Va Form 21-0781

“On April 12, 2007, while on dismounted patrol in the Zhari District, Kandahar, Afghanistan, my squad was ambushed from a grape hut. I was the machine gunner. I saw SPC Mike Torres take a round to the chest. I dragged him 15 meters behind a berm while returning fire. He was dead when I turned him over – his eyes were open. I had to leave his body to continue fighting. I still see his face every night. My lieutenant, 1LT Rachel Chen, witnessed this. Her last known unit was 2-508 PIR, Ft. Bragg. I have no other witnesses I can contact.”

VA Form 21-0781, officially titled Statement in Support of Claim for Post-Traumatic Stress Disorder (PTSD) , is the primary document used by veterans to provide a detailed, personal account of a traumatic in-service event that caused their PTSD. It serves as the veteran’s sworn testimony, establishing the "stressor" required for service connection. va form 21-0781

Check all that apply. If (military sexual trauma - MST), do not use this form. Use VA Form 21-0781a (MST-specific) instead. “On April 12, 2007, while on dismounted patrol

This section requires a . Vague statements like “I saw bad things” will be denied. I dragged him 15 meters behind a berm while returning fire