VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_20-vv-01929
Package ID: USCOURTS-cofc-1_20-vv-01929
Petitioner: Jennifer A. Clasen
Filed: 2020-12-21
Decided: 2022-08-16
Vaccine: influenza
Vaccination date: 2018-10-17
Condition: left Shoulder Injury Related to Vaccine Administration (SIRVA)
Outcome: compensated
Award amount USD: 70000

AI-assisted case summary:
Jennifer A. Clasen filed a petition for compensation alleging she suffered a left shoulder injury related to vaccine administration (SIRVA) as a result of an influenza vaccine she received on or about October 17, 2018. She stated the vaccine was administered in the United States, she suffered residual effects for more than six months, and she had not received prior compensation or filed a civil action for her injuries. Respondent filed a Rule 4(c) report conceding that Petitioner is entitled to compensation, agreeing that she satisfied the criteria for left-shoulder SIRVA, including onset of pain within 48 hours and other requirements. Respondent also agreed that the case was timely filed, the vaccine was received in the U.S., and the severity requirement was met. A ruling on entitlement was issued on June 23, 2022, finding Petitioner entitled to compensation. Subsequently, Respondent filed a proffer on award of compensation, agreeing to an award of $70,000.00 for pain and suffering, which Petitioner accepted. The decision awarding damages was issued on August 16, 2022, granting a lump sum payment of $70,000.00 to Petitioner.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_20-vv-01929-0
Date issued/filed: 2022-07-27
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 06/23/2022) regarding 37 Ruling on Entitlement Signed by Chief Special Master Brian H. Corcoran. (kp) Service on parties made.
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Case 1:20-vv-01929-UNJ Document 48 Filed 07/27/22 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-1929V
UNPUBLISHED
JENNIFER A. CLASEN, Chief Special Master Corcoran
Petitioner, Filed: June 23, 2022
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)
Scott B. Taylor, Urban & Taylor, S.C., Milwaukee, WI, for Petitioner.
Jennifer A. Shah, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On December 21, 2020, Jennifer A. Clasen 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 that she suffered a shoulder injury related to
vaccine administration (“SIRVA”) as a result of an influenza vaccine received on or about
October 17, 2018. Petition at 1. Petitioner further alleges that the vaccine was
administered in the United States, she has suffered residual effects for more than six
months, and she has never received compensation in the form of an award or settlement,
or filed a civil action, for her vaccine-related injuries. Petition at ¶¶ 2, 21, 24. 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-01929-UNJ Document 48 Filed 07/27/22 Page 2 of 2
On June 23, 2022, 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 has satisfied the criteria set forth in the
Table and the Qualifications and Aids to Interpretation (“QAI”) for left-shoulder SIRVA,”
including the onset of pain within 48 hours and all other QAI requirements. Id. at 9-10.
Respondent notes that a provider suggested that Petitioner may have had brachial
plexopathy, but that there were no findings on neurological exam to support this
diagnosis, and Petitioner’s EMG was normal. Id. at 10. Respondent further agrees that
the case was timely filed, the vaccine was received in the United States, and that
Petitioner satisfies the statutory severity requirement because the residual effects or
complications of her injury continued for more than six months. Id. Respondent adds that
Petitioner avers that no civil action or proceedings have been pursued in connection with
her vaccine-related injury. 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-01929-1
Date issued/filed: 2022-08-16
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 07/07/2022) regarding 40 DECISION Stipulation/Proffer, Signed by Chief Special Master Brian H. Corcoran. (kp) Service on parties made.
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Case 1:20-vv-01929-UNJ Document 52 Filed 08/16/22 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 20-1929V
UNPUBLISHED
JENNIFER A. CLASEN, Chief Special Master Corcoran
Petitioner, Filed: July 7, 2022
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)
Scott B. Taylor, Urban & Taylor, S.C., Milwaukee, WI, for Petitioner.
Jennifer A. Shah, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On December 21, 2020, Jennifer A. Clasen 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 that she suffered a shoulder injury related to
vaccine administration (“SIRVA”) as a result of an influenza vaccine received on or about
October 17, 2018. Petition at 1. Petitioner further alleges that the vaccine was
administered in the United States, she has suffered residual effects for more than six
months, and she has never received compensation in the form of an award or settlement,
or filed a civil action, for her vaccine-related injuries. Petition at ¶¶ 2, 21, 24. 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), 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-01929-UNJ Document 52 Filed 08/16/22 Page 2 of 5
On June 23, 2022, a ruling on entitlement was issued, finding Petitioner entitled to
compensation for SIRVA. On July 7, 2022, Respondent filed a proffer on award of
compensation. Proffer at 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.
Pursuant to the terms stated in the attached Proffer, I award Petitioner a lump
sum payment of $70,000.00 (consisting entirely of pain and suffering) 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-01929-UNJ Document 52 Filed 08/16/22 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
JENNIFER CLASEN,
Petitioner, No. 20-1929V
Chief Special Master Corcoran
v. SPU
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
On December 12, 2020, Jennifer Clasen (“petitioner”) filed a petition for compensation
(“Petition”) under the National Childhood Vaccine Injury Act of 1986, 42 U.S.C. §§ 300aa-1 to
–34, as amended (“Vaccine Act” or “Act”). Petitioner alleges that she suffered a left Shoulder
Injury Related to Vaccine Administration (“SIRVA”) that was caused-in-fact by an influenza
(“flu”) vaccine administered on October 17, 2018. Pet. at 1-2.
On June 23, 2022, respondent filed his Vaccine Rule 4(c) report, recommending that
compensation be awarded. ECF No. 36. The same day, this Court issued a Ruling on
Entitlement finding petitioner entitled to compensation. ECF No. 37.
I. Items of Compensation
Respondent proffers that petitioner should be awarded $70,000.00, consisting entirely of
compensation for pain and suffering. This represents all elements of compensation to which
petitioner would be entitled under 42 U.S.C. § 300aa-15(a). Petitioner agrees.

Case 1:20-vv-01929-UNJ Document 52 Filed 08/16/22 Page 4 of 5
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 $70,000.00, representing
compensation for all elements of economic and noneconomic damages, in the form of a check
payable to petitioner, Jennifer Clasen.
III. Summary of Recommended Payment Following Judgment
Lump sum payable to petitioner, Jennifer Clasen: $70,000.00.
Respectfully submitted,
BRIAN BOYNTON
Principal Deputy Assistant Attorney General
C. SALVATORE D’ALESSIO
Acting Director
Torts Branch, Civil Division
HEATHER L. PEARLMAN
Deputy Director
Torts Branch, Civil Division
ALEXIS B. BABCOCK
Assistant 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-01929-UNJ Document 52 Filed 08/16/22 Page 5 of 5
s/ Jennifer A. Shah
Jennifer A. Shah
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) 305-2181
Jennifer.shah@usdoj.gov
Dated: July 7, 2022
3