OMB control number
Statement in Support of Claimed Mental Health Disorder(s) Due to an In-Service Traumatic Event(s) (VA Form 21-0781)
OMB 2900-0659 · VA.
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 can be found here.
Document Name |
|---|
Form |
Supplementary Document |
Supplementary Document |
Supporting Statement A |
|
Approved with change |
Revision of a currently approved collection | 2024-02-15 | |
|
Approved without change |
Reinstatement with change of a previously approved collection | 2021-03-05 | |
|
Approved without change |
Extension without change of a currently approved collection | 2017-04-07 | |
|
Approved without change |
Revision of a currently approved collection | 2014-06-02 | |
|
Approved without change |
Extension without change of a currently approved collection | 2011-04-01 | |
|
Approved without change |
Extension without change of a currently approved collection | 2008-02-26 | |
|
Approved with change |
New collection (Request for a new OMB Control Number) | 2005-03-17 |