So what is DD Form 2828? The short answer: a Defense Department document, officially DD Form 2828, Physician Certificate for Child Annuitant, November 2006, used to Physician Certification for Child Annuitant. Anything else you need follows from that.
Does it apply to your branch? Yes. The DD prefix means Department of Defense, not one service, so the same blank serves the Army, Navy, Air Force, Marine Corps, Space Force and the Coast Guard under Defense jurisdiction. There is no Army version and no Navy version to search for.
Who decides this form exists? not stated owns it; not stated directs its use. If someone told you to file this, the authority traces back to those.
How current is this? Edition not stated, publisher status not stated. That is the version described throughout this page.
What the form asks for
- 1. Deceased member's Social Security Number.
- 2. Annuitant's Name, Last, First, Middle Initial
- 3. Date of birth: 4 digit year, 2 digit month, 2 digit day
- 4. Annuitant's Social Security Number.
- 6. Date condition began: 4 digit year, 2 digit month, 2 digit day
- 5. Brief description of medical or psychiatric diagnosis
- 7. Physician's statement. a. I have attended the patient for: enter number of years.
- Enter number of months.
- 7.b. I last examined the patient on: Enter date.
- 7.c. In my opinion the patient is: X one or both. 1. Incapable of self-support
- For the period of time: Enter time period.
- 7.c.2. Mark X if Incapable of handling his/her own financial affairs
- For the period of time: Enter time period.
- d. In my opinion the incapacity is: X first box if permanent, second box if temporary.
- If temporary, expected recovery date: 4 digit year, 2 digit month, 2 digit day
- Mark X if Psychiatrist authorized to practice medicine in the state of.
- 7.e. I am a licensed: Mark X if Physician or practitioner authorized to practice medicine in the state of
- Enter state.
- Enter state.
- 8. I hereby certify that the information above is correct to the best of my knowledge. a. Phsician's Name, Last, First, Middle Initial
- b. Address, Include zip code
- c. Signature
- d. Date: 4 digit year, 2 digit month, 2 digit day
- Press this Reset button to clear the data from all fields.
Download the form
Which files are here? These: PDF. How much work is involved? 1 pages, about 24 entry fields.
Fillable or printable — which do you have? Click inside a box. If it accepts a cursor and typed text, the file is fillable and your entries save with it. If nothing happens, the pdf is flat, and the only way forward is printing it and writing on paper.
Is handwriting acceptable? Yes, but it is the weaker choice. Scanning flattens pen strokes and reproduction blurs them, while typed characters survive the whole chain intact. Print in capitals if you are working from a paper blank.
In what order do you complete it? The printed order, top to bottom. Header data comes before the body, and the body before the signature block. The sequence is not decorative — later entries are keyed to earlier ones.
What if your copy is old? Replace it. Check the date printed on the form against not stated. Old blanks circulate for years in shared folders, and because a DD revision lands across the whole Department at once, the receiving office will be working from the new layout.
What if a specific field still puzzles you? Read the instructions printed on the form, then not stated. Which wins if they differ? The directive.
What happens after you finish? It routes to the office specified in not stated or in local guidance. And your own record? Save a duplicate first; nobody regrets having one.
Do you need to know which branch issued a related form? No. DD numbering is Department-wide and unified, which means the number on its own is a complete address for the document.
Can you assume a matching number is the same form? No, and this is where downloads go wrong. Read the prefix. Army numbering and Department numbering are independent systems, so the digits alone tell you nothing about which document you need.
Why do editions change at all? Three reasons, mostly: the prescribing directive gets reissued, the information collected changes, or the required notice language is amended. Are you notified when it happens? No. Which is why confirming not stated at the moment you download is worth the few seconds.
Will your completed form be accepted? That is not a question this page can answer. What you have here is a published Department of Defense document, a description of it and instructions for filling it out. Nothing on the page is legal advice, and nothing here determines what any office does with a submission. Where do the remaining questions go? To not stated, to your servicing personnel office, or to the office named in not stated.
Questions and answers
- What is DD Form 2828?
- DD Form 2828, Physician Certificate for Child Annuitant, November 2006
- Which edition is current?
- Not stated by the publisher
- Who is responsible for this form?
- Not stated
- In which formats can it be downloaded?