Vaccine Injury Compensation:

Program Challenged to Settle Claims Quickly and Easily

HEHS-00-8: Published: Dec 22, 1999. Publicly Released: Jan 21, 2000.

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Pursuant to a congressional request, GAO reviewed challenges facing the Department of Health and Human Services' (HHS) Vaccine Injury Compensation Program (VICP), focusing on: (1) how long it takes to process a claim through VICP; (2) the extent to which recent changes to the program's injury table have made it easier or more difficult for petitioners to obtain compensation for vaccine-related injuries; and (3) why the trust fund continues to grow, and what budgetary effect proposed options for addressing the growing trust fund balance would have.

GAO noted: (1) overall, while the program appears to provide an easier process for obtaining compensation than the traditional civil tort system, the process has not been as quick or as easy as expected; (2) processing most VICP claims takes more than 2 years; (3) in 1998 and 1989, the program received about 200 claims and processed nearly all of them within 2 years; (4) but in 1990, when a filing deadline neared for injury claims relating to vaccinations received before October 1988, the number of claims filed jumped to over 3,200; (5) this influx created an immediate and large backlog of claims, which HHS is still working to resolve; (6) another factor significantly increasing processing times is that as the program received additional funding for staff and experts to defend claims, the government increasingly challenged claims in which the cause of injury was in doubt; (7) as a result, petitioners needed more information and time to prepare cases, which resulted in processing times that were much longer than envisioned when the program began; (8) HHS' recent changes to the vaccine injury table will make the process easier for some people to obtain compensation, but will make it more difficult for a larger number to do so; (9) this is because far more claims have historically been associated with injuries HHS removed from the table than for injuries HHS added to it; (10) removing these injuries shifts the burden of proof to the petitioner, making it more difficult to qualify for compensation under VICP; (11) HHS based its decisions to add or remove table injuries on various factors but did not have a clear and transparent methodology to demonstrate that these factors were consistently applied for each injury table change; (12) without such transparency, changes that make compensation more difficult for petitioners may continue to be questioned by some, regardless of their merit; (13) the VICP trust fund has grown to $1.3 billion, primarily because the income from vaccine excise taxes has been higher than payments for claims and associated administrative costs and interest has been accruing on the fund balance; (14) the excess tax revenue--$948 million as of 1998--has been loaned to the Treasury and used for other federal programs and activities; (15) vaccine manufacturers, federal agencies, and petitioner advocates have expressed concerns about the rising balance and have proposed options to decrease the vaccine excise tax or increase trust fund spending; and (16) exercising these options, however, would have implications for the overall federal budget.

Status Legend:

More Info
  • Review Pending-GAO has not yet assessed implementation status.
  • Open-Actions to satisfy the intent of the recommendation have not been taken or are being planned, or actions that partially satisfy the intent of the recommendation have been taken.
  • Closed-implemented-Actions that satisfy the intent of the recommendation have been taken.
  • Closed-not implemented-While the intent of the recommendation has not been satisfied, time or circumstances have rendered the recommendation invalid.
    • Review Pending
    • Open
    • Closed - implemented
    • Closed - not implemented

    Recommendation for Executive Action

    Recommendation: The Secretary of HHS should develop and apply a consistent methodology for evaluating and reporting on the various factors used to add or remove injuries from VICP's injury table. This methodology should include specific scientific and public policy considerations and their relative weight in the decisionmaking process and should be applied to any future table changes.

    Agency Affected: Department of Health and Human Services

    Status: Closed - Not Implemented

    Comments: HHS disagreed with GAO's recommendation, and did not implement it when it made recent changes to the Vaccine Injury Compensation Table.

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