VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_20-vv-00867
Package ID: USCOURTS-cofc-1_20-vv-00867
Petitioner: William Ash
Filed: 2020-07-16
Decided: 2025-04-04
Vaccine: influenza
Vaccination date: 2018-11-05
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 64503

AI-assisted case summary:
William Ash, a 47-year-old professional musician, received an influenza vaccine on November 5, 2018. He alleges he suffered a shoulder injury related to vaccine administration (SIRVA) from this shot, which he believes was given in his right arm despite the record indicating the left. Within two days, he experienced pain, swelling, and redness in his right upper arm, leading to an emergency room visit where he was diagnosed with cellulitis and treated with antibiotics. Although the cellulitis resolved, Mr. Ash continued to experience persistent pain and decreased range of motion in his right shoulder, which he attributed to the vaccine. He sought treatment from multiple medical providers over several years, including orthopedists and physical therapists, and underwent diagnostic imaging like X-rays and an MRI. The medical records documented various shoulder pathologies, including impingement syndrome, bursitis, tendinosis, and adhesive capsulitis. Respondent initially contested entitlement, arguing that the cellulitis explained the early symptoms and that subsequent shoulder issues were a separate condition, and that onset and severity requirements were not met. However, the court found that Mr. Ash's pain began within 48 hours of vaccination, was localized to his right shoulder, and that his cellulitis diagnosis did not preclude a SIRVA finding. The court determined that his symptoms persisted beyond the required six months, satisfying the severity requirement for a Table SIRVA claim. On May 8, 2024, entitlement was granted, and a subsequent decision on April 4, 2025, awarded Mr. Ash $64,503.50 in total compensation. This amount included $60,000.00 for pain and suffering, $212.38 for past unreimbursable expenses, and $4,291.12 to satisfy a New York Medicaid lien.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_20-vv-00867-0
Date issued/filed: 2024-06-11
Pages: 13
Docket text: PUBLIC ORDER/RULING (Originally filed: 05/08/2024) regarding 49 Ruling on Entitlement, Order on Motion for Ruling on the Record. Signed by Chief Special Master Brian H. Corcoran. (tlf) Service on parties made.
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Case 1:20-vv-00867-UNJ Document 52 Filed 06/11/24 Page 1 of 13
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-0867V
WILLIAM ASH, Chief Special Master Corcoran
Petitioner, Filed: May 8, 2024
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Bridget Candace McCullough, Muller Brazil, LLP, Dresher, PA, for Petitioner.
Camille Michelle Collett, U.S. Department of Justice, Washington, DC, for Respondent.
FINDINGS OF FACT AND RULING ON ENTITLEMENT1
On July 16, 2020, William Ash 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 right shoulder injury related to vaccine
administration (“SIRVA”) from an influenza ("flu”) vaccine he received on November 5,
2018. Petition at 1. The case was assigned to the Special Processing Unit of the Office
of Special Masters.
For the reasons discussed below, I find that Petitioner more likely than not suffered
the residual effects of his alleged vaccine-related injury for more than six months, and
1 Because this Ruling 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 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 (2018).

Case 1:20-vv-00867-UNJ Document 52 Filed 06/11/24 Page 2 of 13
that he has satisfied all of the requirements of a Table SIRVA claim. Therefore, Petitioner
is entitled to compensation under the Vaccine Act.
I. Relevant Procedural History
On October 29, 2021, about 16 months after the case was initiated, the parties
began settlement discussions, but reached an impasse a year later. See ECF Nos. 23,
41. Respondent thus filed his Rule 4(c) Report on November 28, 2022, in which he argued
that Petitioner could not satisfy severity or the Table elements of a SIRVA claim. Rule
4(c) Report at 8-11.
Petitioner filed a Motion for Ruling on the Record (“Mot.”) on April 24, 2023. ECF
No. 47. Respondent filed a response (“Resp.”) on June 29, 2023. ECF No. 48. The matter
is now ripe for adjudication.
II. Relevant Facts
a. Medical Records
Petitioner was a 47-year-old professional musician when he received the flu and
pneumonia vaccines3 on November 5, 2018, at Rite Aid Pharmacy in Brooklyn, NY. Ex.
1 at 1. Although the vaccination record states that the flu vaccine was administered into
his “left upper arm,” Petitioner alleges that the vaccine was actually administered into his
right arm. Id.; Ex. 9 at ¶3. Petitioner contacted Rite Aid about the vaccine administration
record and received a letter indicating that the record was created prior to administration
and was not subsequently updated. Ex. 2 at 1.
On November 7, 2018 (two days after vaccination), Petitioner went to the
emergency room with complaints of pain, swelling, and redness of his right upper
arm/biceps. Ex. 5 at 9, 22. He had redness over his arm and normal range of motion. Id.
at 10. He was diagnosed with cellulitis and prescribed a 10-day course of cephalexin. Id.
at 10, 14.
Just over five months later, on April 18, 2019, Petitioner saw his primary care
provider (“PCP”) about his right arm pain. Ex. 3 at 18. He reported that he had “received
influenza and pneumonia vaccines in right arm 11/2018 and then developed cellulitis,”
which was treated with antibiotics and resolved.” Id. He reported persistent pain, which
worsened with movement. Id. On exam, Petitioner’s range of motion was decreased and
his deltoid was tender to palpation. Id. at 19. X-rays revealed “narrowing subacromial
3 The version of pneumonia vaccine Petitioner received is not a covered vaccine under the Vaccine Act.
2

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space,” indicating possible rotator cuff impingement, and narrowing of the AC joint. Id. at
63. Petitioner was referred to an orthopedist. Id.
On April 24, 2019, Petitioner saw orthopedist Dr. Vladimir Shur for his right
shoulder pain. Ex. 4 at 1. He reported that he “had 2 vaccinations on November 5, 2018
which resulted in cellulitis” and continued to have pain and limited range of motion. Id. On
exam, Petitioner had full strength, but limited range of motion. Id. Dr. Shur recommended
NSAIDs, referred Petitioner to physical therapy, and ordered an MRI. Id. at 2.
Petitioner began physical therapy the same day. Ex. 8 at 5. He reported “that after
having a flu shot at Rite Aid Pharmacy on November 5, 2018, he felt sudden onset of pain
and stiffness on his right shoulder upon waking up the next morning.” Id. On exam,
Petitioner had decreased active range of motion, diminished strength, and positive
impingement tests. Id. at 6. Petitioner completed 15 physical therapy treatments through
July 12, 2019. Id. at 14-49.
On May 7, 2019, Petitioner returned to the emergency room with complaints of
“persistent aching pain and tingling to the Rt arm/deltoid.” Ex. 5 at 57. Petitioner reported
that “his symptoms started after received an IM flu and pneumonia shots to the Rt
deltoid/arm at Rite Aid on 11/5/18.” Id. Petitioner noted that he was “treated for cellulitis
of the arm in November and feels he still has “internal cellulitis” or myositis after speaking
to a doctor on the phone. Id. at 57, 64. The physician’s assistant who examined him
“suspect[ed] underlying rotator cuff/referred pain,” and believed that it was “unlikely” that
his “symptoms relate to IM injections given 5 mo ago or cellulitis.” Id. at 57. Petitioner was
referred to an orthopedist. Id.
Petitioner returned to his PCP on May 13, 2019, for treatment for his right arm pain
and for an ear problem. Ex. 3 at 10. Petitioner requested an MRI and a referral to a second
orthopedist for a second opinion. Id.
On May 24, 2019, Petitioner saw an internist for “right shoulder pain since
November when he got flu and pneumonia vaccine.” Ex. 11 at 21. Petitioner reported
having cellulitis “and then pain since November.” Id. On exam, Petitioner displayed
decreased active and passive range of motion. Id. He was diagnosed with impingement
syndrome and referred to an orthopedist. Id. An MRI was also ordered. Id. Five days later,
Petitioner returned for an annual physical during which he reported “right shoulder limited
ROM due to pain since cellulitis 11/18 post vaccine administration.” Id. at 16. He
described dull, aching pain “radiating down his arm” that was worse with movement. Id.
On exam, his range of motion was limited due to pain. Id. at 18. Petitioner was diagnosed
with impingement syndrome, bursitis, and bicipital tendonitis. Id. An MRI was ordered,
after which Petitioner would be referred to rheumatology or orthopedics, as appropriate.
Id. at 19.
3

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Petitioner’s MRI (performed on June 10, 2019) revealed mild supraspinatus
tendinosis, a superior labral tear, mild bursitis, a small glenohumeral joint effusion, and
other findings consistent with adhesive capsulitis. Ex. 7 at 8-9.
Petitioner sought a second opinion from orthopedist, Dr. Yoav Rosenthal, on June
24, 2019. Ex. 6 at 6. Petitioner reported that he received a vaccine on November 5, 2018,
developed cellulitis which was treated, and continued to have shoulder pain. Id. Petitioner
stated that his pain “was acute in onset, located in the anterior part of his shoulder and
arm and was significant” and also complained of limited range of motion. Id. On exam,
Petitioner was tender to palpation and had reduced active and passive range of motion.
Id. at 8-9. Dr. Rosenthal diagnosed adhesive capsulitis (frozen shoulder), tendonitis of
the supraspinatus and long head of biceps, and subacromial bursitis. Id. at 9. He advised
that adhesive capsulitis could take “up to 12-18 months” to resolve and occasionally
requires surgery. Id. at 10. He prescribed over-the-counter anti-inflammatory drugs and
physical therapy. Id.
Petitioner began a new course of physical therapy on July 25, 2019. Ex. 6 at 11.
He reported “having flu vaccine on 11/5/18” and having an “immediate reaction to vaccine
leading to cellulitis.” Id. He stated that progressive worsening of the pain led him to see a
doctor. Id. He reported his prior physical therapy treatment, “which [had] helped improve
symptoms.” Id. Petitioner had decreased range of motion and decreased strength. Id. at
13. Petitioner completed a total of six physical therapy sessions through October 7, 2019.
Id. at 36.
Although Petitioner sought treatment for other medical issues in 2020, he did not
return for further treatment for his shoulder pain until April 7, 2022, two and a half years
after his physical therapy treatment ended. See Ex. 11 at 2-15; Ex. 23 at 5. He told his
orthopedist that he had stopped his previous treatment “due to the pandemic and his wife
had ACL surgery.” Ex. 23 at 6. He reported continued pain with playing musical
instruments and lifting heavy objects. Id. On exam, Petitioner’s range of motion was
reduced and impingement testing was positive. Id. at 8. Petitioner was referred to physical
therapy. Id.
Petitioner returned to physical therapy on April 11, 2022. Ex. 24 at 32. He reported
an “immediate reaction to vaccine leading to cellulitis, which resolved with medication,
however pain and disability persisted.” Id. at 33. Petitioner explained that he believed the
vaccine had been injected into his bursa, leading to him having a recent Covid-19 vaccine
administered in his leg. Id. He explained that he hadn’t finished previous courses of
physical therapy because “insurance kept running out before symptoms resolved.” Id. On
exam, Petitioner had reduced active and passive range of motion and diminished
strength. Id. at 36. He completed a total of eleven physical therapy treatments through
July 27, 2022. Id. at 40-51; Ex. 26 at 11-31.
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Petitioner followed up with his orthopedist on May 2, 2022, and reported
improvement. Ex. 23 at 24. He declined a cortisone injection. Id. at 25.
No further treatment records were filed.
b. Relevant Witness Testimony
Petitioner filed an affidavit with his petition. Ex. 9. He recalled that once his cellulitis
resolved, his shoulder pain “worsened and [he] began to lose [his] range of motion.” Id.
at ¶6.
Several of Petitioner’s family members, friends, and work associates also
submitted affidavits or letters in support of his claim. See ECF No. 22, 28, 30. As these
state:
• Petitioner’s brother-in-law recalled that Petitioner complained of right
shoulder pain when they spent Thanksgiving together in 2018. Ex. 12 at ¶2-
3.
• Petitioner’s wife recalled that after his vaccination, he could no longer help
“to carry things with his right arm,” to open jars, or to clean the house. Ex.
20 at 1. She stated that she and Petitioner “expected . . . that his arm would
heal naturally.” Id.
• Petitioner’s son recalled Petitioner complaining of right shoulder pain during
a phone call on December 30, 2018 (the son’s birthday). Ex. 21 at 1.
• Itai Kriss, a work associate, recalled playing a gig with Petitioner on
December 31, 2018. Ex. 16 at 1. He observed Petitioner rubbing his right
shoulder. Id. He remembered Petitioner “wanted to stop playing as soon as
possible” and that Petitioner’s playing quality was decreased. Id.
• Jose Rivera, a work associate, recalled playing a gig with Petitioner on
February 14, 2019. Ex. 15 at 1. He noted that playing music was difficult for
Petitioner and that he had to assist Petitioner with carrying equipment to his
car “due to the weakness in his shoulder.” Id.
• Jacob Plasse, a work associate, remembered playing music with Petitioner
“every Sunday [at] a restaurant called Verlaine.” Ex. 18 at 1. He observed
that Petitioner “had to change his body position in relation to holding the
bass, which negatively affected his playing ability.” Id. He recalled having to
hire help to set up the stage because Petitioner was unable to help. Id.
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• Bernardo Pons, a work associate, recalled that Petitioner turned down
musical performances scheduled in January, February, March, and April
2019 due to his shoulder pain. Ex. 13 at 1.
III. Applicable Legal Standards
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). The Vaccine Act also requires that a petitioner demonstrate that “residual effects
or complications” of a vaccine-related injury continued for more than six months. Vaccine
Act §11(c)(1)(D)(i). A petitioner cannot establish the length or ongoing nature of an injury
merely through self-assertion unsubstantiated by medical records or medical opinion.
§13(a)(1)(A). “[T]he fact that a petitioner has been discharged from medical care does not
necessarily indicate that there are no remaining or residual effects from her alleged
injury.” Morine v. Sec’y of Health & Human Servs., No. 17-1013V, 2019 WL 978825, at
*4 (Fed. Cl. Spec. Mstr. Jan. 23, 2019); see also Herren v. Sec’y of Health & Human
Servs., No. 13-1000V, 2014 WL 3889070, at *3 (Fed. Cl. Spec. Mstr. July 18, 2014).
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 Section 11(c)(1).
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
petitioner’s injury or illness that is contained in a medical record. Section 13(b)(1).
“Medical records, in general, warrant consideration as trustworthy evidence. The records
contain information supplied to or by health professionals to facilitate diagnosis and
treatment of medical conditions. With proper treatment hanging in the balance, accuracy
has an extra premium. These records are also generally contemporaneous to the medical
events.” Cucuras v. Sec’y of Health & Human Servs., 993 F.2d 1525, 1528 (Fed. Cir.
1993).
Accordingly, where medical records are clear, consistent, and complete, they
should be afforded substantial weight. Lowrie v. Sec’y of Health & Human Servs., No. 03-
1585V, 2005 WL 6117475, at *20 (Fed. Cl. Spec. Mstr. Dec. 12, 2005). However, this rule
does not always apply. In Lowrie, the special master wrote that “written records which
are, themselves, inconsistent, should be accorded less deference than those which are
internally consistent.” Lowrie, at *19. And the Federal Circuit recently “reject[ed] as
incorrect the presumption that medical records are accurate and complete as to all the
patient’s physical conditions.” Kirby v. Sec’y of Health & Human Servs., 997 F.3d 1378,
1383 (Fed. Cir. 2021).
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The United States Court of Federal Claims has recognized that “medical records
may be incomplete or inaccurate.” Camery v. Sec’y of Health & Human Servs., 42 Fed.
Cl. 381, 391 (1998). The Court later outlined four possible explanations for
inconsistencies between contemporaneously created medical records and later
testimony: (1) a person’s failure to recount to the medical professional everything that
happened during the relevant time period; (2) the medical professional’s failure to
document everything reported to her or him; (3) a person’s faulty recollection of the events
when presenting testimony; or (4) a person’s purposeful recounting of symptoms that did
not exist. La Londe v. Sec’y of Health & Human Servs., 110 Fed. Cl. 184, 203-04 (2013),
aff’d, 746 F.3d 1335 (Fed. Cir. 2014).
The Court has also said that medical records may be outweighed by testimony that
is given later in time that is “consistent, clear, cogent, and compelling.” Camery, 42 Fed.
Cl. at 391 (citing Blutstein v. Sec’y of Health & Human Servs., No. 90-2808, 1998 WL
408611, at *5 (Fed. Cl. Spec. Mstr. June 30, 1998). The credibility of the individual offering
such testimony must also be determined. Andreu v. Sec’y of Health & Human Servs., 569
F.3d 1367, 1379 (Fed. Cir. 2009); Bradley v. Sec’y of Health & Human Servs., 991 F.2d
1570, 1575 (Fed. Cir. 1993).
The special master is obligated to fully consider and compare the medical records,
testimony, and all other “relevant and reliable evidence contained in the record.” La
Londe, 110 Fed. Cl. at 204 (citing Section 12(d)(3); Vaccine Rule 8); see also Burns v.
Sec’y of Health & Human Servs., 3 F.3d 415, 417 (Fed. Cir. 1993) (holding that it is within
the special master's discretion to determine whether to afford greater weight to medical
records or to other evidence, such as oral testimony surrounding the events in question
that was given at a later date, provided that such determination is rational).
IV. Findings of Fact
A. Site of Vaccination
The entirety of the record preponderantly supports the conclusion that Petitioner
more likely than not received the flu vaccine in his left arm.
Although the vaccine administration record is problematic (as it indicates that he
received the vaccine in his “left upper arm), Petitioner approached Rite Aid about the
record and received a letter in response which conceded both (1) that the record had
been completed prior to administration to the vaccine and not updated after; and (2) that
Petitioner had otherwise provided evidence of vaccination in the right arm. See Ex. 1 at
1; Ex. 2 at 1.
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Further, Petitioner sought treatment for shoulder pain and redness at the injection
site only two days after his vaccination. Ex. 5 at 8-11. He clearly attributed those
symptoms to his vaccination two days prior, and the treating provider observed redness
on Petitioner’s right arm. Id. at 9-10. Petitioner continued to consistently report vaccination
in the right shoulder when seeking treatment over the next almost three years, which is
especially convincing evidence supporting his situs argument. See, e.g., Ex. 3 at 18; Ex.
4 at 1; Ex. 8 at 5; Ex. 23 at 25.
The totality of Petitioner’s medical records also clearly indicate that he suffered
from right shoulder pain after vaccination, and that he attributed it to a flu shot
administered into his right arm. He received treatment only to his right shoulder, including
physical examinations, x-rays, an MRI, and three courses of physical therapy. There is
no indication in the record of any other possible cause of Petitioner’s right shoulder pain.
Overall, Petitioner’s assertions are sufficiently corroborated by the medical records
to accept his contention of vaccine situs. Accordingly, I find it more likely than not that the
vaccine alleged as causal in this case was administered to Petitioner in the right
shoulder/arm on November 5, 2018.
B. Injury Localized to Vaccinated Arm
Respondent further argues that “Petitioner’s pain was not limited to his right
shoulder.” Resp. at 11. Respondent bases this argument on two records: (1) the May 7,
2019 emergency room record in which Petitioner described his pain as “tingling;” and (2)
the May 24, 2019 record in which Petitioner described pain “radiating down his arm.” Id.
Petitioner’s medical records contain numerous references to his complaints about,
and the treatment he received for, his right shoulder pain. Beyond the two notations cited
by Respondent, there is no evidence in the record that Petitioner complained of, or
received treatment for, pain or injury outside of his right shoulder. Petitioner received
consistent treatment to his right shoulder, including examinations, x-rays, an MRI, and a
total of 32 physical therapy sessions. Other than a lipoma on his right forearm, Petitioner
was not diagnosed with any conditions outside of his shoulder, including to his neck, back,
elbow, wrist, or hand. See Ex. 6 at 9.
While I acknowledge the references cited by Respondent, they are outweighed by
the evidence in Petitioner’s treatment records establishing that pain and decreased range
of motion were limited to the right shoulder. Respondent’s focus on these two records
suggests that to satisfy the third QAI Table criterion, the relevant records must be devoid
of all reference to pain or other symptoms outside the affected shoulder. However, a
petitioner need only present preponderant, not certain, evidence to prevail. See Moberly
ex. rel. Moberly v. Sec’y of Health & Human Servs, 592 F.3d 1315, 1322 (Fed. Cir. 2010)
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(holding that the applicable level of proof is not certainty, but the traditional tort standard
of “preponderant evidence”).
Mr. Ash complained of and was treated for pain and limited range of motion to his
right shoulder, even if pain in other locations was intermittently described. I therefore find
there is preponderant evidence to support a finding that Petitioner has satisfied the third
QAI Table requirement for a SIRVA injury.
C. Other Condition that Explains Petitioner’s Symptoms
Respondent argues that “Petitioner’s medical records demonstrate that another
condition or abnormality was present that explains Petitioner’s symptoms proximate to
vaccination.” Resp. at 11. Specifically, Respondent argues that Petitioner was diagnosed
with cellulitis, which explained all of his early reported symptoms, and then resolved with
one course of antibiotics. Id. Respondent then argues that Petitioner’s subsequent
symptoms must have been a “separate and distinct shoulder injury.” Id. at 12.
However, Respondent’s argument assumes that Petitioner could not have had
both cellulitis (which is a bacterial skin infection) and a SIRVA injury as a result of his
vaccination. Respondent highlights that when Petitioner sought treatment two days after
her vaccination, he “did not have any joint or muscle pain at that time, and he had full
ROM on examination.” Resp. at 11. However, the record of that visit clearly notes that
Petitioner reported “aching” pain in his right upper arm. Ex. 5 at 9, 22. There was no
extensive examination of Petitioner’s shoulder muscles or joint after the obvious cellulitis
diagnosis was made, which is common for emergency room treatment, and there was no
further qualitative assessment of his pain.
Further, as noted by Petitioner, while the symptoms of cellulitis include redness,
swelling, and pain, they do not include the other symptoms experienced by Petitioner,
such as limited range of motion. See Mot. at 12-13. Cellulitis would also not explain the
pathology seen on Petitioner MRI, including bursitis, tendinosis, or a labral tear.
Finally, while Respondent concedes that Petitioner’s cellulitis resolved with
antibiotic treatment, he seemingly ignores the remaining evidence in the record that
Petitioner’s shoulder pain persisted, and that his range of motion decreased over time (as
is often seen in SIRVA cases). Resp. at 11. There is substantial evidence in the record
that Petitioner experienced pain in his right shoulder and arm since his vaccination and
that pain did not resolve with the antibiotics prescribed for his cellulitis. As such, I find that
Petitioner’s cellulitis diagnosis is not another condition that explains Petitioner’s ongoing
SIRVA symptoms and does not preclude a finding of a Table SIRVA injury.
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D. Onset
Respondent argues that Petitioner has not established Table onset because “the
onset of Petitioner’s shoulder pain and reduced range of motion was not present when
Petitioner presented to the emergency department for treatment of his cellulitis two days
after vaccination.” Resp. at 12. But Respondent misstates the QAI requirement for onset,
suggesting that it requires a claimant to demonstrate reduced range of motion within 48
hours after vaccination. In fact, to prove a Table SIRVA injury, a petitioner must only
experience pain in that specified timeframe. See 42 C.F.R. § 100.3(c)(10)(ii)-(iii) (required
onset for pain listed in the QAI; pain and reduced range of motion limited to the shoulder
in which the intramuscular vaccine was administered). Although a Petitioner must
experience some reduced range of motion as well, that symptom need not appear in the
first 48 hours after vaccination - and in many SIRVA cases, it does not.
Further, Respondent discounts the record of the emergency room visit on
November 7, 2018, which clearly indicates that Petitioner was suffering pain in his right
upper arm. Ex. 5 at 9, 22. While the record states that Petitioner had “no joint pain, no
myalgias,” it is not clear that there was any investigation into the quality of Petitioner’s
pain. Id. at 9. Petitioner did, however, describe his pain as “aching,” which may indicate
a deeper pain was present at the time. Id. at 9. I further note that Petitioner described his
pain as “aching” in subsequent records, including on May 7, 2019, when he returned to
the emergency room and on May 29, 2019 during his annual physical. Ex. 5 at 57; Ex. 11
at 16.
Finally, Respondent fails to acknowledge the additional evidence that Petitioner’s
pain was ongoing. When Petitioner returned to treatment five months after his initial visit,
he specifically stated that his “pain persisted” after his cellulitis infection had resolved. Ex.
3 at 18. Petitioner continued to assert that his shoulder pain began within 48 hours of his
vaccination throughout the remainder of his treatment. See e.g. Ex. 6 at 6 (Petitioner
reported that he received a vaccine on November 5, 2018, developed cellulitis which was
treated, and continued to have shoulder pain that “was acute in onset, located in the
anterior part of his shoulder and arm and was significant”); Ex. 6 at 11 (Petitioner reported
“having flu vaccine on 11/5/18” and having an “immediate reaction to vaccine leading to
cellulitis.”); Ex. 8 at 5 (“after having a flu shot at Rite Aid Pharmacy on November 5, 2018,
he felt sudden onset of pain and stiffness on his right shoulder upon waking up the next
morning”); Ex. 11 at 21 (“right shoulder pain since November when he got flu and
pneumonia vaccine”).
Petitioner also provided numerous affidavits and other statements from witnesses
that establish that his shoulder pain persisted from the time of his vaccination, even after
his cellulitis resolved around November 17, 2018 (See Resp. at 11). Petitioner’s brother-
in-law recalled Petitioner’s shoulder pain at Thanksgiving in late-November, 2018. Ex. 12
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at ¶2-3. Petitioner’s colleague recalled a musical performance on December 31, 2018
during which Petitioner rubbed his right shoulder and played worse than usual. Ex. 16 at
1. A work associate recalled playing a gig with Petitioner on February 14, 2019, after
which he had to help Petitioner with carrying equipment to his car “due to the weakness
in his shoulder.” Ex. 15 at 1. Another work associate noted that Petitioner declined
performances (for which he would have been paid) in each of January, February, March,
and April 2019 due to his shoulder pain. Ex. 13 at 1. Such evidence, viewed as a whole,
preponderates in favor of the determination that Petitioner’s shoulder pain began within
48 hours after his vaccination but then worsened, including decreasing range of motion,
over time. The gradual worsening of pain, along with the expectation that it would resolve
naturally (Ex. 20 at 1), is a reasonable and credible explanation for Petitioner’s delay in
seeking further treatment.
Accordingly, I find there is preponderant evidence to establish the onset of
Petitioner’s pain occurred within 48 hours of vaccination.
E. Severity
Respondent argues that Petitioner has not satisfied the statutory severity
requirement because “Petitioner has not established by preponderant evidence that the
initial cellulitis, which fully resolved by November 17, 2018, and subsequent shoulder
pathology are one continuous injury.” Resp. at 13. Again, Respondent’s argument fails.
To satisfy the statutory severity requirement, Petitioner must demonstrate that his
symptoms more likely than not continued until at least May 5, 2019. The record
establishes that Petitioner sought treatment for right upper arm pain, swelling, and
redness two days after his vaccination. Ex. 5 at 9. Then, there was a five-month gap in
treatment until April 18, 2019. Ex. 3 at 18. Thereafter, Petitioner continuously treated his
shoulder pain through October 7, 2019, well past the six-month deadline.
Therefore, the crucial question is whether Petitioner had ongoing symptoms
between November 7, 2018 and April 18, 2019. The record supports the determination
that he did. As stated above, there is ample evidence in the record that Petitioner’s pain
did not resolve with antibiotic treatment (even if the cellulitis did), but instead worsened.
Petitioner in fact has stated that “once his cellulitis resolved, his shoulder pain “worsened
and [he] began to lose [his] range of motion.” Ex. 9 at ¶6. When seeking treatment,
Petitioner consistently mentioned his cellulitis and his continuing pain despite treatment.
See e.g., Ex. 4 at 1 (he reported that he “had 2 vaccinations on November 5, 2018 which
resulted in cellulitis” and continued to have pain and limited range of motion); Ex. 5 at 57,
64 (he reported that he was “treated for cellulitis of the arm in November and feels he still
has “internal cellulitis” or myositis); Ex. 6 at 6 (he reported that he received a vaccine on
11

Case 1:20-vv-00867-UNJ Document 52 Filed 06/11/24 Page 12 of 13
November 5, 2018, developed cellulitis which was treated, and continued to have
shoulder pain); Ex. 24 at 32 (he reported an “immediate reaction to vaccine leading to
cellulitis, which resolved with medication, however pain and disability persisted”). In
additional to all of the medical record evidence, Petitioner provide several statements
from his family and colleagues evidencing continued shoulder pain from November 2018
to April 2019, when he resumed treatment. Those statements, as discussed above, reveal
Petitioner’s continuing pain from at least Thanksgiving 2018 through April 5, 2019, only
13 days before Petitioner resumed treatment. Ex. 12 at ¶2-3; Ex. 13 at 1. In contrast,
there is no evidence in the record suggesting that Petitioner’s shoulder pain had resolved
by November 17, 2018, as argued by Respondent.
Thus, after consideration of the entire record, I find that the evidence
preponderates in Petitioner’s favor on this issue. Of course, the gaps in treatment will
likely affect the award of damages he may receive (and therefore Petitioner must be
realistic about the fairest, and most likely, outcome for any damages award to be received
in this matter).
V. Ruling on Entitlement
A. Requirements for Table SIRVA
I have found that Petitioner has preponderantly established that his pain began
within 48 hours, that his pain and reduced range of motion were limited to the right
shoulder, where he received the flu vaccination, and that Petitioner’s cellulitis diagnosis
does not preclude a finding of a Table SIRVA injury. 42 C.F.R. § 100.3(c)(10)(ii)-(iv).
Respondent has not contested Petitioner’s proof on the remaining element of a Table
SIRVA. See 42 C.F.R. § 100.3(c)(10)(i). Accordingly, I find that Petitioner has provided
preponderant evidence to establish that he suffered a Table SIRVA injury.
B. Additional Requirements for Entitlement
Because Petitioner has satisfied the requirements of a Table SIRVA, he need not
prove causation. Section 11(c)(1)(C). However, he must satisfy the other requirements of
Section 11(c) regarding the vaccination received, the duration and severity of injury, and
the lack of other award or settlement. Section 11(c)(A), (B), and (D).
The vaccine record shows that Petitioner received an influenza vaccination on
November 5, 2018 in Brooklyn, NY. Ex. 1 at 1; Section 11(c)(1)(A) (requiring receipt of a
covered vaccine); Section 11(c)(1)(B)(i) (requiring administration within the United States
12

Case 1:20-vv-00867-UNJ Document 52 Filed 06/11/24 Page 13 of 13
or its territories). Additionally, Petitioner has stated that he has not filed any civil action or
received any compensation for his vaccine-related injury, and there is no evidence to the
contrary. Ex. 9 at ¶11; Section 11(c)(1)(E) (lack of prior civil award). And as noted above,
I have found that severity has been established. See Section 11(c)(1)(D)(i) (statutory six-
month requirement). Therefore, Petitioner has satisfied all requirements for entitlement
under the Vaccine Act.
Conclusion
Based on the entire record in this case, I find that Petitioner has provided
preponderant evidence satisfying all requirements for a Table SIRVA. Petitioner is
entitled to compensation in this case. A separate damages order will be issued.
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
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================================================================================
DOCUMENT 2: USCOURTS-cofc-1_20-vv-00867-1
Date issued/filed: 2025-04-04
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 03/05/2025) regarding 63 DECISION Stipulation/Proffer, Signed by Chief Special Master Brian H. Corcoran. (ppa) Service on parties made.
--------------------------------------------------------------------------------
Case 1:20-vv-00867-UNJ Document 67 Filed 04/04/25 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-0867V
WILLIAM ASH, Chief Special Master Corcoran
Petitioner, Filed: March 5, 2025
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Bridget Candace McCullough, Muller Brazil, LLP, Dresher, PA, for Petitioner.
Camille Michelle Collett, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On July 16, 2020, William Ash 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
(“SIRVA”) following an influenza vaccination he received on November 5, 2018. Petition
at 1. The case was assigned to the Special Processing Unit of the Office of Special
Masters.
On May 8, 2024, a ruling on entitlement was issued, finding Petitioner entitled to
compensation for his SIRVA. On March 4, 2025, Respondent filed a proffer on award of
compensation (“Proffer”) indicating Petitioner should be awarded $60,212.38, comprised
of $60.000.00 for pain and suffering and $212.38 for past unreimbursable expenses, plus
$4,291.12 to satisfy a State of New York Medicaid lien. Proffer at 1-2. In the Proffer,
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.
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-00867-UNJ Document 67 Filed 04/04/25 Page 2 of 5
Pursuant to the terms stated in the attached Proffer, I award the following:
• A lump sum payment of $60,212.38, comprised of $60,000.00 for pain and
suffering and $212.38 for past unreimbursable expenses, to be paid through
an ACH deposit to Petitioner’s counsel’s IOLTA account for prompt
disbursement to Petitioner; and
• A lump sum payment of $4,291.12 in the form of a check jointly payable to
Petitioner, William Ash, and Department of Social Services, New York City –
Human Resources Administration (HRA), Division of Liens and Recovery,
P.O. Box 414799, Boston, MA 02241-4799, Case No. 945372, representing
reimbursement of a Medicaid lien for services received by Petitioner from
the State of New York.
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-00867-UNJ Document 67 Filed 04/04/25 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
___________________________________
)
WILLIAM ASH, )
) No. 20-867V ECF
Petitioner, )
)
v. ) Chief Special Master Corcoran
)
SECRETARY OF HEALTH AND )
HUMAN SERVICES, )
)
Respondent. )
____________________________________)
PROFFER ON AWARD OF COMPENSATION
On April 26, 2023, petitioner filed a Motion for a Ruling on the Record (“Motion”)
arguing that he has established entitlement to compensation for a shoulder injury related to
vaccine administration. ECF No. 47. Respondent filed his Response to Petitioner’s Motion on
June 29, 2023, recommending that entitlement to compensation be denied. ECF No. 48. On
May 8, 2024, the Court issued a Ruling on Entitlement, finding that petitioner is entitled to
compensation.1 ECF No. 49.
I. Compensation for Vaccine Injury-Related Items
A. Pain and Suffering
Based upon the evidence of record, respondent proffers that petitioner should be awarded
a lump sum of $60,000.00 for pain and suffering, in the form of an ACH deposit to petitioner’s
counsel’s IOLTA account for prompt disbursement to petitioner. Petitioner agrees.
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 July 5, 2022, entitlement decision.

Case 1:20-vv-00867-UNJ Document 67 Filed 04/04/25 Page 4 of 5
B. Past Unreimburseable 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 $212.38. 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.
C. Medicaid Lien
Respondent proffers that petitioner should be awarded funds to satisfy the State of New
York Medicaid lien in the amount of $4,291.12, which represents full satisfaction of any right of
subrogation, assignment, claim, lien, or cause of action the State of New York may have against
any individual as a result of any Medicaid payments the State of New York has made to or on
behalf of petitioner from the date of his eligibility for benefits through the date of judgment in
this case as a result of his alleged vaccine-related injury suffered on or about November 5, 2018
under Title XIX of the Social Security Act.
The above amounts represent all elements of compensation to which petitioner would be
entitled under 42 U.S.C. § 300aa-15(a). Petitioner agrees.
II. Form of the Award
The parties recommend that compensation provided to petitioner should be made through
two lump sum payments described below, and request that the Chief Special Master’s decision
and the Court’s judgment award the following: 2
A. A lump sum payment of $60,212.38, to be paid through an ACH deposit to
petitioner’s counsel’s IOLTA account for prompt disbursement to petitioner;
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 1:20-vv-00867-UNJ Document 67 Filed 04/04/25 Page 5 of 5
B. A lump sum payment of $4,291.12, representing compensation for satisfaction of the
State of New York Medicaid lien, in the form of a check payable jointly to petitioner
and:
DEPARTMENT OF SOCIAL SERVICES
New York City - Human Resources Administration (HRA)
Division of Liens and Recovery
P.O. Box 414799
Boston, MA 02241-4799
Case No: 945372
Petitioner agrees to endorse the check to DEPARTMENT OF SOCIAL SERVICES for
satisfaction of the Medicaid lien.
Petitioner is a competent adult. Evidence of guardianship is not required in this case.
Respectfully submitted,
YAAKOV M. ROTH
Acting Assistant Attorney General
C. SALVATORE D’ALESSIO
Director
Torts Branch, Civil Division
HEATHER A. PEARLMAN
Deputy Director
Torts Branch, Civil Division
JULIA A. COLLISON
Assistant Director
Torts Branch, Civil Division
s/Camille M. Collett
CAMILLE M. COLLETT
Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146, Ben Franklin Station
Washington, D.C. 20044-0146
Tel: (202) 616-4098
Fax: (202) 616-4310
Email: Camille.M.Collett@usdoj.gov
Date: March 4, 2025
3