VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_20-vv-00901
Package ID: USCOURTS-cofc-1_20-vv-00901
Petitioner: Raymond Balcer
Filed: 2021-11-19
Decided: 2021-12-22
Vaccine: influenza
Vaccination date: 2018-10-17
Condition: Shoulder Injury Related to Vaccine Administration (SIRVA)
Outcome: compensated
Award amount USD: 55064

AI-assisted case summary:
Raymond Balcer filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging he suffered a Shoulder Injury Related to Vaccine Administration (SIRVA) as a result of his October 17, 2018 influenza vaccination. The petition stated that the vaccine was administered in the United States, that he suffered residual effects for more than six months, and that there had been no prior award or settlement. Respondent filed a Rule 4(c) report conceding that Petitioner is entitled to compensation, specifically that he suffered a SIRVA as defined by the Vaccine Injury Table. Respondent confirmed that Petitioner had no recent history of shoulder issues, that the onset of pain occurred within forty-eight hours after the vaccination, that the pain was limited to the injection shoulder, and that no other condition explained the pain. Respondent also agreed that Petitioner suffered residual effects for more than six months. Based on Respondent's concession and the evidence, the Chief Special Master found Petitioner entitled to compensation. Subsequently, a decision awarding damages was issued. Respondent filed a proffer indicating Petitioner should be awarded $55,064.74, representing $55,000.00 for pain and suffering and $64.74 for past unreimbursed expenses. Petitioner agreed with this proffered award. The Chief Special Master awarded Petitioner the lump sum of $55,064.74, representing compensation for all damages available under Section 15(a).

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_20-vv-00901-0
Date issued/filed: 2021-12-20
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 11/19/2021) regarding 30 Ruling on Entitlement Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:20-vv-00901-UNJ Document 37 Filed 12/20/21 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-901V
UNPUBLISHED
RAYMOND BALCER, Chief Special Master Corcoran
Petitioner, Filed: November 19, 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)
Ronald Craig Homer, Conway, Homer, P.C., Boston, MA, for Petitioner.
James Vincent Lopez, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On July 24, 2020, Raymond Balcer 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 Table injury – Shoulder Injury Related
to Vaccine Administration (“SIRVA”) – as a result of his October 17, 2018 influneza (“flu”)
vaccination. Petition at 1. Petitioner further alleges that the vaccine was administered
within the United States, that he suffered the residual effects of his injury for more than
six months, and that there has been no prior award or settlement of a civil action on his
behalf as a result of his injury. See Petition at ¶¶14-16. The case was assigned to the
Special Processing Unit of the Office of Special Masters.
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-00901-UNJ Document 37 Filed 12/20/21 Page 2 of 2
On November 17, 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 indicates that
[m]edical personnel at the Division of Injury Compensation Programs,
Department of Health and Human Services (“DICP”), have reviewed the
petition and medical records filed in the case. It is [R]espondent’s position
that [P]etitioner suffered a SIRVA as defined by the Vaccine Injury Table.
Specifically, [P]etitioner had no recent history of pain, inflammation, or
dysfunction of his left shoulder that would explain the alleged signs,
symptoms, examination findings and/or diagnostic studies occurring after
vaccine injection; the onset of pain occurred within forty-eight hours after
receipt of an intramuscular vaccination; the pain was limited to the shoulder
in which the vaccine was administered; and, no other condition or
abnormality has been identified to explain [P]etitioner’s left shoulder pain.
42 C.F.R. §§ 100.3(a)(XIV)(B), (c)(10).
Id. at 3-4. Respondent further agrees that “[P]etitioner suffered the residual effects of his
condition for more than six months”. Id. at 4 (citing § 11(c)(1)(D)(i)).
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-00901-1
Date issued/filed: 2021-12-22
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 11/19/2021) regarding 33 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:20-vv-00901-UNJ Document 38 Filed 12/22/21 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-901V
UNPUBLISHED
RAYMOND BALCER, Chief Special Master Corcoran
Petitioner, Filed: November 19, 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)
Ronald Craig Homer, Conway, Homer, P.C., Boston, MA, for Petitioner.
James Vincent Lopez, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On On July 24, 2020, Raymond Balcer 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 Table injury – Shoulder Injury Related
to Vaccine Administration (“SIRVA”) – as a result of his October 17, 2018 influneza (“flu”)
vaccination. Petition at 1. The case was assigned to the Special Processing Unit of the
Office of Special Masters.
On November 19, 2021, a ruling on entitlement was issued, finding Petitioner
entitled to compensation for SIRVA. On November 19, 2021, Respondent filed a proffer
on award of compensation (“Proffer”) indicating Petitioner should be awarded $55,064.74
(representing compensation of $55,000.00 for pain and suffering and $64.74 for past
unreimbursed expenses). Proffer at 1-2. In the Proffer, Respondent represented that
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-00901-UNJ Document 38 Filed 12/22/21 Page 2 of 5
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 $55,064.74 (representing compensation of $55,000.00 for pain and
suffering and $64.74 for past unreimbursed 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 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-00901-UNJ Document 38 Filed 12/22/21 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
___________________________________
)
RAYMOND BALCER, )
)
Petitioner, )
) No. 20-901V
v. ) Chief Special Master Brian H. Corcoran
) ECF
SECRETARY OF HEALTH AND )
HUMAN SERVICES, )
)
Respondent. )
____________________________________)
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
On July 24, 2020, Raymond Balcer (“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
(“flu”) vaccine he received on October 17, 2018. On November 17, 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
November 19, 2021, the Chief Special Master issued a Ruling on Entitlement finding petitioner
entitled to compensation. ECF No. 28; ECF No. 30.
I. Items of Compensation
A. Pain and Suffering
Respondent proffers that petitioner should be awarded $55,000.00 in pain and suffering.
See 42 U.S.C. § 300aa-15(a)(4). Petitioner agrees.

Case 1:20-vv-00901-UNJ Document 38 Filed 12/22/21 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 $64.74. 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 $55,064.74, in the form of a
check payable to petitioner.
III. Summary of Recommended Payments Following Judgment
Lump sum payable to petitioner, Raymond Balcer: $55,064.74
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-00901-UNJ Document 38 Filed 12/22/21 Page 5 of 5
DARRYL R. WISHARD
Assistant Director
Torts Branch, Civil Division
/s James V. Lopez .
JAMES V. LOPEZ
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) 616-3655
Fax: (202) 616-4310
Email: james.lopez@usdoj.gov
Date: November 19, 2021
3