The Six-Month Letter: Navigating the VA's Administrative Claims Process Before You Can Sue

Before any veteran can file a lawsuit against the VA for medical malpractice, they must file an administrative claim using Standard Form 95. The VA then has six months to investigate and respond. This mandatory administrative process is supposed to allow the government to resolve claims without litigation. In practice, it's six months of waiting with minimal communication and, usually, a final denial.

Here's how it typically unfolds: Veterans file SF-95 with detailed information about what happened, when, and what injuries resulted. The VA Regional Counsel's office acknowledges receipt with a form letter. Then—silence. No updates, no status inquiries, no communication about the investigation's progress.

During those six months, the VA presumably reviews medical records and investigates the claim. Veterans aren't part of that process. They don't know what the VA is finding, who they're interviewing, or how the claim is being evaluated. They just wait.

In our experience handling FTCA cases nationwide, most administrative claims receive denial letters on the very last day of the six-month period. Not after four months, not after two months. Day 180 or 181. The VA uses every available day, then issues denials that often provide minimal explanation for the decision.

This waiting period creates practical problems. Evidence can disappear, memories fade, and witnesses become harder to locate. Meanwhile, claimants can't file suit, can't take depositions, can't preserve testimony. They're frozen while the clock runs on the two-year statute of limitations.

Some claims receive settlement offers during the administrative process. These offers are often far below case value and aren't really negotiable in the traditional sense. Veterans can accept or reject, but they can't counter-offer or negotiate terms during the administrative phase. Accepting means signing away all rights to further claims. Rejecting means proceeding to litigation.

The six-month waiting period also complicates deadline management. If veterans file administrative claims close to the two-year statute of limitations, they might have only days to file a federal lawsuit after receiving their denial. Miss that deadline, and valid claims die.

In our practice, we've learned to file administrative claims as early as possible to preserve time for litigation if needed. We use the six months to continue investigating, consulting with experts, and preparing for potential litigation. We can't formally conduct discovery during the administrative phase, but we can prepare.

The administrative process should theoretically promote early resolution and avoid unnecessary litigation. Instead, it functions primarily as a mandatory waiting period that benefits the government while claimants watch evidence deteriorate and deadlines approach. It's frustrating for veterans who've already waited too long for VA healthcare to now wait six more months for legal responses.

But it's the only path to eventually pursuing FTCA claims in federal court, so understanding and managing this process becomes critical for protecting legal rights.