VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_20-vv-00647
Package ID: USCOURTS-cofc-1_20-vv-00647
Petitioner: Jayson Clickner
Filed: 2020-05-27
Decided: 2021-10-27
Vaccine: influenza
Vaccination date: 2019-02-05
Condition: left shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 45812

AI-assisted case summary:
Jayson Clickner filed a petition on May 27, 2020, alleging he suffered a left shoulder injury related to vaccine administration (SIRVA) after receiving an influenza vaccine on February 5, 2019. Respondent filed a Rule 4(c) report conceding entitlement, finding that Mr. Clickner met the criteria for a presumed SIRVA as defined by the Vaccine Injury Table. Specifically, Respondent noted that Mr. Clickner had no prior history of shoulder issues, his pain occurred within 48 hours of vaccination, was limited to the shoulder of injection, and no other condition explained his symptoms. On August 16, 2021, a ruling on entitlement was issued, finding Mr. Clickner entitled to compensation. Subsequently, on September 23, 2021, Respondent filed a proffer proposing an award of $45,000.00 for pain and suffering and $812.02 for past unreimbursable expenses, totaling $45,812.02. Mr. Clickner, identified as a competent adult, agreed with the proffered award. On October 27, 2021, the Chief Special Master issued a decision awarding Mr. Clickner the stipulated sum of $45,812.02.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_20-vv-00647-0
Date issued/filed: 2021-09-16
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 08/16/2021) regarding 21 Ruling on Entitlement Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:20-vv-00647-UNJ Document 23 Filed 09/16/21 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-647V
UNPUBLISHED
JAYSON CLICKNER, Chief Special Master Corcoran
Petitioner, Filed: August 16, 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)
Leigh Finfer, Muller Brazil, LLP, Dresher, PA, for Petitioner.
Sarah Black Rifkin, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On May 27, 2020, Jayson Clickner 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 he suffered a left shoulder injury related to vaccine
administration (SIRVA) resulting from the adverse effects of an influenza (flu) vaccination
he received on February 5, 2019. Petition at 1. The case was assigned to the Special
Processing Unit of the Office of Special Masters.
On August 11, 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. Respondent “concluded that compensation is appropriate because [P]etitioner meets
the criteria for a presumed SIRVA, as defined by the Vaccine Injury Table”. Id. at 6.
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 1:20-vv-00647-UNJ Document 23 Filed 09/16/21 Page 2 of 2
Specifically, Respondent found that “[P]etitioner had no history of pain, inflammation or
dysfunction in his left shoulder; his pain occurred within 48 hours of receipt of an
intramuscular vaccination; his pain and reduced range of motion were limited to the
shoulder in which the vaccine was administered; and no other condition or abnormality
was identified to explain his symptoms . . . . In addition, given the medical records outlined
above, the statutory six month sequela requirement has been satisfied.” Id. at 6-7
(citations and footnote omitted). Respondent further agrees that the scope of damages to
be awarded are limited to petitioner’s left-sided SIRVA and its resulting sequelae only. 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-00647-1
Date issued/filed: 2021-10-27
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 09/24/2021) regarding 25 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:20-vv-00647-UNJ Document 30 Filed 10/27/21 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-647V
UNPUBLISHED
JAYSON CLICKNER, Chief Special Master Corcoran
Petitioner, Filed: September 24, 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)
Leigh Finfer, Muller Brazil, LLP, Dresher, PA, for Petitioner.
Sarah Black Rifkin, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On May 27, 2020, Jayson Clickner 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 he suffered a shoulder injury related to vaccine
administration resulting from the adverse effects of an influenza vaccination he received
on February 5, 2019. Petition at 1. The case was assigned to the Special Processing Unit
of the Office of Special Masters.
On August 16, 2021, a ruling on entitlement was issued, finding Petitioner entitled
to compensation for SIRVA. On September 23, 2021, Respondent filed a proffer on award
of compensation (“Proffer”) indicating Petitioner should be awarded $45,000.00 in pain
and suffering and $812.02 in past unreimbursable expenses. Proffer at 1-2. In the Proffer,
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 1:20-vv-00647-UNJ Document 30 Filed 10/27/21 Page 2 of 5
Respondent represented that Petitioner agrees 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 $45,812.02 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 1:20-vv-00647-UNJ Document 30 Filed 10/27/21 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
JAYSON CLICKNER,
Petitioner, No. 20-647V (ECF)
Chief Special Master Corcoran
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
On May 27, 2020, Jayson Clickner (“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 he suffered a Shoulder Injury Related to Vaccine Administration
(“SIRVA”), as defined in the Vaccine Injury Table, following administration of an influenza
vaccine he received on February 5, 2019. On August 11, 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 16, 2021,
the Chief Special Master issued a Ruling on Entitlement finding petitioner entitled to
compensation. ECF No. 20; ECF No. 21.
I. Items of Compensation
A. Pain and Suffering
Respondent proffers that petitioner should be awarded $45,000.00 in pain and suffering.
See 42 U.S.C. § 300aa-15(a)(4). Petitioner agrees.

Case 1:20-vv-00647-UNJ Document 30 Filed 10/27/21 Page 4 of 5
B. Past Unreimbursable Expenses
Evidence supplied by petitioner documents that he incurred past unreimbursable expenses
related to his vaccine-related injury. Respondent proffers that petitioner should be awarded past
unreimbursable expenses in the amount of $812.02. 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 following1: a lump sum payment of $45,812.02, in the form of a
check payable to petitioner.
III. Summary of Recommended Payments Following Judgment
Lump sum payable to petitioner, Jayson Clickner: $45,812.02
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
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 lost earnings
and future pain and suffering.
2

Case 1:20-vv-00647-UNJ Document 30 Filed 10/27/21 Page 5 of 5
TRACI R. PATTON
Assistant Director
Torts Branch, Civil Division
s/Sarah B. Rifkin
SARAH B. RIFKIN
Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146, Benjamin Franklin Station
Washington, D.C. 20044-0146
Tel: (202) 305-5997
Sarah.Rifkin@usdoj.gov
Dated: September 23, 2021
3