Va form 21 0781a 2025

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The document is a VA form (21-0781a) for veterans to submit a statement in support of their claim for service connection for posttraumatic stress disorder (PTSD) related to personal assault. It includes sections for identifying the veteran, detailing stressful incidents experienced during service, and providing additional information or sources that may support the claim. The form emphasizes the importance of thorough and accurate information to assist in the claims process.

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Click ‘Get Form’ to open VA Form 21-0781a 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 Incident(s). Here, list each incident that contributed to your PTSD claim. Provide detailed descriptions including dates, locations, and unit assignments.
In Section II, continue detailing any other sources of information that may support your claim. Include names and addresses of individuals or organizations that can provide additional context.
Finally, complete Section III by signing and dating the form to certify that the information provided is true and correct.

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Versions	Form popularity	Fillable & printable
2021	4.3 Satisfied (29 Votes)
2017	4.8 Satisfied (55 Votes)
2014	4.4 Satisfied (1022 Votes)
2007	4.4 Satisfied (60 Votes)

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What is the difference between a VA form 21-0781 and 21 0781a?

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.

What is VA Form 21 0781a used for?

Use this form to provide a statement in support of a claimed mental health disorder(s) due to an in-service traumatic event(s). For more information, you can contact us online through Ask VA: or call us toll-free at 1-800-698-2411 (TTY:711).

What is VA form 21-0781 used for?

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.

What evidence does the VA need for PTSD?

The veteran must prove the nexus through medical evidence, such as an opinion from a qualified doctor. Another great resource for establishing a nexus is records from a Vet Center. Vet Centers have licensed social workers that will document the connection between the veterans stressor and their current diagnosis.

What to say to get 70% PTSD compensation?

Provide specific examples of your PTSD symptoms, such as I had a panic attack when I heard a car backfire, I thought it was gunfire, or I heard someone scream on TV and I ran for cover. This will be much more effective than providing clinical descriptions of symptoms that you may have learned while undergoing

va form 21 0781a pdf

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How to fill out the VA form 21-0781?

Step-by-Step Instructions for Completing VA Form 21-0781 Section 1: Veteran Information. Section 2: Stressor/Traumatic Event(s) Description. Section 3: Additional Information Associated With the Event. Section 4: Treatment Information. Section 5: Additional Remarks. Section 6: VBA Notification to VHA (For MST Claims Only)

What do I say to get 70% PTSD compensation?

There arent any magic words you can use to automatically get, say, 70% disability compensation for PTSD. You should instead focus on making sure that your stressor statement describes the traumatic events that led to you developing PTSD, as well as how your life has changed since your diagnosis.