Countermeasures Injury Compensation Program (CICP)

Occasionally, public health emergencies and security dangers threaten our country.

To combat these threats, the government supports the development of countermeasures. A countermeasure is a vaccine, medication, device, or other item used to prevent, diagnose, or treat a public health emergency or a security threat.

Countermeasures save lives. Most people who receive a countermeasure have no serious problems, but like any medicine, they can cause side effects—most of which are rare and mild.

What Is the Purpose of the CICP?

The Countermeasures Injury Compensation Program (CICP) provides compensation for covered serious injuries or deaths that occur as the result of the administration or use of certain countermeasures. Compensation may include unreimbursed medical expenses (expenses that health insurance did not cover), lost employment income, and the survivor death benefit.

Who Is Eligible to File a Claim for Benefits?

On the rare chance you suffered a serious injury, or the death of a loved one, from the administration or use of a covered countermeasure, you may be eligible to file a claim for benefits.

You must file a Request for Benefits Package within one year of receiving or using the countermeasure that you believe caused the injury. You must also provide proof that a covered countermeasure was administered or used.

Learn more about the criteria for demonstrating that a covered injury occurred.

What Is a Request for Benefits Package?

A complete Request for Benefits Package includes the following documents. The CICP will not begin reviewing a claim for eligibility until the Request for Benefits Package is complete.

• Request for Benefits form (PDF - 316 KB) / Formulario de solicitud de beneficios (PDF - 185 KB).
• Authorization for Use or Disclosure of Health Information form (PDF - 228 KB) / Autorización para usar o divulgar información médica (PDF - 248 KB).
  Please note that you need to fill out a separate form for each health care provider who treated you.
• Proof of administration or use of a covered countermeasure, for example, a CDC COVID-19 vaccine card or a prescription for a covered countermeasure.
• The following medical records submitted by you or your health care provider(s):
  • All medical records documenting medical visits, procedures, consultations, and test results that occurred on or after the date of administration or use of the covered countermeasure.
  • All hospital records, including the admission history and physical examination, the discharge summary, all physician subspecialty consultation reports, all physician and nursing progress notes, and all test results that occurred on or after the date of administration or use of the covered countermeasure.
  • All medical records for one year prior to administration or use of the covered countermeasure, as necessary, to show your pre-existing medical history.
  • The CICP prefers that medical records are sent directly to the program by your health care provider(s).

You are responsible for ensuring the CICP has received your medical records. The CICP will not contact your health care providers or facilities. The CICP does not pay or compensate you for your medical records.

What Is the CICP Claims Process?

The CICP reviews and resolves claims through an administrative process.

You may submit a Request for Benefits Package or Letter of Intent either by mail or the HRSA Injury Compensation Programs website. The CICP does not accept Request for Benefits packages or Letters of Intent via email or fax.

After you submit your Request for Benefits Package, which should include proof of administration or use of a covered countermeasure and your complete medical records, CICP medical staff will review the package and decide if you are eligible for program benefits. If found eligible, you will be asked to submit additional documentation to determine how much compensation you should receive.

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