What Form Should I Use for a VA Buddy Statement?

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The specific form you use for a VA buddy statement is far less important than the structure and content of the letter.

However, the VA provides two official forms that are commonly used for buddy letters:

• VA Form 21-4138 (Statement in Support of a Claim): This is a widely used form for submitting written statements to support your VA disability claim, including personal statements and VA buddy letters.

• VA Form 21-10210 (Lay/Witness Statement): This newer form is designed specifically for lay evidence to provide firsthand observations about the veteran’s disability.

Alternatively, you can simply draft the buddy letter using a simple word processing program, such as Microsoft Word.

Once finalized, save the document as a PDF and upload it as supporting evidence to VA.gov.

Whichever method you choose, the most critical factor is ensuring the letter includes detailed, factual observations that effectively support your claim.

Summary of Key Points

• Purpose of a VA Buddy Letter: A VA buddy letter is a firsthand written account providing additional evidence to support a VA disability claim. These statements fill gaps in medical evidence by addressing symptoms, events, or experiences not fully documented in official records.

• Who Can Write a Buddy Statement: Eligible individuals include anyone 18 years or older with firsthand knowledge of the veteran’s condition. Common sources include fellow service members, spouses, family members, friends, coworkers, supervisors, and spiritual leaders.

• VA Forms for Buddy Letters: The VA offers two official forms for submitting buddy letters (#1) VA Form 21-4138: A widely used general-purpose form for written statements. (#2) VA Form 21-10210: A newer, more structured form designed specifically for lay evidence. Alternatively, buddy letters can be drafted in a word processor, saved as a PDF, and uploaded to VA.gov.

• Tips for Writing a Strong Buddy Letter: Effective buddy letters are clear, concise, fact-based, and aligned with VA rating criteria. They should be written by firsthand witnesses, focus on specific observations, and highlight the impact of the veteran’s condition on daily life, work, and relationships.

What is a VA Buddy Letter?

A VA buddy letter, also known as a lay statement, is a firsthand written account from someone who has directly observed the severity and impact of a veteran’s disability.

This letter is used to provide additional evidence to support a VA disability claim by addressing symptoms, events, or experiences that may not be fully documented in the veteran’s medical records.

Buddy letters can fill in critical gaps, offering context and personal insight into how a veteran’s condition affects their daily life, work, and relationships.

These statements are especially impactful for claims where medical evidence is incomplete or the nexus between the disability and military service needs further support.

Who Can Write a Buddy Statement?

A VA buddy letter can be written by anyone 18 years of age or older who has firsthand knowledge of the veteran’s condition, symptoms, or experiences.

These individuals provide unique perspectives and insights that can help strengthen a veteran’s VA disability claim.

Common sources of VA buddy letters include:

• Fellow Service Members: These are some of the most impactful sources of buddy letters, as they can corroborate in-service events, injuries, or observed symptoms.

• Spouse: Offers detailed observations of how the veteran’s disability affects home life, relationships, and daily functioning.

• Adult Children: Can share how the veteran’s condition impacts family dynamics or the ability to perform parenting responsibilities.

• Family Members: Parents, siblings, or extended relatives can provide insight into the veteran’s struggles and how they’ve changed over time.

• Pastor: A spiritual leader can describe the veteran’s challenges, emotional struggles, or behavioral changes from a moral or community perspective.

• Close Friends: Friends who frequently interact with the veteran can attest to symptoms, limitations, or behavioral changes.

• Co-workers: Observations from a professional setting can highlight how the veteran’s disability affects work performance and responsibilities.

• Boss/Supervisor: Provides valuable insights into how the veteran’s disability affects job performance, attendance, or ability to handle work responsibilities. This can be especially impactful for claims involving occupational impairments.

VA Buddy Statement Forms: Does It Matter Which Form I Use?

The form you use for a VA buddy statement is far less important than the structure, content, and credibility of the letter itself.

That said, the VA provides two official forms specifically designed for buddy letters:

#1. VA Form 21-4138 (Statement in Support of a Claim):

The VA Form 21-4138 is one of the most commonly used forms for submitting personal and buddy statements to support VA claims.

It provides a simple format for detailing observations and includes a certification that the information is true and accurate.

#2. VA Form 21-10210 (Lay/Witness Statement):

The VA Form 21-10210 is a newer form specifically tailored for lay evidence, allowing firsthand witnesses to document their observations in support of a veteran’s claim.

It provides a structured format for detailing how the writer knows the veteran, what they observed, and how the disability impacts the veteran’s life.

Tips for Writing a Strong VA Buddy Letter

The most impactful VA buddy statements are written by firsthand witnesses, such as a fellow servicemember who served alongside the veteran on active duty or a spouse who has directly observed the veteran’s condition, severity of symptoms, and the negative effects on their work, life, and social functioning.

• Ensure Firsthand Observation: The buddy must be a firsthand witness who directly observed your disability, symptoms, and the negative impacts on your work, life, and daily activities. This makes the buddy letter credible and increases its probative value in the VA’s eyes.

• Be Clear and Concise: Focus on providing detailed, specific observations without overloading the letter with unnecessary information. Think “less is more.” VA raters (VSRs and RVSRs) have limited time, so aim for 3-5 well-written paragraphs that get straight to the point.

• Stick to the Facts: Avoid speculation or assumptions. The buddy should only share factual, observable information about the veteran’s condition and its impacts. If the buddy cannot provide concrete examples, find someone else who can offer relevant details.

• Align with VA Rating Criteria: When possible, connect the observations in the buddy letter to the severity of symptoms outlined in the VA’s Schedule for Rating Disabilities (38 CFR Part 4). This helps the VA understand how the veteran’s condition matches specific rating percentages for the claimed disability.

Here’s a simple 4-part structure with example content to follow to write a winning buddy statement:

Part #1: Explain Your Relationship to the Veteran and How You Know Them

Begin your VA buddy letter by establishing your relationship with the veteran and the length of time you’ve known them.

Be specific to build credibility.

Example:

“My name is Jane Smith, and I am the sister of veteran [INSERT VETERAN’S NAME].

I’m writing this statement on behalf of [VETERAN’S NAME] to provide insight into her struggles with severe migraines and how they began during her active-duty military service.

I have known [VETERAN’S NAME] my entire life as her sibling, and I witnessed many of the challenges she faced during and after her time in the military. Over the years, we have remained close, interacting frequently through family gatherings, phone calls, and visits.”

Part #2: What You Directly Witnessed or Are Witnessing

Describe, in detail, what you observed about the veteran’s condition during and after their military service.

Include specific examples of events or symptoms.

Example:

“During her time in the Army, particularly after her deployment to Iraq in 2008, [VETERAN’S NAME] began experiencing frequent, debilitating headaches. She often mentioned the intense pressure in her head, sensitivity to light, and nausea after long days in high-stress environments.

When she returned home in 2009, it was clear these headaches had worsened. I remember a family gathering in December 2009 where [VETERAN’S NAME] had to leave early because she was in so much pain from the bright holiday lights and noise. She would frequently retreat to a dark room, sometimes for hours, unable to participate in everyday activities.”

Part #3: List and Explain the Veteran’s Current Severity of Symptoms

Detail the current symptoms of the disability and how they negatively impact the veteran’s work, life, and social functioning.

Use real-life examples to make it personal and relatable.

Example:

“Over the years, [VETERAN’S NAME]’s migraines have significantly impacted her daily life. She experiences severe headaches 3-4 times per week, often accompanied by nausea, vomiting, and an inability to tolerate light or sound.

These episodes are so debilitating that she struggles to maintain a consistent work schedule, often missing workdays or needing extended breaks. I have personally witnessed her becoming frustrated and overwhelmed when her migraines disrupt her ability to care for her children or attend family events.

The migraines have also taken a toll on her mental health. She frequently expresses feelings of hopelessness and anxiety, fearing the next episode and its effects on her responsibilities and relationships. It is my firm belief that these symptoms are connected to her military service, where prolonged exposure to stress and environmental hazards likely triggered her condition.”

Part #4: Certify, Sign, and Date

End the letter with a formal signature, date, and a statement certifying that the information provided is true and accurate to the best of your knowledge.

Be sure to include your contact information such as your email address and phone number.

Example:

“I CERTIFY THAT the statements on this form are true and accurate to the best of my knowledge and belief.” Feel free to contact me at the email address and phone number listed in my signature block below. Thank you for your time and consideration in this matter.

Example VA Buddy Letter for PTSD

Here’s a sample buddy statement for combat-related PTSD.

You’ll need to edit this letter and content for your specific situation.

Note: This is a fictional example for illustration purposes only.

Click the link or button below to download our VA buddy letter template:

Part #1: Explain Your Relationship to the Veteran and How You Know Them

My name is John Doe, and I served alongside veteran [INSERT VETERAN’S NAME] in the United States Army during our deployment to Iraq from January 2005 to December 2005.
We were both assigned to [INSERT UNIT] and worked closely together on a daily basis in [INSERT SPECIFIC DUTY].

I am writing this statement on behalf of [VETERAN’S NAME] to describe the traumatic events we experienced together in Iraq and how those experiences have negatively impacted him over the years.

Having served side by side, I had the unique opportunity to witness firsthand the challenges he faced during service and the lingering effects of those experiences on his mental health.

Part #2: What You Directly Witnessed or Are Witnessing

During our deployment, [VETERAN’S NAME] and I were frequently subjected to rocket and mortar attacks at our base in [INSERT LOCATION].

I vividly remember one particular night in April 2005 when our base came under heavy fire. Rockets and mortars exploded nearby, shaking the ground and forcing us to take cover in bunkers for hours.

I saw the fear and stress on [VETERAN’S NAME]’s face as we waited, unsure if the next explosion would hit us directly. This was not an isolated incident as rocket and mortar attacks happened weekly, sometimes daily, throughout our deployment.

I also recall [VETERAN’S NAME] struggling to sleep at night, often startled awake by loud noises or nightmares. He would sit quietly, visibly shaken, and sometimes mentioned feeling “on edge” or unable to relax.

After returning home, I noticed significant changes in [VETERAN’S NAME]’s behavior. He avoided social gatherings and became irritable in loud or crowded environments. During a reunion in 2010, he confided in me about persistent nightmares involving the rocket and mortar attacks, as well as frequent flashbacks triggered by loud noises like fireworks or construction sounds.

Part #3: List and Explain the Veteran’s Current Severity of Symptoms

Over the years, I’ve seen [VETERAN’S NAME] struggle with symptoms that I believe are directly linked to the traumatic events we experienced in Iraq.

He frequently mentions having trouble sleeping due to recurring nightmares about the attacks, which leave him exhausted, irritable, and unable to focus during the day. His sleep disturbances often lead to severe fatigue and increased agitation, impacting his ability to perform basic daily tasks.

He also experiences episodes of severe anxiety and panic attacks, especially in situations where he feels confined or when he hears sudden loud noises. For example, during a Fourth of July celebration in 2018, he had to leave abruptly because the sound of fireworks caused him to panic, reliving the terror of the mortar attacks. These events trigger flashbacks that completely disconnect him from the present, leaving him visibly shaken and emotionally distraught.

[INSERT VETERAN’S NAME] has also expressed persistent difficulty maintaining close relationships, including feelings of detachment and estrangement from loved ones. He avoids situations that remind him of the deployment and often isolates himself from family and friends. He has mentioned feeling emotionally numb and has struggled to connect with his spouse and children.

In addition, I’ve observed instances of hypervigilance, where he is constantly scanning for threats, even in safe environments. This hyper-awareness causes extreme irritability, outbursts of anger, and an inability to relax or enjoy everyday activities. He also suffers from impaired memory and concentration, often forgetting important tasks or conversations, which has made it difficult for him to hold steady employment.

More concerning, [VETERAN’S NAME] has expressed feelings of hopelessness and has admitted to experiencing suicidal thoughts during particularly dark periods. His depression and emotional instability have significantly affected his ability to find purpose and meaning in life.

It is my firm belief that these severe symptoms, including flashbacks, panic attacks, insomnia, hypervigilance, emotional detachment, and suicidal ideation, are the result of the trauma he endured during our deployment. He was a dedicated and strong soldier, but these experiences have left deep and lasting scars on his mental health, impacting every aspect of his life.

Part #4: Certify, Sign, and Date

I CERTIFY THAT the statements on this form are true and accurate to the best of my knowledge and belief.

Please feel free to contact me at the email address or phone number listed below if additional information or clarification is needed.

Signed,
John Doe
[DATE]
[EMAIL ADDRESS]
[PHONE NUMBER]

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