Denied a PACT Act Claim? You May Still Have a VA Malpractice Case

Last Updated: July 28, 2026

A denied PACT Act claim can feel like the end of the road. It isn't — but the next door is often a different one than veterans expect. In the PACT Act's first year, the VA processed 458,659 PACT Act-related claims and paid out more than $1.85 billion in benefits, according to the VA's own PACT Act resource page. Millions of other claims did not result in an award. If yours was one of them, there are two separate paths forward: appealing the benefits decision itself, and — in a smaller but important set of cases — a completely different legal claim against the VA for the medical care you received.

Does a Denied PACT Act Claim Mean You Have No Options?

No. A denied PACT Act disability claim can be challenged through the VA's own appeals system, and in some cases the underlying facts of your denial point toward a second, separate legal claim: an FTCA medical malpractice claim against the VA under 28 U.S.C. § 1346(b). These are two different legal systems with different rules, different deadlines, and different kinds of compensation, and a denial in one does not close the door on the other.

What's the Difference Between a PACT Act Claim and a VA Malpractice Claim?

A PACT Act claim is a request for VA disability compensation — a monthly benefit paid because a condition is connected to your military service, including the expanded list of presumptive toxic-exposure conditions the PACT Act added. It is processed by the Veterans Benefits Administration under 38 U.S.C. § 1151 and related disability-compensation statutes. There is no fault requirement — you generally do not have to show anyone did anything wrong, only that your condition and your qualifying service meet the statute's terms.

An FTCA malpractice claim is a completely different legal action. It seeks money damages — not a monthly benefit — because a federal medical provider's negligence caused you a new injury: a missed diagnosis, a delayed screening, a surgical error, or a medication mistake at a VA facility. It is filed under 28 U.S.C. § 1346(b), which lets you sue the United States for "injury or loss of property, or personal injury or death caused by the negligent or wrongful act or omission" of a federal employee, "under circumstances where the United States, if a private person, would be liable" under state law. You can read more about how this works in our guide to VA malpractice settlements and VA disability benefits.

Why Was My PACT Act Claim Denied?

VA benefits denials are procedural, not accusations that nothing happened to you. Common reasons a PACT Act or related toxic-exposure claim gets denied include:

1. No current diagnosis on file. The VA generally requires medical evidence of a current, diagnosed condition — not just symptoms or a history of exposure.
2. The condition isn't on the presumptive list. The PACT Act added more than 20 presumptive conditions for burn pit and other toxic exposures, plus additional presumptive-exposure locations for Agent Orange and radiation — but conditions outside that list still require the veteran to independently prove a service connection.
3. Missing or incomplete service records. Establishing the qualifying service period or exposure location is a documentation problem the VA sees often.
4. The rating decision undervalued the severity. A partial grant at a low rating is still technically a "denial" of the rating you sought.

None of these reasons, by themselves, suggest anything went wrong with the medical care you received. But some denials do point that way — and that is the case worth a second look.

Could Your Denial Signal a VA Malpractice Claim Instead of (or In Addition to) a Benefits Appeal?

Sometimes the same facts that led to a PACT Act denial also reveal that VA medical staff were negligent — for example, if VA providers failed to screen you for a condition despite a documented exposure history, misread test results, or delayed a diagnosis long enough for a treatable condition to progress. In 38 U.S.C. § 1151, Congress created a separate VA benefits pathway for exactly this kind of harm: compensation "in the same manner as if such additional disability or death were service-connected" when it is proximately caused by VA hospital care, medical or surgical treatment, or examination, and the proximate cause was VA "carelessness, negligence, lack of proper skill, error in judgment, or similar instance of fault," or an event that was not reasonably foreseeable.

A § 1151 claim still runs through VA benefits channels. An FTCA malpractice claim is different again: it is a lawsuit against the United States, filed first as an administrative claim and — if necessary — later in federal district court, and it can include categories of damages neither VA disability compensation nor a § 1151 award covers, such as pain and suffering, past and future medical expenses, and lost earning capacity attributable to the malpractice itself.

If a delayed cancer diagnosis is part of your story, our guide on VA cancer misdiagnosis claims explains how a missed or delayed diagnosis can become a separate malpractice claim.

What Are My Appeal Options After a PACT Act Denial?

If you want to challenge the benefits decision itself, the VA's own decision review process offers three options:

• Supplemental Claim — you submit new and relevant evidence the VA didn't have before, including evidence that your condition is now on the presumptive list. According to VA's own reported processing data, the average Supplemental Claim for disability compensation was completed in 58.5 days as of June 2026.
• Higher-Level Review — a more senior VA reviewer takes a fresh look at the existing record. You cannot submit new evidence at this stage.
• Board of Veterans' Appeals — a formal appeal decided by a Veterans Law Judge.

These review options exist inside the VA benefits system and do not require an FTCA claim, a Standard Form 95, or a lawsuit. They are worth pursuing on their own if you believe the rating decision itself was wrong.

The 2-Year Deadline That Applies Only to the Malpractice Track

This is the detail that catches people who are focused on their benefits appeal and don't realize a separate clock may be running. VA disability claims, including § 1151 claims, have no statute of limitations — Congress repealed the original filing deadline in 1962. An FTCA malpractice claim is different: under 28 U.S.C. § 2401(b), "a tort claim against the United States shall be forever barred unless it is presented in writing to the appropriate Federal agency within two years after such claim accrues."

The Supreme Court addressed what "accrues" means in United States v. Kubrick, 444 U.S. 111 (1979): the clock starts when you know both the existence of your injury and its cause — not when you later learn that a lawyer would call it negligence. In practice, this means the two-year deadline for a malpractice-based claim can expire while a PACT Act benefits appeal is still working its way through VA review, because the benefits appeal has no deadline pressure of its own. Filing the required Standard Form 95 is the first step in preserving an FTCA claim, and it should not wait on the outcome of a separate benefits appeal. For the full mechanics of how that deadline works, see our guide to the FTCA statute of limitations.

Can You Pursue Both a PACT Act Claim and an FTCA Malpractice Claim?

Yes. These are separate legal systems, and pursuing one does not require giving up the other. Filing an FTCA claim does not affect your VA disability rating or your VA healthcare enrollment. If you already have a § 1151 claim, an FTCA settlement can affect the timing of certain overlapping benefit payments, so coordinating both tracks with the same case team matters. Our guide on VA malpractice settlements and VA disability benefits walks through how the offset rules work in practice.

What to Do If You Think Your PACT Act Denial Involves VA Negligence

1. Request your complete VA medical records — not just the file used for your benefits decision, but the full treatment record around the time of the denial.
2. Note the dates. When did symptoms first appear in your records? When was the condition finally diagnosed? That gap is the heart of a delayed-diagnosis malpractice claim.
3. Keep pursuing your benefits appeal on its own timeline — a Supplemental Claim, Higher-Level Review, or Board Appeal is not affected by whether you also explore a malpractice claim.
4. Get the malpractice question answered early, because the two-year FTCA clock under § 2401(b) does not wait for your benefits appeal to finish.

Frequently Asked Questions

Does a denied PACT Act claim mean I don't have a malpractice case? No. A benefits denial and a malpractice claim ask different legal questions. A benefits denial means the VA did not find your condition met the disability-compensation criteria. A malpractice claim asks whether VA medical staff were negligent in diagnosing or treating you. You can lose the first and still have the second.

Do I have to choose between a benefits appeal and a malpractice claim? No. You can pursue a VA benefits appeal (Supplemental Claim, Higher-Level Review, or Board Appeal) and an FTCA malpractice claim at the same time. They run on separate tracks with separate rules.

What's the deadline for the malpractice track? Under 28 U.S.C. § 2401(b), an FTCA claim generally must be presented in writing to the VA within two years of when you knew of your injury and its cause, per United States v. Kubrick. There is no equivalent deadline for a VA benefits appeal.

Will an FTCA claim affect my VA disability benefits or healthcare? No. Your VA disability rating and VA healthcare enrollment are separate systems and are not automatically reduced or terminated by filing an FTCA claim. Coordination matters only where a 38 U.S.C. § 1151 award and an FTCA settlement overlap.

What's the first step if I think VA negligence is part of my story? Request your complete VA medical records and have them reviewed for gaps between when symptoms appeared and when the condition was diagnosed or treated, then speak with an attorney before the two-year FTCA deadline runs.

Related Articles

• Veterans Medical Malpractice & the FTCA → — how FTCA works for VA malpractice claims nationwide
• VA Malpractice Settlement vs. VA Disability Benefits → — how the two systems interact and offset
• Standard Form 95: How to File an FTCA Claim → — the required first step in any malpractice claim
• FTCA Statute of Limitations → — the 2-year deadline explained in full
• Feres Doctrine Explained → — why the Feres doctrine does not bar veterans (only active-duty claims)
• Misdiagnosis and Failure to Diagnose Cases → — when a delayed diagnosis becomes malpractice
• Military & VA Medical Malpractice in California → — state-specific FTCA claim information

The information provided on this website does not, and is not intended to, constitute legal advice. All information, content, and materials available on this site are for general informational purposes only. Readers should contact their attorney to obtain advice concerning any legal matter.

The author, EJ Archuleta, J.D., is a 13-year federal practice lawyer. He is licensed to practice law in the courts of the State of Texas, is a member of the State Bar of Texas, and is admitted to the United States District Court for the Western District of Texas. He has helped hundreds of military service members, veterans, and their families receive compensation for injuries and wrongful death caused by the Department of Veterans Affairs.