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The DD Form 689, often referred to as the Individual Sick Slip, plays a crucial role in military health management. This form is used to document an individual's illness or injury formally, ensuring that both the patient and military hierarchy are informed about health status. Key areas covered by the form include personal details, such as the last name, first name, middle initial, service number or Social Security Number, and the patient's grade or rate. The organization and station information are also vital for identification purposes. The form contains sections designated for input from both the unit commander and the medical officer, which are integral for reporting whether the illness or injury occurred in the line of duty. It allows for various dispositions of the patient, such as returning to duty, being assigned to quarters, or requiring hospitalization. Space for remarks provides room for additional notes related to the patient’s condition or circumstances surrounding their health issue. Finally, both the unit commander and medical officer must sign the form, endorsing its contents and the validity of the reported illness or injury. It is essential that those completing the form understand its significance, as previous editions are obsolete and can create confusion in records management.

Dd 689 Example

 

 

INDIVIDUAL SICK SLIP

 

DATE

 

 

 

 

 

 

 

 

ILLNESS

INJURY

 

 

 

 

 

 

 

 

LAST NAME - FIRST NAME - MIDDLE INITIAL OF PATIENT

ORGANIZATION AND STATION

 

 

 

 

 

 

 

 

SERVICE NUMBER/SSN

 

GRADE/RATE

 

 

 

 

 

 

 

 

 

UNIT COMMANDER'S SECTION

 

MEDICAL OFFICER'S SECTION

 

 

 

 

 

 

 

IN LINE OF DUTY

 

 

IN LINE OF DUTY

 

 

 

 

 

 

 

 

REMARKS

 

 

DISPOSITION OF PATIENT

DUTY

QUARTERS

 

 

 

 

 

 

 

 

 

SICK BAY

HOSPITAL

 

 

 

 

 

NOT EXAMINED

OTHER (Specify):

 

 

 

 

 

 

 

 

 

 

 

 

REMARKS

 

 

 

 

 

 

 

SIGNATURE OF UNIT COMMANDER

 

 

SIGNATURE OF MEDICAL OFFICER

 

 

 

 

 

 

 

DD FORM 689, MAR 63

 

PREVIOUS EDITIONS ARE OBSOLETE.

 

 

Form Characteristics

Fact Name Detail
Form Purpose The DD Form 689 serves as an official document to report an individual's illness or injury within military settings.
Form Title Officially referred to as the "Individual Sick Slip," this form is integral to military health management.
Completion Dates It is crucial to complete the form accurately with the date of illness or injury for proper record-keeping.
Required Information Mandatory details include the patient's last name, first name, middle initial, and the organization and station.
Identification Service number or Social Security Number (SSN) must be provided to identify the patient correctly.
Certification Signatures from both the unit commander and the medical officer authenticate the form's validity.
Medical Determination The form includes sections to indicate whether the injury or illness is "In Line of Duty" or not.
Disposition Options Different options for patient disposition are available, including "Duty," "Sick Bay," and "Hospital." Other options may be specified.
Version Information The current edition of this form is dated March 1963, with previous editions noted as obsolete.
Legal Framework This form is governed by military regulations, specifically the Department of Defense directives related to medical records and health assessments.

Guidelines on Utilizing Dd 689

When filling out the DD Form 689, you’ll provide essential information related to a patient’s illness or injury. The details you enter help ensure that accurate medical care and support are provided. Follow these steps to complete the form.

  1. Begin with the date: Enter the current date at the top of the form.
  2. Detail the illness or injury: Clearly describe the nature of the illness or injury experienced by the patient.
  3. Enter patient information: Fill in the last name, first name, and middle initial of the patient accurately.
  4. Provide organization details: Specify the organization and station of the patient.
  5. Include service number or SSN: Write the service number or Social Security Number to identify the patient.
  6. Indicate grade or rate: Fill in the patient's grade or rate as applicable.
  7. List the unit: Write the unit to which the patient belongs.
  8. Complete the commander’s section: Provide necessary details in the unit commander's section.
  9. Fill out the medical officer’s section: This part includes additional remarks and the final disposition of the patient.
  10. Determine duty status: Specify whether the patient is in line of duty or not.
  11. Choose a disposition: Indicate where the patient will be treated: duty quarters, sick bay, hospital, not examined, or other (be sure to specify if selecting 'other').
  12. Signatures required: Make sure both the unit commander and medical officer sign the form.

What You Should Know About This Form

What is the DD Form 689?

The DD Form 689, commonly referred to as the Individual Sick Slip, is a document used primarily by military personnel to report illnesses or injuries. It serves as an official notification for a service member's inability to perform their duties due to health issues.

Who is required to fill out the DD Form 689?

Service members who are unable to perform their duties due to a medical issue must fill out the DD Form 689. This applies to all branches of the military, and it is often completed by the individual affected or their attending medical officer.

What information is needed on the DD Form 689?

The form requires specific details, including the patient's last name, first name, middle initial, service number or Social Security Number, grade or rate, and the unit. Additionally, it asks for information regarding the nature of the illness or injury, the date on which the sick leave begins, and the disposition of the patient, such as whether they are resting at duty quarters, in a hospital, or have not been examined.

How do I obtain a DD Form 689?

The DD Form 689 can be obtained from a variety of sources, including military medical facilities, your unit's administrative office, or online through authorized military publications and resources. It is important to use the correct version of the form, as previous editions may no longer be valid.

Is the DD Form 689 a permanent record?

The DD Form 689 itself is not usually part of a service member's permanent medical record. However, it serves as an important temporary record. Depending on the circumstances, the information may be recorded in the patient's medical history by their healthcare provider.

What should be included in the remarks section of the DD Form 689?

The remarks section allows for additional notes that may be relevant to the patient's condition or treatment. Common entries might include specific instructions from the medical officer, any required follow-up appointments, or unique circumstances related to the illness or injury.

What happens after the DD Form 689 is submitted?

Once submitted, the form is reviewed by the unit commander and the medical officer. Appropriate actions are taken based on the information provided, which may include granting sick leave or providing further medical care. It is essential for service members to ensure that their absence is properly documented to avoid complications with their duty status.

Can a DD Form 689 be rescinded or modified?

Yes, the DD Form 689 can be modified or rescinded if circumstances change. If a service member's medical condition improves or worsens, the form can be updated to reflect the current status. This ensures that all relevant parties are informed and appropriate care is continued.

What should I do if my unit does not recognize the DD Form 689?

If there are concerns regarding the recognition or acceptance of the DD Form 689 within your unit, it is important to raise these issues with your immediate supervisor or unit administrative personnel. They can provide guidance or further clarification on the use of the form within your specific context.

Common mistakes

When filling out the DD 689 form, individuals often overlook critical details that can lead to errors or delays in processing. One common mistake is failing to provide the full name of the patient. This includes the last name, first name, and middle initial. Incomplete names can create confusion, especially if there are multiple people with similar names within the organization.

Another frequent error is neglecting to include specific details about the illness or injury. Simply writing "sick" or leaving that section blank does not provide enough information for medical personnel. Clarity is essential, so describing the nature of the ailment or injury is important for determining the necessary care.

Additionally, individuals sometimes forget to check the appropriate boxes in the section regarding whether the condition occurred in line of duty. This designation can significantly affect the patient's care and any subsequent evaluations. It's crucial to accurately indicate this status to ensure proper processing of the patient’s medical records.

People may also make the mistake of omitting their service number or Social Security Number. This information connects the patient with their military records and is essential for processing medical care. Without these details, there could be a delay in treatment or coordination of care.

Many also fail to sign the form correctly. The DD 689 requires signatures from both the unit commander and the medical officer. If either signature is missing or unclear, it could result in complications in processing the sick slip. Always double-check that signatures are present and legible.

Moreover, writing unclear or illegible information can cause significant issues. Handwriting that is difficult to read may result in misinterpretation of information, which can lead to incorrect treatment or care. It’s best to write neatly or type the form if possible.

Sometimes individuals neglect to fill out the "Remarks" section. This section can provide additional context that may be necessary for the medical personnel reviewing the case. Providing a few details in this area can help clarify the situation, which is beneficial for everyone involved.

Finally, failing to select the patient's location for care can lead to uncertainty about where the treatment should take place. Whether it is a duty quarters, sick bay, or hospital, indicating the correct location allows medical staff to tailor their response effectively. It's all about ensuring comprehensive care and correct processing of the sick slip.

Documents used along the form

The DD Form 689, also known as the Individual Sick Slip, serves as a crucial document in documenting a service member's illness or injury. Alongside this form, several other documents facilitate the management of medical records and patient care. Below is a list of other forms and documents commonly used in conjunction with the DD Form 689.

  • SF 600 - Chronological Record of Medical Care: This form records all outpatient treatment provided to a patient. It details each visit and summarizes the patient's health history.
  • SF 513 - Consultation Sheet: Aimed at facilitating communication between healthcare providers, this document requests an evaluation or consultation from a specialist.
  • DD Form 2992 - Medical Recommendations for Flying Duty: This form provides a medical assessment of a service member's fitness specifically for flying duties.
  • DA Form 3349 - Physical Profile: This document outlines any physical limitations or restrictions imposed on a service member due to health concerns.
  • SF 515 - Medical Record Report: Used for summarizing medical information and treatment plans, this report is essential for continuity of care.
  • DD Form 2860 - Command Notification of Eligibility: This form informs patients of their eligibility for specific treatments or benefits based on their condition.
  • SF 88 - Report of Medical Examination: This examination report is utilized to assess a service member's overall health and suitability for service.
  • SF 93 - Report of Medical History: Completed by the patient, this form collects detailed medical history and prior health issues to inform current care.

These documents work together to ensure comprehensive management of medical treatment for service members. Utilizing them alongside the DD Form 689 enhances communication and accuracy in medical documentation.

Similar forms

The DD Form 689 is an essential document used for recording individual sick leave. It shares similarities with several other forms commonly used in various medical and administrative contexts. Here are nine documents that are similar to the DD Form 689:

  • SF 600 - Chronological Record of Medical Care: This form documents all medical encounters, much like the DD Form 689, which records illnesses or injuries for leave purposes.
  • DA Form 3349 - Physical Profile: Used to indicate a service member's medical limitations, it parallels the DD Form 689's function of noting health issues affecting duty status.
  • AF Form 422 - Physical Profile Serial Report: Similar to a physical profile, this form assesses medical conditions and restricts duties, akin to the DD Form 689's focus on illness and injury.
  • VA Form 10-5345 - Request for and Authorization to Release Medical Records or Health Information: Both forms involve the documentation of medical conditions, although this one is tailored for information release.
  • DD Form 214 - Certificate of Release or Discharge from Active Duty: While primarily a discharge document, it also often reflects any medical issues that might influence a service member’s duty history.
  • DD Form 2807-1 - Report of Medical History: This form records a patient’s medical history and presents information about past and present health, similar to how the DD Form 689 notes current illnesses.
  • DD Form 1380 - U.S. Field Medical Card: This card provides immediate medical information in the field, paralleling the DD Form 689’s purpose to document a patient’s status.
  • OPNAV 5211/9 - Medical Care Record: This form collects health care data similar to the DD Form 689, focusing on medical attention and patient disposition.
  • AF Form 1776 - Patient Care Report: Documenting details about patient care, this form serves a role similar to that of the DD Form 689 in recording health assessments.

Dos and Don'ts

When filling out the DD 689 form, careful attention to detail is essential. Here are ten important dos and don'ts to ensure the process runs smoothly.

  • Do fill in the date accurately at the top of the form.
  • Do provide your full name, including last, first, and middle initial.
  • Do clearly state the nature of the illness or injury.
  • Do include your service number or Social Security Number (SSN) for proper identification.
  • Do indicate your grade or rate to contextualize your military status.
  • Don't leave any section blank; incomplete forms can delay processing.
  • Don't forget to specify the organization and station associated with your unit.
  • Don't use medical jargon that may be misunderstood; clarity is key.
  • Don't neglect to have both the unit commander and medical officer sign the form.
  • Don't submit previous editions of the form; ensure you are using the latest version.

Misconceptions

Here are six common misconceptions about the DD Form 689, often associated with its use in military and medical contexts:

  • It's only for serious injuries. Many people think this form is reserved for severe medical issues. In reality, it can be used for a variety of illnesses or injuries, both minor and major.
  • Only medical officers can fill it out. While medical officers complete certain sections, unit commanders also play a crucial role. They are responsible for signing off on the form.
  • It does not track the patient's status. Some believe the DD Form 689 is simply a temporary slip. However, it provides important details about a patient's condition, including whether they are fit for duty.
  • It’s unnecessary if the illness is minor. Individuals often think they don’t need to submit the form for mild illnesses. However, using the form ensures that there’s a proper record, regardless of the severity.
  • Only regular military personnel need it. Another misconception is that only active-duty members are required to use it. The form can also be relevant for reservists and other affiliated members seeking medical attention.
  • Submitting it guarantees medical care. While the form documents the patient's condition, it does not automatically ensure treatment. Approval for medical care depends on further assessments and available resources.

Key takeaways

When filling out and utilizing the DD Form 689, certain key aspects must be understood to ensure proper compliance and clarity. Here are essential takeaways to consider:

  • The DD Form 689 is an Individual Sick Slip used by military personnel to report illness or injury.
  • Complete the form in a clear and concise manner, providing necessary details such as last name, first name, and middle initial of the patient.
  • Include the patient's organization and station, as well as their service number or Social Security Number.
  • Indicate the patient’s grade or rate, ensuring that the information is accurate to prevent delays.
  • Medical officers should review and sign the form in the designated section to validate the entry.
  • Be clear about whether the illness or injury occurred in the line of duty, as this affects documentation and benefits.
  • Utilize the remarks section to add any pertinent information that may aid in understanding the situation.
  • In the “Disposition of Patient” section, specify where the patient is sent, whether to duty, quarters, sick bay, or hospital.
  • Always ensure that both the unit commander and medical officer provide their signatures to complete the process.
  • Keep a copy of the form for personal records, as it may be needed for future reference or inquiries.

Understanding these elements will facilitate the effective use of the DD Form 689, promoting a smoother process in health management within military settings.