In order to complete a medical review for eligibility, the CICP requires your complete medical records, including for those visits to primary care providers and specialists, consultations, and hospitalizations, as well as the immunization record in the case of vaccine injuries.
You must submit medical records dating from one year prior to the receipt of the covered countermeasure until the present, so that the CICP can assess your total health picture before, and after, your alleged injury occurred. For example, if you received an anthrax vaccine on November 1, 2011, you must send your entire medical record from November 1, 2010, to the present.
You must also complete an Authorization for Use or Disclosure of Health Information Form for each healthcare provider (e.g. doctor, specialist, or hospital) you saw during the time frame indicated above and request that they send your records to the CICP. You must also submit a copy of each Form to the CICP so that the Program knows which medical records to expect. If your healthcare provider(s) prefers that you request medical records using their own authorization form, the CICP will accept a copy of that form.
For security reasons, the CICP does not accept medical records sent by email.
The CICP will not begin its review of your Request for Benefits until all records are received.
Learn more about the CICP Filing Process.