VA Section 1151 claims compensation for harm from VA care: requirements, deadlines and what wins
A Section 1151 claim asks VA to pay compensation, as if service connected, for a disability or death caused by VA medical care, a VA exam, vocational rehabilitation or work therapy. You must show VA care caused it and that VA was at fault, lacked your informed consent, or caused an unforeseeable event. The Board granted 7.5% of 5,753 decided rulings.
How the Board ruled on Section 1151 claims, 2021 to 2026
5,753
decided rulings in Claim Raven's library of Board of Veterans' Appeals decisions
- 7.5%granted
- 62.7%sent back
- 29.7%denied
- 7.5%of decided Board rulings on Section 1151 were grants
- 62.7%were sent back to VA, most often for an inadequate opinion
- 83.4%granted when the Board relied most on a private medical opinion
- 2 yearsto present a malpractice claim under the Federal Tort Claims Act
Board figures: Claim Raven's analysis of Board of Veterans' Appeals rulings on Section 1151, 2021 to 2026. Deadline: 28 U.S.C. 2401(b).
On this page
What is a Section 1151 claim?
A Section 1151 claim asks VA to pay compensation, as if it were service connected, for a disability or death caused by VA health care: hospital care, medical or surgical treatment, or a VA exam, or by VA vocational rehabilitation or compensated work therapy (38 U.S.C. 1151, 38 CFR 3.361).
- It is a VA benefits claim, not a lawsuit. You file it with VA like any disability claim, and it is rated and paid like a service-connected condition.
- It covers new and worsened conditions. VA compares your condition right before the care with your condition after it ended, body part by body part (38 CFR 3.361(b)).
- Survivors can use it too. If VA care caused a veteran's death, the survivor can claim DIC under Section 1151. See the DIC guide.
Section 1151 requirements: what you have to prove
Three things: you have an additional disability, VA care actually caused it, and the cause was VA's fault, care without your informed consent, or an event a reasonable provider wouldn't have foreseen (38 CFR 3.361(c) and (d)).
An additional disability
A new condition, or an existing one that got worse, measured from just before the care to after it ended.
Actual causation
The care resulted in the disability. Showing only that you had care and now have a disability isn't enough. Care can't cause the natural progress of the condition being treated, unless VA's failure to diagnose or treat it in time did. And harm from not following properly given medical instructions doesn't count.
One of three kinds of proximate cause
Fault: VA failed to use the care a reasonable health care provider would. No informed consent: VA treated you without the consent its rules require (38 CFR 17.32 (opens in a new tab)). Not reasonably foreseeable: the event wasn't an ordinary risk a reasonable provider would have expected or disclosed.
For vocational rehabilitation or compensated work therapy, the test is different: taking part in an essential activity of the program has to have caused the disability or death (38 CFR 3.361(d)(3)). Claims VA received before October 1, 1997 follow an older rule (38 CFR 3.358 (opens in a new tab)).
What Section 1151 doesn't cover
Care from a community provider under a VA contract (38 U.S.C. 1703) and nursing home care under 38 U.S.C. 1720 aren't VA care for Section 1151 purposes (38 CFR 3.361(f)). If a community care provider harmed you, the 1151 route generally doesn't apply.
Section 1151 claim or VA malpractice lawsuit: deadlines and the offset
They are two different routes. A Section 1151 claim is a VA benefits claim with no filing deadline, though filing within a year of the injury protects back pay. A malpractice claim under the Federal Tort Claims Act must be presented to the agency in writing within two years after it accrues (28 U.S.C. 2401(b) (opens in a new tab)).
- The 1151 effective date. If VA receives your claim within one year after the injury or worsening, the award can start from that date; otherwise it starts from the date VA receives the claim (38 CFR 3.400(i)(1)).
- You can pursue both, but you aren't paid twice. If you win a court judgment or settlement for the same disability, VA offsets your Section 1151 compensation by your share of it, including your share of attorney fees, before paying (38 CFR 3.362(b)).
- Lawyers for each. A VA-accredited attorney or agent can help with the 1151 claim; a malpractice lawsuit needs a lawyer who handles federal tort claims. If you might sue, watch the two-year clock.
Original research
How often the Board grants Section 1151 claims: what 5,753 rulings show
Section 1151 is one of the hardest claims to win at the Board. The Board granted 7.5% of 5,753 decided rulings from 2021 to 2026, against 24.7% across all issues, and sent 62.7% back to VA. When it made a final call, it granted 20.2%. The grant rate rose from 6.8% in 2022 to 11.0% in 2026 so far.
The remands tell the story: 66.2% were because the VA medical opinion wasn't adequate. An 1151 claim turns on a medical judgment about causation and the standard of care, and the Board needs an opinion that answers both.
Section 1151 claims at the Board, by year
Share of decided Section 1151 rulings granted, sent back and denied each year.
- 4.7% granted, 62.5% sent back, 32.8% denied
- 6.8% granted, 63.9% sent back, 29.3% denied
- 6.5% granted, 65.5% sent back, 28.0% denied
- 8.0% granted, 61.9% sent back, 30.1% denied
- 9.7% granted, 61.5% sent back, 28.8% denied
- 11.0% granted, 55.0% sent back, 34.0% denied
Source: Claim Raven analysis of Board of Veterans' Appeals decisions. Dismissed and withdrawn appeals are left out.
What the Board relied on most, and how often it granted
Rulings on Section 1151 claims the Board granted or denied, 2021 to 2026, by the evidence it relied on most. The share is granted. Across all of them, 20.2% were granted (2,145 rulings).
Remands are left out, because the Board weighs the evidence only when it grants or denies. Associations, not causes. Source: Claim Raven analysis of Board decisions.
When the Board relied most on a VA opinion (75.6% of final decisions), it granted 13.2%. When it relied most on a private medical opinion, it granted 83.4%. A doctor writes a favorable opinion when the records support one, so this shows which claims had that support, not that any opinion wins.
Why the Board sent Section 1151 claims back to VA
Share of 3,608 remanded rulings, 2021 to 2026. A remand can give more than one reason.
Source: Claim Raven analysis of Board decisions.
Section 1151: grant rate by Board docket
Appeals under the current system (AMA), 2021 to 2026. Granted out of every decided ruling, remands included.
Source: Claim Raven analysis of Board decisions. What went together, not proof that a docket caused a result: veterans with new evidence tend to pick the evidence docket.
How to file a Section 1151 claim, and what wins
File it as a disability compensation claim and say it is under Section 1151, naming the VA care and the harm (VA.gov (opens in a new tab)). Then build the medical case: what your condition was before, what VA did, what went wrong and why a reasonable provider would have done otherwise.
Section 1151 evidence checklist
- VA records from before the care showing your condition then
- The records of the care itself: notes, operative report, medication records
- The signed informed consent form, and what risks it listed
- Records after the care showing the new or worse condition
- A medical opinion from an outside doctor on causation and on the standard of care, or on why the event wasn't a foreseeable risk
- Your own statement and statements from family on what changed
- Any malpractice claim, judgment or settlement, which VA will offset
If VA denies it, you have a year to choose a Supplemental Claim with new evidence, a Higher-Level Review or a Board appeal. Compare them with the Appeals Advisor.
What happened to Section 1151 claims after a remand
Legacy appeals the Board sent back and then decided again on the same docket, with the second decision in 2010 to 2026: 2,705 appeals. 12.9% were granted the second time, and 17.9% came back with nothing new the Board relied on.
Associations, not causes: a doctor usually writes a private opinion because the facts support the claim. Appeals under the 2019 system start a new docket each time, so they cannot be followed this way. More: what happens after a VA remand.
Questions veterans ask about 1151 claims
What is a 1151 claim?
A claim for VA compensation, paid as if service connected, for a disability or death caused by VA hospital care, medical or surgical treatment, a VA exam, VA vocational rehabilitation or compensated work therapy.
Is there a statute of limitations for a 1151 claim?
There is no filing deadline for the VA claim, but filing within one year of the injury lets the award start from the injury date; later, it starts from the date VA receives the claim. A malpractice claim under the Federal Tort Claims Act has a separate two-year deadline to present it in writing.
Can I file a 1151 claim and a malpractice lawsuit?
Yes, but you aren't paid twice. VA offsets your Section 1151 compensation by your share of any judgment or settlement for the same disability, including your share of attorney fees.
Does Section 1151 cover community care?
Generally no. Care from a community provider under a VA contract and nursing home care under 38 U.S.C. 1720 aren't VA care for Section 1151 purposes.
Do I have to prove VA was negligent?
Not always. You can show VA failed to use reasonable care, that VA treated you without proper informed consent, or that the harm was an event a reasonable provider wouldn't have foreseen.
How often does the Board grant 1151 claims?
Rarely. In Claim Raven's library, the Board granted 7.5% of 5,753 decided Section 1151 rulings from 2021 to 2026 and sent 62.7% back to VA, most often for an inadequate medical opinion.
Sources and method
Board data. Claim Raven reads every Board of Veterans' Appeals decision in its library ruling by ruling: 1,378,030 rulings in 511,036 decisions from 2021 to 2026, each tagged with the issue it decided, the outcome in the decision's order and what the Board relied on. This page counts the 6,232 rulings on Section 1151 claims. Grant rates are granted out of granted, denied and sent back (remanded); dismissed and withdrawn appeals are left out because the Board never decided them. "What the Board relied on" is read only on rulings the Board granted or denied, so it compares with that group's own grant rate. Groups under 100 rulings aren't shown. The library holds only part of 2021's decisions. These figures show what went together in decided appeals, not what caused a result, and they are appeals, not VA's first decisions. The full method is on the VA disability statistics page.
Rules (checked against the eCFR and U.S. Code text on 2026-10-06):
- 38 U.S.C. 1151; 38 CFR 3.361, 3.362, 3.400(i), 17.32 (opens in a new tab) and 3.358 (opens in a new tab)
- 28 U.S.C. 2401(b) (opens in a new tab) (Federal Tort Claims Act time limit)
- VA.gov: Title 38 U.S.C. 1151 claims (opens in a new tab)
Cite this page
Claim Raven. VA Section 1151 claims: requirements and Board outcomes. Board data 2021 to 2026. https://claimraven.com/section-1151
Claim Raven explains VA rules in plain English so you can work your own claim. It is not legal advice, and Claim Raven is not affiliated with the Department of Veterans Affairs. Board outcomes describe appeals that reached the Board; they don't predict any one claim.