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DD Form 294 is a Department of Defense form, not a service form: DD Form 294, Application for a Review by the PDBR of the Rating Awarded Accompanying a Medical Separation from the Armed Forces of the United States, January 2009, used to Application for a Review by the Physical Disability Board of Review (PDBR) of the Rating Awarded Accompanying a Medical Separation from the Armed Forces of the United States. The DD prefix is the operative fact. It means one blank serves every military department — Army, Navy, Air Force, Marine Corps, Space Force, Coast Guard under Defense jurisdiction — plus the defense agencies and combatant commands. No branch variant exists.
Authority: not stated prescribes it, not stated maintains it. Those two names settle most disputes about why the form is being asked for. Local commands add timing on top; the requirement itself comes from above them.
Use not stated, status not stated. Older printings circulate widely and lose their currency Department-wide the moment a new edition issues.
Formats: PDF. Length 3 pages, approximately 30 entries. Pick on the basis of how you will complete it.
Take the fillable pdf unless you have a reason not to. Fillable means the boxes are real fields that accept typed text and retain it in the file. Printable means a flat blank — no fields, printer and pen only. The difference is not cosmetic: one produces a record that reproduces cleanly through scanning and forwarding, the other depends on penmanship.
Nothing costs anything here. Work in a full desktop pdf application rather than a browser preview; field behaviour in browsers is unreliable.
What the form asks for
- 1. Applicant data. a. Branch of Service. Press space bar to mark X in first box if Army, second box if Marine Corps, third box if Navy, fourth box if Air Force, or fifth box if Coast Guard.
- b. Name while serving (last, first, middle initial). If name has changed, enter "AKA", then current name.
- c. Pay grade at time of separation.
- d. Date of separation (4 digit year, 2 digit month, 2 digit day).
- e. Social security number.
- 2. Final disability rating awarded by service for unfitting condition. X first box if 0 percent, second box if 10 percent, or third box if 20 percent.
- 3. Issues why the rating for the condition which rendered the member unfit should be changed (continue in item 12 if necessary).
- 4. In support of this application, the following documents are submitted as evidence (continue in item 13 if necessary).
- 5. VA rating information. a. I have received a VA disability rating that includes the condition for which I was found unfit. X first box if yes, second box if no, third box if not applicable, or fourth box if pending.
- b. I have attached my VA determination letter (N/A if 5.a. is no or pending). X first box if yes, second box if no, third box if not applicable.
- 6. VA consent. X first box if do, or second box if do not, freely authorize the VA to release information to PDBR.
- 7.a. Counsel/Representative (if any). Name (last, first, middle initial) and Address (see Item 7 of the Instructions).
- b. Telephone number (include area code).
- c. E-mail address.
- d. Fax number (include area code).
- 8. Applicant must sign in item 11.a. below. If the record in question is that of a deceased or incompetent person, legal proof of death or incompetency must accompany the application. If the application is signed by other than the applicant, print the name:
- If signed by other than applicant, indicate relationship: X first box if spouse, second box if widow, third box if widower, fourth box if next of kin, fifth box if legal representative, or sixth box if other.
- Specify other relationship.
- 9.a. Current address of applicant or person in item 8 above (forward notification of any change in address.
- b. Telephone number (include area code).
- c. Cell phone number (include area code).
- d. E-mail address.
- 11. Certification. a. Signature - Required. Applicant or person in Item 8 above.
- b. Date signed (current date).
Start by matching the printed date to not stated. Old blanks accumulate in shared folders for years. Because the Department reissues to all services in one action, nobody is still accepting the previous layout by local custom.
Unclear entries — read the form face, then not stated; the directive prevails.
Route it where not stated or local procedure directs, and keep a copy first. On a Department form the receiving office is frequently outside your own chain — another service, a defense agency, a joint command — which makes recovering a lost original slower than it would be internally.
Look up cross-referenced forms by series and number. DD numbering is unified across the Department, which removes the usual step of identifying which service issued the thing.
Prefix before number. A DA citation and a DD citation in the same instruction point at separate systems — one Army, administered by an Army proponent, one Department-wide under not stated — and there is no correspondence between them at any number.
Revision follows directive changes, changed data requirements and amended notice language, unannounced. Verify not stated each time rather than trusting a saved copy — the cost of the check is seconds.
What is here is the blank form and a description of it. What is not here is legal guidance or any assurance about a particular filing — this page is not the issuing authority and does not speak for one. Those questions go to not stated, to your servicing administrative office, or to the authority identified in not stated.
Questions and answers
- What is DD Form 294?
- DD Form 294, Application for a Review by the PDBR of the Rating Awarded Accompanying a Medical Separation from the Armed Forces of the United States, January 2009
- Which edition is current?
- Not stated by the publisher
- Who is responsible for this form?
- Not stated
- In which formats can it be downloaded?