What is VA Form 21-4138?

VA Form 21-4138, the Statement in Support of Claim, is a form where you write a statement in your own words to support a VA claim. It describes what happened, your symptoms, and how the condition affects you.

What makes a strong statement?

Describe your worst days, not your average day. VA rating criteria turn on how often and how badly your symptoms flare. Be specific: how often, how severe out of 10, what you cannot do, how long it lasts, and how it affects work, sleep, and daily life.

Is anything I type saved or sent anywhere?

Nothing is uploaded or sent. The builder runs entirely in your browser. Your draft is saved only on your own device so you don't lose it, and you can clear it anytime with Start fresh.

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VA Personal Statement Builder

A Statement in Support of Claim is where you tell the VA, in your own words, what happened and how it affects you. This builder follows the structure that works: it asks about your typical day and your worst days, because VA ratings turn on how often and how badly your symptoms flare.

🔒 Private: it runs entirely in your browser. Nothing is uploaded or sent. Your draft is saved on this device so you don't lose it — use Start fresh to wipe it, especially on a shared computer.

The one rule that matters most

Describe your worst day, not your average day. Ratings turn on how often and how badly your hardest episodes hit — so that's what the VA needs to read.

This isn't exaggerating, it's being complete. Most veterans understate what they actually live with.
Be specific: "once or twice a month I can't get out of bed for a day" tells them far more than "my back is about a 4 out of 10."
Stick to what you personally went through. This is your firsthand account, in your own true words.

The basics

Your name

VA claim number

Condition this is about

Date

The examples below change to match the condition you type.

What happened in service

The event or exposure

What happened, when and where, and whether you sought treatment at the time (and why not, if you didn't).

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Example — write your own

Your symptoms

A typical day

The day-to-day baseline. What the condition is like on an ordinary day.

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Example — write your own

The worst days (this matters most)

How often it flares, how bad it gets out of 10, what you can't do, and how long it lasts. Be specific — this is what the rating turns on.

This section carries the most weight. Add how often it flares, how bad out of 10, what you can't do, and how long it lasts.

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Example — write your own

How it affects you

Work

Days missed, tasks you can't do, changes you've had to make.

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Example — write your own

Sleep

How it affects your rest.

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Example — write your own

Daily life and relationships

Activities you've given up, help you need, effect on family and social life.

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Example — write your own

Since you separated

Continuity of the condition

Has it been continuous or gotten worse? When were you first treated? If there was a gap before diagnosis, explain why.

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Example — write your own

A strong statement covers

✓ What happened in service

✓ Your worst days (how often, how bad)

✓ Impact on work, sleep, or daily life

✓ Continuity since you separated

Style

Your statement

0 words

Fill in the fields and your statement builds here.

How to use it

Fill in the prompts, then Copy or Download your statement. Send it to the VA one of two ways: paste it into VA Form 21-4138 (PDF) and mail or upload it, or use the online Submit a statement in support of a claim tool on VA.gov. Read it over once, make sure every word is true, and sign the actual form. For the full breakdown of what wins a claim, see the Evidence That Wins guide.

This tool is a drafting aid, not legal advice. It helps you organize your own words; it does not write your claim for you, supply a medical opinion, or guarantee any outcome. A nexus opinion must come from a provider. Veteran Field Manual is an independent educational resource, not affiliated with, endorsed by, or representing the U.S. Department of Veterans Affairs or any government agency. Informational only, not legal, medical, or VA-accredited claims advice. Review your statement, make sure it is true and complete, and submit it on the official VA Form 21-4138 or through VA.gov.