When a mental health condition is caused or aggravated by a traumatic event during service, providing additional details beyond those included in the basic application can help strengthen a veteran’s disability claim. That’s where VA form 21-0781 comes in.
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While optional, submitting a Statement in Support of Claimed Mental Health Disorder(s) Due to an In-Service Traumatic Event(s) form allows veterans to explain their experiences, describe related events, and share how their condition affects their daily lives. We explain more below.
In this article about VA form 21-0781:
VA form 21-0781: What it is and when to use it
VA form 21-0781 is just one of many forms veterans may use when seeking VA disability or health care benefits. It is an optional form used by veterans with mental health conditions that are related to one or more traumatic incidents they experienced during service.
Among many others, service-connected mental health conditions may include:
- Bipolar disorder
- Depression or dysthymia
- Generalized anxiety disorder
- Schizoaffective disorder
- Panic disorders
- Chronic adjustment disorders
Some examples of the traumatic events these veterans may have experienced include combat events, military sexual trauma, witnessing a death, ongoing harassment or hazing, stalking, or other traumatic personal events.
While the event must have occurred during military service, it does not have to be related to combat. For example, the VA recognizes car accidents, robberies, assault, and other traumatic events as valid stressors if they took place while the veteran was serving or training for active duty service.
How to fill out VA form 21-0781
VA form 21-0781 is divided into several sections we will walk through below. While the form itself is straightforward, recounting traumatic experiences may feel overwhelming, especially for those already struggling with symptoms of PTSD or other mental health conditions.
If at any point you need mental or emotional support, consider calling the VA’s Veterans Crisis Line. This support line is available 24/7.
VA form 21-0781, Section I
The first section of form 21-0781 asks for identification information, including basic details like name and contact information. While this is a required section, most of the rest of the form is not. However, the more information you can include in the following sections, the more helpful it may be in supporting your case.
VA form 21-0781, Section II
Section two of VA form 21-0781 asks for information about the traumatic events in service.
First, the section specifically requests information on what types of traumatic events you experienced, then asks for additional information on where and when the events took place.
The VA may use this information to find other records or evidence that can support these claims. If you don’t remember an exact date or place, don’t worry. Including a month and a year, a season, or simply an answer like “basic training” will still help more than if it’s left blank.
This section provides space to explain up to six different events. More information can be included in Section V, “Remarks,” if needed.
VA form 21-0781, Section III
The third section of the form asks about behavioral changes that occurred after the traumatic event. The form lists several examples and asks you to check all that apply. The list includes options like “legal difficulties,” “episodes of depression,” “breakup of a significant relationship,” and more. Each example has a space to provide additional details.
Section three then asks if an official report was filed and requests details that might help the VA find the report.
The last question in section three asks about other possible sources of evidence that may exist to support your claim. Sources may include places, people, and things like crisis centers, personal journals, medical or police reports, or accounts from family, friends, or roommates. You can check any situation that may apply.
VA form 21-0781, Section IV and V
Section four asks for information about any treatment you have received for your mental health condition, including questions about when and where the treatment took place.
Section five, as referenced above, is a space to provide additional remarks, especially if you ran out of room in a previous section. This section is optional and can be left blank if you included everything you wanted in the sections above.
VA form 21-0781, Section VI
Section six is only for veterans who answered that they experienced a personal traumatic event involving MST. It asks if you want the VBA to notify the Veterans Health Administration (VHA) about upcoming events, such as scheduled C&P exams or hearings, during the application or appeal process.
Opting to consent to give the VBA access to notify the VHA about these events alerts your VA healthcare provider when one of these events is coming up.
The way you answer this question will not influence the outcome of your disability claim.
VA form 21-0781, Sections VII – X
Sections seven, eight, nine, and ten require you to certify the information that you provided is true to the best of your knowledge.
If the veteran cannot sign, two witnesses can sign off on the document. A certified alternate signer or the veteran’s power of attorney can also sign if needed.
2024 update: VA form 21-0781 vs 21-0781a
Before June of 2024, there were two different forms veterans could use to provide additional information about traumatic events in service causing mental health conditions.
VA form 21–0781a was used only for veterans who were experiencing PTSD related to a personal assault. VA form 21-0781 was used for all other mental health conditions and traumatic events.
Now, there is only one combined form covering all mental health conditions and traumatic events. This means veterans who have service-connected PTSD due to MST and want to fill out a statement in support of their claim should use VA form 21-0781.
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Additional evidence and forms to support your mental health claim
Submitting VA form 21-0781 is one way to support your claim, but it is just one piece of the larger puzzle when it comes to evidence. Medical documents, military records, and lay statements can all help paint a more complete picture for the VA about the severity of your condition and its connection to military service.
Your C&P exam results will also affect your claim. Because C&P exams can be especially difficult for those with service-connected trauma and mental health disorders, we have written a blog on preparing for your exam.
Talk to Us About Your Claim:
(812) 426-7200
FREQUENTLY ASKED QUESTIONS
VA form 21-0781 is a form available for veterans who have a mental health condition caused by a traumatic event in service and are seeking VA benefits for that condition.
No, VA form 21-0781 is not required for veterans seeking a VA disability rating for a mental health condition caused by a traumatic event in service, but it can be helpful. Veterans can use it to provide additional information about their experience if desired.
Neil Woods
Neil Woods is a VA disability attorney and the owner and president of Woods & Woods. He received his law degree from Western Michigan University.
