VA Form 21-0781a
PTSD Secondary Statement
For PTSD related to personal assault or MST (Military Sexual Trauma).
PTSD Secondary Statement
In Plain English
For PTSD related to personal assault or MST (Military Sexual Trauma).
Supplements the PTSD claim for cases involving personal assault or Military Sexual Trauma (MST).
Step-by-Step Guide
How to file 21-0781a
When to use this form
When filing a PTSD claim based on Military Sexual Trauma (MST) or personal assault. The VA has relaxed evidence standards for MST claims — you do not need to have reported the incident at the time.
Recommended (if applicable)
- +Evidence of behavioral changes after the event
Performance reports, transfer requests, counseling records, or personal journal entries.
- +Statements from counselors, chaplains, or confidants
Anyone you told about the event, even years later.
- +Current mental health treatment records
Shows ongoing impact and supports your claim.
You'll need to provide
- ✓Description of the personal assault or MST event
- ✓Behavioral changes after the event (transfer requests, performance changes, substance use)
- ✓Any reports filed at the time (if applicable, but not required)
- ✓Current symptoms and how they affect your life
- ✕Thinking you need a police report or official record — you do not for MST claims
- ✕Not describing behavioral changes after the event — these are key evidence markers
- ✕Using the wrong form — use 21-0781 for combat PTSD, this form is specifically for personal assault/MST
Mail to
Department of Veterans Affairs, Claims Intake Center, PO Box 4444, Janesville, WI 53547-4444
Submit with your 21-526EZ. Your claim will be handled by a specially trained MST team at the VA.
Pro Tip
MST claims have special evidence rules. The VA accepts behavioral markers as evidence: sudden requests for transfer, drop in performance, substance use changes, relationship changes. You do NOT need to have reported the assault at the time.
Related Forms
You might also need
PTSD Statement
Details the traumatic event(s) connected to your PTSD claim. Combat and non-combat versions exist.
Disability Compensation Claim
THE claim form. This is how you officially apply for disability benefits.
Lay/Witness Statement (Buddy Statement)
A written statement from someone backing up your claim — friends, family, or fellow service members.
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