What it is
VA Form 21-0781, "Statement in Support of Claimed Mental Health Disorder(s) Due to an In-Service Traumatic Event(s)," is your sworn description of what happened in service and how it affects you today. In June 2024 VA expanded this form to replace the old 21-0781a and to cover mental health conditions beyond PTSD.
When you use it
File it with any claim for service connection of PTSD, major depression, generalized anxiety, bipolar disorder, or a related mental health condition tied to a service event. Three evidentiary tracks at 38 CFR 3.304(f) can ease your burden of proof:
- (f)(2) Combat: if the record shows you engaged in combat and the stressor is consistent with that service, your lay statement alone can establish the stressor.
- (f)(3) Fear of hostile military or terrorist activity: a VA psychiatrist or psychologist confirming the stressor is sufficient to support PTSD lets your lay statement establish it.
- (f)(5) Personal assault: alternative evidence and behavioral markers can corroborate the event.
What to gather before you fill it out
- Dates, locations, units, and names tied to each event, be as specific as memory allows.
- Buddy statements, deployment records, after-action reports, or award citations.
- Treatment records for the mental health condition.
- Your DD-214 and any combat indicators (CIB, CAB, CAR, hostile fire pay).
How to submit
Upload it with VA Form 21-526EZ on VA.gov, mail to the Evidence Intake Center, or file through an accredited representative.
Common pitfalls
- Listing only "PTSD from deployment" with no dates, places, or unit.
- Skipping the section that describes current symptoms and impact.
- Not requesting the C&P exam topics that match your stressor track.
- Submitting the discontinued 0781a, use the current 0781.
Related forms
21-526EZ (claim), 21-4138 (additional statements), 21-22 (representative).
Sources
- https://www.va.gov/find-forms/about-form-21-0781/
- 38 CFR 3.304(f)