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va form 21 0781a pdf fillable

VA 21-0781a 2021-2024 free printable template

OMB Approved No. 29000659 Respondent Burden: 1 hour and 10 minutes Expiration Date: 06/30/2024VA DATE STAMP(DO NOT WRITE IN THIS SPACE)STATEMENT IN SUPPORT OF CLAIM FOR SERVICE CONNECTION FOR POST-TRAUMATIC
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Comments and Help with how to va form claim ptsd

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:

  • Veteran’s personal information;

  • Stressful Incident description (date, location, unit assignment, and dates of the unit assignment);

  • Description of the Incident;

  • Other Sources of Information;

  • 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.

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