Military Sexual Trauma (MST) Claims

Military Sexual Trauma (MST) is the VA's term for sexual assault or repeated, threatening sexual harassment that occurred during military service. MST is not a diagnosis, it is a stressor event. You do not file a claim for "MST." You file for the conditions MST caused - most commonly PTSD, depression, or anxiety.

The legal framework is 38 CFR § 3.304(f)(5), which establishes a relaxed evidentiary standard specifically for personal assault claims, including MST. This means the VA cannot require the same level of proof it requires for other types of PTSD claims.

This is the most important section. MST itself is not a ratable condition. You must claim a diagnosable condition that was caused by the MST. Here are the conditions to consider:

Primary Conditions (claim one or more)

• PTSD (DC 9411) - the most common MST-related claim. Rated 0-100% based on occupational and social impairment.
• Major Depressive Disorder (DC 9434) - if depression is your primary symptom rather than classic PTSD symptoms.
• Generalized Anxiety Disorder (DC 9400) - chronic anxiety, hypervigilance, difficulty concentrating.
• Other specified trauma disorder (DC 9440) - adjustment disorders related to the trauma.

Step 1: File Your Intent to File

Call 1-800-827-1000 or file at VA.gov. This locks in your effective date. Every day you wait is a day of back pay you lose.

Step 2: Complete VA Form 21-526EZ

You can file online at VA.gov or with a VSO representative. On the form:

• List each condition separately (PTSD, depression, etc.)
• For each condition, state "due to military sexual trauma" or "due to personal assault"
• You will be asked to complete VA Form 21-0781, the Statement in Support of Claimed Mental Health Disorder(s) Due to an In-Service Traumatic Event(s). This is where you describe what happened and list your evidence markers.

One-page guide: VA Form 21-0781 Guide Guide to the current VA traumatic-event statement form and the discontinued 21-0781a. Opens the full-size chart, free to save or print.

Step 3: Submit VA Form 21-0781

This is the critical form for MST claims. It asks you to describe:

• The traumatic event(s), in as much detail as you are comfortable providing
• Behavioral changes after the event (the "markers", see next section)
• Sources of evidence that may corroborate the event

Step 4: Gather Your Evidence

This is where MST claims differ from other claims. See the full list of accepted markers below.

Step 5: Get a Nexus Letter

A private medical opinion (nexus letter) from a psychologist or psychiatrist linking your current diagnosis to the in-service MST is the single strongest piece of evidence. In our BVA data, PTSD appeals were granted about 97% of the time when a nexus letter was in the file. That reflects a pattern in already-decided appeals (cases with a nexus letter also tend to be stronger overall), not a prediction of your individual outcome.

The VA must consider these behavioral and circumstantial markers as evidence that MST occurred, even without a service record of the event (see 38 CFR § 3.304(f)(5)):

One-page guide: MST Lay Statement Guide Guide for firsthand lay statements about observed changes and timing. Opens the full-size chart, free to save or print.

How to Get Your Records

• Service Personnel Records: Request your complete personnel file from the National Personnel Records Center (SF-180 form). Look for performance evaluations, counseling statements, and any changes around the time of the trauma.
• Service Treatment Records: Request from NPRC. Look for mental health visits, STI tests, pregnancy tests, or any medical visits around the timeframe.
• Buddy Statements: Ask anyone who observed behavioral changes (spouse, roommate, fellow service member, family member) to write a statement describing what they noticed and when.

A VA Office of Inspector General audit (October 2023 - January 2024) found that 51% of MST claims were processed incorrectly.

Key findings:

• 46% of denied MST claims were denied without the VA ordering a required C&P exam
• The centralized MST Operations Center has 22.6% staff turnover (vs 7.5% VA-wide)
• Many claims processors lacked specialized MST training

The overall MST claim grant rate is 63%, up from 40% a decade ago. This means the system is improving, but errors remain common. Having strong evidence and a VSO representative significantly improves your chances.

If the VA orders a Compensation & Pension exam for your MST claim, know these rights:

• You can request the gender of your examiner. If you are more comfortable with a female or male examiner, tell the VA when scheduling. This is your right.
• You can bring a support person - a friend, family member, VSO representative, or victim advocate can accompany you.
• You do not have to describe the assault in graphic detail to the examiner. A factual summary is sufficient. The examiner is assessing your current symptoms, not investigating the event.
• Describe your worst days. The examiner rates your current level of impairment. Be honest about how bad it gets: frequency of nightmares, panic attacks, difficulty working, relationship problems.
• If the examiner seems dismissive or uninformed about MST, document this and report it to your VSO representative. You can request a new exam.

MST can cause or worsen conditions beyond PTSD. Consider filing for these as secondary to your MST-related primary diagnosis:

• Sleep disorders - insomnia, nightmares, sleep apnea (secondary to PTSD)
• Migraines - chronic headaches secondary to PTSD/anxiety
• Eating disorders - anorexia, bulimia (separately ratable)
• Substance use disorders - secondary to PTSD/depression
• Fibromyalgia - research links trauma to central sensitization
• Sexual dysfunction - directly related to MST
• Irritable Bowel Syndrome (IBS) - stress-related gastrointestinal conditions
• TMJ / teeth grinding - stress and anxiety-related

Each secondary condition requires a nexus letter from a medical provider linking it to your primary MST-related diagnosis. Use our Secondary Conditions tool →

MST-related treatment is free for every veteran, regardless of:

• Whether you have a service-connected disability rating
• Whether you are enrolled in VA healthcare
• Whether you reported the MST during service
• Your discharge status
• Your gender

You do not need to provide documentation that MST occurred to receive free treatment. Simply tell the VA you experienced MST and they must provide care.

If your discharge characterization was influenced by MST: the Kurta memo (2017) directs the Discharge Review Board and BCMR to apply liberal consideration to upgrade applications connected to MST. See the record-corrections guide for the DRB / BCMR / DARB paths.

Types of Treatment Available

• Individual therapy - including Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE)
• Group therapy - MST-specific support groups
• Medication management - for depression, anxiety, sleep, nightmares
• Residential/inpatient programs - intensive treatment programs for MST survivors
• Vet Center counseling - confidential counseling in non-clinical community settings

One-page guide: MST Coordinators and Support Roles Roles of VHA and VBA MST coordinators, accredited representatives, and claim examiners. Opens the full-size chart, free to save or print.

MST Coordinators

Every VA medical center has a designated MST Coordinator who can connect you with treatment, answer questions, and help you work through the system. Ask at the front desk or call your local VA medical center.

• Vet Center Confidential Call Center: 877-927-8387 - 24/7, MST counseling in non-clinical settings
• VA Health Benefits Hotline: 877-222-8387
• VA MST Information: va.gov/health-care/health-needs-conditions/military-sexual-trauma
• Vet Center Locator: vetcenter.va.gov
• Find a VSO Representative: Search 18,600+ accredited reps →
• RAINN National Sexual Assault Hotline: 800-656-4673