Who needs a VA Form 21-0781a?
Form VA 21-0781a, Statement in Support of Claim for Service Connection Post-Traumatic Stress Disorder, should be completed by a military serviceman suffered stressful incident or incidents that occurred in service and are contributed to a person’s current conditions.
What is VA Form 21-0781a for?
The VA Administration will make their own investigation order to assess whether this person is owed any benefits in connection with the incident; based on the information provided the VA will conduct research of military records and other sources identified in this form.
A submitter must provide all available sources (military and non-military) that may provide information concerning reported incident.
Is VA Form 21-0781a accompanied by other forms?
The Statement in Support of Claim for Service Connection Post-Traumatic Stress Disorder should be submitted along with this Statement if you would like the VA to obtain the treatment records from the particular provider.
How do I fill out VA Form 21-0781a PDF?
You should complete the following blocks in order to complete VA PTSD Statement:
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Veteran’s personal information;
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Stressful Incident description (date, location, unit assignment, and dates of the unit assignment);
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Description of the Incident;
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Other Sources of Information;
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Any other information to be important;
Once completed, the form 21 0781a should be signed and dated.
Where do I send VA Forms 21-0781a?
Once completed and signed, this Statement in Support of Claim for Service Connection Post-Traumatic Stress Disorder should be directed to the chain commander or any other person responsible for such an evaluation.
