Reviewed by Jonathan Teplitsky · Updated August 2026
What a VA 1151 claim is
A VA 1151 claim asks the Department of Veterans Affairs to pay disability compensation for an injury that VA care itself caused. The claim takes its name from 38 U.S.C. § 1151, the statute behind it. The harm needs no connection to your military service.
Ordinary service connection requires a link between your disability and your service. A 1151 claim does not. A veteran who developed a nerve injury during a VA surgery in 2019 can claim it, even with a spotless service record.
When VA grants the claim, the statute directs it to pay "in the same manner as if such additional disability or death were service-connected." You receive the same monthly rates on the same rating schedule as any other rated veteran. The rules on back pay and dependents apply unchanged.
VA draws one line around that language. It treats the disability as service-connected for payment purposes only. A 1151 grant is therefore never a finding that your military service caused anything.
Who qualifies for a 1151 claim
You qualify when VA care caused a new disability or worsened an existing one. On treatment, surgery, and exam claims, VA must also have been at fault or the outcome must have fallen outside the ordinary risks. VA lists five settings where this can happen, and at least one must have led directly to the added disability.
- VA carelessness or negligence
- VA medical or surgical treatment
- A VA health examination
- A VA vocational rehabilitation course under 38 U.S.C. chapter 31
- VA compensated work therapy under 38 U.S.C. § 1718
Willful misconduct disqualifies a claim. An injury you brought on through your own misconduct sits outside the statute, whatever VA did afterward.
The vocational rehabilitation and work therapy settings run on a lighter test. Under 38 U.S.C. § 1151(a)(2) and 38 CFR § 3.361(d)(3), a veteran hurt during a VA-run job training placement does not have to show fault or an unforeseeable event. That veteran has to show that participation in what the regulation calls "an essential activity or function" of the VA program proximately caused the disability.
The two routes to a 1151 grant
On care, treatment, and exam claims, VA law gives you two separate routes to a 1151 grant. Only one of them has to succeed. The first is fault by VA, and the second is an outcome that nobody should have expected.
The fault route turns on one standard. VA must have failed "to exercise the degree of care that would be expected of a reasonable health care provider," which is set at 38 CFR § 3.361. The statute names carelessness, negligence, lack of proper skill, error in judgment, or a similar instance of fault. That last phrase is the catch-all for conduct the first four labels do not fit.
The second route drops fault entirely. It asks whether the injury was "an event not reasonably foreseeable." The regulation reads that as a result a reasonable provider would not have treated as an ordinary risk of the care given.
Nobody has to have done anything wrong for the second route to work. Say your surgeon met the standard of care, and the result was still rare and outside the risks you were told about. That is the fact pattern the foreseeability route was written for.
Pleading only fault leaves that second route unused. Name both in writing when you file. VA decides the claim on the theory the record raises.
What counts as an added disability
VA measures added disability by comparing your condition immediately before the care to your condition after that care stopped. Each affected body part or system gets its own comparison. The method is written into 38 CFR § 3.361.
Natural worsening of a disease you already had usually does not count. If your kidney function would have declined at the same pace without the treatment, there is no added disability for VA to pay. The question is what the care changed.
38 CFR § 3.361(c)(2) carries one exception that matters. Natural progress does count when VA's failure to timely diagnose and properly treat the disease caused that progress. A missed diagnosis or a delayed treatment can therefore support a 1151 claim of its own.
Proximate cause carries its own regulatory definition. It is "the action or event that directly caused the disability or death, as distinguished from a remote contributing cause." A distant or partial contribution will not carry the claim.
Informed consent as a second path to fault
Care delivered without informed consent can establish VA fault even when the treatment itself was competent. The consent rules sit at 38 CFR § 17.32. A provider who never disclosed a risk that then materialized may have missed that standard.
Paperwork gaps alone will not win a claim. The regulation says minor deviations that are immaterial do not defeat a finding of informed consent. The gap has to have mattered to the decision you made.
Request your consent forms early. They are part of your VA medical record, and you can ask for them alongside the operative reports and treatment notes.
A 1151 claim compared with a Federal Tort Claims Act suit
A 1151 claim and a tort suit are two different remedies for the same injury, and you may pursue both. The 1151 claim pays monthly compensation through the benefits system. A Federal Tort Claims Act (FTCA) claim seeks a one-time money judgment from the government.
| Criterion | VA 1151 claim | FTCA claim |
|---|---|---|
| What it pays | Monthly disability compensation | One-time money damages |
| Where it is filed | VA benefits system | VA Office of General Counsel |
| Form used | VA Form 21-526EZ | Standard Form 95 |
| Deadline to file | No statutory filing deadline | Two years from when the claim accrued |
| Representation | Free accredited representative available | Typically a private attorney |
| Verdict | Start here in almost every case | Add it when damages run past what monthly compensation covers |
Winning both triggers an offset. Under 38 U.S.C. § 1151(b), VA withholds monthly payments once an FTCA judgment or settlement becomes final, until the withheld benefits equal the amount in that judgment. The benefit is delayed rather than lost.
The deadlines are where veterans get caught. An FTCA claim must reach the agency within two years of when it accrued. No statute sets a comparable deadline on a 1151 claim, so a veteran who is years out of time in court may still have a live benefits claim worth filing.
Filing later costs you back pay rather than eligibility. Under 38 U.S.C. § 5110(a)(1), an award on an original claim cannot be dated earlier than the date VA received the application.
How to file a VA 1151 claim
You file a 1151 claim on the same form as any other disability claim. No VA form carries the number 1151. Use VA Form 21-526EZ, the Application for Disability Compensation and Related Compensation Benefits.
- Name the claim. Write that you are claiming benefits under 38 U.S.C. § 1151, and identify the VA treatment, examination, or program involved.
- Identify the added disability. State the body part or system affected and the date the care took place.
- Request your VA records. Ask the treating facility for treatment notes, operative reports, and consent forms.
- Get a medical opinion. A physician has to link the added disability to the VA care and address fault or foreseeability. Our nexus letter guide covers what that opinion needs to say.
- Submit and track it. File online, by mail, or in person. VA's 1151 claims page lists the current filing channels.
A free accredited representative can file the claim for you. VA's representative search lists accredited organizations, agents, and attorneys by state. The general steps in our guide to filing a VA claim apply here too.
The evidence that decides these claims
A 1151 claim turns on the medical opinion more than on any other document. VA already holds the treatment records, so the records alone rarely decide anything. The opinion is what tells the rater whether the care caused the harm.
A useful opinion does four things. It states your condition before the care and your condition after it. It says the care caused the difference between them. It then addresses either the standard of care or whether the outcome was an ordinary risk.
Expect VA to order its own examination. A C&P exam with a causation opinion is a normal development step on these claims, and it stretches the VA claim timeline.
If VA denies your 1151 claim
A denied 1151 claim moves through the same review lanes as any other denial. You can file a Supplemental Claim with new evidence, request a Higher-Level Review, or appeal to the Board. Our guide on a denied VA claim walks through the three lanes.
Read the decision for which element failed, because the fix differs. A causation denial needs a stronger medical opinion. A fault denial may need the foreseeability argument raised instead, using the same records you already filed.
Attorney fees are barred on an initial claim and permitted only after VA issues a decision. Our page on whether you need a VA appeals attorney explains how those fee rules work.
Your next step
Start by pulling the VA records for the care that injured you. Request the treatment notes, the operative report, and the signed consent form from the facility that provided it. Those three documents decide whether a medical opinion can be written at all.
Then file VA Form 21-526EZ and state the section 1151 claim in plain words. A free accredited representative can handle both steps at no cost to you.