Understanding the Requirements for a Vaccine Claim

If you suffered an injury from a vaccine, you may be eligible for compensation. The National Vaccine Injury Compensation Program (VICP) is a federal no-fault program that allows victims to seek funds for monetary damages relating to vaccine injuries. Understanding the requirements for a vaccine claim with the VICP can help you seek maximum compensation for your damages.

Key Ingredients for a Winning Vaccine Claim

Not everyone suffering from vaccine injuries will qualify for compensation through the VICP. Since the program began in 1989, 22,789 people have filed for compensation, though only 10,179 were deemed compensable through the program, according to Health Resources & Services Administration Data. Keep in mind that some of these cases from the last few years may still be open.

If you want a successful outcome, you must meet the VICP’s qualifications, which include the following:

  • You must file within three years of the onset of your vaccine injury.
  • You must have received an eligible vaccine.
  • Your injury must fall under the covered category.
  • Your injury must last at least six months or result in in-patient hospitalization and surgical intervention.
  • You must have all the documentation required for processing.
  • You need medical evidence proving the vaccine caused your injury.
  • You must have documentation outlining all of your financial losses.

The definition of “surgical intervention” varies on a case-by-case basis. Courts typically determine “surgical intervention” based on whether the procedure involved anesthesia, pre-operative testing, and more.

Understanding the Basics of Vaccine Claims

syringe with one hundred dollar banknote inside on dollar bills

As mentioned above, vaccine claims involve a few key critical components you must provide to qualify for compensation. We will discuss the key components of winning vaccine injury claims in more detail below.

Eligible Vaccines and Covered Injuries

To qualify for the National Vaccine Injury Compensation Program, you must have received an eligible vaccine and suffered a qualifying injury. The qualifying injuries depend on the vaccine you received, as each may cause varying injuries.

The eligible vaccines and associated injuries include the following:

  • Influenza (trivalent influenza vaccine – TIV): Anaphylaxis, shoulder injury related to vaccine administration (SIRVA), vasovagal syncope, and Guillain-Barré syndrome
  • Chickenpox (varicella vaccine – VZV): Anaphylaxis, disseminated varicella vaccine-strain viral disease, SIRVA, and vasovagal syncope
  • Hepatitis A (HAV): SIRVA and vasovagal syncope
  • Hepatitis B (HBV): Anaphylaxis, SIRVA, and vasovagal syncope
  • Rotavirus (RV): Intussusception
  • Tetanus (DTaP, DTP, DT, Td, Tdap, and TT): Anaphylaxis, brachial neuritis, SIRVA, and vasovagal syncope
  • Whooping cough (pertussis – DTaP, DTP, Tdap, P, and DTP-Hib): Anaphylaxis, encephalopathy or encephalitis, SIRVA, and vasovagal syncope
  • Hemophilus influenzae type B (HiB): SIRVA and vasovagal syncope
  • Measles, mumps, rubella (MMR, MR, M, R): Anaphylaxis, encephalopathy or encephalitis, SIRVA, vasovagal syncope, thrombocytopenic purpura, vaccine-strain measles viral disease in an immunodeficient recipient, and chronic arthritis
  • Human papillomavirus (HPV) (Gardasil and Cervarix): Anaphylaxis, SIRVA, and vasovagal syncope
  • Meningococcal (MCV4, MPSV4): Anaphylaxis, SIRVA, and vasovagal syncope
  • Pneumococcal conjugate vaccine (PCV): SIRVA and vasovagal syncope
  • Polio (IPV, OPV): Paralytic polio in a non-immunodeficient recipient, vaccine-strain polio viral infection in a non-immunodeficient recipient, anaphylaxis, SIRVA, and vasovagal syncope

Documentation Needed for Processing

If you meet the requirements for a vaccine claim, you must provide numerous documents to submit your petition. The U.S. Court of Federal Claims requires proof of your vaccination, injury, and economic losses. You will need to submit one or two copies of the petition, all medical records, a cover sheet, and all supplemental documentation to process your application.

Proof of Vaccination

stethoscope with medical card and clipboard

One key component of a successful vaccine injury claim is your proof of vaccination. While you may not expect an injury to occur at the time, you must prepare in advance by keeping all relevant documentation. Be sure to maintain your proof of vaccination and all associated medical records.

Causation and Medical Evidence

The U.S. Court of Federal Claims requires that you provide evidence showing your vaccine directly caused your injury. In many cases, proving this link isn’t easy.

The moment you begin noticing symptoms, you should visit your doctor for a confirmed diagnosis. If your doctor confirms that the vaccine caused your injury, be sure s/he includes this in your diagnosis. Moving forward, you must follow all treatment recommendations.

Losses and Damages

You can claim compensation for the following items:

  • Past and future medical costs
  • Past and future lost wages
  • Pain and suffering up to $250,000

You must keep track of your expenses and medical records to claim as much compensation as possible. You can use prognoses to seek compensation for future expenses. You will likely need the support of an experienced attorney if you wish to claim pain and suffering damages.

Are the Requirements the Same for COVID Vaccines?

woman holding wooden cubes with question marks

No, because the VICP does not cover COVID-19 vaccines, you must go through the Countermeasures Injury Compensation Program (CICP), which has its own set of requirements.

Countermeasures Injury Compensation Program Requirements

To qualify for the CICP, you must meet the following requirements:

  • You must file within one year of your vaccine data, not the injury date.
  • You must provide proof of your qualifying countermeasure, like the COVID-19 vaccine.
  • Your injury must qualify based on the vaccine you received.
  • You need to provide all required medical records and documentation.

The primary difference between the CICP and the VICP is the timeline. You only have one year to file for the CICP.

Common Pitfalls in the Submission Process

Many pitfalls can occur in the submission process, including the following:

  • Submitting too late
  • Petitioning for a non-qualifying vaccine or injury
  • Leaving out the necessary documentation
  • Not providing evidence of causation

You can avoid these pitfalls by submitting your claim with the help of an experienced attorney.

Navigating Disputes and Appeals

If the U.S. Court of Federal Claims denies your initial application, you may request an appeal. A VICP court judge will review your appeal and accept or deny it. If denied, you may request a final review by the Federal Court of Appeals.

To avoid this process, we recommend working with an experienced attorney who can help you submit a strong claim.

Legal Timelines and Their Exceptions

golden clock and calendar with red mark in number twenty one

You must adhere to legal timelines to meet the requirements for a vaccine claim. For most VICP claims, you will need to submit your petition within three years of the onset of your injury. A few exceptions apply here:

  • Death: In death cases, loved ones must file within two years of the date of death.
  • Vaccine Injury Table revisions: If a change occurs relating to your injury, you must file within two years of the date of change for injuries, or eight years for deaths.
  • Court extensions: The court may occasionally provide extensions in rare circumstances.

Legal Considerations in Filing Vaccine Claims

The final requirement when filing vaccine claims is the barrier around litigation. When going through the VICP, you cannot file a lawsuit against the vaccine manufacturer, the vaccine administrator, or any other parties, as the program is a no-fault system. If you wish to take legal action, you will not qualify for this program.

Now that you understand the requirements for a vaccine claim, you may want to seek legal support for building a successful petition. Call Sadaka Law today at (800) 810-3457 to speak with one of our experienced vaccine injury attorneys about your case.

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