DA Form 7574-2 Soldier's Acknowledgement of Incapacitation Pay Counseling

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:

1. 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.
2. 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.
3. 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.
4. 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.
5. 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:

• DA Form 7574, Incapacitation Pay Monthly Claim Form, is a document used for claiming incapacitation pay. The data provided within the DA 7574 is used to determine the soldier's eligibility for any payments;
• DA Form 7574-1, Military Physician's Statement of Soldier's Incapacitation/Fitness For Duty, contains the information necessary to verify the soldier's eligibility for military duties after an injury or illness.