Once a claimant submits a Standard Form 95 to the VA, 28 U.S.C. § 2675(a) gives the agency up to six months to investigate and respond before the claimant can legally file suit. Understanding what happens, and roughly when, during that window can make an otherwise anxious wait a little more predictable.
General Timeline:
- Weeks 1–4: The VA logs the claim and typically assigns it to a VA attorney or investigator for initial review.
- Months 1–3: The assigned attorney typically requests the full medical record and may interview the healthcare providers involved at the VA facility. The VA also consults a medical reviewer to assess the standard of care (negligence) and causation (harm) questions. The VA has no legal obligation to share any information about its investigation with the claimant.
- Months 3–6: The VA continues its investigation.
- Month 6+: In recent years, VA attorneys have taken an average of 12–18 months to complete the initial investigation, obtain medical expert input, and decide whether to deny the claim or attempt to settle it.
- After denial (or after six months of silence): The claimant has the option to file a lawsuit in federal district court. Deciding whether to sue or keep waiting for a VA decision is complex, and you should make that choice in consultation with your attorney, if you have one.
For a more detailed, practice-based walkthrough of this exact period, see our earlier post, The Six-Month Letter: Navigating the VA’s Administrative Claims Process Before You Can Sue. If your claim is approaching this deadline, our VA malpractice team can help you understand where your case stands and what to expect next.
If a VA healthcare provider or VA facility has injured you or a loved one, you may be able to recover compensation. Contact our office and schedule a free consultation.