The second and more likely pathway is that a Claimant presents such specific, medical evidence that it convinces the agency that the Claimant’s health condition “is the direct result of the administration or use of a” covered vaccine. At minimum, a Claimant will probably have to have treating doctors provide specific, written opinions that the vaccine itself directly caused a diagnosed injury and resulting loss of work, and explain why. And that in itself will not satisfy the agency. Its own published guidance warns: “Such proof must be based on compelling, reliable, valid, medical and scientific evidence.” This standard of proof is much higher than the evidence of causation we must prove in court, which is typically preponderance of the evidence, or greater than 50% likelihood. Basically, the agency hires medical practitioners whose main qualification is to be highly skeptical of any claim that a vaccine results in injury, and unless your evidence is based upon well-established and undeniable consensus in the medical community, they can say no.