DDFORMS.ORG – DD Form 2527 – Statement of Personal Injury – Possible Third Party Liability, Defense Health Agency – The Defense Health Agency is responsible for providing healthcare and health-related services to members of the United States Armed Forces. In this role, they have developed a form specifically related to the filing of claims for personal injuries that may be the result of third-party liability – DD Form 2527. This article will provide an overview of the form, including its purpose, who must use it, and how to complete it.
Download DD Form 2527 – Statement of Personal Injury – Possible Third Party Liability, Defense Health Agency
| Form Number | DD Form 2527 |
| Form Title | Statement of Personal Injury |
| Edition Date | 3/1/2020 |
| File Size | 67 KB |
What is a DD Form 2527?
DD Form 2527 is a document issued by the Defense Health Agency (DHA) to military members and their dependents. This form serves as an official statement of injury or illness, which can be used in cases where third-party liability may be possible. The DD Form 2527 must be completed accurately and submitted to the DHA in order to receive medical care benefits and services related to that injury or illness.
The DD Form 2527 includes information such as whether the member was injured while on active duty, reserves, or civilian status; the time period during service when the injury occurred; any circumstances surrounding the injury; details about any treatment received prior, during, or after service; and other pertinent information. It also requires signatures from both a healthcare provider and a representative from DHA in order for it to be approved.
Where Can I Find a DD Form 2527?
DD Form 2527, also known as the Statement of Personal Injury, is used by the Defense Health Agency (DHA) to investigate potential third-party liability in cases of personal injury. The form is a mandatory document for any claims filed against another party due to an injury sustained while serving in the military. Knowing where to find and submit DD Form 2527 is essential if you are filing a claim.
The DD Form 2527 can be obtained from the DHA website, or through your local Military Treatment Facility (MTF). Once filled out with all relevant information regarding your claim, it should be sent directly to the DHA Claims Office. The address for this office can also be found on their website. It is important that this form is filled out accurately and submitted promptly in order to ensure that your claim is taken seriously and processed quickly.
DD Form 2527 – Statement of Personal Injury – Possible Third Party Liability, Defense Health Agency
The Defense Health Agency (DHA) provides DD Form 2527, Statement of Personal Injury – Possible Third Party Liability, to facilitate the processing of injury claims. This form is used to document any personal injuries or illnesses that occur to beneficiaries while under the care of a military treatment facility (MTF). It is important for patients and families to understand this form prior to submission in order to ensure accuracy and timely reimbursement.
When submitting a claim for possible third-party liability, the DHA requires that you complete DD Form 2527. This form requests information such as the date and time of injury, location of the injury, type and severity of injury or illness, cause of injury/illness, and potentially responsible party(s). In addition, you will need to provide supporting documentation such as medical reports related to the incident.
DD Form 2527 Example
