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E ZIP Code) TO: (Include ZIP Code) FROM: (Include ZIP Code) 1. NAME OF INDIVIDUAL EXAMINED (Last, First, and Middle Initial) 2. SSN 5. 4. ORGANIZATION AND STATION 3. GRADE ACCIDENT INFORMATION a. DATE b. PLACE (City and State) SECTION I - TO BE COMPLETED BY ATTENDING PHYSICIAN OR HOSPITAL PATIENT ADMINISTRATOR 6. INDIVIDUAL WAS OUT PATIENT ADMITTED DEAD ON ARRIVAL 7. NAME OF HOSPITAL OR TREATMENT FACILITY 8. HOUR AND DATE ADMITTED 10. NATURE AND EXTENT OF 11. MEDICAL OPINION: INJURY.

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Informal LODs are appropriate to use for illnesses, injuries, or diseases sustained in the line of duty requiring continuing medical care or treatment beyond the period of duty, when the member requires hospitalizing, if the member dies or incurs an injury traveling to or from the place where duty is performed or while ...

1:24 4:13 How to Fill Out DA-31 Form (Request and Authority for Leave) Online YouTube Start of suggested clip End of suggested clip Box 13 asks for the approving authority's signature and title box 14 asks for the date. And time ofMoreBox 13 asks for the approving authority's signature and title box 14 asks for the date. And time of your departure. As well as the name title and signature of the departure. Authority.

Statement of Medical Examination and Duty Status (DA Form 2173) (LOD) are initiated for all soldiers who die, sustain certain injuries, diseases or illnesses while on active duty.

The letter should include the following information: leave dates including expected date of return, contact information of the authorized official, your rank and duty station. 5. If applicable, notify your department of the name, address and telephone number of your designated Power of Attorney.

The purpose of the DA 31 form is to authorize military leave; document the start and stop of such leave; record address and telephone number where a soldier may be contacted in case of an emergency during leave; and certify leave days chargeable to a soldier's leave account.

Q: What is an LOD? A: Line of Duty (LOD) determination is an administrative tool for determining a Soldier's duty status at the time of injury, illness, disability, or death. Eligibility to determine entitlements and benefits authorized by the Army National Guard will be determined by LOD determination.

What is DA 31 form? The purpose of the DA 31 form is to authorize military leave; document the start and stop of such leave; record address and telephone number where a soldier may be contacted in case of an emergency during leave; and certify leave days chargeable to a soldier's leave account.

Every command will have its own procedures for requesting leave. It may involve a paper or electronic leave request form sometimes called a “leave chit.” The command will then approve or deny the leave request.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232