Supporting evidence for a disability compensation claim
Department of Veterans Affairs
Evidence Intake Center
PO Box 4444
Janesville, WI 53547-4444
VA Form 21-0781 — Optional traumatic-event statement
Optionally describe an in-service traumatic event related to a claimed mental health condition. The disability application remains a separate step.
Use the current official form
Revision: March 2024.
Attach it to the applicable claim or review request; sending evidence alone does not necessarily initiate a review. Other benefit destinations are separate.
Submission instructions
In person
Disability compensation documents through the applicable claim or review channel.
A VA regional benefits office