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Click ‘Get Form’ to open VA Form 21-0781 in the editor.
Begin with Section I: Veteran's Identification Information. Fill in your name, social security number, date of birth, and contact details. Ensure all information is accurate and legible.
Proceed to Section II: Stressful Incidents. Here, list each incident that contributed to your PTSD claim. For each incident, provide the date, location, unit assignment, and a detailed description.
If applicable, include information about individuals who were killed or injured during these incidents. Use the provided fields for their names, ranks, and details of the incidents.
Complete Section III by signing and dating the form to certify that all information is true to the best of your knowledge.
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VA Form 21-0781, Statement in Support of Claimed Mental
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