Filing a Claim with the VICP

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. The only form required is the Court’s cover sheet for the claim. You may obtain a copy of the cover sheet and a sample claim by calling (202) 357-6400. 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 $250.00 filing fee. If you are unable to pay this fee, call (202) 357-6400 for assistance. The original claim and two copies plus a $250.00 filing fee should be sent to:

Clerk
U.S. Court of Federal Claims
717 Madison Place, N.W.
Washington, DC 20005

Medical Records and Other Documentation

You must include certain medical records and/or other appropriate documents with the claim. If some medical records are unavailable, you must identify those records and explain why they are unavailable. The medical review and processing of the claim may be delayed if you do not include the appropriate medical records and other documents with the claim.

In order to ensure that your claim is processed in a timely manner, the VICP suggests that you include the following medical records and other documents when filing your claim with the Court and the Secretary of Health and Human Services, c/o Director, Division of Vaccine Injury Compensation.

TYPES OF MEDICAL RECORDS

1. Prenatal and Birth Records
   • Mother’s prenatal record
   • Delivery record
   • Birth certificate
   • Newborn hospital record including providers’ notes, and radiology/lab results
   • Any hospitalization face sheet with final diagnosis
     
     
2. Medical Records Prior to Vaccination
   • Clinic notes (such as Well Baby visits)
   • Private doctor visits
   • Growth charts/lab/radiology results
   • Consultation reports and evaluations
   • Developmental charts
     
     
3. Vaccination Record (if available)
   • Lot number
   • Manufacturer
     
     
4. Post-Injury Hospital/Emergency Treatment Records
   • Admission/discharge summaries
   • History and physical records
   • Progress notes (including doctors’/nurses’ notes)
   • Medication records
   • Lab/radiology/EEG results
   • Flow sheets (respiratory care/treatment)
   • Consultation reports and evaluations
     
     
5. Post-Injury Outpatient Records
   • History and physical records
   • Progress notes (including doctors’/nurses’ notes)
   • Medication records
   • Lab/radiology/EEG results
   • Clinic notes
   • All evaluations
     
     
6. Vaccine Adverse Event Reporting System (VAERS) form (if submitted)
   
   
7. Long Term Records (that apply to your injury)
   • School records
   • Consultation reports and evaluations
   • Educational testing records
   • Psychological testing records
   • Police/ambulance records
     
     
8. Death Records (if applicable)
   • Death Certificate
   • Autopsy report (if done)
   • Autopsy slides

*Note: Number 1 may be omitted if the injured person is an adult.

Filing a Claim With or Without a Lawyer

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 legal costs, whether or not the claim is paid as long as certain minimal requirements are met.

Filing a Claim Outside the VICP

Most of the time, you must first file and have your claim processed with the VICP before a civil lawsuit can be filed against the vaccine company or the person who gave the vaccine. If you would like to file a civil lawsuit outside of the VICP, contact a lawyer for advice.

Obtaining a List of Lawyers Who File VICP Claims

• Contact:
  Clerk
  U.S. Court of Federal Claims
  717 Madison Place, N.W.
  Washington, DC 20005
  
  
• Telephone: (202) 357-6400; or your State or local bar association

A Summary of the Claims Process

The Court has documents which explain the process in more detail. To obtain these documents, you may visit the U.S. Court of Federal Claims Web site or call (202) 357-6400. 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 $250 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 Vaccine Injury Compensation;
   
   
3. the Court sends one copy of the claim and medical records to the DOJ;
   
   
4. 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. Supreme Court.

Reasons for Compensation

To be paid, you must prove that:

• the injured person received a vaccine listed on the Vaccine Injury Table (Table); and
  
  
• the first symptom of the injury/condition on the Table as defined in the Qualifications and Aids to Interpretation (Aids) 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.

Types of Payments Awarded

For an injury, you may be paid:

• a reasonable amount for past and future nonreimbursable 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.

This information reflects the current thinking of the United States Department of Health and Human Services on the topics addressed. This information is not legal advice and does not create or confer any rights for or on any person and does not operate to bind the Department or the public. The ultimate decision about the scope of the statutes authorizing the VICP is within the authority of the United States Court of Federal Claims, which is responsible for resolving claims for compensation under the VICP.