Injured countermeasure recipient
An individual who was administered or used a covered countermeasure may file for compensation for their out-of-pocket, unreimbursed medical expenses and lost employment income benefits.
Representative of an injured countermeasure recipient
An injured countermeasure recipient may choose to use a legal or personal representative to assist in filing for medical and/or lost employment income benefits.
A representative may be:
- A parent or guardian of a minor child
- A spouse
- A family member (e.g. sibling or adult child)
- An attorney
- Any other legal or personal representative capable of filing for benefits
If the injured countermeasure recipient is a minor, or does not have the legal capacity to file for Program benefits or receive payments, then a legal or personal representative must submit a Request Form on his or her behalf.
Please note: The CICP is not authorized to pay or reimburse any fees or costs incurred by using a legal or personal representative; therefore, you would be responsible for the cost of using one.
Administrator of the Estate of a deceased injured countermeasure recipient
The estate of a deceased injured countermeasure recipient may file for CICP benefits in the case where an injured countermeasure recipient has died.
The estate may receive medical and/or lost employment income benefits that the eligible injured countermeasure recipient would have received for benefits prior to death. The estate may be eligible for benefits regardless of the injured countermeasure recipient’s cause of death, but their injuries must have resulted directly from the administration or use of a covered countermeasure. An estate may file when:
- The injured countermeasure recipient died before filing a Request Form; or
- The injured countermeasure recipient submitted a Request Form, which was in review or was approved for Program benefits, but died before receiving CICP payments in full.
In order to be an executor or an administrator of an estate, an individual must have a letter or other documentation from a court of competent jurisdiction indicating their status as administrator. The executor or administrator of the estate is required to provide this documentation to the CICP in order to receive benefits.
Survivor of a deceased injured countermeasure recipient
For an individual to be a survivor, the injured countermeasure recipient must have died as a direct result of his or her injuries caused by the administration or use of a covered countermeasure. An eligible survivor may receive death benefits, but not other benefits.
In order to be considered for death benefits, the survivor must be in one of the categories listed below. If there is more than one survivor, the death benefit is divided and disbursed in order of priority. The priority order for survivors is:
- Spouse - if there is no surviving child of the injured countermeasure recipient: A spouse will qualify for CICP benefits if he or she qualifies as a spouse under the Public Safety Officers’ Benefits (PSOB) Program. For more information on the PSOB Program, please see: psob.gov. Generally, a spouse refers to an individual’s lawful husband, wife, widower, or widow. Certain common law marriages may qualify in states that recognize common law marriages. An eligible spouse who is separated but not legally divorced may be considered for death benefits.
- Spouse, child(ren), and minor dependent(s) - if there is at least one surviving child of the injured countermeasure recipient and a surviving spouse: The spouse may receive 50% of the death benefit and the child(ren) and minor dependent(s) may receive a percentage. A surviving child will qualify under this category if he or she is a natural, illegitimate, adopted, or posthumous child, or stepchild of a deceased injured countermeasure recipient who, at the time of the countermeasure recipient’s death, is:
- 18 years old or younger, or
- between 19 and 22 years of age and a full-time student,
- or incapable of self-support due to a physical or mental disability, regardless of age.
- Child(ren) - if there is no surviving spouse, child(ren) as defined in category two above: If there is at least one surviving child but no surviving spouse, the surviving child (or surviving children in equal shares) receives the death benefit.
- Named Beneficiary - if there is no surviving spouse or child: In the event that the injured countermeasure recipient dies without a spouse, child, or dependent minor, then the person(s) named in a beneficiary designation form supplied by an employer or, if no such form exists, the most recently executed insurance policy may be eligible for death benefits. The individual(s) may receive the entire death benefit if there is no spouse, no child, and no minor dependent.
- Parents - if none of the above: In the event that there is no spouse, no child, no minor dependent, and no named beneficiary, then the two parents may divide the death benefit into equal shares. If there is only one surviving parent, then he or she would receive the entire benefit.
- Legal guardian of a deceased minor without surviving parents: If the deceased injured countermeasure recipient was a minor, then his or her legal guardian if other than a parent (such as a grandparent) may receive the death benefit if there are no other survivors as listed above under the standard calculation.
- Adult Children - if none of the above: In the event that there is no spouse, no child as defined under category two above, no minor dependent, no named Beneficiary, and no surviving parent, then the death benefit may be paid to the individual(s) who would qualify as surviving child(ren) under category two above, but for age.
There is an additional category of survivors who may be eligible for the alternative calculation of the death benefit. This category is:
- Dependent(s) younger than the age of 18: A person whom the Internal Revenue Service would consider to be the deceased injured countermeasure recipient’s dependent at the time the covered injury was sustained and who is younger than the age of 18 at the time of the filing of the Request Form. This category may include individuals who would also qualify as a surviving minor child (as defined under category two in the section above) as well as dependents other than the decedent’s children, such as nieces, nephews, foster children or other minors. Surviving dependents younger than the age of 18 under this category have the same priority as surviving children as described under category two in the section above (2. Spouse, child(ren), and minor dependent(s)).
Types of Benefits
The CICP provides various types of benefits to eligible requesters.