Official VA Form

VA Form 21-0781a

Statement in Support of Claim for Service Connection for PTSD Secondary to Personal Assault

VA Form 21-0781a — Statement in Support of Claim for Service Connection for PTSD Secondary to Personal Assault is an official U.S. Department of Veterans Affairs form used for disability, health care. The current version was last revised 2021-06-18. It is 3 pages long. Download the up-to-date PDF below — BaseNeed syncs form data directly from VA.gov so you always get the current edition.

Download the official PDF (VA.gov) →

Last revised: 2021-06-18
First issued: 2022-07-18
Pages: 3
Administered by: VBA

DisabilityHealth care

Frequently asked questions

What is VA Form 21-0781a used for?

Statement in Support of Claim for Service Connection for PTSD Secondary to Personal Assault. It is an official VA form in the Disability, Health care categories, administered by VBA.

Where can I download the current VA Form 21-0781a?

Download the official PDF from VA.gov here: https://www.vba.va.gov/pubs/forms/VBA-21-0781a-ARE.pdf (last revised 2021-06-18).

How long is VA Form 21-0781a?

VA Form 21-0781a is 3 pages long, last revised 2021-06-18.

Always the current version — synced from VA.gov. BaseNeed is not affiliated with the U.S. Department of Veterans Affairs.

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Nearby form numbers

VA Form 21-0538 — Mandatory Verification of Dependents
VA Form 21-0779 — Request for Nursing Home Information in Connection with Claim for Aid and Attendance
VA Form 21-0781 — Statement in Support of Claim for Service Connection for PTSD
VA Form 21-0788 — Information Regarding Apportionment of Beneficiary's Award
VA Form 21-0789 — Your Rights to Representation and a Hearing
VA Form 21-0845 — Authorization to Disclose Personal Information to a Third Party