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About VA Form 21-0781

Form name: Statement in Support of Claim for Service Connection for PTSD
Related to: Disability, Health care
Form last updated: April 14, 2020

When to use this form

Use VA Form 21-0781 if you’ve been diagnosed with PTSD (posttraumatic stress disorder) and want to apply for related benefits or services.

Downloadable PDF

Download VA Form 21-0781 (PDF)
  • VA Form 21-0781a

    Form name: Statement in Support of Claim for Service Connection for Post-Traumatic Stress Disorder (PTSD) Secondary to Personal Assault (Fillable)

    Use this VA form if you’ve been diagnosed with PTSD related to or because of personal assault and want to apply for related benefits or services.

    Download VA Form 21-0781a (PDF)
  • How to apply for VA health care

    Find out how to apply for VA health care. This can be a first step in getting treatment and support for PTSD.

  • VA mental health services

    Learn how to get started using VA mental health services. You can use some services even if you’re not enrolled in VA health care.

  • PTSD treatment

    Find out how to access PTSD health services through VA. Our National Center for PTSD is the world leader in PTSD research, education, and treatment.

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