VA Form 21P-0518-1-2025

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Use VA Form 21-0781 if youve been diagnosed with a mental health condition related to a traumatic event during your military service, and you want to apply for related benefits or services.
After completing the form, mail to: Department of Veterans Affairs, Evidence Intake Center, P.O. Box 4444, Janesville, WI 53547-4444. Show your monthly living expenses, including any monthly installment payments. If you do not have expenses from a particular source, write 0 or none in the space provided.
VA Form 21-0781a is specifically for use in cases of stressors related to personal assault, including military sexual trauma and physical attacks. Any trauma not related to personal assault should be reported on a 0781.
Adjustment disorder and Post-Traumatic Stress Disorder (PTSD) may seem like similar disorders, but their unique characteristics differentiate them. With adjustment disorder, individuals are unable to adapt to major life changes. PTSD develops after a traumatic event and leads to prolonged feelings of intense fear.
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.
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Use VA Form 21P-601 to apply for accrued benefits due the beneficiary but not paid prior to death.

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