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How to use or fill out VA Form 21-0781 STATEMENT IN SUPPORT OF CLAIM FOR SERVICE CONNECTION FOR POST-TRAUMATIC STRESS DISOR
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Click ‘Get Form’ to open it 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 for processing.
Move to SECTION II: STRESSFUL INCIDENTS. Here, list each incident that contributed to your PTSD. Provide detailed descriptions including dates, locations, and unit assignments.
For each incident, include information about any individuals who were killed or injured. Use the provided fields to document their names, ranks, and circumstances.
In SECTION III: REMARKS, add any additional information that may support your claim.
Finally, complete SECTION IV: CERTIFICATION AND SIGNATURE by signing and dating the form to certify its accuracy.
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I still suffer from symptoms of PTSD, including nightmares, flashbacks, severe emotional distress, feelings of hopelessness, lack of interest in activities, difficulty sleeping, self-destructive behavior, memory problems, severe anger, paranoia, and feeling detached from loved ones.
What is an example of a PTSD stressor statement?
In order to get a disability rating and subsequent benefits for PTSD, veterans must complete VA Form 21-0781. This is a statement in support of a claim for service connection for PTSD. If your PTSD was the result of physical assault or military sexual trauma, you should use VA Form 21-0781a.
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VA has forms specifically developed for PTSD claims: VA Form 21-0781, Statement in Support of Claim for Service. Connection for Post-Traumatic Stress Disorder
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