How Are Cases Decided? A Review of One Possibility

 Posted on March 25, 2026 in Vaccine Information

In the National Vaccine Injury Compensation Program (NVICP), one of the ways a case can be resolved is through an entitlement hearing.

Some vaccine injury cases, such as those involving straightforward SIRVA or flu vaccine GBS injuries, may resolve via settlement. Other more complex matters, often involving injuries such as ADEM, GBS related to non-flu vaccines, MS, Intussusception, ITP, or transverse myelitis, are not conceded by the government and often proceed on a litigation track to a full hearing on entitlement.

In an entitlement hearing, the Special Master (judge) hears evidence from both sides and then issues a written decision explaining their determination of whether the evidence supports that the petitioner (plaintiff) was more likely than not injured by the vaccine. In other words, the presiding judge decides whether the injured party should be compensated or not.

The hearing may be held in person, or more often, via Zoom. In person hearings are often held at the Court of Federal Claims in Washington, D.C., which is the homebase for the presiding Court. Hearings can also be held at a federal courthouse near the petitioner’s location, though since the pandemic, this practice has decreased.

Currently, the most common practice is for hearings to be held remotely, with the participants appearing via video conference from their homes and/or offices.

In either event, the participants include the parties (the petitioner and their attorney and the respondent in the case, the Secretary of Health and Human Services, represented by an attorney from the Department of Justice), their expert witnesses, other possible fact witnesses, and a court reporter who prepares a written transcript of the proceedings. All hearings are private and only those involved in the case can attend/participate.

At the hearing, the petitioner will often testify and talk about their vaccine injury experience. They may discuss their life before vaccination, what happened after their vaccination and how it has impacted them. Usually, the petitioner’s attorney will ask the petitioner questions so that they can more fully get their story across to the Special Master. The Special Master and counsel for the government may also ask the petitioner questions. A witness, typically a family member or friend, may also testify.

Generally, much of the crucial evidence at a hearing comes from the testimony of medical experts who have prepared reports for the Court explaining each side’s arguments about whether and how the vaccine did (or did not) cause the petitioner’s injury. This is scientific evidence often supported by medical literature, studies, and case reports and relates to whether a vaccine is capable of causing a specific injury as well as if it did so in the instant case. Each side has the opportunity to present their evidence through direct questioning of their medical experts, and to cross-examine the other side’s experts. The Special Master can also ask his or her own questions of the medical experts.

An entitlement hearing generally lasts 1-2 days. Typically, at the end of a hearing the Special Master does not issue a decision. Instead, he or she takes time to review the complex issues discussed at the hearing and later issues a written decision setting forth their reasons for finding that the petitioner did/did not have a vaccine related injury. The timeline for issuance of a written decision varies widely and is influenced by both the complexity of the matters to be resolved and the number of other cases waiting to be decided.  

At Kraus Law Group, we work with each client directly throughout the pendency of their case, so they know what to expect at every stage. Our client’s best interests are at the forefront of all we do, whether the case resolves quickly through settlement or advances over time to a multi-day entitlement hearing. Since vaccine injury law is all we do, we deal with all aspects of vaccine injury litigation and have helped many clients resolve their case. We always strive for the best possible outcome.

If you wish to discuss a possible vaccine injury, please give us a call at 312-858-2177.