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Understanding The 1151 VA Claim

Last updated: February 8, 2024

A 1151 VA claim is designed for veterans who experience additional disability or worsening of an existing condition due to VA medical care, surgery, treatment, or vocational rehabilitation.[1]

Veterans can file a 1151 claim online, by mail, in person, or with the assistance of a trained professional. The claim must demonstrate that the injury or condition was directly caused by VA care.

Success in a 1151 claim hinges on providing substantial evidence linking the veteran's injury or worsened condition to VA healthcare services.[2]

If a 1151 claim is denied, veterans have the right to appeal the decision. The appeals process offers several options, including Supplemental Claims, Higher-Level Review, and Board Appeals.

There is no specific deadline for filing a 1151 claim, allowing veterans to file at any time. However, filing early is advantageous as benefits may be backdated.

VA-accredited attorneys and law firms specialize in assisting veterans through the 1151 claims process, providing guidance on gathering evidence, filing claims, and appealing denials.[3]

Veterans Affairs (VA) claims are a crucial aspect of ensuring that veterans receive the compensation and care they deserve after serving their country. Among these, the 1151 VA claim holds significant importance due to its specific focus on injuries or disabilities resulting from VA hospital care, medical treatment, or vocational rehabilitation. This comprehensive guide aims to shed light on the intricacies of the 1151 VA claim, providing veterans and their families with the knowledge needed to navigate the claims process effectively.

Understanding The 1151 VA Claim

The 1151 VA claim, named after Section 1151 of Title 38, U.S. Code, allows veterans to receive compensation for injuries or illnesses that are a direct result of VA medical care, surgery, therapy, or training.[1] These claims are particularly relevant for situations where the care provided by VA facilities leads to additional health issues or exacerbates existing conditions. Understanding the eligibility criteria, the claims process and the type of compensation available is essential for veterans seeking to file a 1151 claim.

What Is A VA 1151 Claim?

A VA 1151 claim is not a statement of fault against the VA but rather a mechanism to acknowledge and compensate for the unintended consequences of VA-administered care. To be eligible for compensation under a 1151 claim, a veteran must prove that their injury or illness was caused by VA healthcare services, including hospital stays, surgeries, treatments, and vocational rehabilitation programs. This claim covers a wide range of outcomes, from minor injuries to severe disabilities and even death.

Eligibility Criteria:

  • The injury or illness must have occurred while receiving VA sponsored medical treatment or vocational rehabilitation.

  • The condition must not be a result of the veteran's willful misconduct.

  • The injury or illness must result in additional disability or the death of the veteran.

Compensation Details:

Compensation for 1151 claims can include monthly disability payments, which are determined based on the severity of the disability incurred. Additionally, if the injury or illness leads to the veteran's death, survivors may be eligible for dependency and indemnity compensation (DIC).

Fast Facts

Veterans' 1151 claims can hinge on whether they were fully informed about risks before VA treatments, underscoring the importance of clear VA-patient communication.

How To File An 1151 Claim

Filing an 1151 claim involves several steps to ensure your claim is ready for evaluation by the VA. Initially, veterans can file a claim online, by mail, in person, or with the assistance of a trained professional. When filing, it's crucial to demonstrate that the added disability or aggravation of an existing disability occurred as a direct result of VA medical care, VA vocational rehabilitation, or participation in a VA employment program. The specific form used to apply for 1151 benefits is the same across all filing methods. In the application, particularly in section V, you're asked to describe your disability and relate it to your service, specifying that you are seeking benefits under Section 1151​​​​.

What Evidence is Needed to Win 38 U.S.C. 1151 Claims?

To successfully win an 1151 claim, veterans must provide compelling evidence that their disability was directly caused or aggravated by VA-sponsored care. This includes showing that the disability was not a reasonably foreseeable result of the treatment received.[2] A strong claim will include:

  • Proof that the disability was an immediate or direct result of VA's negligence or lack of proper skill.

  • Medical evidence that the condition developed was unforeseeable based on the care received at the VA facility.

  • A nexus letter from a medical professional outside the VA system stating that the new or worsened condition was at least as likely as not a result of VA medical malpractice.

  • Documentation comparing the medical status before and after VA care.

  • Records from VA hospitals or medical facilities that demonstrate inadequate aftercare instructions​​​​.

Key Considerations For Filing An 1151 Claim

  • Documentation is Critical: Comprehensive medical records and evidence linking the injury or illness to VA care are essential for a successful claim.

  • Seek Expert Advice: Navigating the 1151 claim process can be complex. Consulting with VA-accredited representatives or legal professionals who specialize in veterans' benefits can increase the chances of a favorable outcome.

  • Understanding the Appeals Process: If a 1151 claim is denied, veterans have the right to appeal the decision. Familiarizing oneself with the appeals process is vital for pursuing further action.

Fast Facts

Denied 1151 claims have several appeal options, highlighting the VA's effort to ensure veterans can secure their deserved benefits.

The Impact Of 1151 Claims On Veterans' Lives

Filing a 1151 claim and receiving compensation can significantly impact a veteran's life, providing financial support and acknowledgment of the sacrifices made. Compensation can aid in covering medical expenses, rehabilitation costs, and loss of income due to disability, thereby offering a measure of relief and stability for veterans and their families.

Additional Resources

For veterans facing difficulties with VA medical malpractice or developing a disability due to VA care, various resources are available.[3] VA-accredited attorneys and law firms specialize in helping veterans and their families navigate the complex 1151 claims process and secure the compensation they deserve. These professionals provide invaluable assistance in gathering evidence, filing claims, and appealing denied claims. Veterans are encouraged to seek out these resources to ensure they have the support and guidance needed throughout the claims process​​.

Frequently Asked Questions

What differentiates a 1151 claim from other VA disability claims?

Unlike standard VA disability claims, which are based on injuries or conditions directly related to military service, a 1151 claim focuses on compensating veterans for injuries or conditions caused or aggravated by VA healthcare, including medical or surgical treatment, examinations, and vocational rehabilitation.

Can family members benefit from a 1151 claim if the veteran passes away?

Yes, if a veteran's death can be attributed to an injury or illness that falls under a successful 1151 claim, surviving family members may be eligible for Dependency and Indemnity Compensation (DIC), which offers monthly benefits to the spouse, children, or dependent parents of the deceased veteran.

How long does it take to process a 1151 claim?

The processing time for a 1151 claim can vary based on the complexity of the case, the need for additional evidence, and the current workload of the VA. While some claims may be processed within a few months, others may take longer. Veterans are encouraged to submit as much relevant evidence as possible to expedite the process.

Is it possible to receive both 1151 benefits and service-connected disability compensation?

Yes, veterans can receive compensation under a 1151 claim in addition to service-connected disability benefits. However, the compensation awarded under a 1151 claim will be offset by any service-connected disability payments that apply to the same condition.

What role does informed consent play in 1151 claims?

Informed consent is a critical factor in 1151 claims, especially in cases where the lack of informed consent prior to treatment results in adverse outcomes. If a veteran can demonstrate that they were not properly informed of the risks associated with a medical procedure or treatment that resulted in additional disability, this may strengthen their 1151 claim.

Can a denied 1151 claim be reopened?

Yes, if new and material evidence becomes available, a previously denied 1151 claim can be reopened. Veterans or their representatives must submit the new evidence to the VA for consideration, which could change the outcome of the initial decision.

Filing A 1151 VA Claim

Filing an 1151 VA claim can be a complex and daunting process, but armed with the right information and resources, veterans can navigate this pathway more confidently. Remember, the goal of the 1151 claim is to ensure that veterans receive the compensation they deserve for injuries or conditions caused by VA care. By meticulously preparing your claim, gathering comprehensive evidence, and seeking expert advice, you can significantly improve your chances of a favorable outcome. Veterans are encouraged not to face this process alone but to leverage the available resources and support. This journey, while challenging, is a vital step towards securing the benefits and recognition veterans rightfully deserve for their service and sacrifice.

Find out the procedure for filing disability claims with our detailed guide. Learn more by visiting Disability Help and exploring our comprehensive resources.

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Chloe Powers
Chloe works with policymakers on behalf of Disability Help to support their work at a strategic level, ensuring the conditions are in place for creative individuals and organizations to grow, reach their potential and effect relevant, sustainable change.
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