VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_20-vv-00465
Package ID: USCOURTS-cofc-1_20-vv-00465
Petitioner: Shoshana Robuck
Filed: 2020-04-20
Decided: 2024-05-20
Vaccine: influenza
Vaccination date: 2019-01-25
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 62920

AI-assisted case summary:
Shoshana Robuck, an adult, received an influenza vaccine on January 25, 2019. Within two weeks, she developed pain and reduced range of motion in her right shoulder, which was diagnosed as Shoulder Injury Related to Vaccine Administration (SIRVA). The court found that her injury met the criteria for a Table SIRVA, meaning causation was presumed. Specifically, the court determined she had no prior history of shoulder problems that would explain her symptoms, her pain began within 48 hours of vaccination, and the pain was limited to her right shoulder. The court also found no other condition explained her symptoms. The entitlement ruling was issued on August 21, 2023. Subsequently, on April 17, 2024, the parties submitted a proffer agreeing to a compensation award. The court awarded Shoshana Robuck a total of $62,920.00, comprising $62,500.00 for pain and suffering and $420.00 for past unreimbursable expenses.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_20-vv-00465-0
Date issued/filed: 2023-09-25
Pages: 12
Docket text: PUBLIC ORDER/RULING (Originally filed: 08/21/2023) regarding 31 Ruling on Entitlement, Order on Motion for Ruling on the Record. Signed by Chief Special Master Brian H. Corcoran. (kle) Service on parties made.
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Case 1:20-vv-00465-UNJ Document 34 Filed 09/25/23 Page 1 of 12
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-0465V
UNPUBLISHED
SHOSHANA ROBUCK, Chief Special Master Corcoran
Petitioner,
v. Filed: August 21, 2023
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Leah VaSahnja Durant, Law Offices of Leah V. Durant, PLLC, Washington, DC, for
Petitioner.
Debra A. Filteau Begley, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On April 20, 2020, Shoshana Robuck filed a petition for compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. §300aa-10, et seq.2 (the
“Vaccine Act”) alleging that she suffered a shoulder injury related to vaccine
administration (“SIRVA”) as a result of an influenza (“flu”) vaccine administered to her on
January 25, 2019. Petition, ECF No. 1 at 1. The case was assigned to the Special
Processing Unit of the Office of Special Masters.
1 Because this unpublished opinion contains a reasoned explanation for the action in this case, it must be
made publicly accessible and will be posted on the United States Court of Federal Claims' website, and/or
at https://www.govinfo.gov/app/collection/uscourts/national/cofc, in accordance with the E-Government
Act of 2002. 44 U.S.C. § 3501 note (2018) (Federal Management and Promotion of Electronic Government
Services). This means the opinion 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 1:20-vv-00465-UNJ Document 34 Filed 09/25/23 Page 2 of 12
For the reasons discussed below, the record preponderantly supports the
conclusion that Petitioner’s shoulder injury would not be explained by her prior medical
history; that Petitioner suffered the onset of symptoms within 48 hours; that Petitioner’s
pain and reduced range of motion were limited to her right shoulder; and that no other
condition or abnormality is present that would explain Petitioner’s symptoms. Petitioner is
entitled to compensation under the Vaccine Act.
I. Relevant Procedural History
Following an initial status conference on June 23, 2020, Respondent was directed
to file a status report providing counsel’s informal reaction to Petitioner’s claim. ECF No.
11; Non-PDF order, dated July 27, 2020. Respondent did so on December 2, 2020,
asserting that several records needed for his evaluation remained unfiled (including
records pertaining to Petitioner’s mental health history). ECF No. 14 at 2, n.2. Petitioner
raised some objections to certain of the requested documents as irrelevant (see ECF No.
18 at 1-4). But the dispute was not fully resolved, and eventually (in light of the substantial
time this matter had been pending) I ordered the parties to brief the issue of Petitioner’s
entitlement (including the disputed documents issue). ECF No. 23.
On September 20, 2021, Petitioner filed her Motion for a Ruling on the Record
(“Motion”) arguing that she has established entitlement to compensation for SIRVA. ECF
No. 24. Respondent filed his combined response and Rule 4(c) Report (“Response”) on
October 22, 2021. ECF No. 26. Noting that a few of Petitioner’s medical records appeared
incomplete, Respondent argued that Petitioner may have a history of shoulder pain or
dysfunction. Id. at 8. Respondent also argued that Petitioner has neither established that
her symptoms began within 48 hours of vaccination nor that her symptoms were limited
to her right shoulder, and that the mental health records were likely relevant to the issue
of an alternative explanation for her alleged injury. Response at 8-10.
Petitioner filed her reply (“Reply”) on October 29, 2021. ECF No. 27. Among other
things, she repeated her contention that the mental health records were irrelevant and
otherwise protected from disclosure. Reply at 4. On May 10, 2023, Petitioner filed two
additional exhibits as well as a status report and statement of completion confirming that,
with the exception of mental health records, “the record in this matter is now complete.”
ECF Nos. 28-30.
II. 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
2

Case 1:20-vv-00465-UNJ Document 34 Filed 09/25/23 Page 3 of 12
Section 11(c)(1). A Petitioner may prevail on his claim if he has “sustained, or endured
the significant aggravation of any illness, disability, injury, or condition” set forth in the
Vaccine Injury Table (the “Table”). Section 11(c)(1)(C)(i). The most recent version of the
Table, which can be found at 42 C.F.R. § 100.3, identifies the vaccines covered under
the Program, the corresponding injuries, and the time period in which the particular
injuries must occur after vaccination. Section 14(a). If a claimant establishes that he has
suffered a “Table Injury,” causation is presumed.
Section 11(c)(1) also contains requirements concerning the type of vaccination
received and where it was administered, the duration or significance of the injury, and the
lack of any other award or settlement. See Section 11(c)(1)(A), (B), (D), and (E). With
regard to duration, a petitioner must establish that he suffered the residual effects or
complications of such illness, disability, injury, or condition for more than six months after
the administration of the vaccine. Section 11(c)(1)(D).
Effective for petitions filed beginning on March 21, 2017, SIRVA is an injury listed
on the Vaccine Injury Table. See Vaccine Injury Table: Qualifications and aids to
interpretation (“QAI”). 42 C.F.R. § 100.3(c)(10). The criteria are as follows:
A vaccine recipient shall be considered to have suffered SIRVA if such
recipient manifests all of the following: (i) No history of pain, inflammation
or dysfunction of the affected shoulder prior to intramuscular vaccine
administration that would explain the alleged signs, symptoms, examination
findings, and/or diagnostic studies occurring after vaccine injection; (ii) Pain
occurs within the specified time-frame; (iii) Pain and reduced range of
motion are limited to the shoulder in which the intramuscular vaccine was
administered; and (iv) No other condition or abnormality is present that
would explain the patient’s symptoms (e.g. NCS/EMG or clinical evidence
of radiculopathy, brachial neuritis, mononeuropathies, or any other
neuropathy).
Id.
III. Relevant Factual Evidence
I have fully reviewed the evidence, including all medical records, affidavits, and the
parties’ briefing. I find most relevant the following:
• On November 21, 2017, Petitioner presented to Dr. Stella Gandhi for an annual exam.
Ex. 5 at 5-7. The medical record documents Petitioner’s complaint of dizzy spells and
a discussion concerning “polycystic ovaries.” Id. at 7. The date of any previous annual
exam was not included in this record. However, in a letter dated February 22, 2022
3

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(and hence filed during the pendency of this case), Dr. Gandhi explained that she
“inadvertently did not include the date of the last physical exam for [Petitioner] in the
records from the appointment date of 11/21/2017.” Ex. 18 at 1.
• Petitioner sought gynecological care from N.P. Doris Perez on March 16, 2018. Ex. 9
at 7-10. There is no indication that Petitioner’s right shoulder was discussed during
this visit.
• Petitioner’s insurance benefit statements indicate that Petitioner received care from
Hilda M. Saliba on or around April 12, 2018. Ex. 10 at 12. The Present on Admission
(“POA”) indicator notes “generalized anxiety disorder.” Id.
• Petitioner’s insurance benefit statements also indicate that Petitioner received care
from Dr. Landis Block in 2018 and 2019. Ex. 10 at 14-22, 28. The POA indicator for
these visits note “adjustment disorder with mixed anxiety and depressed mood.” Id.
• On January 25, 2019, Petitioner presented to Adrian Gonzalez Medical Care (“AG
Medical Care”) for an annual physical exam. Ex. 2 at 3-5. The record documenting
this appointment indicates that Petitioner’s medical history included eczema,
depression, anxiety, “post-infective IBS,” and polycystic ovarian syndrome. Id. at 3.
During this visit, Petitioner received the flu vaccine in her right deltoid. Id. at 4-5.
• Petitioner returned to AG Medical Care on February 8, 2019 (two weeks post-
vaccination). Ex. 2 at 6-7. The medical record reflects Petitioner’s complaint of “right
shoulder pain since . . . flu shot [a] few weeks ago.” Id. at 6. On exam, Petitioner was
determined to have full range of motion, but “pain with resisted abduction” in her right
shoulder. Id. The note documenting this visit further indicates that Petitioner suffered
from “acute pain of right shoulder” with an “unclear etiology. ?shoulder injury after
injection.” Id.
• Also on February 8, 2019, Petitioner underwent an initial physical therapy exam and
session for her right shoulder at Young’s Physical Therapy & Acupuncture (“Young’s”).
Ex. 3 at 48-50. The mechanism of injury was noted as “severe pain after injection.” Id.
at 48. On exam, Petitioner exhibited limited range of motion and pain with flexion and
external rotation. Id. at 47. Petitioner also demonstrated tenderness in several areas
associated with her right shoulder. Id. Approximately 8 minutes of Petitioner’s physical
therapy session was dedicated to therapeutic interventions aimed at improving
Petitioner’s posture, kinesthetic and proprioceptive sensations. Id.
4

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• Petitioner participated in seven sessions of physical therapy between February 8 and
February 28, 2019. Ex. 3 at 41 - 47. Her chief complaint was consistently noted as
right shoulder pain, stiffness, and right “sh[oulder] girdle.” Id.
• Petitioner returned to Young’s on February 19, 2019 for an initial acupuncture
evaluation. Ex. 3 at 19. Petitioner’s chief complaint was “neck, upper back & R
sh[oulder]” pain.” Id.
• Over the course of around two months, Petitioner attended 15 acupuncture
appointments for her “neck/upper back”, mid-back and right “shoulder/arm.” Ex. 3 at
4-18.
• On February 19, 2019, Petitioner presented to Dr. Sonali Lai at Integrative Spine and
Sports for an evaluation of her right shoulder. Ex. 17 at 3-5. Dr. Lai noted that
Petitioner reported persistent pain “for the past week following receiving the flu shot”
and that “[t]hey localize the pain to the anterior and anterolateral shoulder.” Id. at 3.
• Petitioner returned to Integrative Spine and Sports on March 11, 2019 for a re-
evaluation of her right shoulder. Ex. 17 at 7-9. Petitioner’s pain was noted to have
“been persistent for the past few weeks following the flu shot from her PCP.” Id. at 7.
• On March 20, 2019, Petitioner presented to NY Presbyterian for an MRI of her right
shoulder due to pain and weakness. Ex. 4 at 3-4. The MRI revealed “[m]ild rotator
cuff tendinosis” with no rotator cuff tear. Id.
• Petitioner continued physical therapy through March and April 2019. Ex. 3 at 20-30,
39-40. Her chief complaint continued to be noted as right shoulder pain, stiffness, and
her right shoulder girdle. Id. Approximately 8 minutes of each session was dedicated
to therapeutic interventions aimed at improving Petitioner’s posture, kinesthetic and
proprioceptive sensations. Id.
• Following an approximate one-month break, Petitioner returned to physical therapy
on May 13, 2019. Ex. 3 at 36. Petitioner’s chief complaints were noted to include
headaches, difficulty sleeping, and issues with her neck, right shoulder, and upper
back. Id. The evaluation form reflects that the “[h]istory of [p]resent
condition/mechanism of injury” was “chronic pain caused by poor posture from
working, daily life / after injection.” Id.
• Petitioner’s participation in physical therapy continued throughout the spring and
summer of 2019, with an additional focus on her cervical spine. Ex. 3 at 31-34; 51-60.
5

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Her chief complaint was consistently noted as “c/s t/s tightness, stiffness, pain,
weakness r[ight] shoulder pain.” Id.
• Petitioner returned to AG Medical on July 2, 2019, for a follow-up examination
regarding her shoulder symptoms. Ex. 2 at 8. Although Petitioner reported some
improvement, the medical record reflects that her shoulder pain was “still present
despite physical therapy.” Id.
• On July 23, 2019, Petitioner presented to Dr. Charles M. Jobin, an orthopedic surgeon,
at Columbia University Medical Center. Ex. 6 at 2-3. Although Petitioner’s symptoms
included [f]atigue, neck stiffness, and irregular monthly cycles,” Dr. Jobin’s medical
note focuses on Petitioner’s complaint of “right shoulder problems that began after a
flu shot which was given in January 2019.” Id. at 2. Dr. Jobin documented Petitioner’s
report of “immediate[ ] . . . discomfort in the shoulder, trouble raising it up.” Id. at 2.
After performing a physical examination and considering Petitioner’s MRI, Dr. Jobin
assessed Petitioner with “[r]ight shoulder flu shot bursitis and biceps tendinitis” and
administered a steroid injection to Petitioner’s right shoulder. Id. at 2-3.
• Petitioner underwent a physical therapy evaluation on September 11, 2019 (over
seven months after vaccination). Ex. 13 at 5. The mechanism of Petitioner’s injury was
identified as “[e]xcessive work, stress and attention during work leads to pain in
midback, upper back, neck and shoulder.” Id. The preliminary diagnosis was
“Midback, Upper neck pain, R[ight] shoulder pain, Fibromyalgia.” Id. At 7.
• Between September 11 and October 3, 2019, Petitioner attended four additional
sessions of physical therapy. Ex. 13 at 1-7. Her chief complaint was noted to be “t/s
c/s tightness, stiffness, pain, weakness [and] R[ight] shoulder pain.” Id. at 1-4.
• Petitioner presented for a physical exam on October 18, 2019. Ex. 14 at 1-9.
Petitioner’s medical history was noted to include anxiety, depression, polycystic ovary
syndrome, and “R shoulder injury (SIRVA)” and further reflect that in “Jan. 2019 . . .
[Petitioner] went to get a flu shot and got infected – went to get a steroid shot/could
not lift shoulder.” Ex. 14 at 1- 2.
6

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IV. Findings of Fact Regarding Contested QAI Criteria for Table SIRVA
A. Prior Condition
The first QAI requirement for a Table SIRVA is lack of a history revealing problems
associated with the affected shoulder which were experienced prior to vaccination and
would explain the symptoms experienced after vaccination. 42 C.F.R. § 100.3(c)(10)(i).
Respondent argues that “it is not clear if [P]etitioner had any shoulder pain or
dysfunction prior to her vaccination” because “some information may be missing” from a
singular record generated by Dr. Gandhi on November 21, 2017 (which notably precedes
the vaccination at issue by more than a year). Response at 2, 8. Respondent specifically
points to a sentence fragment contained in the history of present illness:
Last physical was
also concerned about dizzy spells.
travels a lot for work. 2 months ago was in Japan, awoke with with vertigo,
dizziness, lightheadedness with a syncopal episode. lasted 1 week. saw a
dr on Tokyo and was told she was fine and prescribed a vertigo
medication.
Ex. 5 at 7. Although Respondent suggests that Dr. Gandhi failed to detail Petitioner’s full
medical history, Dr. Gandhi has submitted a letter explaining that she “inadvertently did
not include the date of the last physical exam for [Petitioner].” Ex. 18 at 1. Although this
unsworn explanation was offered over four years after the error was made, I find it to be
credible based on a common-sense examination of the medical note itself.
Respondent also argues that treatment records generated by Drs. Saliba and
Block “could provide evidence as to [P]etitioner’s physical state both prior to and
immediately after her vaccination.” Response at 8. A review of Petitioner’s insurance
benefits statements indicate that Petitioner received care from these two treaters for
mental health issues. See Ex. 10 at 12, 14-22, 28. See also Ex. 15.
While there is a remote possibility that Petitioner’s mental health records might
shed light on the existence of shoulder pain prior to January 2019, “[t]he mere possibility
of a clue does not satisfy the ‘reasonable and necessary’ standard” that applies to what
discovery is permitted in the Program. Phillips-Deloatch v. HHS, No. 09-171V, 2015 WL
1950107, at *6 (Fed. Cl. Spec. Mstr. Apr. 9, 2015) (referencing Vaccine Act Section
12(d)(3)(B)). See also Vaccine Rule 7 (providing that there is no discovery as a matter of
right and that the special master shall determine the scope of discovery); In re Claims for
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Vaccine Injuries Resulting in Autism Spectrum Disorder or a Similar Neurodevelopmental
Disorder, Various Petitioners v. Sec'y of Health & Human Servs., 2007 WL 1983780 at *6
(Fed. Cl. Spec. Mstrs. May 25, 2007) (providing that a special master has “broad
discretion” in determining what material is necessary or not, in the overall context of the
case).
The Vaccine Guidelines recommend that in a claim involving a vaccinee who is an
adult, “the filed records should include all records from all primary care providers for three
years prior to the administration of the vaccine(s) alleged to be causal.”3 Though few,
Petitioner has filed these records. See Ex. 5 at 1 (cover page requesting “all medical
records in [Dr. Gandhi’s] possession dated 1/1/2016 present . . . Please be sure to include
all archived records and all records located in storage. Please release any and all records
ranging from Dr. Stella Gandhi[‘]s office and any other physicians”). See also Ex. 18 at 1
(February 22, 2022 letter from Dr. Gandhi stating that “complete medical records have
been sent . . . as requested.”). Additionally, Petitioner has filed multiple records from
other medical providers which appear to provide a comprehensive picture of her medical
condition. These records do not reveal any evidence that Petitioner suffered a pre-
vaccination history of problems that would explain her post-vaccination shoulder
symptoms. And the possibility of an alternative explanation for Petitioner’s injury that
might be found in these unfiled records is simply too unlikely to make it reasonable to
require the records be filed in this case.
Accordingly, I find that Petitioner has met the first criterion to establish a Table
SIRVA.
B. Onset
A petitioner alleging a SIRVA claim must also show that she experienced the first
symptom or onset within 48 hours of vaccination (42 C.F.R. § 100.3(a)(XIV)(B)), and that
her pain began within that same 48-hour period (42 C.F.R. § 100.3(c)(10)(ii) (QAI
criteria)). While Respondent acknowledges that Petitioner’s “report of right shoulder pain
on February 8, 2019 . . . assists in establishing the onset of her condition,” he argues that
this piece of evidence “cannot be viewed in a vacuum, particularly given the lack of pre-
vaccination records, missing records and conflicting medical records.”4 Response at 8.
3 Guidelines for Practice Under the National Vaccine Injury Compensation Program (as revised April 24,
2020), available at https://www.uscfc.uscourts.gov/vaccine-guidelines.
4 Respondent argues that “[n]o effort has been made to explain the discrepancies between [P]etitioner’s
visits on February 8, 2019.” Response at 9. Specifically, Respondent notes that on February 8, 2019, Dr.
Gonzalez observed that “[P]etitioner could move her right shoulder through a full range of motion . . . and
[only experienced] increased pain with resisted abduction” - but that PT notes from the same date indicate
that Petitioner suffered extreme limitations in right shoulder range of motion. Response at 8-9, citing Ex. 2
8

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Despite Respondent’s contentions, the totality of the record – not just a lone
document from February 2019 – supports the conclusion that Petitioner’s shoulder pain
most likely began within 48 hours of vaccination. 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 (e.g., pain “following the flu shot . . .” (emphasis added)) allow for
the possibility that onset could have occurred more than 48 hours from vaccination.
However, at Petitioner’s first post-vaccination medical appointment (for this is not a case
with intervening records that rebut Petitioner’s contentions), she specifically complained
of “right shoulder pain since . . . flu shot [a] few weeks ago.” This report was made
precisely two weeks after vaccination. Ex. 2 at 6. Moreover, in one instance, Petitioner’s
shoulder symptoms were noted to have occurred “immediately” after vaccination. Ex. 6
at 2. Also significant is that Petitioner consistently related the onset of her pain to the
vaccination on January 25, 2019. See, e.g., Ex. 17 at 3, 7 (reporting persistent pain that
began after her January 2019 vaccination). Therefore, I find that Petitioner has provided
preponderant evidence that the onset of her right shoulder pain and dysfunction began
within 48 hours of receiving the flu vaccine on January 25, 2019.
Respondent appears to also argue that Petitioner is unable to satisfy the onset
requirement because she “could move her right shoulder through a full range of motion”
during her February 8, 2019 medical examination. Response at 8. However, the QAI for
SIRVA only state that a petitioner’s pain must occur within the specified 48-hour
timeframe. 42 C.F.R. § 100.3(c)(10). See also Portee v. Sec'y of Health & Hum. Servs.,
No. 16-1552V, 2018 WL 5284599 (Fed. Cl. Spec. Mstr. Sept. 14, 2018) (determining
limited ROM manifesting within 48 hours is not required for a Table SIRVA). Accordingly,
I find that Petitioner has met the second criterion to establish a Table SIRVA.
C. Scope of Pain
The third QAI requirement for a Table SIRVA requires a petitioner’s pain and
reduced range of motion to be “limited to the shoulder in which the intramuscular vaccine
was administered.” 42 C.F.R. § 100.3(c)(10)(iii). Respondent implies that Petitioner has
not satisfied this criterion because “acupuncture notes document pain in multiple regions
including [P]etitioner’s neck, upper back, and right shoulder.” Response at 9.
I find, however, that (for purposes of the Table SIRVA claim), a preponderance of
the evidence supports the conclusion that Petitioner’s injury was limited to her right
at 6; Ex. 3 at 48. This contradiction is not fatal to Petitioner’s claim. As the Claims Court has recognized,
physicians may enter information incorrectly and “typically record only a fraction of all that occurs.” Shapiro
v. Sec'y of Health & Human Servs., 101 Fed. Cl. 532, 538 (2011) (citing Murphy v. Sec'y of Health & Human
Servs., 23 Cl. Ct. 726, 733 (1991)).
9

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shoulder, even if symptoms elsewhere were documented in the context of treatment. It is
true that Petitioner’s acupuncture treatment included both her neck and back. Ex. 3 at 4-
19. And I also note that Petitioner’s cervical spine issues were addressed during physical
therapy sessions after May 2019. Ex. 3 at 31-60. However, prior to May 2019, Petitioner’s
right shoulder injury was the focus of therapy – and this remained a central purpose of
her medical appointments. See, e.g., Ex. 2 at 8 (July 2, 2019 primary care record
documenting Petitioner’s follow-up exam for right shoulder pain); Ex. 6 at 2 (July 23, 2019
orthopedic note detailing Petitioner’s concern regarding her right shoulder pain and
charting her receipt of a steroid injection).
Moreover, I have previously recognized that this QAI criteria does not prevent a
petitioner with simultaneous areas of pain due to unrelated conditions from also meeting
the Table SIRVA definition. Rodgers v. Sec’y of Health & Hum. Servs., No. 18-0559, 2021
WL 4772097, at *8 and n.16 (Fed. Cl. Spec. Mstr. Sept. 9, 2021). However, Petitioner
must bear in mind that unrelated conditions must be separated out from the damages
attributable for a Table SIRVA. Rodgers, 2021 WL 47772097 at n. 16; see also Knudsen
v. Sec'y of Health & Hum. Servs., No. 18-1971V, 2021 WL 4448738, at *5 (Fed. Cl. Spec.
Mstr. Aug. 23, 2021) (“distinguishable injuries are not an additional basis for recovery”).
Here, the preponderance of evidence suggests the shoulder was the main concern – and
any distinguishable treatment can be differentiated in the process of calculating damages.
D. Other Condition or Abnormality
The last QAI criteria for a Table SIRVA states that there must be no other condition
or abnormality which would explain a petitioner’s current symptoms. 42 C.F.R. §
100.3(c)(10)(iv).
Noting that “poor posture is a ‘common cause of shoulder impingement,’”
Respondent suggests that Petitioner’s shoulder symptoms are related to the improper
alignment of her body. Response at 9. In support of this argument, Respondent
references physical therapy records generated in February and March 2019. Response
at 9. These records – as well as those documenting Petitioner’s physical therapy through
the spring and summer of 2019 – reveal that approximately 8 minutes of each session
were dedicated to therapeutic interventions aimed at improving Petitioner’s posture,
kinesthetic and proprioceptive sensations. Ex. 3 at 27-34, 44, 51-60. However, they do
not indicate that Petitioner’s shoulder symptoms were actually caused by her posture.
Respondent also references a March 2019 physical therapy evaluation form.
Response at 9, citing Ex. 3 at 26. Petitioner’s chief complaints were noted to include
headaches, difficulty sleeping, and issues with her neck, right shoulder, and upper back.
10

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Ex. 3 at 26. In addition, the “[h]istory of [Petitioner’s] present condition/mechanism of
injury” was noted as “chronic pain caused by poor posture from working, daily life / after
injection.” Id. Although Petitioner asserts that the backslash denotes “two separate
potential sources of pain – one for the back/neck pain, and the other for shoulder pain”
(Reply at 7), this record is ambiguous. However, given the weight of other evidence, it is
not necessary for me to resolve this ambiguity.
Respondent not only ignores that concerns regarding Petitioner’s posture are not
mentioned in the medical records, but also that Petitioner’s shoulder symptoms were
consistently linked to vaccination. First, Petitioner has provided preponderant evidence
that she first sought treatment for her shoulder pain on February 8, 2019 – 14 days after
her vaccination – and attributed her injury to a flu shot. See Ex. 2 at 6. And second, the
vast majority of Petitioner’s records consistently connect her shoulder symptoms to
vaccination with no suggestion that Petitioner’s posture may be causal. See, e.g., Ex. 3
at 48-50 (February 8, 2019 physical therapy record noting “severe pain after injection”);
Ex. 17 at 3, 7 (February 19 and March 11, 2019 orthopedic notes reflecting Petitioner’s
report of persistent post-vaccination pain).
And despite acknowledging that Dr. Jobin assessed Petitioner with “right shoulder
flu shot bursitis and biceps tendinitis” in July 2019, Respondent suggests that this
diagnosis was faulty because he “appeared to rely on [P]etitioner’s statement that her
right shoulder pain was triggered by her vaccination, and not a review of [P]etitioner’s PT
or prior records.” Response at 10. However, Dr. Jobin’s notes from this date reveal that
he performed a physical examination of Petitioner’s right shoulder and reviewed her MRI
before reaching a conclusion about her condition. Ex. 6 at 2. There is no indication that
he believed that Petitioner’s symptoms were caused by poor posture.
At best, there is Petitioner’s September 11, 2019 report that “[e]xcessive work,
stress and attention during work leads to pain in midback, upper back, neck and
shoulder.” Ex. 13 at 5. However, this record (created over seven months post-vaccination)
is not enough to outweigh earlier medical records attributing Petitioner’s shoulder
symptoms to her January 2019 flu shot. (And it can be given weight in the context of
determining damages).
Thus, the record contains preponderant evidence establishing that there is no
other condition or abnormality which would explain the symptoms of Petitioner’s right
shoulder injury.
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V. Other Table Requirements for Entitlement
Even if a petitioner has satisfied the requirements of a Table injury or established
causation-in-fact, he or she must also provide preponderant evidence of the additional
requirements of Section 11(c), i.e., receipt of a covered vaccine, residual effects of injury
lasting six months, etc. See generally § 11(c)(1)(A)(B)(D)(E). But those elements are
established or undisputed. Petitioner has therefore established that she suffered a Table
SIRVA, satisfying all other requirements for compensation.
Conclusion
Based on the entire record, I find that Petitioner has provided preponderant evidence
satisfying all requirements for a Table SIRVA. Petitioner is entitled to compensation. A
subsequent order will set further proceedings towards resolving damages.
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
12

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DOCUMENT 2: USCOURTS-cofc-1_20-vv-00465-1
Date issued/filed: 2024-05-20
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 04/18/2024) regarding 41 DECISION Stipulation/Proffer. Signed by Chief Special Master Brian H. Corcoran. (kle) Service on parties made.
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Case 1:20-vv-00465-UNJ Document 42 Filed 05/20/24 Page 1 of 5
CORRECTED
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-0465V
SHOSHANA ROBUCK, Chief Special Master Corcoran
Petitioner, Filed: April 18, 2024
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Leah VaSahnja Durant, Law Offices of Leah V. Durant, PLLC, Washington, DC, for
Petitioner.
Debra A. Filteau Begley, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On April 20, 2020, Shoshana Robuck 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 administered to her on
January 25, 2019. Petition at 1. The case was assigned to the Special Processing Unit of
the Office of Special Masters.
On August 21, 2023, a ruling on entitlement was issued, finding Petitioner entitled
to compensation for SIRVA. On April 17, 2024, Respondent filed a proffer on award of
compensation (“Proffer”) indicating Petitioner should be awarded $62,920.00 (comprised
of $62,500.00 in pain and suffering and $420.00 in past unreimbursable expenses).
Proffer at 2. In the Proffer, Respondent represented that Petitioner agrees with the
1 Because this Decision contains a reasoned explanation for the action taken in this case, it must be made
publicly accessible and will be posted on the United States Court of Federal Claims' website, and/or
at https://www.govinfo.gov/app/collection/uscourts/national/cofc, in accordance with the E-Government
Act of 2002. 44 U.S.C. § 3501 note (2018) (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 (2018).

Case 1:20-vv-00465-UNJ Document 42 Filed 05/20/24 Page 2 of 5
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 $62,920.00 (comprised of $62,500.00 in pain and suffering and
$420.00 in past unreimbursable 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 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 1:20-vv-00465-UNJ Document 42 Filed 05/20/24 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
__________________________________________
)
SHOSHANA ROBUCK, )
)
Petitioner, )
) No. 20-465V (ECF)
v. ) Chief Special Master Corcoran
)
SECRETARY OF HEALTH )
AND HUMAN SERVICES, )
)
Respondent. )
__________________________________________)
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
On April 20, 2020, Shoshana Robuck (“petitioner”) filed a petition for compensation
under the National Childhood Vaccine Injury Act of 1986, 42 U.S.C. §§ 300aa-1 to -34
(“Vaccine Act” or “Act”), alleging that she suffered a Shoulder Injury Related to Vaccine
Administration (“SIRVA”), as defined in the Vaccine Injury Table, following administration of
an influenza vaccine she received on January 25, 2019. Petition at 1. On September 20, 2021,
petitioner filed a Motion for Ruling on the Record. ECF No. 24. On October 22, 2021,
respondent filed his Response, and on October 29, 2021, petitioner filed a Reply. ECF Nos. 26,
27. On August 21, 2023, the, Chief Special Master issued a Ruling on Entitlement finding
petitioner entitled to compensation.1 ECF No. 31.
1 Respondent has no objection to the amount of the proffered award of damages set forth herein.
Assuming the Chief Special Master issues a damages decision in conformity with this proffer,
respondent waives his 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 August 21, 2023, entitlement decision.

Case 1:20-vv-00465-UNJ Document 42 Filed 05/20/24 Page 4 of 5
I. Items of Compensation
A. Pain and Suffering
Respondent proffers that petitioner should be awarded $62,500.00 in pain and suffering.
See 42 U.S.C. § 300aa-15(a)(4). Petitioner agrees.
B. Past Unreimbursable Expenses
Evidence supplied by petitioner documents that she incurred past unreimbursable
expenses related to her vaccine-related injury. Respondent proffers that petitioner should be
awarded past unreimbursable expenses in the amount of $420.00. See 42 U.S.C. § 300aa-
15(a)(1)(B). Petitioner agrees.
These amounts represent all elements of compensation to which petitioner is entitled
under 42 U.S.C. § 300aa-15(a). Petitioner agrees.
II. Form of the Award
Petitioner is a competent adult. Evidence of guardianship is not required in this case.
Respondent recommends that the compensation provided to petitioner should be made through a
lump sum payment as described below and requests that the Chief Special Master’s decision and
the Court’s judgment award the following: a lump sum payment of $62,920.00, in the form of
a check payable to petitioner.2
Respectfully submitted,
BRIAN M. BOYNTON
Principal Deputy Assistant Attorney General
C. SALVATORE D’ALESSIO
Director
Torts Branch, Civil Division
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,
unreimbursed expenses, future lost earnings, and future pain and suffering.
2

Case 1:20-vv-00465-UNJ Document 42 Filed 05/20/24 Page 5 of 5
HEATHER L. PEARLMAN
Deputy Director
Torts Branch, Civil Division
JULIA M. COLLISON
Assistant Director
Torts Branch, Civil Division
/s/ DEBRA A. FILTEAU BEGLEY
DEBRA A. FILTEAU BEGLEY
Senior Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146
Benjamin Franklin Station
Washington, D.C. 20044-0146
Phone: (202) 616-4181
Dated: April 17, 2024 debra.begley@usdoj.gov
3