Mental Health Traumatic Event Statement

1. 1

   Do now · 01

   Before you start

   Estimated time

   1-2 hours

   Use this form when: When you have a diagnosed mental health condition related to a traumatic event during service. Since June 28, 2024, this form also covers personal assault, sexual assault or harassment, and MST; VA discontinued Form 21-0781a.

2. Gather · 02

   Gather your documents

   Helpful when available

   • +Deployment records or combat action documentation — Helps corroborate your stressor events.
   • +Buddy statements from fellow service members — Statements from people who were there or witnessed the aftermath.
   • +Current PTSD diagnosis from a mental health provider — A diagnosis strengthens your claim significantly.
3. 3

   Waypoint · 03

   Complete the form

   • ✓Description of each stressor event (what happened, where, when)
   • ✓Unit assignment and dates of service at the time
   • ✓Names of others involved or who witnessed the event
   • ✓How the event affects you now
4. 4

   Waypoint · 04

   Avoid common mistakes

   • ×Being too vague about the stressor — include dates, locations, and unit assignments
   • ×Not connecting the event to your current symptoms
   • ×Omitting a relevant event or marker — include each one that may support the claim, and use continuation space if you need more room
5. Go next · 05

   Submit the form

   Available methods

   • Online
   • Mail

   Mail to

   Department of Veterans Affairs, Claims Intake Center, PO Box 4444, Janesville, WI 53547-4444

   Submission note

   The online disability application asks the relevant mental health and traumatic-event questions. You can also upload the completed PDF with a claim.

   Start on VA.gov↗ (opens in a new tab)View or download official form↗ (opens in a new tab)

Continue the route

Forms are just one piece. Make sure your full claim is solid.