VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_18-vv-01874
Package ID: USCOURTS-cofc-1_18-vv-01874
Petitioner: Doreen Wyffels
Filed: 2018-12-06
Decided: 2021-09-14
Vaccine: influenza
Vaccination date: 2017-10-04
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 79017

AI-assisted case summary:
Doreen Wyffels filed a petition alleging she suffered a shoulder injury related to vaccine administration (SIRVA) as a result of an influenza vaccine she received on October 4, 2017. The case was assigned to the Special Processing Unit. On January 26, 2021, the Chief Special Master issued Findings of Fact, determining that the onset of petitioner’s symptoms was consistent with the Table requirements for a SIRVA claim and occurred within 48 hours of vaccination. Respondent filed an Amended Rule 4(c) Report indicating that while preserving his right to appeal, he did not dispute that Petitioner had satisfied all legal prerequisites for compensation under the Act, including that her condition persisted for more than six months. On March 2, 2021, a ruling on entitlement was issued, finding Petitioner entitled to compensation. On August 12, 2021, Respondent filed a proffer on award of compensation, recommending an award of $79,017.68, comprised of $77,500.00 for pain and suffering and $1,517.68 for unreimbursable medical expenses. Petitioner, a competent adult, agreed with the proffered award. The Chief Special Master issued a decision awarding damages in the amount of $79,017.68.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_18-vv-01874-0
Date issued/filed: 2021-03-02
Pages: 6
Docket text: PUBLIC ORDER/RULING (Originally filed: 01/26/2021) regarding 27 Findings of Fact & Conclusions of Law, Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:18-vv-01874-UNJ Document 31 Filed 03/02/21 Page 1 of 6
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
18-1874
UNPUBLISHED
DOREEN WYFFELS, Chief Special Master Corcoran
Petitioner, Filed: January 26, 2021
v.
Special Processing Unit (SPU);
SECRETARY OF HEALTH AND Findings of Fact; Onset; Influenza
HUMAN SERVICES, (Flu) Vaccine; Shoulder Injury
Related to Vaccine Administration
Respondent. (SIRVA)
Bridget Candace McCullough, Muller Brazil, LLP, Dresher, PA, for Petitioner.
Lara Ann Englund, U.S. Department of Justice, Washington, DC, for Respondent.
FINDINGS OF FACT1
On December 6, 2018, Doreen Wyffels filed a petition for compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. §300aa-10, et seq.2 (the
“Vaccine Act”). Petitioner alleges that she suffered a shoulder injury related to vaccine
administration (“SIRVA”) as a result of an influenza (“flu”) vaccination administered on
October 4, 2017. Petition at 1. The case was assigned to the Special Processing Unit of
the Office of Special Masters.
1 Because this unpublished fact ruling contains a reasoned explanation for the action in this case, I am
required to post it on the United States Court of Federal Claims' website in accordance with the E-
Government Act of 2002. 44 U.S.C. § 3501 note (2012) (Federal Management and Promotion of Electronic
Government Services). This means the fact ruling will be available to anyone with access to the
internet. In accordance with Vaccine Rule 18(b), petitioner has 14 days to identify and move to redact
medical or other information, the disclosure of which would constitute an unwarranted invasion of privacy.
If, upon review, I agree that the identified material fits within this definition, I will redact such material from
public access.
2 National Childhood Vaccine Injury Act of 1986, Pub. L. No. 99-660, 100 Stat. 3755. Hereinafter, for ease
of citation, all section references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C. §
300aa (2012).

Case 1:18-vv-01874-UNJ Document 31 Filed 03/02/21 Page 2 of 6
For the reasons discussed below, I find the onset of Petitioner’s shoulder pain
occurred within 48 hours of vaccination, consistent with the Table requirements for a
SIRVA claim.
I. Relevant Procedural History
As noted above, the case was initiated in December 2018. On November 7, 2019,
Respondent filed his Rule 4(c) Report asserting that the case was not appropriate for
compensation under the terms of the Vaccine Act. ECF No. 15. Respondent argued that
Petitioner failed to seek treatment for her shoulder injury for more than three months after
her vaccination. Id. at 4. Respondent also noted that when Petitioner did seek treatment,
“she reported that her shoulder was sore for the first few days, then improved and then
became progressively worse . . . [suggesting] that she had the usual soreness associated
with a vaccination, which improved . . . and she only developed more significant
symptoms later.” Id. Finally, Respondent asserted that, “[g]iven the delay in seeking
treatment, there are no contemporaneous medical records that clarify the sequence of
events.” Id.3
From January 8 through February 13, 2020, Petitioner filed updated medical
records, a supplemental affidavit, witness statement and letters from her treating
physician and chiropractor. ECF Nos. 17, 19-20. Then, on February 14, 2020, Petitioner
filed a motion for a ruling on the record (“Motion”). ECF No. 21. Respondent filed a
response to the Motion on March 10, 2020 and, on March 24, 2020, Petitioner filed her
reply. ECF Nos. 22-23.
An expedited hearing to resolve the issue of onset was scheduled to take place on
January 15, 2021. Order, ECF No. 26. However, during the pre-hearing status
conference, I expressed my view that due to the nature of the dispute (as evidenced in
the parties’ filings), the matter could be resolved simply on the papers. See Minute Entry,
dated January 5, 2021. The matter is now ripe for adjudication.
II. Issue
At issue is whether the onset of Petitioner’s left shoulder pain was within 48-hours
after vaccination, as set forth in the Vaccine Injury Table for a SIRVA injury after receipt
of the flu vaccine. 42 C.F.R. § 100.3(a) XIV.B. (2017) (influenza vaccination). The Table’s
“Qualifications and Aids to Interpretation” (“QAI”) for a SIRVA-based claim also require
3 Respondent also asserted that Petitioner’s symptoms were not limited to her left arm, but this argument
will not be addressed herein.
2

Case 1:18-vv-01874-UNJ Document 31 Filed 03/02/21 Page 3 of 6
that a petitioner’s pain have occurred within this same 48-hour time frame. 42 C.F.R. §
100.3(c)(10).
III. Authority
Pursuant to Vaccine Act Section 13(a)(1)(A), a petitioner must prove, by a
preponderance of the evidence, the matters required in the petition by Vaccine Act
Section 11(c)(1). I have discussed the factors to be considered in determining whether a
petitioner has met their burden in several recent decisions. I fully adopt and hereby
incorporate my prior discussion in section III of the following decisions: Marrow v. Sec’y
of Health & Hum. Servs., No. 17-1964V, 2020 WL 3639775 (Fed. Cl. Spec. Mstr. June 2,
2020); Robinson v. Sec’y of Health & Hum. Servs., No. 17-1050V, 2020 WL 3729432
(Fed. Cl. Spec. Mstr. June 5, 2020); Decoursey v. Sec’y of Health & Hum. Servs., No.18-
870V, 2020 WL 4673228 (Fed. Cl. Spec. Mstr. July 9, 2020).
In sum, a special master must consider, but is not bound by, any diagnosis,
conclusion, judgment, test result, report, or summary concerning the nature, causation,
and aggravation of the petitioner’s injury or illness that is contained in a medical record.
Section 13(b)(1). Moreover, a special master may find that the first symptom or
manifestation of onset of an injury occurred “within the time period described in the
Vaccine Injury Table even though the occurrence of such symptom or manifestation was
not recorded or was incorrectly recorded as having occurred outside such period.” Section
13(b)(2). “Such a finding may be made only upon demonstration by a preponderance of
the evidence that the onset [of the injury] . . . did in fact occur within the time period
described in the Vaccine Injury Table.” Id.
IV. Finding of Fact
I make the following finding regarding onset after a complete review of the record
to include all medical records, affidavits, Respondent’s Rule 4 report, and briefing by the
parties. Specifically, I base the findings on the following evidence:
• Ms. Wyffels was administered a flu vaccine in her left shoulder on October 4,
2017. Ex. 1.
• In her affidavit, Ms. Wyffels averred “I remember the vaccination being
particularly painful and felt the needle going into my arm.” Ex. 4 at ¶ 4. In her
supplemental affidavit Ms. Wyffels further stated that “I remember thinking . . .
boy that one hurt, and I must have not relaxed my arm good enough. It bled,
[the nurse] applied a band-aide and it had ached afterwards.” Ex. 9 at 1.
3

Case 1:18-vv-01874-UNJ Document 31 Filed 03/02/21 Page 4 of 6
• Arlene Lopez, Ms. Wyffels’ coworker, submitted an affidavit dated January 20,
2020. Ex. 10. In it, she asserted that Ms. Wyffels “was complaining of her upper
arm area being sore and not being able to move it like she normally could and
this started in October 2017.” Id.
• Ms. Wyffels presented to Douglas County Hospital, Alexandria Clinic on
November 20, 2017 (a little over six weeks post-vaccination) with complaints
of eye irritation. Ex. 2 at 20-21. The medical record documenting this visit does
not indicate that Petitioner complained of shoulder pain. Id.
• In her supplemental affidavit, Ms. Wyffels stated that she did not mention her
left should pain during her November 2017 appointment because “I only talk
about my personal health with my doctor. . .”. Ex. 9 at 1.
• On January 8, 2018 (three months and four days after vaccination), Ms. Wyffels
presented to her primary care physician, Dr. Jenessa Warzecha, with a
complaint of left shoulder soreness “ever since she received her flu shot on
October 4th.” Ex. 2 at 21-22. It was noted that Ms. Wyffels’ shoulder “was sore,
but not severe, for the first few days, then improved, then became progressively
worse.” Id. at 21.
• On January 27, 2020, Dr. Warzecha submitted a letter recounting Ms. Wyffels’
January 8, 2018 examination. Ex. 11. In it, she recalls that Ms. Wyffels
“indicated to me [her left sided shoulder pain] was new and had occurred since
her flu shot was given on 10/4/2017.” Id. She further notes that Ms. Wyffels
“certainly has had continued pain since this time, MRI evidence of bursitis, and
side effects from medications used to treat this . . .”. Id.
• Ms. Wyffels underwent an initial physical therapy evaluation on January 15,
2018. Ex. 3 at 1-2. She reported “feeling random onset of [left] shoulder pain
that started when she got the flu shot this year. She had no pain in her shoulder
and then after the shot started to have more and more pain.” Id. at 1. Ms.
Wyffels attended four physical therapy sessions between January 15, 2018 and
February 20, 2018. Id. at 1-9.
• On April 18, 2018, Ms. Wyffels underwent an MRI of her left shoulder. Ex. 2 at
35-38. The record indicates that Ms. Wyffels suffered from left shoulder pain
“since receiving flu shot in October 2017.” Id. at 36.
• Ms. Wyffels presented to Dr. Warzecha on September 7, 2018. Ex. 5 at 1-6.
The medical note documenting this visit indicates that her shoulder pain had
been present “since last fall/flu shot.” Id. at 5.
• Dr. Barbara L. Dolezal, Ms. Wyffels’ chiropractor, submitted a letter
summarizing her interaction with Petitioner during a December 9, 2019
examination. Ex. 13 at 6. Dr. Dolezal stated that Ms. Wyffels “noted that she
had intense L[eft] upper arm/shoulder pain and swelling with limited and painful
4

Case 1:18-vv-01874-UNJ Document 31 Filed 03/02/21 Page 5 of 6
range of motion following a flu immunization 2 ½ years before, commonly
known as SIRVA.” Id.
• In her supplemental affidavit, Ms. Wyffels asserted that she did not seek
medical treatment for her arm prior to January 8, 2018 because “[e]veryone
knows that the arm is sore for a couple of days after a flu shot, and I had never
heard of SIRVA before. After a while, I just thought it was because I was
overusing it with carrying the grandkids and playing with them all the time.” Ex.
9 at 1. Ms. Wyffels also asserted that, due to a worldwide flu epidemic, “[o]ur
own local hospital said no visitors, and I remember the clinic indicating not to
come in unless you really needed to be seen by a doctor.” Id.
The above items of evidence collectively establish that Ms. Wyffels’ shoulder pain
most likely began within 48 hours of receiving the October 4, 2017 flu vaccine. I recognize
that Petitioner’s medical records do not reflect a precise date of onset, and also that the
vague temporal references to onset in the record (i.e., “since receiving the flu shot in
October 2017 . . . “) allow for the possibility that onset could have occurred more than 48
hours from vaccination. However, there is no counter-evidence undercutting Ms. Wyffels’
contention that her pain began close-in-time to vaccination, and she consistently reported
this issue.
Admittedly, there is evidence of an intervening medical appointment
(approximately six weeks post-vaccination) in November 2017 that makes no mention of
the purported onset. Ex. 2 at 20-21. However, I do not find that this single record rebuts
Petitioner’s onset contention. Petitioner explained that she did not mention her shoulder
pain during this visit because “I only talk about my personal health with my doctor.” Ex. 9
at 1. While this explanation is somewhat opaque, I conclude that Petitioner’s intent is to
differentiate the purpose for this medical visit (an eye appointment) from a more
comprehensive visit with a personal care physician – a distinction that is not
unreasonable. A single intervening medical encounter where only one issue is addressed
is not enough to disprove onset, especially given the overwhelmingly consistent
assertions about close-in-time onset at all subsequent medical encounters.
Moreover, although Ms. Wyffels did not seek treatment for her left shoulder injury
until approximately three months following her October 4, 2017 vaccination, I do not find
this delay to be dispositive regarding the issue of onset. Indeed, Ms. Wyffels’ medical
records and affidavits reflect a pattern similar to other SIRVA claims, in which injured
parties reasonably delay treatment, often based on the assumption that their pain is likely
transitory. See, e.g., Tenneson v. Sec’y of Health & Human Servs., No. 16-1664V, 2018
WL 3083140, at *5 (Fed. Cl. Spec. Mstr. Mar. 30, 2018), review denied, 142 Fed. Cl. 329
(2019), (finding a 48-hour onset of shoulder pain despite a nearly six-month delay in
seeking treatment); Williams v. Sec’y of Health & Human Servs., 17-830V, 2019 WL
5

Case 1:18-vv-01874-UNJ Document 31 Filed 03/02/21 Page 6 of 6
1040410, at *9 (Fed. Cl. Spec. Mstr. Jan. 31, 2019) (noting a delay in seeking treatment
for five-and-a-half months because petitioner underestimated the severity of her shoulder
injury); Knauss v. Sec’y of Health & Human Servs., 16-1372V, 2018 WL 3432906 (Fed.
Cl. Spec. Mstr. May 23, 2018) (noting a three-month delay in seeking treatment).
Finally, Respondent asserts that when Ms. Wyffels did seek treatment, she
“reported that her shoulder was sore for the first few days, then improved, and then
became progressively worse.” Resp. at 3 citing Ex. 2 at 21-22. Respondent maintains
that this statement “suggests that [Petitioner] had the usual soreness associated with a
vaccination, which improved . . . and she only developed more significant symptoms
later.” Resp. at 3. While Ms. Wyffels did report some initial improvement, her medical
records and affidavits support her contention that her symptoms worsened over time and
had not resolved by her September 7, 2018 appointment with Dr. Warzecha. See, e.g.,
Ex. 3 at 1; Ex. 9 at 1; Ex. 5 at 5. At worst, this evidence supports a determination that
Petitioner’s overall severity of injury does not justify a substantial pain and suffering award
– not that onset is not consistent with the Table.
Accordingly, I find there is preponderant evidence to establish that the onset of Ms.
Wyffels’ left shoulder pain occurred within 48 hours of the October 4, 2017 flu vaccination.
V. Scheduling Order
Given my finding of fact regarding onset – and specifically that it is consistent with
the Table requirements of a SIRVA claim – Respondent shall show cause, by no later
than Friday, March 12, 2021, why Petitioner should not be found to be entitled to
compensation.
Any questions about this order or about this case may be directed to OSM staff
attorney Reiko Suber at (202) 357-6378 or Reiko_Suber@cfc.uscourts.gov.
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
6

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DOCUMENT 2: USCOURTS-cofc-1_18-vv-01874-1
Date issued/filed: 2021-04-01
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 03/02/2021) regarding 29 Ruling on Entitlement Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:18-vv-01874-UNJ Document 33 Filed 04/01/21 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 18-1874V
UNPUBLISHED
DOREEN WYFFELS, Chief Special Master Corcoran
Petitioner, Filed: March 2, 2021
v.
Special Processing Unit (SPU);
SECRETARY OF HEALTH AND Ruling on Entitlement; Table Injury;
HUMAN SERVICES, Influenza (Flu) Vaccine; Shoulder
Injury Related to Vaccine
Respondent. Administration (SIRVA)
Bridget Candace McCullough, Muller Brazil, LLP, Dresher, PA, for Petitioner.
Lara Ann Englund, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On December 6, 2018, Doreen Wyffels filed a petition for compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. §300aa-10, et seq.2 (the
“Vaccine Act”). Petitioner alleges that that she suffered a shoulder injury related to
vaccine administration (“SIRVA”) as a result of an influenza (“flu”) vaccine she received
on October 4, 2017. Petition at 1. The case was assigned to the Special Processing Unit
of the Office of Special Masters.
On January 26, 2021, I issued Findings of Fact in which I determined that
Petitioner’s shoulder pain occurred within 48 hours of vaccination. ECF No. 27 at 2. In
reaction, on February 27, 2021, Respondent filed an Amended Rule 4(c) Report indicating
that while preserving his right to appeal the January 26, 2021 Fact Finding, he “does not
1 Because this unpublished ruling contains a reasoned explanation for the action in this case, I am required
to post it on the United States Court of Federal Claims' website in accordance with the E-Government Act
of 2002. 44 U.S.C. § 3501 note (2012) (Federal Management and Promotion of Electronic Government
Services). This means the ruling will be available to anyone with access to the internet. In accordance
with Vaccine Rule 18(b), Petitioner has 14 days to identify and move to redact medical or other information,
the disclosure of which would constitute an unwarranted invasion of privacy. If, upon review, I agree that
the identified material fits within this definition, I will redact such material from public access.
2 National Childhood Vaccine Injury Act of 1986, Pub. L. No. 99-660, 100 Stat. 3755. Hereinafter, for ease
of citation, all “§” references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C. § 300aa
(2012).

Case 1:18-vv-01874-UNJ Document 33 Filed 04/01/21 Page 2 of 2
dispute that [P]etitioner has satisfied all legal prerequisites for compensation under the
Act.” Respondent’s Rule 4(c) Report at 5 (citing 42 U.S.C. § 300aa-13).
Specifically, Respondent stated as follows:
Based on the Chief Special Master’s fact ruling, and medical record
evidence submitted in this case, [the Secretary] will not continue to contest
that petitioner suffered SIRVA as defined by the Vaccine Injury Table . . . In
addition, petitioner suffered the residual effects of [her] condition for more
than six months. 42 U.S.C. § 300aa-11(c)(1)(D)(i). Therefore, based on the
record as it stands and subject to his right to appeal the Findings of Fact,
respondent does not dispute that petitioner has satisfied all legal perquisites
for compensation under the Act. 42 U.S.C. § 300aa-13.
Id. at 4-5.
In view of Respondent’s position and the evidence of record, I find that
Petitioner is entitled to compensation.
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
2

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DOCUMENT 3: USCOURTS-cofc-1_18-vv-01874-2
Date issued/filed: 2021-09-14
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 08/12/2021) regarding 38 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:18-vv-01874-UNJ Document 42 Filed 09/14/21 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 18-1874V
UNPUBLISHED
DOREEN WYFFELS, Chief Special Master Corcoran
Petitioner, Filed: August 12, 2021
v.
Special Processing Unit (SPU);
SECRETARY OF HEALTH AND Damages Decision Based on Proffer;
HUMAN SERVICES, Influenza (Flu) Vaccine; Shoulder
Injury Related to Vaccine
Respondent. Administration (SIRVA)
Bridget Candace McCullough, Muller Brazil, LLP, Dresher, PA, for Petitioner.
Lara Ann Englund, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On December 6, 2018, Doreen Wyffels filed a petition for compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. §300aa-10, et seq.2 (the
“Vaccine Act”). Petitioner alleges that she suffered a shoulder injury related to vaccine
administration (“SIRVA”) as a result of an influenza (“flu”) vaccine she received on
October 4, 2017. Petition at 1. The case was assigned to the Special Processing Unit of
the Office of Special Masters.
On March 2, 2021, a ruling on entitlement was issued, finding Petitioner entitled to
compensation for SIRVA. On August 12, 2021, Respondent filed a proffer on award of
compensation (“Proffer”) indicating Petitioner should be awarded $79,017.68 (comprised
of $77,500.00 for pain and suffering and $1,517,68 for unreimbursable medical
expenses). Proffer at 2. In the Proffer, Respondent represented that Petitioner agrees
1 Because this unpublished decision contains a reasoned explanation for the action in this case, I am
required to post it on the United States Court of Federal Claims' website in accordance with the E-
Government Act of 2002. 44 U.S.C. § 3501 note (2012) (Federal Management and Promotion of Electronic
Government Services). This means the decision will be available to anyone with access to the
internet. In accordance with Vaccine Rule 18(b), Petitioner has 14 days to identify and move to redact
medical or other information, the disclosure of which would constitute an unwarranted invasion of privacy.
If, upon review, I agree that the identified material fits within this definition, I will redact such material from
public access.
2 National Childhood Vaccine Injury Act of 1986, Pub. L. No. 99-660, 100 Stat. 3755. Hereinafter, for ease
of citation, all “§” references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C. § 300aa
(2012).

Case 1:18-vv-01874-UNJ Document 42 Filed 09/14/21 Page 2 of 5
with the proffered award. Id. Based on the record as a whole, I find that Petitioner is
entitled to an award as stated in the Proffer.
Pursuant to the terms stated in the attached Proffer, I award Petitioner a lump
sum payment of $79,017.68 (comprised of $77,500.00 for pain and suffering and
$1,517.68 for unreimbursable medical expenses) in the form of a check payable to
Petitioner. This amount represents compensation for all damages that would be available
under Section 15(a).
The clerk of the court is directed to enter judgment in accordance with this
decision.3
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
3 Pursuant to Vaccine Rule 11(a), entry of judgment can be expedited by the parties’ joint filing of notice
renouncing the right to seek review.
2

Case 1:18-vv-01874-UNJ Document 42 Filed 09/14/21 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
DOREEN WYFFELS, )
)
Petitioner, )
)
v. ) No. 18-1874V
) Chief Special Master Brian H. Corcoran
SECRETARY OF )
HEALTH AND HUMAN SERVICES, )
)
Respondent. )
)
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
On December 6, 2018, Doreen Wyffels (“petitioner”) filed a petition for compensation
under the National Childhood Vaccine Injury Act of 1986, as amended (“the Vaccine Act” or
“the Act”), 42 U.S.C. §§ 300aa-1 to -34, alleging that she suffered a Shoulder Injury Related to
Vaccine Administration (“SIRVA”) as a result of receipt of an influenza vaccination
administered on October 4, 2017. See Petition at 1. On January 26, 2021, the Chief Special
Master issued Findings of Fact, finding that the onset of petitioner’s symptoms was “consistent
with the Table requirements of a SIRVA claim.” ECF No. 27 at 6. On February 27, 2021,
respondent filed an Amended Vaccine Rule 4(c) report concluding that petitioner had otherwise
satisfied the requirements of a Table SIRVA claim, and requesting that the Chief Special Master
decide the issue of entitlement. ECF No. 28 at 6. Accordingly, on March 2, 2021, the Chief
Special Master issued a Ruling on Entitlement finding petitioner entitled to compensation. ECF
No. 29.

Case 1:18-vv-01874-UNJ Document 42 Filed 09/14/21 Page 4 of 5
I. Items of Compensation
Respondent proffers that petitioner should be awarded $77,500.00 for pain and suffering
and $1,517.68 for unreimbursable medical expenses. These amounts represent all elements of
compensation to which petitioner is entitled under 42 U.S.C. § 300aa-15(a). Petitioner agrees. 1
II. Form of the Award
Respondent recommends that the compensation provided to petitioner should be made
through a lump sum payment of $79,017.68 in the form of a check payable to petitioner.2 This
lump sum payment represents all elements of compensation to which petitioner would be entitled
under 42 U.S.C. § 300aa-15(a). Petitioner agrees.
Petitioner is a competent adult. Evidence of guardianship is not required in this case.
Respectfully submitted,
BRIAN M. BOYNTON
Acting Assistant Attorney General
C. SALVATORE D’ALESSIO
Acting Director
Torts Branch, Civil Division
HEATHER L. PEARLMAN
Deputy Director
Torts Branch, Civil Division
ALEXIS B. BABCOCK
Assistant Director
Torts Branch, Civil Division
1 The parties have no objection to the amount of the proffered award of damages. Assuming that
the Chief Special Master issues a damages decision in conformity with this proffer, the parties
waive their right to seek review of such damages decision. However, respondent reserves his
right, pursuant to 42 U.S.C. § 300aa-12(e), to seek review of the Chief Special Master’s January
26, 2021 Findings of Fact.
2 Should petitioner die prior to entry of judgment, the parties reserve the right to move the Court
for appropriate relief. In particular, respondent would oppose any award for future medical
expenses, future pain and suffering, and future lost wages.
2

Case 1:18-vv-01874-UNJ Document 42 Filed 09/14/21 Page 5 of 5
s/ LARA A. ENGLUND
LARA A. ENGLUND
Assistant Director
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146 Benjamin Franklin Station
Washington D.C. 20044-0146
Tel: (202) 307-3013
E-mail: lara.a.englund@usdoj.gov
Dated: August 12, 2021
3