers Documentation
This Line of Duty Checklist is essential for Soldiers to report injuries, illnesses, or incidents. It outlines the necessary forms and documentation required for proper benefits and investigations. Utilize this checklist to ensure all required information is accurately provided for timely processing.
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How do I fill this out?
Filling out this checklist requires careful attention to detail. Begin by gathering all necessary documentation listed in the checklist. Complete each section accurately to facilitate a smooth submission process.

How to fill out the Line of Duty Checklist for Soldiers Documentation?
1
Collect all required supporting documents listed in the checklist.
2
Fill out personal information such as full name, rank, and SSN.
3
Complete sections regarding the nature of injury, incident details, and medical evaluation.
4
Ensure all sections are signed by relevant authorities as necessary.
5
Submit the form along with supporting documents to the designated authority.
Who needs the Line of Duty Checklist for Soldiers Documentation?
1
Soldiers who have sustained injuries while on duty need this checklist for benefit claims.
2
Medical personnel require it for proper documentation of injuries.
3
The unit commander needs this file to support claims and manage medical leave.
4
Legal representatives may require it for investigations related to duty injuries.
5
Administrative staff use it to process claims for benefits related to incidents experienced by soldiers.
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What are the instructions for submitting this form?
To submit this form, ensure that all sections are filled accurately. You may submit it via your unit's administrative office through email, fax, or physical delivery. Ensure any required supporting documents are attached and sent to the designated authority for processing.
What are the important dates for this form in 2024 and 2025?
In 2024 and 2025, it is vital to stay aware of submission deadlines associated with this checklist. Ensure all documentation is submitted promptly to avoid any delays. Special dates may also align with annual training schedules, so verify with unit directives.

What is the purpose of this form?
The purpose of this form is to formalize documentation of injuries or incidents experienced by Soldiers on active duty. It ensures that all relevant information is collected for investigations and benefit claims. By tracking the details surrounding such events, the form serves to protect the rights and welfare of Soldiers.

Tell me about this form and its components and fields line-by-line.

- 1. Full Name: The Soldier's complete name.
- 2. Rank: The Soldier's rank in the military.
- 3. SSN: The Soldier's Social Security Number.
- 4. Date of Injury: The specific date when the injury occurred.
- 5. Unit: The unit to which the Soldier belongs.
What happens if I fail to submit this form?
Failure to submit this form may lead to delays in processing benefits and necessary medical evaluations. Moreover, it can hinder the Soldier's ability to receive due entitlements under military policies. It is essential to adhere to the submission guidelines to ensure all procedures are followed correctly.
- Delay in Benefits: Without submission, Soldiers risk delaying crucial benefits.
- Adverse Action on Case: Not submitting may result in unfavorable outcomes regarding medical claims.
- Inadequate Documentation: Failure may lead to incomplete medical records impacting future care.
How do I know when to use this form?

- 1. Injury Reporting: To formally report injuries sustained on duty.
- 2. Benefit Claims: For filing claims associated with injuries or illnesses.
- 3. Documentation for Investigations: Provides necessary data for inquiries into incident circumstances.
Frequently Asked Questions
What is the Line of Duty Checklist?
It is a document for Soldiers to report injuries or incidents that affect duty status.
Who needs to fill out this checklist?
Any Soldier involved in an incident or injury while on duty should complete this checklist.
What supporting documents are required?
You must submit forms such as DA Form 2173, medical documentation, and official statements.
How do I edit this PDF?
Use the PrintFriendly PDF editor to easily modify text and fields.
Can I share the PDF after editing?
Yes, you can share your edited PDF via email or social media.
What happens if I don't submit this form?
Failure to submit may delay your benefits and proper case adjudication.
Is there a deadline for submitting this form?
It’s crucial to submit within specified timelines to avoid complications.
How can I sign the PDF?
You can add a signature electronically using the signing tool in PrintFriendly.
What is the purpose of this checklist?
It helps track a Soldier's status concerning medical evaluations and benefit eligibility.
Is training required to fill this out?
No formal training is required, but attention to detail is crucial.
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