Part VIII, Subpart iv, Chapter 6, Section ADeveloping Claims Filed Under 38 U.S.C. 1151

Revised August 18, 2025

VIII.iv.6.A.1.a#General Information About Claims Filed Under 38 U.S.C. 1151

38 U.S.C. 1151 provides for the payment of compensation for additional disability or death proximately caused by

• Department of Veterans Affairs (VA)
  • hospital care
  • medical or surgical treatment, or
  • examination
• participation in vocational rehabilitation training, or
• participation in compensated work therapy.

Disabilities and/or causes of death recognized under this provision of law are compensated “ as if ” service-connected (SC), but are not actually SC.

• entitlement to benefits under 38 U.S.C. 1151, see M21-1, Part VIII, Subpart iv, 6.B, and
• considering direct and presumptive service connection in 1151 claims, see M21-1, Part VIII, Subpart iv, 6.B.6.a.

VIII.iv.6.A.1.b#Possible Sources of Information About the Incident

Documentary evidence pertinent to the incident upon which the claim is based may assume many possible forms, including

• medical records
• surgical records
• hospital clinical records, and/or
• nurses’ notes.

Upload to the Veteran’s electronic claims folder any and all clinical reports, progress notes, and hospital summaries associated with the incident in question housed in the

• Compensation and Pension Record Interchange (CAPRI), and/or
• Joint Logitudinal Viewer (JLV).

VIII.iv.6.A.1.c#Requesting Information From the Medical Facility

For all claims under 38 U.S.C. 1151, request comprehensive evidence of the claimed incident using CAPRI’s electronic VA Form 10-7131, Exchange of Beneficiary Information and Request for Administrative and Adjudicative Action , request functionality. Select the 7131 REQUEST tab in the patient’s CAPRI record; check the OTHER/EXAM (REVIEW REMARKS) box; and cut and paste the following text into the COMMENTS field, populating necessary details about the claimant where appropriate: We have received a claim from the person identified below for benefits under 38 U.S.C. 1151 based on alleged injury while at your facility. _Name:__File Number:_SSN:Date of Birth: The claimant alleges sustaining an injury to the [condition]. This injury occurred on [MM-DD-YYYY]. To assist us in making a determination, please furnish all of the following evidence, if available, for this patient for the period of medical care from[MM-DD-YYYY]to[MM-DD-YYYY]:

• medical records
• surgical records
• hospital clinical records
• nurses’ notes, and
• any other documentation of patient injury.

Note: The electronic VA Form 10-7131 in CAPRI

• supports text entry of up to four pages, and
• maintains tracking information regarding the status of requests.

References: For more information on

• obtaining VA medical records, see M21-1, Part III, Subpart ii, 1.A.2
• obtaining records in 1151 claims, see M21-1, Part VIII, Subpart iv, 6.B.5.f, and
• requesting medical opinions for 1151 claims, see
  • M21-1, Part IV, Subpart i, 2.A.7.g, and
  • M21-1, Part VIII, Subpart iv, 6.B.5.g.

VIII.iv.6.A.1.d#Quality Assurance Investigative Reports

Request quality assurance investigative reports only if the claimant

• identifies these records as evidence necessary to substantiate the claim
• identifies quality assurance records consistent with 38 U.S.C. 5103A(b)(1), and
• furnishes sufficient information to locate the records consistent with 38 U.S.C. 5103A(c)(2).

Notes:

• If the Veterans Health Administration (VHA) denies access to these records, request an Office of General Counsel (OGC) review.
• An OGC review is not appropriate when VHA denies access to these records because they are no longer available.

References: For more information on

• the documents that qualify as quality assurance reports, see
  • 38 CFR 17.501, and
  • VAOPGCPREC 1-2011, and
• when and how to contact OGC, see M21-5, Chapter 7, Section G, 1.j.