The following information about this VA form comes from the VA forms database, and any changes are updated here nightly. Contact the form administration for further information.
Form number
21-0781
Row ID
4259
Form title
Statement in Support of Claim for Service Connection for PTSD (Fillable)
Issue date
Revision date
Form administration
Number of pages
3
Deleted
False
Form name
Statement in Support of Claim for Service Connection for PTSD
Form Language
English
Related to
Benefits
VA disability compensation
VA health care
When to use

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

Online tool
You can apply online instead of filling out and sending us the paper form.