VA 21-0781 Forms and Templates

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total templates

What Is the VA Form 21-0781 Series?

VA Form 21-0781, Statement in Support of Claim for Service Connection for PTSD is an application form that should be filled out by every veteran filing a claim for service-related PTSD. The form is submitted to the Department of Veterans Affairs (VA) explaining and describing the traumatic circumstances surrounding an in-service incident that has lead to the current condition.

VA Form 21-0781a, Statement in Support of Claim for Service Connection for Post-Traumatic Stress Disorder (PTSD) Secondary to Personal Assault is a similar form used by veterans whose diagnosis was determined to have been caused by a personal assault.  

VA Disability Forms 21-0781

Both forms will ask the applicant to describe the event or events that caused the current condition along with the exact dates, time frames, and locations of the incident. Additional requested information includes your unit assignment and the dates of assignment along with the names and other details about the participants of the event.

VA Disability Compensation for PTSD

Post-Traumatic Stress Disorder - or PTSD - is a medical condition that may occur when a person underwent a particularly traumatic event in their past or was subjected to the risk of injury or death to themselves or someone close to them. The common symptoms of PTSD include:

  • Continuous memories of the event along with nightmares, flashbacks, and difficulties with sleeping;
  • Refusing to discuss the event, avoiding any situation that may generate bad memories;
  • Feeling numbness and detachment, depression and disinterest in normal daily activities;
  • Feeling constantly on edge, expecting an attack, uneasiness.

The disorder is most common among veterans and military personnel. If a veteran has a Purple Heart award, a Combat Infantryman Badge, or a Combat Action Ribbon an account of what happened during the incident does not need to be provided. The VA will concede that a stressful event happened when making a decision on the PTSD claim. All other cases required following a specific set of steps needed for establishing a direct service connection with PTSD. The required information includes:

  • A current diagnosis of post-traumatic stress disorder;
  • A statement from the veteran about the “stressor” (the traumatic event) that occurred during their service;
  • Evidence that the stressor was caused by circumstances of the military service;
  • No strong evidence that the stressor didn’t take place; and
  • A medical opinion from a VA psychologist or psychiatrist or of the same specialist that is under contract with the VA.

Documents

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VA Form 21-0781 Statement in Support of Claim for Service Connection for Post-traumatic Stress Disorder (Ptsd)

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4.4(4.4 / 5) 90 votes
Size: 1 MB
3 pages

The form is filled out by every service member claiming for Post Traumatic Stress Disorder (PTSD) with the Department of Veterans Affairs (VA). The veterans are expected to document the events that led to the disorder during their duty.

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VA Form 21-0781A Statement in Support of Claim for Service Connection for Posttraumatic Stress Disorder (Ptsd) Secondary to Personal Assault

Rate
4.8(4.8 / 5) 27 votes
Size: 1 MB
3 pages

This is a form issued by the Department of Veterans Affairs (VA) and filed by veterans whose primary reason for PTSD was caused by a personal assault.

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