These are two lines in the help that pretty much torpedo my use of the tool:
This tool can only be used with database tables, not geodatabase tables.
If a database-maintained, incrementing ID field already exists in the table, this tool will not add another one.
My use case is when a record is added, I need to generate an incremental unique id; I could use a trigger on the back-end sql database, but I'd like to avoid that if at all possible.
That should just about do it....