VA 1151 Claims for Veterans (2024)

Published on by Neil Woods
Last Updated on December 28, 2023

1151 claims, sometimes referred to as VA medical malpractice claims, cover conditions caused or worsened while under VA-sponsored medical care or training. This type of claim allows a veteran to earn VA disability even though the veteran’s condition or death isn’t a result of their military service.

Filing an 1151 claim and knowing what evidence is required can be challenging. This article will help you understand what a VA 1151 claim is, how to file a claim, and what evidence you need to support your claim.

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In this article about VA 1151 claims:

  • What is a VA 1151 claim?
  • Who is eligible to file a VA 1151 claim?
  • How to file an 1151 claim
  • What evidence is needed to win 38 U.S.C. 1151 claims?
  • Additional resources are available

What is a VA 1151 claim?

Millions of veterans every year receive medical care at a VA facility or participate in VA job-training programs.

Unfortunately, VA medical malpractice can leave veterans with an aggravated disability or a new condition, or could even lead to death. If you’re a veteran that experienced VA medical negligence or an added or aggravated disability because of VA care, you can file a VA 1151 claim.

If you are the surviving spouse or dependent of a veteran who qualifies in this category, you could be eligible for Dependency and Indemnity Compensation (DIC) for VA medical malpractice.

Claims granted under VA 1151 are not for conditions related to service, but veterans are compensated in the same way as a service-connected disability. These claims also use the same diagnostic codes and rating criteria as service-connected disabilities.

Who is eligible to file a VA 1151 claim?

A VA 1151 claim is designed for veterans that suffer from an added disability or from an existing disability that got worse due to any of the following:

  • VA carelessness or negligence
  • VA medical or surgical treatment
  • A VA health exam
  • A VA vocational rehabilitation course
  • VA compensated work therapy

If your added disability was directly caused by VA medical care, and the added disability wasn’t a reasonably expected result or complication of the treatment, you could be eligible to earn VA benefits by filing an 1151 claim. However, if you meet one or more of the criteria above, but your new or worsened condition is an expected complication of surgery or treatment, you won’t be eligible for compensation under 1151.

How to file an 1151 claim

Fortunately, there is no statute of limitations on filing a VA 1151 claim, meaning you can file a claim at any time.

A VA 1151 claim can be filed in several ways:

  • Online
  • By mail
  • In person at a VA regional office near you
  • With the help of a VA-accredited attorney or accredited VSO or claims agent

The application you need to complete for 1151 benefits is the same, regardless of how you choose to file it. In section V of this application form, you’ll be asked to describe your disability and how it relates to your service. Here you can specify that you are seeking benefits payable under Section 1151.

VA 1151 Claims for Veterans (1)

What evidence is needed to win 38 U.S.C. 1151 claims?

Veterans will need to provide proof that their disability was “as least as likely as not” caused or aggravated by their VA-sponsored care. Only providing evidence that a veteran received care or treatment at a VA medical facility, and that the veteran has an additional disability or died does not prove it was the VA’s fault.

A strong 1151 claim should include evidence showing that as a result of VA hospitalization, medical or surgical treatment, examination, or training, you have:

  • An additional disability or disabilities, or your existing injury or disability was aggravated, or death;
  • AND your disability was an immediate or direct result of VA carelessness, negligence, lack of proper skill, or error in judgment,
  • OR your disability or injury is not a reasonably foreseeable result or complication of the VA care or treatment;
  • OR is the direct result of participation in a VA Veterans Readiness and Employment or Compensated Work Therapy (CWT) program.

VA disability lawyer Cecilia Ton said, “Medical evidence is extremely important in the 1151 cases because the veteran has to show that the disability that they developed was unforeseeable from the type of care that they received at the VA facility.”

Examples of evidence that could help support your 1151 claim include:

  • A nexus letter from a medical professional stating that your new or worsened condition was at least as likely as not a result of VA medical malpractice.
  • Documentation from a medical professional that compares your medical status before and after VA care.
  • Paperwork from a VA hospital or VA medical facility showing that you did not receive accurate or thorough aftercare instructions.

They have shown me nothing but professionalism and quick responsiveness to any situation. Without this firm, I truly believe I would not have gotten all the benefits that I was eligible and entitled to receive. I have referred 16 veterans to this law firm.

VA 1151 Claims for Veterans (2)

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Additional resources are available

There is help available should you experience VA medical malpractice or develop a disability due to VA care. The VA-accredited attorneys at Woods and Woods have decades of experience with helping veterans and their families get the compensation they deserve. If you need additional resources or a referral to help you file an 1151 claim, give us a call.

Talk to Us About Your Claim:
(812) 426-7200

Get a Free Consultation Today!

FREQUENTLY ASKED QUESTIONS

Is there a deadline or statute of limitations to file a VA 1151 claim?

There is no statute of limitations on filing a VA 1151 claim, meaning, you can file a claim at any time.

Who is eligible to file an 1151 claim?

A VA 1151 claim is reserved for veterans that suffer from a new or aggravated disability as a result of any of the following:
1. VA carelessness or negligence
2. VA medical or surgical treatment
3. A VA health exam
4. A VA vocational rehabilitation course
5. VA compensated work therapy

Related Articles about VA Disability Benefits

VA 1151 Claims for Veterans (2024)

FAQs

What evidence is needed to win a 38 USC 1151 claim? ›

The VA typically approves 1151 claims that show carelessness, negligence, errors in judgment, lack of proper skill, or other faults on the part of the VA when furnishing hospital or medical care or examinations.

What is the average compensation for the PACT Act? ›

Based on current compensation rates, a single veteran with no children and a 60% disability rating may be entitled to over $1,000 in compensation per month. This amount increases to over $3,000 with a 100% VA disability rating.

What is the success rate of the VA supplemental claims? ›

The VA does not publish success rates for Supplemental Claims, so the exact number is not known. However, in my experience, I'd estimate a 50% success rate if you submit new and relevant evidence not previously considered. That means one in two veterans will get a successful VA higher level review decision.

How does an 1151 claim work? ›

In 1151 claims, VA issues compensation “in the same way [it] would” for service-connected disabilities. This means you would be entitled to a certain amount of monthly compensation depending on your combined disability rating.

What is the time limit for a VA 1151 claim? ›

Fortunately, there is no statute of limitations on filing a VA 1151 claim, meaning you can file a claim at any time. A VA 1151 claim can be filed in several ways: Online.

What to say to get 70% PTSD compensation? ›

There aren't any "magic words" you can use to automatically get, say, 70% disability compensation for PTSD. You should instead focus on making sure that your stressor statement describes the traumatic events that led to you developing PTSD, as well as how your life has changed since your diagnosis.

What VA claims can they not prove? ›

No, there aren't any VA disability claims that cannot be proven. In fact, all VA claims must be proven on an “at least as likely as not” basis. If you have no evidence (no proof), your VA claim will be denied. Also, you must first ensure you're even eligible for VA disability benefits under the law.

What is the fastest VA claim decision? ›

The Decision Ready Claim (DRC) Program is the fastest way to get your VA claim processed. With the DRC Program, you can get a decision on your claim within 30 days by working with an accredited Veterans Service Organization (VSO).

Does VA deny most claims? ›

Why are claims denied? The Veteran Affairs website reports that 75 percent of all initial applications for VA benefits are denied. These applications are often denied because they have incomplete information or lack necessary documentation.

Which type of medical opinion is required for an 1151 claim? ›

Section 1151 claims, similar to a medical mal-practice claim against the VA, have been know to be very difficult to win. To offset the VA's very high standard of proof, the Veteran or survivor should consider obtaining a competent medical opinion that the VA was at fault for the disability or death of the Veteran.

What is the difference between 1151 and tort claim? ›

You can file a lawsuit under the Federal Torts Claims Act (FTCA) when any employee of the VA acts negligently and causes you an injury. In contrast, Section 1151 is limited to claims of injury resulting from a VA hospital, outpatient clinic, medical examination or surgery.

Can a surviving spouse file an 1151 claim? ›

A veteran or surviving spouse can initiate a section 1151 claim by filling out an application online through eBenefits or by contacting his/her VA Regional Office.

How to prove arthritis is service connected? ›

This evidence can be submitted as a doctor's report or a report from a hospital showing your arthritis diagnosis. Once the evidence is received, the VA will proceed in the following ways: The VA will review your service medical records to determine if you were seen or treated for arthritis during your active duty.

What can be used as evidence for VA claim? ›

All private medical records related to the claimed condition, like reports from your own doctor or X-rays or other test results from a non-VA hospital or other treatment center, and. Any records of medical treatment you've received for the claimed condition while serving in the military, and.

How to prove back pain is service connected? ›

How to Prove a Service Connection for Back Pain
  1. First, you'll need a current diagnosis.
  2. Second, you'll need an in-service injury, stressor, or illness. ...
  3. Finally, you'll need to prove that there's a link between your current diagnosis and your in-service injury or stressor.
Apr 25, 2024

What are the three new VA presumptive conditions? ›

What if VA denied my claim for bladder cancer, hypothyroidism, or Parkinsonism in the past? We added these conditions to the presumptive condition list in 2021.

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