Fill out VA 21-0781 (Statement in Support of Claim for Service Connection for Post-Traumatic Stress Disorder) online
VA Form 21-0781 is used by veterans to provide a detailed statement supporting a claim for service connection for Post-Traumatic Stress Disorder (PTSD). The form asks the veteran to describe the stressful event(s) (stressors) that occurred during military service and that they believe caused or contributed to their PTSD. This information helps the VA verify the stressor and evaluate the claim.
How to fill out VA 21-0781 (Statement in Support of Claim for Service Connection for Post-Traumatic Stress Disorder)
Enter personal and service information
Provide your full name, Social Security number, VA file number (if known), date of birth, branch of service, and dates of service. Include your unit assignment at the time of the stressful event.
Describe the stressful event in detail
Provide a detailed account of the traumatic event(s) that you believe caused your PTSD. Include the approximate date (month and year at minimum), geographic location, your unit designation, and a description of what happened. Be as specific as possible about who was involved and what occurred.
Identify any witnesses or corroborating sources
List the names of any service members who witnessed the event, their units, and any contact information you may have. Identify any official records, news reports, or after-action reports that may document the event.
Describe the impact on your life
Explain how the stressful event has affected you since it occurred. Describe symptoms such as nightmares, flashbacks, avoidance behaviors, hypervigilance, and how PTSD affects your daily activities, relationships, and ability to work.
Sign and submit with supporting evidence
Sign and date the form. Submit it along with any supporting evidence: buddy statements from fellow service members, medical records showing PTSD diagnosis and treatment, service records, and any other documentation that corroborates your account.
About VA 21-0781 (Statement in Support of Claim for Service Connection for Post-Traumatic Stress Disorder)
Who needs this form
Veterans who are filing a disability compensation claim for PTSD and need to describe the traumatic event(s) that occurred during their military service. This form is typically submitted alongside VA Form 21-526EZ (the disability compensation application) and supports the PTSD-specific portion of the claim.
Where to submit
Submit to the VA by mail to the Evidence Intake Center, by fax, or through your Veterans Service Organization (VSO). This form should be submitted with your VA 21-526EZ disability compensation application or as supplemental evidence for an existing PTSD claim.
Source and content freshness
- Reviewed: 2026-02-24
- Filing deadlines may shift for weekends and holidays. Verify due dates with official instructions.
Common mistakes to avoid
- Not providing enough specific detail about the stressor event (dates, locations, units involved, and what happened)
- Failing to submit supporting evidence such as buddy statements, service records, or news articles corroborating the event
- Not connecting the described stressor to the current PTSD diagnosis from a qualified mental health professional
- Omitting additional stressor events that may also support the claim (you can describe multiple incidents)
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