A tort claim against the United States, based on a negligent or wrongful act or omission of an employee of the Department of Veterans Affairs acting within the scope of his or her employment, may be filed by the injured person or his or her legal representative using Standard Form 95, Claim for Damage, Injury, or Death; however, use of the SF 95 is not mandatory as long as the following requirements are met: 1) detailed allegation; 2) sum certain (total dollar amount claimed in damages); and 3) signature of appropriate claimant.

Standard Form 95 (SF 95), Claim for Damage, Injury, or Death, must be submitted with every claim based on property damage, injury, or death caused by Government employees acting within the scope of their employment. Read the instructions on both sides of the form and complete the SF 95 as accurately as possible.