Statement in Support of Claimed Mental Health Disorder(s) Due to an In-Service Traumatic Event(s) (VA Form 21-0781)

VA Form 21-0781 is used to gather certain information about in-service stressors, so VA may assist claimants in establishing the occurrence of the claimed stressor(s). To establish a grant of service-connected compensation, there must be evidence to support the in-service stressor(s) reported by the veteran. This form is voluntary, however, without this information, VA cannot thoroughly assist certain claimants with the research of military records and other sources of information for supporting evidence about the in-service stressor(s). The form requests information that is necessary to conduct meaningful research of evidence to help substantiate the claim.

The latest form for Statement in Support of Claimed Mental Health Disorder(s) Due to an In-Service Traumatic Event(s) (VA Form 21-0781) expires 2027-03-31 and is listed under ICR 202311-2900-013.