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: July 2022
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)Online tool
You can apply online instead of filling out and sending us the paper form.
Go to the online toolRelated forms and instructions
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VA Form 21-0781a
Form name: Statement in Support of Claim for Service Connection for PTSD Secondary to Personal Assault
Use VA Form 21-0781a if you’ve been diagnosed with PTSD related to or because of personal assault, and you want to apply for related benefits or services.
Download VA Form 21-0781a (PDF)
Helpful links related to VA Form 21-0781
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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.
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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.
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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.