Get Va 21-0781a 2017-2025

The VA 21-0781a form is essential for veterans seeking service connection for posttraumatic stress disorder (PTSD) related to personal assault. This guide provides clear, step-by-step instructions for filling out this form online, ensuring you have the necessary information to provide a comprehensive account of your experiences.

Follow the steps to complete the VA 21-0781a form online effectively.

1. Press the ‘Get Form’ button to acquire the form and open it for completion.
2. Begin with Section I, where you will provide your identification information. Fill in your name, social security number, VA file number if applicable, date of birth, telephone number, and optional email address. Ensure all provided information is accurate to avoid processing delays.
3. Proceed to Section II, where you will describe the stressful incidents that contributed to your PTSD. Start with the date of the first incident, the unit assignment dates, and the location where each incident occurred.
4. In the same section, detail your unit assignment during the incident, followed by a comprehensive description of the incident. Use clear and specific language to aid in the understanding of your experience.
5. Continue to identify any other sources of information. Complete the fields for names and mailing addresses of individuals or organizations that can corroborate your experiences. If you have sought help or counseling, include those details.
6. In the space provided, share any additional information that may support your claim. This may include behavioral changes you experienced following the incidents.
7. Finally, Section III requires your signature and the date signed. Ensure you certify that all information provided is true to the best of your knowledge before submitting.
8. Once all sections are complete, review your entries for accuracy. You can save changes, download the form, print it for submission, or share it as needed.

Complete your VA 21-0781a form online to support your claim for service-connected PTSD.