What is involved in an administrative claim when suing the VA?

VA malpractice lawsuits are filed against the U.S. government under a federal law called the Federal Torts Claims Act (FTCA).

File Standard Form 95

Before you (or your dependent) can sue, you have to make an administrative claim against the VA for the full amount of damages you have suffered. This claim can be made on a Standard Form 95 that is available from government agencies and U.S. Attorney offices.

You could file this on your own, but you should think carefully before doing so. You will never be able to ask for more damages than the amount you put on the form unless you can prove that the additional damages are based on evidence you couldn’t have known at the time you filed your administrative claim. For this reason, it’s important to know the amount of damages you might be entitled to receive. Attorneys is this area of law are equipped to help injured vets calculate damages.

The VA’s Response

Once an administrative claim is filed, the VA has 6 months to review and investigate the claim. It may then either accept the claim and pay it out in full, settle the claim for less, or reject the claim outright. If the VA rejects your claim, you may file a lawsuit in federal court to pursue the matter further. If the VA does nothing and 6 months goes by, this will be interpreted as a rejection of the claim.

Taking Your Case to Federal Court

If you wind up in federal court, you will sue under the FTCA. Overall, the FTCA allows you to file a lawsuit within 2 years of discovering your injury and what caused it. But given the 6-month time period needed to file and complete your administrative claim, you really only have a little over a year at most to begin taking action on your FTCA claim (and the federal court will dismiss your claim if you try to file it before your administrative claim period is done).

Case Studies: Administrative Claims and Lawsuits Against the VA

Case Study 1: John’s Administrative Claim

John, a military veteran, suffered injuries due to medical malpractice at a VA hospital. Seeking compensation, John filed an administrative claim against the VA using Standard Form 95. With the assistance of an attorney specializing in VA malpractice cases, John accurately calculated the damages he was entitled to receive. The VA responded within the mandated 6-month period, accepting the claim and agreeing to pay the full amount.

Case Study 2: Mary’s Administrative Claim

Mary, another veteran, filed an administrative claim against the VA for injuries she sustained during her treatment. She decided to handle the claim on her own and submitted Standard Form 95 without fully understanding the potential damages. As a result, Mary could only seek damages up to the amount stated on the form.

The VA reviewed her claim but offered a settlement for a lower amount than she believed she deserved. Dissatisfied with the settlement, Mary decided to pursue the matter further by filing a lawsuit in federal court.

Case Study 3: Robert’s Federal Lawsuit

Robert, a veteran, faced a complex case of medical malpractice at a VA facility. He filed an administrative claim, which was rejected by the VA. As the 6-month period elapsed without any response from the VA, it was interpreted as a rejection of the claim. Robert then proceeded to file a lawsuit in federal court, invoking the Federal Torts Claims Act. Due to the strict timeline involved, he ensured that his administrative claim period was completed before taking his case to federal court.