2017-2023 Form VA 21-0781a Fill Online, Printable, Fillable-2025

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Veterans should provide a description of what occurred, the approximate date and geographic location, their unit and dates of assignment, and the full names and assignments of anyone who was killed or injured during the incident. VA requests veterans complete the form with as many specific details as possible.
If your PTSD was the result of physical assault or military sexual trauma, you should use VA Form 21-0781a. For all other service-connected stressors, fill out VA Form 21-0781.
Intent to File VA Claim Online Go to .ebenefits.va.gov to register or log in, and: initiate a claim. complete the personal information page. hit save to establish your effective date (youll have one year to complete your application from this date)
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please complete and submit VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits.
When to use this form. Use VA Form 21-0781 if youve been diagnosed with PTSD (posttraumatic stress disorder) and want to apply for related benefits or services.
You can fill out VA Form 21-0781 when you file a disability claim online. You can fill out VA Form 21-0781a when you file a disability claim online.
The best way to file for disability compensation is to apply online at .va.gov/disability. Or, you can fax it to: (844) 531-7818 (inside the U.S.) (248) 524-4260 (outside the U.S.)
How do I file my claim? File your claim by mail using an Application for Disability Compensation and Related Compensation Benefits (VA Form 21-526EZ). Find a VA regional office near you. Get help from an accredited representative. Find out how to submit an intent to file form. Find out what happens after you file.