VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_20-vv-00560
Package ID: USCOURTS-cofc-1_20-vv-00560
Petitioner: Diane Jebran
Filed: 2020-05-06
Decided: 2022-11-07
Vaccine: influenza
Vaccination date: 2018-09-27
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 192686

AI-assisted case summary:
Diane Jebran filed a petition for compensation under the National Vaccine Injury Compensation Program on May 6, 2020, alleging she suffered a shoulder injury related to vaccine administration (SIRVA) after receiving an influenza vaccine on September 27, 2018. She further alleged her injury persisted for more than six months. The respondent conceded entitlement, agreeing that Ms. Jebran had no prior shoulder issues, her pain and reduced range of motion occurred within 48 hours of the intramuscular vaccination, her symptoms were localized to the vaccinated shoulder, and no other condition explained her symptoms. The respondent also agreed her injury effects lasted over six months. A ruling on entitlement was issued on August 30, 2021, finding her eligible for compensation as a SIRVA Table injury. Subsequently, on November 7, 2022, a decision on damages was issued. The parties agreed to a total award of $192,686.89, which included $120,000.00 for pain and suffering, $7,479.99 for past unreimbursable expenses, and $65,206.90 for past lost wages. Ms. Jebran is a competent adult and received the award as a lump sum payment.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_20-vv-00560-0
Date issued/filed: 2021-09-30
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 08/30/2021) regarding 32 Ruling on Entitlement Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:20-vv-00560-UNJ Document 34 Filed 09/30/21 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-0560V
UNPUBLISHED
DIANE JEBRAN, Chief Special Master Corcoran
Petitioner, Filed: August 30, 2021
v.
Special Processing Unit (SPU);
SECRETARY OF HEALTH AND Ruling on Entitlement; Concession;
HUMAN SERVICES, Table Injury; Influenza (Flu) Vaccine;
Shoulder Injury Related to Vaccine
Respondent. Administration (SIRVA)
Phyllis Widman, Widman Law Firm, LLC, Northfield, NJ, for Petitioner.
Lynn Christina Schlie, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On May 6, 2020, Diane Jebran 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 from a shoulder injury related to vaccine
administration (SIRVA) as a result of receiving an influenza (“flu”) vaccine administered
on September 27, 2018. Petition at ¶¶ 2, 18. Petitioner further alleges that her injury has
persisted for more than six months. Petition at ¶ 14. The case was assigned to the Special
Processing Unit of the Office of Special Masters.
On August 30, 2021, Respondent filed his Rule 4(c) report in which he concedes
that Petitioner is entitled to compensation in this case. Respondent’s Rule 4(c) Report at
1. Specifically, Respondent agrees that Petitioner had no relevant history of pain,
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 section references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C. §
300aa (2012).

Case 1:20-vv-00560-UNJ Document 34 Filed 09/30/21 Page 2 of 2
inflammation, or dysfunction in her left shoulder prior to vaccination; Petitioner’s pain and
reduced range of motion occurred within 48 hours of receipt of an intramuscular
vaccination; Petitioner’s symptoms were limited to the shoulder in which the vaccine was
administered; and no other condition or abnormality was identified to explain her
symptoms. Id. at 5. Respondent further agrees that Petitioner suffered the residual effects
or complications of her injury for more than six months after vaccine administration. Id.
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 2: USCOURTS-cofc-1_20-vv-00560-1
Date issued/filed: 2022-11-07
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 10/07/2022) regarding 55 DECISION Stipulation/Proffer. Signed by Chief Special Master Brian H. Corcoran. (kle) Service on parties made.
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Case 1:20-vv-00560-UNJ Document 59 Filed 11/07/22 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-0560V
UNPUBLISHED
DIANE JEBRAN, Chief Special Master Corcoran
Petitioner, Filed: October 7, 2022
v.
Special Processing Unit (SPU);
SECRETARY OF HEALTH AND Damages Decision Based on Proffer;
HUMAN SERVICES, Influenza (Flu); Shoulder Injury
Related to Vaccine Administration
Respondent. (SIRVA).
Phyllis Widman, Widman Law Firm, LLC, Northfield, NJ, for Petitioner.
Austin Joel Egan, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION ON DAMAGES1
On May 6, 2020, Diane Jebran 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 from a shoulder injury related to vaccine
administration (SIRVA) as a result of receiving an influenza (“flu”) vaccine administered
on September 27, 2018. Petition at ¶¶ 2, 18. Petitioner further alleges that her injury has
persisted for more than six months. Petition at ¶ 14. The case was assigned to the Special
Processing Unit of the Office of Special Masters.
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), Petitioners have
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-00560-UNJ Document 59 Filed 11/07/22 Page 2 of 5
On August 30, 2021, a ruling on entitlement was issued, finding that Petitioner was
entitled to compensation for a SIRVA Table injury. On October 7, 2022, Respondent filed
a proffer on award of compensation, which indicates Petitioner’s agreement to the
amount(s) therein. 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 a lump sum payment
of $192,686.89 (representing $120,000.00 for pain and suffering; $7,479.99 for past
unreimbursed expenses; and $65,206.90 for past lost wages) 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.

Case 1:20-vv-00560-UNJ Document 59 Filed 11/07/22 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
)
DIANE JEBRAN, )
)
Petitioner, )
) No. 20-560V
v. ) Chief Special Master Corcoran
) ECF
SECRETARY OF HEALTH AND HUMAN )
SERVICES, )
)
Respondent. )
)
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
On May 6, 2020, Diane Jebran (“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
(“flu”) vaccine she received on September 27, 2018. Petition at 1. On August 30, 2021, the
Secretary of Health and Human Services (“respondent”) filed a Rule 4(c) Report indicating that
this case is appropriate for compensation under the terms of the Act for a SIRVA Table injury,
and on August 30, 2021, the Chief Special Master issued a Ruling on Entitlement finding
petitioner entitled to compensation. ECF Nos. 31-32.
I. Items of Compensation
A. Pain and Suffering
Respondent proffers that petitioner should be awarded $120,000.00 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

Case 1:20-vv-00560-UNJ Document 59 Filed 11/07/22 Page 4 of 5
expenses related to her vaccine-related injury. Respondent proffers that petitioner should be
awarded past unreimbursable expenses in the amount of $7,479.99. See 42 U.S.C. § 300aa-
15(a)(1)(B). Petitioner agrees.
C. Lost Wages
Evidence supplied by petitioner documents that she incurred past lost wages related to
her vaccine-related injury. Respondent proffers that petitioner should be awarded past lost
wages in the amount of $65,206.90. See 42 U.S.C. § 300aa-15(a)(3)(A). 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 following1: a lump sum payment of $192,686.89, in the form of
a check payable to petitioner.
III. Summary of Recommended Payments Following Judgment
Lump sum payable to petitioner, Diane Jebran: $192,686.89
Respectfully submitted,
BRIAN M. BOYNTON
Principal Deputy Assistant Attorney General
C. SALVATORE D’ALESSIO
Director
Torts Branch, Civil Division
1 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-00560-UNJ Document 59 Filed 11/07/22 Page 5 of 5
HEATHER L. PEARLMAN
Deputy Director
Torts Branch, Civil Division
DARRYL R. WISHARD
Assistant Director
Torts Branch, Civil Division
/s/ AUSTIN J. EGAN
Austin J. Egan
Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146, Ben Franklin Station
Washington, DC 20044-0146
Tel: (202) 451-7479
Austin.J.Egan@usdoj.gov
Date: October 7, 2022
3