You do NOT need to have reported the assault at the time it occurred

VA accepts alternative evidence: sudden performance drops, requests for transfer, substance use changes, relationship changes

VA has specialized MST coordinators at every VA medical center — request to speak with one

Veterans Affairsvery hard

Statement in Support of PTSD (Personal Assault)

VA 21-0781a · VA

Statement for PTSD claims secondary to personal assault including military sexual trauma (MST). Allows alternative evidence sources.

Form Details

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Where to Submit This Form

🌐

VA.gov

https://www.va.gov/disability/file-disability-claim-form-21-526ez/

Submit as supporting evidence with your PTSD claim based on personal assault.

📬

Mail to VA Evidence Intake Center

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

📠

Fax to VA

Fax: 844-531-7818

Required Attachments

📎 Description of the personal assault or MST event
📎 Any corroborating evidence: behavioral changes, performance reports, buddy statements, police reports, counseling records
📎 Treatment records for PTSD or related conditions

Processing Time

Processed as part of your PTSD disability claim — 3-6 months total.

What Happens Next

VA will review behavioral markers and alternative evidence sources. A C&P exam will be scheduled. VA is required to send the claim to a specialized MST coordinator for review.

Tips for This Form

✓ You do NOT need to have reported the assault at the time it occurred
✓ VA accepts alternative evidence: sudden performance drops, requests for transfer, substance use changes, relationship changes
✓ VA has specialized MST coordinators at every VA medical center — request to speak with one

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