VA Form 21-0781a

Statement in Support of Claim for Service Connection for PTSD Secondary to Personal Assault

Special MST-related variant of 21-0781. VA can use "markers" (medical-record changes, pregnancy tests, transfer requests, behavioral changes) as evidence in lieu of formal incident reports.

Who files

Veterans claiming PTSD secondary to military sexual trauma.

Next step

Pair with 21-526EZ. Vet Centers offer free MST counseling and can help compile markers.

Related VA Disability Claim forms

• VA Form 21-526EZ — Application for Disability Compensation and Related Compensation BenefitsPrimary form for filing a VA disability claim — the standard "Fully Developed Claim" application. Use for orig…
• VA Form 21-0966 — Intent to File a Claim for Compensation and/or Pension, or Survivors Pension and/or DICFiles an "intent to file" date with VA — locks in your effective date so back-pay starts from when you filed t…
• VA Form 21-0781 — Statement in Support of Claim for Service Connection for PTSDCompanion form for a PTSD claim. Documents the in-service stressor (combat, MST, accident). Required for non-p…

About this form catalog

This is part of a 22-form catalog covering disability claims, appeals, representation, education benefits, healthcare, housing, pension, and records access — maintained by Wounded Warriors. Every entry includes the official VA download URL, plain-English description, who-files-it, and next-step routing to free claims help (CVSOs and VSOs). Free to use under CC-BY 4.0. Browse all forms → · Find a free CVSO →

This page is informational only and is not a VA-affiliated source. The official form is hosted at va.gov.