Vaccines save lives by preventing disease in the people who receive them. Most people who get vaccines have no serious problems. However, vaccines, like any medicines, can rarely cause serious problems, such as severe allergic reactions. In those rare cases, the VICP, which is a Federal program, provides compensation to people found to be injured by certain vaccines. The U.S. Court of Federal Claims decides who will be paid. Three Federal government offices have a role in the process, The U.S. Department of Health and Human Services (HHS); The U.S. Department of Justice (DOJ); and The U.S. Court of Federal Claims (the Court).
What vaccines are covered by the VICP?
- Diphtheria, tetanus, pertussis (DTP, DTaP, Tdap, DT, Td, or TT)
- Haemophilus influenzae type b (Hib)
- Hepatitis A (HAV)
- Hepatitis B (HBV)
- Human papillomavirus (HPV)
- Influenza (TIV, LAIV) [seasonal flu]
- Measles, mumps, rubella (MMR, MM, MMRV)
- Meningococcal (MCV4, MPSV4, MenB-FHbp, MenB-4C)
- Polio (OPV or IPV)
- Pneumococcal conjugate (PCV)
- Rotavirus (RV)
- Varicella (VZV)
- Any combination of the vaccines above and
- Any new vaccine recommended by the CDC for prevention and administration to children, after publication by the Secretary of Health and Human Services.
How does the VICP work?
First, a claim must be filed by or on the behalf of the individual thought to be injured by a vaccine covered by the VICP. A claim is started by filing a legal document called a petition that is prepared by you or your lawyer to request compensation under the VICP. Anyone who files a claim is called a petitioner. Your claim should address the following information; who was injured by the vaccine; which vaccine caused the injury; when the vaccine was given; the city and state or country where the vaccine was given; the type of injury; when the first symptom of the injury appeared; and how long the effects of the injury lasted. Your claim should also include your medical records and/or other appropriate documents, the court’s cover sheet, and the $400/00 filing fee.
Who may file a claim?
You may file a claim if you received a vaccine covered by the VICP and believe that you have been injured by this vaccine. You may also file a claim if you are a parent or legal guardian of a child or disabled adult who received a vaccine covered by the VICP and believe that the person was injured by this vaccine. You may file a claim if you are the legal representative of the estate of a deceased person who received a vaccine covered by the VICP and believe that the person’s death resulted from the vaccine injury. You may file a claim if you are not a United States citizen. Some people who receive vaccines outside of the U.S. may be eligible for compensation. The vaccines must have been covered by the VICP and given in the following circumstances: the injured person must have received a vaccine in the U.S. trust territories; or if the vaccine was administered outside of the U.S. or its trust territories, the injured person must have been a U.S. citizen serving in the military or a U.S. government employee, or have been a dependent of such a citizen; or the injured person must have received a vaccine manufactured by a vaccine company located in the U.S. and returned to the U.S. within 6 months after the date of vaccination. In addition, to be eligible to file a claim, the effects of the person’s injury must have lasted for more than 6 months after the vaccine was given; or resulted in a hospital stay and surgery; or resulted in death.
Do I need a lawyer to file a claim?
You do not need a lawyer to file a claim. However, since this is a legal process, most people use a lawyer/ If certain minimal requirements are met, the VICP will pay your lawyer’s fees and other legal costs related to your claim, whether or not you are paid for a vaccine injury or death. The VICP will not pay the fees of petitioners representing themselves but will pay their other legal costs, whether or not the claim is paid as long as certain minimum requirements are met.
What are the deadlines to file a claim?
The general filing deadlines are: For an injury, your claim must be filed within 3 years after the first symptom of the vaccine injury. For a death, your claim must be filed within 2 years of the death and 4 years after the start of the first symptom of the vaccine-related injury from which the death occurred. When a new vaccine is covered by the VICP or when a new injury/condition is added to the 7 Vaccine Injury Table (Table), claims that do not meet the general filing deadlines must be filed within 2 years from the date the vaccine or injury/condition is added to the Table for injuries or deaths that occurred up to 8 years before the Table change. The Table lists and explains injuries that are presumed to be caused by vaccines. For more details about the Table, visit www.hrsa.gov/vaccinecompensation.
What is the process for filing a claim?
A summary of the claims process is provided below. The Court has documents that explain the process in more detail. To obtain these documents, you may visit the Court’s Website at www.uscfc.uscourts.gov. Most petitioners use a lawyer since this is a legal process, and the Rules of the Court are very specific and must be followed. The process for filing a claim is:
1. The petitioner or petitioner’s lawyer sends one original and two copies of the claim along with the medical records, other appropriate documents, and a $400 filing fee to the Court;
2. The petitioner or petitioner’s lawyer sends one copy of the claim including the medical records and other appropriate documents to the Secretary of Health and Human Services, c/o Director, Division of Injury Compensation Programs;
3. The Court sends one copy of the claim and medical records to the Department of Justice (DOJ);
4. Health and Human Services (HHS) reviews the medical information in the claim and this review is sent to the DOJ lawyer who represents the Secretary of Health and Human Services;
5. The DOJ lawyer reviews the legal aspects of the claim and writes a report;
6. The HHS and DOJ reviews are combined into one report that is sent to the Court and petitioner or petitioner’s lawyer;
7. The DOJ and petitioner or petitioner’s lawyer take legal action to resolve the claim;
8. A “special master” (a lawyer appointed by the judges of the Court) decides if the claim will be paid and how much will be paid for the claim;
9. If the special master decides to pay the claim, the petitioner must make a decision to accept or reject the special master’s decision in writing; and
10. The special master’s decision may be appealed to a judge of the Court by the petitioner or HHS, then to the U.S. Court of Appeals for the Federal Circuit and, finally, to the U.S. 8 Supreme Court.
What must be proven in order to be paid?
You must prove that: the injured person received a vaccine listed on the Table; and the first symptom of the injury/condition on the Table as defined in the Qualifications and Aids to Interpretation (QAIs)* occurred within the time period listed on the Table; or the vaccine caused the injury; or the vaccine caused an existing illness to get worse (significantly aggravated). In addition, the Court must determine that the injury or death did not result from any other possible causes.
What is the Vaccine Injury Table?
The Table makes it easier for some people to get compensation. The Table lists and explains injuries/conditions that are presumed to be caused by vaccines. It also lists time periods in which the first symptom of these injuries/conditions must occur after receiving the vaccine. If the first symptom of these injuries/conditions occurs within the listed time periods, it is presumed that the vaccine was the cause of the injury or condition unless another cause is found. For example, if you received the tetanus vaccine and had a severe allergic reaction (anaphylaxis) within 4 hours after receiving the vaccine, then it is presumed that the tetanus vaccine caused the injury if no other cause is found. If your injury/condition is not on the Table or if your injury/condition did not occur within the time period on the Table, you must prove that the vaccine caused the injury/condition. Such proof must be based on medical records or opinions, which may include expert witness testimony. The Table and QAI’s change sometimes. To obtain a copy of the latest Table and QAI’s, visit the VICP Website at www.hrsa.gov/vaccinecompensation.
What are the types of payments?
For an injury, you may be paid: A reasonable amount for past and future non-reimbursable medical, custodial care, and rehabilitation costs, and related expenses (There is no limit on the amount a person with an injury may be paid for these types of expenses. Payments are based on your vaccine injury needs.); up to $250,000 for actual and projected pain and suffering; lost earnings; and/or Reasonable lawyers’ fees and other legal costs or legal costs, not fees, of petitioners representing themselves, if your claim was filed on a reasonable basis and in good faith. For a death, you may be paid: up to $250,000 as a death benefit for the estate of the deceased; and Reasonable lawyers’ fees and other legal costs or legal costs, not fees, of petitioners representing themselves, if your claim was filed on a reasonable basis and in good faith.