PTSD VA Claim Field Manual

Mission Brief

Diagnosed with PTSD and ready to file or upgrade your rating? This playbook shows you how to use the updated VA Form 21-0781, document stressors, connect DSM-5 symptoms to CFR §4.130, and stay in command of every C&P exam.

Whether you are filing a new PTSD claim or reopening with new evidence, the fastest route starts with a stressor timeline, corroborating records, and statements that prove current occupational and social impairment.

Pair this brief with the Claim Prep Checklist, log every panic episode or sleep disruption, and line up medical opinions that translate your worst days into VA-ready language.

  • Document stressors: build a chronological log with unit assignments, locations, and witness statements that corroborate the event.
  • Use the right form: as of June 28, 2024 all PTSD and MST events flow through VA Form 21-0781; make sure every stressor is captured there.
  • Map symptoms to CFR §4.130: align your DSM-5 diagnosis, therapy notes, and lay statements with the ratings table for mental disorders.
  • Control the C&P exam: rehearse daily-impact narratives, bring treatment records, and submit a post-exam statement if the report misses key facts.

Situation Brief

You have a PTSD diagnosis tied to service, the symptoms impact work and relationships, and you need the VA to recognize it. PTSD remains one of the VA’s most common new awards—over 81,000 veterans received new PTSD ratings in FY 2024—so your evidence must stand out.1 Success hinges on translating your experiences into a documented stressor, stacking current treatment records, and showing how the condition disrupts daily life.

Signals You Need This

  • You endured a qualifying traumatic event on active duty, drill, or deployment and now hold a PTSD diagnosis from a licensed provider.
  • You have panic attacks, avoidance, sleep disruption, or occupational issues that match the VA rating schedule but lack a clear record in your file.
  • You are reopening an underrated PTSD claim with fresh therapy notes, lay statements, or deck logs that the VA has never evaluated.

Stay on Course

Start a stressor log that documents who, what, where, and when—including unit designations and after-action references. Pair each major symptom with therapy notes, medication adjustments, and lay statements that prove reduced reliability and productivity. Make sure the log mirrors the entries you submit on VA Form 21-0781 so raters and examiners see a consistent story.

  • Collect treatment records from VA and private clinicians, including DSM-5 diagnostic language, therapy frequency, and medication changes.
  • Draft buddy statements from shipmates, squad members, or family who witnessed behavior changes, sleep issues, or anger outbursts.
  • Backstop the file with employment records—write-ups, accommodations, or leave patterns—to prove occupational impairment.

Keep the log updated weekly and reference it during exams, therapy sessions, and every submission to the VA.

Pro tip: If your stressor is non-combat, track down unit logs, CID reports, or medical incident slips that corroborate the event before you file. Personal assault (MST) cases should reference the post-2024 VA Form 21-0781 prompts for “markers.”

Prep Checklist

Lock in proof that ties your PTSD diagnosis to service and shows the severity today.

  • File an Intent to File to save your effective date and use that window to gather therapy notes, DBQs, and stressor statements.
  • Request your personnel and medical records for unit assignments, deployment orders, and any counseling statements tied to the stressor.
  • Complete the latest VA Form 21-0781; it now covers both combat and personal assault (MST) stressors after VA retired Form 21-0781a in June 2024.
  • Ask your treating provider to refresh the PTSD Disability Benefits Questionnaire (VA Form 21-0960P-3) so examiners see clinical findings tied to the rating schedule.

Keep digital and physical copies of every document—stressors, statements, and treatment notes—tagged to the specific symptom they support.

Step-by-Step Playbook

  1. Lock in your intent date: Submit VA Form 21-0966 or start the online intent so you have one year to finalize the PTSD submission.
  2. Document the stressor: Build a timeline with unit details, incident summaries, and corroborating buddy or official reports, then mirror it on VA Form 21-0781.
  3. Prove current severity: Collect therapy notes, medication records, and lay statements that map to CFR §4.130 rating levels.
  4. Rehearse for exams: Practice describing your worst days, bring your symptom log, and note inaccuracies immediately after the C&P exam.

Evidence Arsenal

Focus on three pillars: verified stressor, current diagnosis, and occupational/social impairment.

Documents to Gather

  • Service and unit records: deployment orders, incident reports, CID or MP logs, and award narratives that document the stressor.
  • Mental health treatment notes: therapy summaries, medication management notes, inpatient/outpatient discharge papers, and GAF scores if available.
  • Lay evidence: spouse, friend, or supervisor statements that describe panic episodes, isolation, anger, or workplace conflicts; align them with the symptom clusters in CFR §4.130.

Templates & Tools

Reminder: Label every upload with the veteran’s name, file number, and the specific rating element it supports—stressor, diagnosis, or impairment. Reference CFR §4.130 wording in your cover letters so raters see how each exhibit satisfies the schedule.

Intel & Tools

Treat PTSD claims like a continuous watch—track every communication and symptom shift.

  • Weekly symptom logs: track panic attacks, nightmares, and missed work days; upload updates before exams or reviews.
  • Therapy coordination: let your therapist know when you file so session notes highlight occupational and social impact. Ask them to echo CFR §4.130 language (for example, “deficiencies in most areas”) when it applies.
  • C&P debrief: document the examiner’s questions, demeanor, and duration immediately after the appointment in case a rebuttal is needed. If the report omits a stressor, reference the matching entry from your updated VA Form 21-0781 in your rebuttal.

Related Questions

Related Tips

Stay consistent: if symptoms escalate, update your log and get a treatment note in the record before the VA issues a decision.

Next Actions & Support

Stay Organized

  • Keep a shared binder with stressor evidence, therapy notes, and lay statements so every evidence request is answered fast.
  • Set reminders post-intent to review VA.gov message center, IRIS replies, and any duty-to-assist letters within 48 hours.
  • Log all VA calls or appointments with date, time, and outcome in your claim tracker.

More Routes

PTSD Claim FAQs

As of June 28, 2024 the VA retired Form 21-0781a. Every PTSD or personal assault (MST) event now lives on VA Form 21-0781, including combat, fear-of-hostile activity, and MST “marker” prompts.
Match therapist notes, medication changes, and lay statements to the General Rating Formula in 38 C.F.R. § 4.130. Reference phrases like “deficiencies in most areas” or “reduced reliability and productivity” so the rater sees how your evidence fits the schedule.
Write a post-exam statement immediately. Cite the stressor entry from your VA Form 21-0781, attach symptom logs or lay statements, and ask the VA to consider a new exam if the report is incomplete or inaccurate.

Stay in the PTSD Intel Loop

Short briefings when forms, CFR guidance, or PTSD rating tactics change—no fluff. Written by a submariner who has run this gauntlet.