DA Form 7652: DES Commander’s Statement | Download PDF

DA Form 7652: DES Commander’s Statement | Download PDF – If you’re a U.S. Army Soldier, commander, or PEBLO navigating the Disability Evaluation System (DES)—also known as the Integrated Disability Evaluation System (IDES)—you’ve likely encountered DA Form 7652. This critical document, officially titled DISABILITY EVALUATION SYSTEM (DES) COMMANDER’S PERFORMANCE AND FUNCTIONAL STATEMENT, provides the Physical Evaluation Board (PEB) with a commander’s firsthand, non-medical assessment of how a Soldier’s medical conditions affect duty performance.

Accurate completion of DA Form 7652 can significantly influence fitness determinations, disability ratings, retention, retirement, or separation decisions under Army Regulation (AR) 635-40. Here’s everything you need to know in this up-to-date, SEO-optimized guide for U.S. Army personnel.

What Is DA Form 7652?

DA Form 7652 (dated APR 2019) is the official U.S. Army form used exclusively in the Disability Evaluation System. Commanders use it to document a Soldier’s actual functional limitations and performance in their Primary Military Occupational Specialty (PMOS) or specialty code duties.

  • Purpose (per the form’s Privacy Act Statement): To supply the PEB with clear information on the impact of medical impairments (physical, behavioral, emotional, or cognitive) on a Soldier’s ability to perform duties. It also includes administrative details that affect disability adjudication and benefits if the Soldier is found unfit.
  • Governing Regulation: AR 635-40, Disability Evaluation for Retention, Retirement, or Separation.
  • Proponent: Deputy Chief of Staff, G-1 (DCS, G-1).

This form is not a medical document—the commander provides a non-medical, performance-based perspective. Medical providers handle the Narrative Summary (NARSUM); the commander focuses on real-world duty impact.

Why Is DA Form 7652 Important in the DES/IDES Process?

The DES process evaluates Soldiers with conditions that may prevent them from meeting medical retention standards (AR 40-501). DA Form 7652 is a required enclosure in the Medical Evaluation Board (MEB) packet sent to the PEB.

  • It helps the Informal PEB (IPEB) and Formal PEB (FPEB) determine unfitness.
  • Detailed, specific examples of limitations (e.g., inability to lift, march, or perform MOS-specific tasks) strengthen the case for unfit findings and appropriate DoD disability ratings.
  • Commanders must return it quickly—often within 5 days of the PEBLO’s request—to avoid delays.
  • It can influence VA compensation claims processed concurrently through IDES.

Many Soldiers and commanders underestimate its weight. Lawyers and PEB advocates frequently note that a well-written DA Form 7652 helps align the MEB Narrative Summary with observed performance and supports the Soldier’s goals during board review.

Who Completes DA Form 7652?

  • Primary responsibility: The Soldier’s immediate unit commander (typically O-3 or higher; battalion commander O-5 or higher in some cases, with assumption-of-command memo if needed).
  • Line commanders familiar with daily performance provide the most accurate input.
  • The PEBLO (Physical Evaluation Board Liaison Officer) requests the form after MEB referral.
  • Soldiers may provide input or bullet points to their commander, but the commander must complete and sign it based on personal observation.

Key Sections of DA Form 7652 (Overview)

While you should always use the official fillable PDF, the form generally includes:

Section I – Soldier Information
Name, rank, SSN, PMOS, unit, etc.

Section II – Administrative Information

  • Active or Reserve Component
  • Referral to DES (date)
  • Line of Duty (LOD) determination
  • Prior rank history
  • MAR2 results (if applicable)

Section III – Commander’s Performance Information (The Heart of the Form)
Detailed yes/no questions and narrative space covering:

  • Difficulties completing tasks or duties
  • Physical limitations (running, lifting, marching, weapon handling, etc.)
  • MOS-specific performance issues
  • Behavioral, emotional, or cognitive impacts on unit functioning
  • Any accommodations or profile restrictions observed in daily duties

The commander must paint an accurate, factual picture of functional limitations without diagnosing medical conditions.

How to Complete DA Form 7652? Step-by-Step Tips for Commanders

  1. Download the official form (link below).
  2. Observe the Soldier — Base every statement on direct knowledge of performance.
  3. Be specific and detailed — Generic answers weaken the packet. Use concrete examples (e.g., “Soldier cannot complete a 12-mile ruck march without stopping due to knee pain” vs. “Has mobility issues”).
  4. Focus on impact — Describe what the Soldier cannot do in garrison, field, or deployment settings.
  5. Coordinate with PEBLO — Ask for guidance if needed.
  6. Sign and date — Digital signatures are preferred in many units.
  7. Return promptly to the PEBLO.

Pro Tip for Soldiers: Politely provide your commander with a bullet-point list of observed limitations tied to your profile or conditions. This helps ensure the statement supports your case without appearing coached.

Official DA Form 7652 PDF Download

Direct link to the current official fillable form (APR 2019 edition):
Download DA Form 7652 PDF

This is the authoritative version hosted by the U.S. Army Publishing Directorate. Always use this source—third-party sites may have outdated or altered versions.

  • AR 635-40 (Disability Evaluation) – Available on armypubs.army.mil
  • Local IDES/PEBLO office at your Military Treatment Facility
  • IDES Guidebooks from various installations (search “IDES Guidebook” on .mil sites)

Frequently Asked Questions (FAQs)

Q: Is DA Form 7652 only for Active Duty?
A: No—it applies to Active Army, Army National Guard, and Army Reserve Soldiers in the DES process.

Q: Can a Soldier fill it out themselves?
A: No. The commander must complete and sign it.

Q: What if the commander is new to the unit?
A: Use the best available information and note any limitations in observation time. The PEBLO can advise.

Q: Does it affect VA ratings?
A: Indirectly—it helps the integrated DES process but VA makes its own ratings via C&P exams.

Q: Is the form still current in 2026?
A: Yes—the APR 2019 edition remains the standard form referenced in current Army guidance.

Final Thoughts

DA Form 7652 is more than paperwork—it’s your commander’s opportunity to ensure the PEB has a clear, accurate view of how medical conditions affect real Soldier performance. A thorough, factual statement helps protect the Soldier’s rights and benefits while supporting fair disability evaluations under AR 635-40.

If you’re a Soldier entering DES or a commander asked to complete this form, download the official PDF today and work closely with your PEBLO. Accurate documentation leads to better outcomes.

Need the form right now?
Download Official DA Form 7652 Here