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HomeResourcesLegalLSCLSC Claims Division

USCG Judge Advocate General

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A Civilian Not Employed by the Coast Guard

**•Who may file a claim against the Coast Guard?**

**•What is a claim?**

**•I think I have a claim. What do I do?**
SF-95                                     - Legal Service Command (LSC-C)   US Coast Guard   300 East Main Street, Suite 400   Norfolk, VA 23510-9100
                                      

**•When should I use the SF-95?**
> **Note:**A SF-95 is not required for Admiralty claims but we recommend using the form to ensure that you provide all of the required information.

**•Where can I find a SF-95? **
SF-95 

**•I am not sure what to enter in a certain Block on the SF-95.    What should I do? **
SF-95 > **Note:** That these comments are for instructional purposes only and are not intended to be legal advice.

SF-95D05-SMB-Claims@uscg.mil

**•I have completed the SF-95. Now what do I do? **
SF-95                                    - Legal Service Command (LSC-C)   US Coast Guard   300 East Main Street, Suite 400   Norfolk, VA 23510-9100
                                      

**•What are examples of supporting documentation for the SF-95? **
                                    - •Two estimates for repair or 1 itemized repair bill (once repairs are made)   •Pictures of damaged property   •Rental car receipts   •Witness Statements   •Police reports   •Any other documentation that supports the amount claimed
                                      

**•If I am claiming personal injury, what supporting documentation should I      provide? **
                                    - • Medical bills   • Doctor reports (e.g., ambulance and emergency room records, in-patient and out-patient records, doctors’ and nurses’ notes, x-rays, lab reports, and any other reports prepared in connection with diagnosis and treatment).   • Lost wages   • Any information that helps describe or support your personal injury amount.
                                      

**•Can I submit the SF-95 electronically?**
SF-95                                    - Legal Service Command (LSC-C)   US Coast Guard   300 East Main Street, Suite 400   Norfolk, VA 23510-9100
                                      

**•I filled out a SF-95. Where do I mail it? **
SF-95                                    - Legal Service Command Norfolk   LSC-C, Claims Division   300 East Main Street, Suite 400   Norfolk, VA 23510-9100
                                      

**•I am an active duty military member not employed by the Coast Guard    and I have a claim against the Coast Guard; what should I do? **
                                    - Legal Service Command (LSC-C)   US Coast Guard   300 East Main Street, Suite 400   Norfolk, VA 23510-9100
                                      

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**Contact Us**

----

If you have questions, you can call us at (757) 628-4212, e-mail us at: **D05-SMB-Claims@uscg.mil** or write us at our mailing address:
                                - Legal Service Command (LSC-C)   US Coast Guard   300 East Main Street, Suite 400   Norfolk, VA 23510-9100

 

A Coast Guard Unit or an Investigating Officer Completing an Investigation

**I am an Investigating Officer for a potential administrative claim against the government. What should I know?**

• You need to fill out a Letter Incident Report (LIR). ATTACH SAMPLE LIR or a CG-4112A for personnel claims.• Report facts in a clear and concise manner.• Avoid including your opinion of fault in the report.• Sometimes it may be necessary to contact the claimant during your investigation. It is acceptable to contact the claimant during your investigation if you need specific information from the claimant but NEVER contact the claimant if they have retained counsel.• Attached is a Checklist for Investigating Officers

**What is involved in a Claims Investigation? **
• As soon as possible after an incident that might give rise to a claim against the Coast Guard, the responsible unit should undertake an investigation.• In most claims matters, the preferred investigation format is the Letter Incident Report (LIR). If the Claimant is a Coast Guard employee use CG-4112A as the format for the investigation.• Refer to the Administrative Investigations Manual (AIM), COMDTINST M5830.1, and Chapter 2 of the Coast Guard Claims and Litigation Manual, COMDTINST M5890.9 for specific guidance.

**How long do I have to complete an investigation? **
• Claims investigations should be completed immediately after an incident and forwarded to LSC-5E no later than 45 days after the date of incident.

**What forms are required for Personnel claims and where can I find each form?**
• Personnel claims should b filled out by the claimant (Coast Guard or Civilian Employee) on form CG-4112.

• Personnel claims normally do not require full administrative investigations. Instead, units should use the CG-4112A, Claims Investigating Officer’s Report of Personal Property Claim.• Page 2 of the CG-4111, which is an inventory sheet, may also be requested by the Settlement Officer when the claim involves damage to several items. 

**I received a SF-95. What do I do with the form? **
                                    - Legal Service Command (LSC-C) US Coast Guard 300 East Main Street, Suite 400 Norfolk, VA 23510-9100

**I received papers from an attorney or insurance company regarding a CG-related incident. What do I do?**

• Contact LSC immediately. Do not respond to the company or the attorney.• If you receive a phone call please inform the attorney or insurance company that LSC-C, the Coast Guard’s Claims office is the responsible office. Provide them with our contact information. Contact LSC-C and provide contact information for the attorney or insurance company.

 

 
**Contact Us**

----

If you have questions, you can call us at (757) 628-4212, e-mail us at: **D05-SMB-Claims@uscg.mil** or write us at our mailing address:
                                - Legal Service Command (LSC-C)   US Coast Guard   300 East Main Street, Suite 400   Norfolk, VA 23510-9100

How to file a claim

If you have questions, you can call us at (757) 628-4212, e-mail us at: **D05-SMB-Claims@uscg.mil** or write us at our mailing address:
                                - Legal Service Command (LSC-C)   US Coast Guard   300 East Main Street, Suite 400   Norfolk, VA 23510-9100

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