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Section 1151 is a lifeline that can offer support to veterans with injuries or conditions that occurred due to the negligence or fault of a VA healthcare provider. We’ll explain what Section 1151 is, how it differs from standard VA disability benefits, and how you can make a VA claim under this provision.

What Is Section 1151?

Section 1151 is part of Title 38 of the United States Code, the law that governs veterans’ benefits. This specific section is designed to protect veterans who have been harmed due to the negligence or shortcomings of the VA’s medical staff or facilities. The provision allows you to claim benefits for injuries or medical conditions that happened because of:

  1. Mistakes made during medical treatment at a VA facility.
  2. Lack of proper care or improper actions during your stay at a VA facility.
  3. Surgical errors or other medical mishaps.

In essence, Section 1151 is there to support veterans who have experienced harm due to the VA’s fault. It’s a way for the government to take responsibility for any mistakes that happen under their watch.

These are benefits above and beyond the standard VA disability benefits you may already be receiving. Knowing about Section 1151 can be invaluable because it can open doors to additional support and compensation for you.

Section 1151 Claims vs. Standard VA Benefits

The world of VA benefits can be confusing, with various types and categories to navigate. However, understanding the differences between standard VA disability benefits and Section 1151 claims can be a game-changer.

  • Origin of Condition: Standard benefits are for service-related conditions, while Section 1151 claims are for conditions caused by VA medical care.
  • Purpose: Standard benefits aim to compensate for service-related harm, whereas Section 1151 aims to compensate for harm due to medical errors or negligence.
  • Claim Process: The procedures to claim these two types of benefits are different and require different sets of documents and evidence.

Standard VA Disability Benefits

Standard VA disability benefits are provided to veterans who have sustained injuries or suffer from conditions that are related to their military service. Here’s what they usually cover:

  1. Physical Injuries: Such as loss of limb, hearing loss, or other bodily harm.
  2. Mental Health Conditions: Like post-traumatic stress disorder (PTSD) or depression.
  3. Illnesses: Acquired during or after your service, including diseases like Agent Orange exposure.

Section 1151 Claims

Section 1151 is a bit different. These benefits are not for injuries or conditions directly caused by your military service, but rather for those that occur due to the negligence or mistakes made by VA healthcare providers. Under Section 1151, you can claim benefits for:

  1. Medical Errors: Including surgical mistakes or wrong medication dosage.
  2. Inadequate Care: Such as failure to diagnose or treat a medical condition properly.
  3. Mistreatment: Any improper action that led to your harm while in a VA facility.

How to File a Section 1151 Claim

Before diving into the paperwork, you must first meet specific conditions to qualify for a Section 1151 claim. You must be able to demonstrate that:

  1. You have a new or worsened medical condition.
  2. This condition was caused or aggravated by VA medical care or treatment.
  3. The care or treatment did not meet the generally accepted standards in the medical community.

The Filing Process

  1. Consult Medical Records: Thoroughly review your VA medical records to find evidence that supports your claim.
  2. Seek Professional Opinion: If possible, consult an independent medical professional for an opinion linking your condition to the VA’s negligence or fault.
  3. Fill Out the Appropriate Forms: The primary form for a Section 1151 claim is VA Form 21-0966 (Intent to File a Claim). You may also need additional forms based on your specific circumstances.
  4. Compile Evidence: Along with the forms, prepare all supporting documentation, such as medical reports, eyewitness accounts, or expert opinions.
  5. Submit Your Claim: Once everything is prepared, you can submit your claim either online, by mail, or in person at a VA facility.
  6. Follow Up: Keep track of your claim status and be prepared to attend any required medical examinations or interviews.

Documents Required for a Section 1151 Claim

  1. Completed VA Form 21-0966 (Intent to File a Claim)
  2. Medical records and reports supporting your claim
  3. Statements from eyewitnesses, if applicable
  4. Any additional evidence that strengthens your claim

Challenges and Pitfalls in Section 1151 Claims

Navigating the legal landscape of Section 1151 claims can sometimes feel like walking through a maze. It’s crucial to know the potential challenges you might face and how to avoid common pitfalls.

Legal Complexities

Section 1151 claims are fraught with legal nuances that can make or break your case. Here are some of the legal challenges you may encounter:

  1. Burden of Proof: Proving that the VA’s negligence directly caused your condition can be challenging.
  2. Statute of Limitations: You usually have one year from the date of knowledge of the injury to file your claim, which can be a narrow window.
  3. Technicalities: Legal language and documentation requirements can be complex, potentially leading to mistakes or omissions.

Common Mistakes

  1. Incomplete Documentation: Failing to submit all required forms and supporting documents can stall or even derail your claim.
  2. Lack of Medical Evidence: Insufficient or unclear medical records may weaken your case substantially.
  3. Missed Deadlines: Failing to file your claim within the prescribed time frame can result in forfeiture of your benefits.

To navigate these challenges successfully, it may be wise to seek professional assistance, like hiring an experienced VA disability attorney who specializes in Section 1151 claims. They can provide targeted advice and help you build a strong case.

FAQs About Section 1151

What conditions are eligible for a Section 1151 claim?

Any condition that was caused or worsened due to the negligence, errors, or shortcomings of VA medical staff or facilities can qualify for a Section 1151 claim.

Do I need a lawyer to file a Section 1151 claim?

While you can file a claim on your own, the process is intricate and often requires legal expertise. Consulting with an attorney who specializes in VA disability and Section 1151 claims can increase your chances of a successful outcome.

How long does it take for a Section 1151 claim to be processed?

The duration can vary widely depending on the complexity of your case and the evidence provided. Generally speaking, it could take several months to a year for a decision.

Can I appeal if my Section 1151 claim is denied?

Yes, you can appeal a denied claim. The appeal process is another complex undertaking and it’s highly advisable to seek legal counsel for it.

How are Section 1151 benefits calculated?

Benefits are usually determined based on the severity of your condition, just like standard VA disability benefits. However, under Section 1151, you may also be eligible for additional compensation for suffering and inconvenience.

Can I file for both standard VA disability benefits and a Section 1151 claim?

Yes, you can file for both. They are not mutually exclusive and, in fact, a Section 1151 claim can provide benefits in addition to your standard VA disability benefits.

Case Studies: Real-world Examples

Sometimes the best way to understand the ins and outs of Section 1151 claims is to look at actual cases. These real-world examples can offer insights into what works and what doesn’t, and can provide you with a clearer perspective on the process.

Case Study 1: Surgical Error

  1. Background: A veteran underwent surgery at a VA facility and experienced severe complications due to a surgical error.
  2. Outcome: Filed a Section 1151 claim, backed by medical evidence and expert opinions, leading to a successful grant of benefits.
  3. Lesson: The importance of collecting robust medical evidence and expert testimonies can’t be overstated.

Case Study 2: Misdiagnosis

  1. Background: A veteran was misdiagnosed for a serious condition, which led to ineffective treatment and worsened health.
  2. Outcome: Initially denied benefits due to lack of direct evidence. Hired a VA disability attorney and successfully appealed the decision.
  3. Lesson: Legal expertise can be crucial, especially in complicated cases where initial claims may be denied.

Case Study 3: Delay in Treatment

  1. Background: A veteran had to wait an extended period to receive treatment, exacerbating their condition.
  2. Outcome: Faced challenges in proving that the delay was due to VA negligence but ultimately succeeded by presenting internal VA correspondence as evidence.
  3. Lesson: Sometimes unconventional forms of evidence, like internal communications, can tip the scales in your favor.

These case studies show that every Section 1151 claim is unique, and various factors can influence the outcome. However, strong evidence, timely filing, and legal expertise often play critical roles in the success of a claim.

Have Questions About Appealing Your Claim or Understanding How the Claims Process Works?

The attorneys at Hill & Ponton are here to support you with appealing a claim to get benefits. If you are intending to appeal a denied VA disability claim, you can contact us for an evaluation and we can help you with this process.

However, if you are considering filing an initial claim, or even if you are interested in learning about the appeals process, we offer a free ebook to get you started on the right foot!

The Road to VA Compensation Benefits will help break down the claims process from start to finish. Click the link below to learn more.

Written by

Claire Szewczyk

Claire Szewczyk is a former US Airforce civilian employee who worked at Hill Air Force Base in Layton, UT as a flight testing administrator. She has also spent several years working with the Department of Veterans Affairs audiology programs in Salt Lake City, UT and Pocatello, ID. She enjoys working with the Veteran population and keeping them up to date with information they need the most.