VICP Registry Case Source Bundle Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_19-vv-01134 Package ID: USCOURTS-cofc-1_19-vv-01134 Petitioner: Ethel Love Filed: 2019-08-05 Decided: 2021-10-06 Vaccine: influenza Vaccination date: 2016-10-14 Condition: left shoulder injuries related to vaccine administration Outcome: compensated Award amount USD: 63500 AI-assisted case summary: Ethel Love filed a petition on August 5, 2019, seeking compensation under the National Vaccine Injury Compensation Program. She alleged that she suffered left shoulder injuries related to vaccine administration (SIRVA) after receiving an influenza vaccine on October 14, 2016, and that her injury lasted more than six months. The respondent denied that Ms. Love sustained the onset of a left shoulder injury within the time period set forth in the Vaccine Injury Table, denied that the vaccine caused her alleged injuries or any other injury or disability, and denied that she sustained a SIRVA Table injury. Despite these denials, on August 31, 2021, the parties filed a joint stipulation agreeing to a settlement. Chief Special Master Brian H. Corcoran reviewed the stipulation and found it reasonable, adopting it as his decision. Pursuant to the stipulation, Ms. Love was awarded a lump sum of $63,500.00, payable to her, as compensation for all damages available under the Vaccine Act. This amount represents a compromise of the parties' respective positions on liability and damages. The decision was issued on October 6, 2021. Petitioner was represented by Paul R. Brazil of Muller Brazil, LLP, and respondent was represented by Alexa Roggenkamp of the U.S. Department of Justice. The public decision does not describe the specific onset, symptoms, medical tests, treatments, or expert witnesses involved in this case. Theory of causation field: Ethel Love received an influenza vaccine on October 14, 2016, and alleged a left shoulder injury related to vaccine administration (SIRVA). Respondent denied that the injury was a SIRVA Table injury or that the vaccine caused the alleged injuries. The parties filed a joint stipulation agreeing to settle the case. Chief Special Master Brian H. Corcoran adopted the stipulation, awarding $63,500.00 as compensation for all damages. This award represents a compromise of the parties' positions. The stipulation does not admit that the vaccine caused the injury. The theory of causation is based on the Vaccine Injury Table (SIRVA). Petitioner was represented by Muller Brazil, LLP, and respondent by the U.S. Department of Justice. The decision date was October 6, 2021. Public staged source text: ================================================================================ DOCUMENT 1: USCOURTS-cofc-1_19-vv-01134-0 Date issued/filed: 2021-10-06 Pages: 7 Docket text: PUBLIC DECISION (Originally filed: 08/31/2021) regarding 26 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made. -------------------------------------------------------------------------------- Case 1:19-vv-01134-UNJ Document 32 Filed 10/06/21 Page 1 of 7 In the United States Court of Federal Claims OFFICE OF SPECIAL MASTERS No. 19-1134V UNPUBLISHED ETHEL LOVE, Chief Special Master Corcoran Petitioner, Filed: August 31, 2021 v. Special Processing Unit (SPU); Joint SECRETARY OF HEALTH AND Stipulation on Damages; Influenza HUMAN SERVICES, (Flu) Vaccine; Shoulder Injury Related to Vaccine Administration Respondent. (SIRVA) Paul R. Brazil, Muller Brazil, LLP, Dresher, PA, for Petitioner. Alexa Roggenkamp, U.S. Department of Justice, Washington, DC, for Respondent. DECISION ON JOINT STIPULATION1 On August 5, 2019, Ethel Love 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 left shoulder injuries related to vaccine administration (“SIRVA”) as a result of an influenza (“flu”) vaccine she received on October 14, 2016. Petition at 1; Stipulation, filed at August 31, 2021, ¶¶ 2, 4. Petitioner further alleges that her vaccine injury lasted more than six months. Petition at ¶ 23. Respondent denies that “petitioner sustained the onset of a left shoulder injury within the time period set forth in the Table; denies that the vaccine caused petitioner’s alleged injuries or any other injury or petitioner’s current disabilities; and denies that petitioner sustained a SIRVA Table injury.” Stipulation at ¶ 6. Nevertheless, on August 31, 2021, the parties filed the attached joint stipulation, stating that a decision should be entered awarding compensation. I find the stipulation reasonable and adopt it as my decision awarding damages, on the terms set forth therein. 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 section references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C. § 300aa (2012). Case 1:19-vv-01134-UNJ Document 32 Filed 10/06/21 Page 2 of 7 Pursuant to the terms stated in the attached Stipulation, I award the following compensation: A lump sum of $63,500.00, in the form of a check payable to Petitioner. Stipulation at ¶ 8. This amount represents compensation for all items of damages that would be available under Section 15(a). Id. I approve the requested amount for Petitioner’s compensation. In the absence of a motion for review filed pursuant to RCFC Appendix B, 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 1:19-vv-01134-UNJ Document 32 Filed 10/06/21 Page 3 of 7 IN THE UNITED STA TES COURT OF FEDERAL CLAIMS OFFICE OF SPECIAL MASTERS ETHEL LOVE, Petitioner, No. 19-1134V Chief Special Master Corcoran v. ECF SECRETARY OF HEALTH AND HUMAN SERVICES, Respondent. STIPULATION The parties hereby stipulate to the following matters: 1. Petitioner, Ethel Love, filed a petition for vaccine compensation under the National Vaccine Injury Compensation Program, 42 U.S.C. § 300aa-10 to 34 (the ''Vaccine Program"). The petition seeks compensation for injuries allegedly related to petitioner's receipt of the Influenza ("flu") vaccine, which vaccine is contained in the Vaccine Injury Table (the "Table"), 42 C.F.R. § 100.3 (a). 2. Petitioner received the vaccine on or about October 14, 2016. 3. The vaccine was administered within the United States. 4. The petition alleges that petitioner suffered from a left shoulder injury related to vaccination administration ("SIRVA") as a resuh of receiving the flu vaccine. 5. Petitioner represents that there has been no prior award or settlement of a civil action for damages arising out of the alleged vaccine injury. 6. Respondent denies that petitioner sustained the onset of a left shoulder injury within the time period set forth in the Table; denies that the vaccine caused petitioner's alleged -1- Case 1:19-vv-01134-UNJ Document 32 Filed 10/06/21 Page 4 of 7 injuries or any other injury or petitioner's current disabilities; and denies that petitioner sustained a SIRVA Table injury. 7. Maintaining their above-stated positions, the parties nevertheless now agree that the issues between them shall be settled and that a decision should be entered awarding the compensation described in paragraph 8 of this Stipulation. 8. As soon as practicable after an entry of judgment reflecting a decision consistent with the terms of this Stipulation, and after petitioner has filed an election to receive compensation pursuant to 42 U.S.C. § 300aa-21(a)(l), the Secretary of Health and Human Services will issue the following vaccine compensation payment: A lump sum of $63,500.00 in the form of a check payable to petitioner. This amount represents compensation for all damages that would be available under 42 U.S.C. § 300aa-15(a). 9. As soon as practicable after the entry of judgment on entitlement in this case, and after petitioner has filed both a proper and timely election to receive compensation pursuant to 42 U.S.C. § 300aa-2l(a)(l), and an application, the parties will submit to further proceedings before the special master to award reasonable attorneys' fees and costs incurred in any proceeding upon this petition. 10. Petitioner and petitioner's attorney represent that compensation to be provided pursuant to this Stipulation is not for any items or services for which the Program is not primarily liable under 42 U.S.C. § 300aa-15(g), to the extent that payment has been made or can reasonably be expected to be made under any State compensation programs, insurance policies, Federal or State health benefits programs (o ther than Title XIX of the Social Security Act (42 U.S.C. § 1396 et seq.)), or by entities that provide health services on a pre-paid basis, and represent that they have identified to respondent all known sources of payment for items or -2- Case 1:19-vv-01134-UNJ Document 32 Filed 10/06/21 Page 5 of 7 services for which the Program is not primarily liable under 42 U.S.C. § 300aa-15(g). 11. Payment(s) made pursuant to paragraph 8 and any amounts awarded pursuant to paragraph 9 of this Stipulation will be made in accordance with 42 U.S.C. § 300aa-15(i), subject to the availability of sufficient statutory funds. 12. The parties and their attorneys further agree and stipulate that, except for any a ward for attorneys' fees and litigation costs, and past unreimbursable expenses, the money provided pursuant to this Stipulation will be used solely for the benefit of petitioner as contemplated by a strict construction of 42 U.S.C. § 300aa-15(a) and (d), and subject to the conditions of 42 U.S.C. § 300aa-15(g) and (h). 13. In return for the payments descnbed in paragraphs 8 and 9, petitioner, in petitioner's individual capacity, and on behalf of petitioner's heirs, executors, administrators, successors or assigns, does forever irrevocably and unconditionally release, acquit and discharge the United States and the Secretary of Health and Human Services from any and all actions or causes of action (including agreements,judgments, claims, damages, loss of services, expenses and all demands of whatever kind or nature) that have been brought, could have been brought, or could be timely brought in the United States Court of Federal Claims, under the National Vaccine Injury Compensation Program, 42 U.S.C. § 300aa-10 et seq., on account of, or in any way growing out of, any and all known or unknown, suspected or unsuspected personal injuries to or death of petitioner resulting from, or alleged to have resulted from, the vaccination as alleged by petitioner in a petition for vaccine compensation filed on or about August 5, 2019, in the United States Court of Federal Claims as petition No. 19-1134V. 14. If petitioner should die prior to entry of judgment, this agreement shall be -3- Case 1:19-vv-01134-UNJ Document 32 Filed 10/06/21 Page 6 of 7 voidable upon proper notice to the Court on behalf of either or both of the parties. 15. If the special master fails to issue a decision in complete conformity with the terms of this Stipulation or if the United States Court of Federal Claims fails to enter judgment in conformity with a decision that is in complete conformity with the terms of this Stipulation, then the parties' settlement and this Stipulation shall be voidable at the sole discretion of either party. 16. This Stipulation expresses a full and complete negotiated settlement of liability and damages claimed under the National Childhood Vaccine Injury Act of 1986, as amended, except as otherwise noted in paragraph 9 above. There is absolutely no agreement on the part of the parties hereto to make any payment or to do any act or thing other than is herein expressly stated and clearly agreed to. The parties further agree and understand that the award descnbed in this Stipulation may reflect a compromise of the parties' respective positions as to liability and/or amount of damages, and further, that a change in the nature of the injury or condition or in the items of compensation sought, is not grounds to modify or revise this agreement. 17. This Stipulation shall not be construed as an admission by the United States or the Secretary of Health and Human Services that the vaccine caused petitioner's alleged injury or any other injury or petitioner's current condition. 18. All rights and obligations of petitioner hereunder shall apply equally to petitioner's heirs, executors, administrators, successors, and/or assigns. END OF STIPULATION I I I -4- Case 1:19-vv-01134-UNJ Document 32 Filed 10/06/21 Page 7 of 7 Respectfully submitted, PETITIONER: ETHEL LOVE ATTORNEY OF RECORD AUTBORIZJtD REPRESENTATIVE FOR PETITIONER: OF THE ATTORNEY GENERAL: ~ Q ~~~~ PABRAZll, HEATHER L. PEARLMAN Muller Brazil, LLP Deputy Director 71S Twining Road, Suite 208 Torts Branch Dresher, PA 19025 Civil Divilion (215) 885-16SS U.S. Department of Justice P.O. Box 146 Beqjamin Franklin Station Washington, DC 20()44-.()146 AUTHORIZED REPRESENTATIVE ATTORNEY OF RECORD FOR OF THE SECRETARY OF HEALTH RESPONDENT: AND HUMAN SERVICES: ~ L #f,, ~ P-<-u..Ar--- Z)JtL ~I ~C,I TAMARA OVERBY ALEXA ROOGENKAMP Acting Director, Divwion of lnjmy Trial Attorney Compensation Program., Torts Branch Healthcare System Bureau Civil Division Health Resources and Services U.S. Department of Justice Adminiltration P.O.Box 146 U.S. Department of Health Benjamin Franklin Station and Human Services Washington, DC 20044-0146 5600 Fimers Lane, 08Nl46B 202-616-4179 Rockville, MD 208S7 alexa.roggenkamp@usdoj.gov Dated: og/31/ ~ / -s- ================================================================================ DOCUMENT 2: USCOURTS-cofc-1_19-vv-01134-1 Date issued/filed: 2021-10-08 Pages: 3 Docket text: PUBLIC ORDER/RULING (Originally filed: 09/03/2021) regarding 29 Findings of Fact & Conclusions of Law, Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made. -------------------------------------------------------------------------------- Case 1:19-vv-01134-UNJ Document 33 Filed 10/08/21 Page 1 of 3 In the United States Court of Federal Claims OFFICE OF SPECIAL MASTERS No. 19-1134V ETHEL LOVE, Chief Special Master Corcoran Petitioner, v. Filed: September 3, 2021 SECRETARY OF HEALTH AND Compensation Under the Vaccine HUMAN SERVICES, Program; Offset; Section 15(g); Claim of Subrogation; Section 15(h); Respondent. Medicare; Special Processing Unit (SPU) Paul R. Brazil, Muller Brazil, LLP, Dresher, PA, for Petitioner. Alexa Roggenkamp, U.S. Department of Justice, Washington, DC, for Respondent. RULING ON INABILTY TO CLAIM MEDICARE HEALTHCARE INSURANCE OFFSET AGAINST VACCINE PROGRAM DAMAGES AWARDS1 On August 5, 2019, Ethel Love filed a petition for compensation under the National Vaccine Injury Compensation Program, 42 U.S.C. §300aa-10, et seq. (the “Vaccine 2 Act”). Petitioner alleged that she suffered left shoulder injuries related to vaccine administration (“SIRVA”) as a result of an influenza (“flu”) vaccine she received on October 14, 2016. Petition at 1; Stipulation, filed August 31, 2021, ¶¶ 2, 4. On August 31, 2021, I entered a decision awarding Petitioner compensation based on the joint stipulation filed by the parties. (ECF No. 26). Approximately two weeks prior, on August 19, 2021, Petitioner’s counsel contacted the Court to advise that the Medicare division of the Centers for Medicare & Medicaid Services (CMS) has expressed an intent to assert a lien on her damages award in this 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). I intend to post this ruling on the United States Court of Federal Claims' website. 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. Case 1:19-vv-01134-UNJ Document 33 Filed 10/08/21 Page 2 of 3 case. See Informal Remark, dated Aug. 19, 2021. Petitioner therefore requests a “ruling” concerning how Sections 15(g) and (h) of the National Childhood Vaccine Injury Compensation Program (the “Vaccine Act”)2 pertains to the present case. In other words, Petitioner seeks to clarify whether Medicare is entitled to reimbursement of benefits that it has paid now that Petitioner is receiving compensation in her Vaccine case. Under the Vaccine Program, a petitioner may recover actual and projected unreimbursable expenses, lost wages, and pain and suffering, and an award of $250,000 if the injury resulted in death. Section 15(a); see also Helman v. Sec’y of Health & Human Servs., No. 10-813V, 2014 WL 3589564, at *1 (Fed. Cl. Spec. Mstr. June 24, 2014) (citing Bruesewitz v. Wyeth, LLC, 131 S.Ct. 1068, 1074 (2011)). But such compensation elements are limited by subsequent sections of the Act. Thus, punitive and exemplary damages are prohibited, and for unreimbursable expenses and pain and suffering, compensation may be provided only for the “health, education, or welfare of the person who suffered the vaccine-related injury.” Section 15(d). Additionally, total recoverable compensation for an established vaccine injury can be offset by amounts paid or expected to be paid under an insurance policy and certain State or Federal programs. Section 15(g).3 Thus, the Vaccine Act always and by its own terms functions as a secondary payer to a petitioner’s health care insurance. Any entitlement award paid to a petitioner cannot include amounts already paid, or expected to be paid, under his or her existing health care insurance policy. The Act also prohibits any health insurance policy from “mak[ing] payment of benefits under the policy secondary to the payment of compensation under the Program.” Section 15(h). Although the Program has long represented that payments received from Medicaid for health care needs associated with a vaccine injury should be reimbursed (and hence constitute a lien against any Vaccine Program award), no other health care compensation or insurance 2 The National Childhood Vaccine Injury Act of 1986, Pub. L. No. 99-660, 100 Stat. 3755, codified as amended, 42 U.S.C. §§ 300aa-10 et seq. Hereafter, individual section references will be to 42 U.S.C. §300aa of the Act. 3 Section 15(g) states: 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 U.S.C. 1396 et seq.]), or (2) by an entity which provides health services on a prepaid basis. 2 Case 1:19-vv-01134-UNJ Document 33 Filed 10/08/21 Page 3 of 3 program receives the same protections. See e.g., Helman v. Sec'y of Health & Hum. Servs., No. 10-813V, 2014 WL 3589564, at *1 (Fed. Cl. June 24, 2014). In light of the above, it is readily evident that the plain language of the Vaccine Act does not authorize reimbursement for benefits already paid in this case under Petitioner’s Medicare health care insurance policy.4 This means that Petitioner’s insurer cannot be reimbursed by the Vaccine Program for its payments for Petitioner’s treatment in connection with the injury, sickness, accident, or condition which has been alleged. Petitioner shall so inform any entity that indicates the intent to act in controversion of the Act’s requirements. Any questions regarding this order or about this case generally may be directed to OSM Staff Attorney, Francina Segbefia, at (202) 357-6358 or Francina_Segbefia@cfc.uscourts.gov. IT IS SO ORDERED. s/Brian H. Corcoran Brian H. Corcoran Chief Special Master 4 I and other special masters have issued similar rulings in other cases, with the goal of informing secondary parties that they are not entitled to receive part of Vaccine Program awards. See Gram v. Sec’y of Health & Human Servs., No. 15-0305V, 2018WL 2015 WL 7166097 (Fed. Cl. Spec. Mstr. Sept. 29, 2015); Dashty v. Sec’y of Health & Human Servs., No. 15-0966V, 2018 WL 2411049 (Fed. Cl. Spec. Mstr. Mar. 5, 2018); Kuhl v. Sec’y of Health & Human Servs., No. 16-1716V, 2018 WL 4391002 (Fed. Cl. Spec. Master May 24, 2018); Fennig v. Sec’y of Health & Human Servs., No. 17-2019V, 2018 WL 7247224 (Fed. Cl. Spec. Mstr. Dec. 17, 2018). Fennig involved a self-funded ERISA insurance plan. 2018 WL 7247224, at *1. 3