Section 1151 VA Claims—What They Are and How to File
CCK Law: Our Vital Role in Veterans Law
An 1151 claim allows veterans to receive VA disability compensation for an injury or illness caused by improper VA medical care or by a VA training program, even if the condition has nothing to do with their military service. Under 38 USC § 1151, VA must pay compensation for these conditions in the same manner as service-connected disabilities.
The key facts veterans need to know:
- VA negligence, surgical error, a VA health exam, or an unforeseeable complication can all qualify.
- Veterans must prove a direct link between VA care and the resulting disability. Simply receiving VA care is not enough.
- Surviving spouses and dependents may file an 1151 claim if a veteran died as a result of qualifying VA care, making them potentially eligible for Dependency and Indemnity Compensation (DIC).
- There is no statute of limitations. Veterans can file an 1151 claim at any time, though filing sooner generally results in an earlier effective date.
- These claims are among the most difficult VA claims to win. Strong medical evidence and, often, an independent expert opinion are essential.
What Is an 1151 VA Claim?
An 1151 VA claim is a VA disability compensation claim filed under 38 USC § 1151. The statute instructs VA to compensate a veteran for a qualifying additional disability—or a worsened existing disability—as if the condition were service connected, even though it arose from VA care rather than military service.
Under § 1151 and its implementing regulation, 38 CFR § 3.361, qualifying circumstances fall into two categories:
1. VA Hospital Care, Medical Treatment, or Examination
The additional disability must have resulted from the “carelessness, negligence, lack of proper skill, error in judgment, or similar instance of fault” on VA’s part—or from “an event not reasonably foreseeable” given the treatment being provided. A known surgical risk or complication that was disclosed and consented to does not qualify.
2. VA Vocational Rehabilitation or Compensated Work Therapy (CWT)
The additional disability must have been proximately caused by the veteran’s participation in a Chapter 31 vocational rehabilitation program or a Section 1718 compensated work therapy (CWT) program. Claims in this category do not require evidence of negligence on VA’s part.
What Makes 1151 Claims Difficult to Win?
1151 claims are widely regarded as among the hardest VA disability claims to win. The evidentiary standard is similar to medical malpractice. Common challenges include:
- Proving fault. VA rarely admits errors, and the burden of proof rests entirely on the veteran.
- The “reasonably foreseeable” defense. VA often argues that a complication was a known risk of the treatment, even when the specific outcome was not anticipated.
- Countering VA’s own medical opinions. VA may issue internal C&P examination findings that contradict the veteran’s evidence, requiring the veteran to rebut them with an independent expert opinion.
- Documentation gaps. Incomplete or inconsistent medical records—especially records showing the veteran’s baseline condition before VA care—can significantly weaken a claim.
Assistance from an experienced VA-accredited law firm is highly recommended.
Who Is Eligible for an 1151 Claim?
You may be eligible for § 1151 compensation if you suffered an added disability—or an existing disability got worse—as a direct result of at least one of the following:
- VA carelessness or negligence
- VA medical or surgical treatment
- A VA health examination
- A VA vocational rehabilitation course (under 38 USC Chapter 31)
- VA compensated work therapy (under 38 USC § 1718)
The added disability must not have been a reasonably expected result or complication of the treatment.
Surviving spouses and dependents are also eligible. If a veteran died as a result of a qualifying event under § 1151, a surviving spouse or dependent may file for Dependency and Indemnity Compensation (DIC) rather than disability compensation.
How To Prove an 1151 Claim
1151 claims follow the same general structure as other VA disability claims, but with important differences in what must be shown.
A successful 1151 claim requires three elements:
- A current, medically diagnosed disability (or a worsened existing disability).
- A qualifying event: An occurrence during VA hospital care, medical treatment, or examination; or participation in a VA vocational rehabilitation or CWT program.
- A medical nexus: A competent medical opinion linking the disability to the qualifying VA event, with supporting evidence that the event resulted from VA fault or was not reasonably foreseeable.
Under 38 CFR § 3.361(c), actual causation is required. Merely showing that a veteran received care and now has an additional disability is not sufficient to establish the link.
Evidence that can support an 1151 claim includes:
- Medical records from the VA facility where the treatment occurred.
- Records documenting the veteran’s condition before and after the VA care.
- An independent medical opinion (nexus letter) from a qualified professional stating that the disability was at least as likely as not caused by the VA event.
- Documentation suggesting a departure from accepted medical standards or failure to obtain informed consent.
- Any written aftercare instructions or discharge paperwork from VA.
Watch CCK Law Partner April Donahower discuss recent developments in VA’s duty to assist in 1151 and federal tort claims:
How To File an 1151 Claim
There is no separate form for an 1151 claim. Veterans file using VA Form 21-526EZ, the standard Application for Disability Compensation and Related Benefits.
Steps to file:
- Gather evidence. Collect all relevant VA medical records, private medical records, and any documentation related to the qualifying VA event. If needed, obtain an independent medical opinion from a qualified physician.
- Complete VA Form 21-526EZ. In the section describing your disability and how it relates to your claim, clearly specify that you are filing under 38 USC § 1151 and describe the qualifying VA event.
- Submit your claim. File online through VA.gov, by mail, or in person at a VA regional office. An accredited veterans service organization, claims agent, or veterans law attorney can help you file.
- Respond to VA’s requests. VA may schedule a Compensation & Pension (C&P) examination. Attend all scheduled appointments and follow up on any additional evidence requests.
What About Filing Both an 1151 Claim and a Federal Tort Claim?
Veterans who were harmed by VA negligence may also consider a federal tort claim under the Federal Tort Claims Act (FTCA). These are separate legal avenues. The key differences include:
- Federal tort claims are civil lawsuits that can result in a lump-sum payment but have a strict two-year statute of limitations from the date of injury.
- 1151 claims result in monthly VA disability compensation, with no filing deadline.
- If a veteran wins both, VA is required to offset § 1151 benefits by the amount of the Federal Tort judgment or settlement. Veterans cannot receive double recovery for the same injury.
Because the FTCA deadline can expire while an 1151 claim is pending, veterans in this situation should consult an attorney promptly.
Watch CCK Law Partner Jenna Zellmer and Attorney Kaitlyn Degnan discuss how a court win by CCK Law helped shape the law for VA 1151 claims:
Frequently Asked Questions About 1151 Claims
What is a VA 1151 claim?
An 1151 claim is a request for VA disability compensation for a condition caused or worsened by VA medical care, a VA health examination, or participation in a VA vocational rehabilitation or compensated work therapy program. These claims are authorized under 38 USC § 1151 and are compensated as if the condition were service connected.
Is there a statute of limitations for an 1151 claim?
No. There is no statute of limitations for an § 1151 claim—veterans can file at any time. However, the effective date is generally the date the claim is received, so earlier filing typically means more retroactive back pay.
Does an approved 1151 claim change my disability rating?
No. VA will not change your existing disability rating. Instead, the additional compensation is calculated based on the severity of the new or worsened condition and added to your monthly payment amount.
What form do I use to file an 1151 claim?
There is no special 1151 form. Veterans file using VA Form 21-526EZ and specify in the claim that they are seeking compensation under 38 USC § 1151.
Can a surviving spouse file an 1151 claim?
Yes. If a veteran died as a result of a qualifying VA care event, a surviving spouse or dependent can file an 1151 claim for Dependency and Indemnity Compensation (DIC).
What evidence do I need to win an 1151 claim?
A successful 1151 claim typically requires VA and private medical records documenting the qualifying event and its outcome, and an independent medical opinion (nexus letter) establishing that the disability was caused by VA fault or an unforeseeable complication. Because these claims are highly complex, working with an accredited representative or veterans law attorney is strongly recommended.
If VA care caused a new disability or worsened an existing condition, CCK may be able to help. Learn more about CCK’s approach to VA disability appeals.
