Heinzelman v. Secretary of Health & Human Services
2011 U.S. Claims LEXIS 1137
| Fed. Cl. | 2011Background
- Petitioner Stacey Heinzelman received a flu vaccine on December 10, 2003 and developed Guillain-Barré syndrome (GBS) five to ten days later.
- The case was brought under the Vaccine Act, with damages awarded after the Special Master found causation-in-fact.
- Petitioner’s pre-vaccination earnings were about $50,000/year; anticipated SSDI benefits were about $20,000/year due to GBS.
- Two prior rulings informed the damages decision: Ruling Granting Compensation (Dec. 11, 2008) and Ruling Regarding Offset (May 18, 2010).
- A dispute arose whether SSDI benefits should offset Petitioner’s Vaccine Act compensation, and whether the Special Master adequately considered the record as a whole.
- Respondent moved for review alleging error in record consideration and in not offsetting SSDI under 42 U.S.C. § 300aa-15(a)(3)(A) and (g).
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Did the Special Master properly allocate burdens of proof? | Heinzelman argues the Master considered the record as a whole and correctly shifted to Respondent for alternative causation. | Respondent contends the Master failed to weigh Respondent’s evidence adequately and did not fully assess the GI illness as alternative causation. | Yes; proper consideration and burden allocation. |
| Was causation-in-fact proven under Althen prongs? | Petitioner provided a reputable medical theory linking vaccination to GBS and a proximate temporal relationship. | Respondent argued the GI illness could be a more likely cause and challenged the logical sequence. | Yes; Petitioner proven under Althen, including prong two through medical testimony. |
| Should SSDI be offset from Vaccine Act damages under § 300aa-15(a) and/or (g)? | SSDI should not offset 15(a); SSDI is not a health benefits program offset under 15(g). | SSDI constitutes a health benefits program offsets under 15(g) and could reduce the award. | SSDI should not offset under either provision; damages not reduced. |
| Is SSDI a “Federal health benefits program” for offset purposes? | SSDI is not a health benefits program because it compensates lost earnings, not medical costs, and 15(g) excludes Medicare/CHIP explicitly. | SSDI could be treated as a health benefits program for offset purposes due to its disability benefits framework. | No; SSDI is not a Federal health benefits program for 15(g) offset. |
| What is the proper interpretation of § 300aa-15 with respect to damages calculation? | Loss of earnings includes actual and anticipated future earnings; offsets are not intended to double-count. | Offsets are permissible where government benefits substitute for lost earnings. | § 300aa-15(a)(3)(A) sets baseline; § 300aa-15(g) offsets not applicable to SSDI here. |
Key Cases Cited
- Althen v. Sec’y of HHS, 418 F.3d 1274 (Fed. Cir. 2005) (three-prong causation test for vaccine-injury claims)
- Capizzano v. Sec’y of HHS, 440 F.3d 1317 (Fed. Cir. 2006) (logical sequence; medical evidence probative for prong two)
- Knudsen v. Sec’y of HHS, 35 F.3d 543 (Fed. Cir. 1994) (bare statistical probabilities are insufficient to prove causation)
- Walther v. Sec’y of HHS, 485 F.3d 1146 (Fed. Cir. 2007) (on-Table vs. off-Table causation paths and presumption framework)
- de Bazan v. Sec’y of HHS, 539 F.3d 1347 (Fed. Cir. 2008) (government may contest petitioner’s theory with unrelated-factor evidence)
- Doe 11 v. Sec’y of HHS, 601 F.3d 1349 (Fed. Cir. 2010) (support for allocation of burdens and review standard)