Heinzelman v. Secretary of Health & Human Services

681 F.3d 1374, 2012 WL 2131106, 2012 U.S. App. LEXIS 12000
CourtCourt of Appeals for the Federal Circuit
DecidedJune 13, 2012
Docket20-2291
StatusPublished
Cited by25 cases

This text of 681 F.3d 1374 (Heinzelman v. Secretary of Health & Human Services) is published on Counsel Stack Legal Research, covering Court of Appeals for the Federal Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Heinzelman v. Secretary of Health & Human Services, 681 F.3d 1374, 2012 WL 2131106, 2012 U.S. App. LEXIS 12000 (Fed. Cir. 2012).

Opinion

O’MALLEY, Circuit Judge.

This case involves a dispute over the amount of compensation Petitioner Stacey Heinzelman (“Heinzelman”) is entitled to receive under the National Childhood Vaccine Injury Act of 1986, 42 U.S.C. §§ 300aa-1 to 300aa-34 (“Vaccine Act”). The Secretary of Health and Human Services (“the government”) appeals the final decision of the United States Court of Federal Claims, which affirmed the special master’s decision that Petitioner’s compensation under the Vaccine Act should not be reduced by the amount of benefits she is eligible to receive through Social Security Disability Insurance (“SSDI”). See Heinzelman v. Sec’y of Health & Human Servs., 98 Fed.Cl. 808 (2011); Heinzelman v. Sec’y of Health & Human Servs., No. 07-01V, 2010 WL 2342468, 2010 U.S. Claims LEXIS 333 (Fed.Cl.Spec.Mstr. May 18, 2010). Because we agree that SSDI benefits should not be taken into account in calculating Heinzelman’s “actual or anticipated loss of earnings” under 42 U.S.C. § 300aa-15(a)(3)(A), and that SSDI does not fall within any of the categories of authorized offsets under § 300aa-15(g), we affirm.

BACKGR0UND

Heinzelman was born in 1971. On December 10, 2003, she received a flu vaccine, and within thirty days thereafter she was hospitalized for Guillain-Barre syndrome (“GBS”) — a disorder affecting the peripheral nervous system.

Before Heinzelman developed GBS, she was employed full-time as a hairstylist earning $49,888 per year. At this stage in the proceedings, it is undisputed that, due to her injury, Heinzelman: (1) will never be able to work again; and (2) is eligible to receive SSDI benefits of approximately $20,000 per year.

On January 3, 2007, Heinzelman filed a petition for compensation under the Vaccine Act alleging that the flu vaccine caused her to develop GBS. In a December 2008 decision, the special master found that Heinzelman proved, by a preponderance of the evidence, that the flu vaccine caused her injury and that she was entitled to compensation. Heinzelman v. Sec’y of Health & Human Servs., No. 07-01V, 2008 WL 5479123, at *19-20, 2008 U.S. Claims LEXIS 434, at *53-56 (Fed.Cl.Spec.Mstr. Dec. 11, 2008). That decision is not at issue on appeal.

In May 2010, the special master issued a separate ruling regarding the amount of compensation to which Heinzelman is entitled. In that decision, the special master rejected the government’s argument that Heinzelman’s eligibility for SSDI benefits should be considered in determining her compensation under the Vaccine Act. Specifically, the special master found that: (1) Heinzelman’s anticipated SSDI income should not be taken into consideration in *1376 calculating her “actual or anticipated loss of earnings” under § 300aa-15(a)(3)(A); and (2) SSDI is not a “federal ... health benefits program” within the meaning of § 300aa-15(g), and therefore her compensation should not be offset based on her eligibility for SSDI benefits.

On December 7, 2010, the special master entered final judgment awarding Heinzel-man $1,133,046.08, plus an annuity to cover future medical expenses. Of the lump sum awarded, $900,000 was to compensate Heinzelman for her lost earnings. According to the government, Heinzelman’s lost earnings award would have been roughly $316,000 less had the special master taken her anticipated SSDI benefits into account.

The government moved the Court of Federal Claims to review the special master’s final judgment awarding damages, which incorporated both the December 2008 decision granting compensation under the Vaccine Act, and the May 2010 ruling regarding offset. In June 2011, the Court of Federal Claims affirmed the special master’s decisions in their entirety. In relevant part, the court agreed that SSDI benefits should not be taken into account in determining Heinzelman’s compensation under § 300aa-15. The government timely appealed that issue to this court, and we have jurisdiction pursuant to 42 U.S.C. § 300aa-12(f).

Discussion

The sole question on appeal is whether a petitioner’s compensation under the Vaccine Act should be reduced by the amount of SSDI benefits she is eligible to receive. Resolution of this question involves the interpretation and interplay between two provisions of the Vaccine Act: § 300aa-15(a)(3)(A) — which provides compensation for lost earning capacity — and § 300aa-15(g) — which offsets the compensation award where the petitioner is expected to receive payments under certain other programs. Because statutory interpretation is a question of law, we review the trial court’s determination de novo. Aull v. Sec’y of Health & Human Servs., 462 F.3d 1338, 1342 (Fed.Cir.2006).

Where, as here, the petitioner has suffered a vaccine-related injury after attaining the age of eighteen, and her earning capacity is impaired by that injury, her compensation under the Vaccine Act includes “compensation for actual and anticipated loss of earnings determined in accordance with generally recognized actuarial principles and projections.” 42 U.S.C. § 300aa-15(a)(3)(A). The Act provides, however, that the Vaccine Program is “not primarily liable,” and that an award under the Vaccine Act is offset to the extent the petitioner is entitled to receive payments from certain specified programs. Specifically, § 15(g) provides that:

Payment of compensation under the Program shall not be made for any item or service to the extent that payment has been made, or can reasonably be expected to be made, with respect to such item or service (1) under any State compensation program, under an insurance policy, or under any Federal or State health benefits program (other than under title XIX of the Social Security Act [42 USCA § 1396 et seq.]) [Medicaid], 1 or (2) by an entity which *1377 provides health services on a prepaid basis.

42 U.S.C. § 300aa-15(g).

On appeal, the government argues that the special master and the Court of Federal Claims erred in concluding that SSDI benefits should not be considered in determining compensation under the Vaccine Act. Specifically, the government argues that Heinzelman’s eligibility for SSDI benefits should have been considered either as part of the “lost earnings” calculation under § 300aa-15(a)(3)(A) or as an offset under § 15(g). In the alternative, the government argues that § 300aa-15 of the Vaccine Act is ambiguous, and that principles of sovereign immunity weigh against exposing the federal government to further liability.

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681 F.3d 1374, 2012 WL 2131106, 2012 U.S. App. LEXIS 12000, Counsel Stack Legal Research, https://law.counselstack.com/opinion/heinzelman-v-secretary-of-health-human-services-cafc-2012.