Without a completed 21-0781, VA cannot verify the traumatic event. This form is your voice when records are missing, incomplete, or classified. A thorough, consistent, and emotionally precise statement is often the difference between a grant and a denial.

You should submit this form if you have been diagnosed with a mental health condition that you believe was caused by a traumatic event during your military service. As of , the VA discontinued the separate Form 21-0781a (formerly used for personal assault or Military Sexual Trauma); all such claims are now consolidated into the standard VA Form 21-0781 . Key Sections of the Form