VA Form 95

Claim for Damage, Injury, or Death

File a claim against the federal government under the Federal Tort Claims Act (FTCA) for damage to property, personal injury, or death caused by a VA employee's negligent or wrongful act.

Official VA Form

Opens the official VA.gov form in your browser. Print, complete, and submit through approved VA channels.

Use this official VA form to file your claim through approved VA channels.