In order to complete a medical review for eligibility, the CICP requires the injured countermeasure recipient’s complete medical records, including primary care visits, specialists, consultations, and hospitalizations, as well as the immunization record in the case of vaccine injuries. The representative must submit medical records dating back one year prior to the receipt of the covered countermeasure until the present, so that the CICP can assess the injured countermeasure recipient’s total health picture before, and after, the alleged injury occurred. For example, if he/she received an anthrax vaccine on November 1, 2011, the representative must send his/her entire medical record from November 1, 2010, to the present.
The representative or the injured countermeasure recipient must complete an Authorization for Use or Disclosure of Health Information Form for each healthcare provider (e.g. doctor, specialist, or hospital) the injured countermeasure recipient saw during the time frame indicated above, and request that the records be sent to the CICP. The representative must also submit a duplicate copy of each Form to the CICP so that the Program knows which medical records to expect. If the healthcare provider(s) prefers that the medical records be requested 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 a medical review until all records are received.
Learn more about the CICP Filing Process.