VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_21-vv-00441
Package ID: USCOURTS-cofc-1_21-vv-00441
Petitioner: T.S.
Filed: 2021-01-11
Decided: 2025-02-10
Vaccine: influenza
Vaccination date: 2019-11-11
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 97672

AI-assisted case summary:
On January 11, 2021, T.S. filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging that she suffered a shoulder injury related to vaccine administration (SIRVA) as a result of an influenza vaccine received on November 11, 2019. Petitioner, born in 1977, had no prior history of left shoulder pain or dysfunction. The influenza vaccine was administered in her left arm on November 11, 2019, as a work requirement. The earliest evidence of injury was a workplace incident report filed on December 23, 2019, stating the injury began on November 11, 2019, at 10:47 a.m., immediately after receiving the vaccine, with subsequent difficulties raising her left arm, lifting, and pushing a door. On the same day, a primary care physician noted left shoulder pain that began approximately three to four weeks after the flu vaccine, with tenderness at the vaccination site and limited passive range of motion due to pain. The physician assessed likely adhesive capsulitis secondary to decreased use after the vaccination. Petitioner began physical therapy, and by December 31, 2019, a physician's assistant noted worsening pain and severely restricting range of motion. Petitioner was placed on temporary total disability from her job as a medical researcher on December 30, 2019, and later moved to temporary partial disability. She attended physical therapy sessions, and an MRI showed an intact rotator cuff and labrum but trace fluid in the subacromial/subdeltoid bursa. In January 2020, Petitioner resigned from her job due to the ongoing shoulder injury and loss of health insurance. She was evaluated by an orthopedic surgeon on January 29, 2020, who assessed SIRVA, rotator cuff bursitis, and adhesive capsulitis, and administered a steroid injection. Petitioner experienced fluctuating pain and reduced range of motion throughout 2020, with her orthopedic surgeon recommending surgical intervention, specifically a bursectomy and subacromial decompression, starting in August 2020. Workers' compensation denied further coverage, leading to a treatment gap. Petitioner received additional steroid injections and physical therapy in 2021, with her shoulder assessed as "much improved" by March 2022, though still experiencing stiffness and pain. Following an eighteen-month gap in treatment, during which she experienced an unrelated lower back injury after a car accident, Petitioner returned for evaluation in November 2023, reporting ongoing pain and weakness with basic functions. The orthopedics PA assessed remnant posterior capsular contracture with secondary impingement. Respondent initially disputed Petitioner's showing of onset within the required 48-hour window for a Table SIRVA claim. However, the Special Master found that Petitioner had established the onset of left shoulder pain within 48 hours post-vaccination, supported by her workplace incident report and subsequent medical records, including a workers' compensation physician's acceptance of immediate onset. The Special Master concluded that Petitioner met all criteria for a Table SIRVA, including no prior history of shoulder issues, onset within the specified timeframe, pain and reduced range of motion limited to the left shoulder, and no other condition explaining the symptoms. The injury persisted for more than six months, and the vaccine was administered in the United States. The Special Master awarded T.S. $95,000.00 for pain and suffering and $2,672.00 for unreimbursable expenses, totaling $97,672.00. The award considered the moderately severe nature and duration of the injury, her job resignation due to the condition, and financial obstacles to recommended surgery. Petitioner was represented by Brynna Gang of Kraus Law Group, LLC, and Respondent was represented by Mitchell Jones. The decision was issued by Chief Special Master Brian H. Corcoran.

Theory of causation field:
Petitioner T.S. filed a petition alleging a Shoulder Injury Related to Vaccine Administration (SIRVA) following an influenza vaccine administered on November 11, 2019. The Special Master found that Petitioner established entitlement to compensation under the Vaccine Injury Table for SIRVA. The key disputed issue was whether the onset of pain occurred within 48 hours of vaccination, a requirement for a Table SIRVA claim. Petitioner presented evidence, including a workplace incident report filed on the day of vaccination and subsequent medical records, indicating immediate onset of left shoulder pain and limited range of motion. Respondent initially disputed this onset period, citing a medical record stating onset "3 to 4 weeks after having a flu vaccine." However, the Special Master found Petitioner's explanation credible, supported by contemporaneous reports and later medical notations, including from a workers' compensation physician, accepting immediate onset. The Special Master determined that Petitioner met all criteria for a Table SIRVA: no prior shoulder issues, onset within 48 hours, pain and limited ROM confined to the left shoulder, no other explanatory condition, injury lasting over six months, and receipt of a covered vaccine in the U.S. without other compensation. The Special Master awarded $95,000.00 for pain and suffering and $2,672.00 for unreimbursable expenses, totaling $97,672.00, considering the injury's moderate severity and duration (approximately two years), job resignation, and financial obstacles to recommended surgery. Petitioner was represented by Brynna Gang (Kraus Law Group, LLC), and Respondent was represented by Mitchell Jones. The decision was issued by Chief Special Master Brian H. Corcoran on February 10, 2025.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_21-vv-00441-1
Date issued/filed: 2025-02-10
Pages: 14
Docket text: PUBLIC ORDER/RULING (Originally filed: 11/19/2024) regarding 62 Ruling on Entitlement, DECISION of Special Master ( Signed by Chief Special Master Brian H. Corcoran. )(mpj) Service on parties made.
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Case 1:21-vv-00441-UNJ Document 70 Filed 02/10/25 Page 1 of 14
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-0441V
T.S., Chief Special Master Corcoran
Petitioner,
v. Filed: November 19, 2024
SECRETARY OF HEALTH AND Refiled as Redacted: February 7,
HUMAN SERVICES, 2025
Respondent.
Brynna Gang, Kraus Law Group, LLC, Chicago, IL, for Petitioner.
Mitchell Jones, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT AND DECISION AWARDING DAMAGES1
On January 11, 2021, T.S. filed a petition for compensation under the National
Vaccine Injury Compensation Program, 42 U.S.C. §300aa-10, et seq.(the “Vaccine Act”).
Petitioner alleges that she suffered a shoulder injury related to vaccine administration
(“SIRVA”) as the result of an influenza (“flu”) vaccine received on November 11, 2019.
Petition (ECF No. 1). For the reasons discussed below, I find that Petitioner has
preponderantly established the onset of left shoulder pain within 48 hours post-
vaccination, and she is otherwise entitled to compensation for a Table SIRVA. I also
conclude that her actual pain and suffering warrants an award of $95,000.00.
1 When this Ruling was originally filed, I advised my intent to post it 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 EGovernment Act of 2002. 44 U.S.C. § 3501 note (2018) (Federal Management and Promotion of
Electronic Government Services). In accordance with Vaccine Rule 18(b), Petitioner filed a timely motion
to redact certain information. This Ruling is being reissued with reduction of Petitioner’s full name down to
her initials throughout the Ruling on Entitlement and in the case caption. Except for those changes and this
footnote, no other substantive changes have been made. This Ruling will be posted on the court’s website,
and/or at https://www.govinfo.gov/app/collection/uscourts/national/cofc, with no further opportunity to move
for redaction.

Case 1:21-vv-00441-UNJ Document 70 Filed 02/10/25 Page 2 of 14
I. Procedural History
In May 2021, the claim was assigned to the Office of Special Masters’ Special
Processing Unit (“SPU”) (OSM’s adjudicatory system for expedited resolution). ECF No.
10. In June 2024, Respondent completed his review of the medical records, and advised
that he would be opposing compensation. ECF No. 14. Respondent completed his
medical review and entered into settlement discussions in July 2022, but those
discussions hit an impasse a year later. ECF Nos. 32, 45. Thus on December 6, 2023,
Respondent filed his Rule 4(c) Report, in which he solely disputed Petitioner’s showing
of onset within the period required for a Table SIRVA. ECF No. 48. The parties
subsequently submitted briefing. Petitioner’s Entitlement and Damages Brief filed Mar.
25, 2024 (ECF No. 55); Respondent’s Entitlement Response filed May 24, 2024 (ECF
No. 57); Respondent’s Damages Response filed July 26, 2024 (ECF No. 60); Petitioner’s
Reply filed August 5, 2024 (ECF No. 61). The matter is ripe for adjudication.
II. Evidence
I have reviewed all submitted evidence including all medical records and affidavits,
as well as the Petition, the Rule 4(c) Report, and both parties’ briefing. The following
section focuses on the evidence most relevant to 1) the injury’s onset, and 2) the resulting
pain and suffering.
Petitioner was born in 1977. For at least three years prior to vaccination, she did
not have a primary care provider, and never evidenced left shoulder pain or dysfunction.
Rule 4(c) Report at 1 - 2. She was employed as a medical researcher, at a hospital in
Wisconsin. Ex. 1 at 378, 428. As a work requirement and at her workplace, the at-issue
flu vaccine was administered in Petitioner’s left arm on November 11, 2019. Ex. 4 at 1;
Ex. 5 at ¶ 5.
The earliest evidence of an injury is found in Petitioner’s workplace incident report,
submitted on the morning of December 23, 2019 (six weeks post-vaccination). Ex. 7 at 1;
Ex. 11 at 1. In it, Petitioner reported an injury beginning on November 11th at 10:47 a.m.,
when she had received the flu vaccine from occupational health. Ex. 7 at 1; Ex. 11 at 2.
Earlier that morning, her work had involved “regular typing as usual – nothing strenuous
or out of ordinary,” and “both arms were perfectly normal in function and without any pain.”
Id. Petitioner described subsequent difficulties raising her left arm, lifting a small package,
and pushing a door. Id. She described resting the shoulder in hopes that it would improve
on its own to no avail, and therefore, she was planning to seek medical treatment. Id.
2

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Later in the day on December 23rd, Petitioner was evaluated by a primary care
physician (“PCP”) at her employing hospital. Ex. 1 at 410.2 The PCP recorded:
Patient with history of left shoulder pain. This began approximately 3 to 4
weeks after having a flu vaccine administered in the left deltoid. She shows
me the region where this vaccine was given, and it was provided in the
appropriate place in the upper outer quadrant of the deltoid itself.
Tenderness in this area ensued, and patient did not move the arm
significantly over the next few weeks. Then she began noticing it was
difficult and painful to abduct the arm significantly…
Id. On exam, Petitioner’s left shoulder had no tenderness to palpation, but passive range
of motion (“ROM”) was limited by pain and resistance. Id. at 411. The PCP assessed:
“[l]ikely adhesive capsulitis secondary to decrease[d] use. Seems to have ensued after
influenza vaccination. Unclear if she did not use this arm for a number of weeks secondary
to tenderness at the site of the vaccination.” Id. The PCP recommended that Petitioner
continue taking ibuprofen (200 mg up to four times per day) and start physical therapy
(“PT”). Id. at 402, 411.
On her December 26, 2019, PT new patient questionnaire, Petitioner reported
“pain left arm, decreased ROM. Occurred after flu shot in the left arm [on] 11/11/2019.”
Ex. 1 at 386. The therapist similarly recorded:
[L]eft shoulder pain that started after receiving the flu shot on 11/11/19.
Immediate onset of shoulder pain but able to move her shoulder the rest of
the day after the flu shot. Progressively started to lose range of motion over
the next couple of days/ weeks. Initially ignored the soreness and
contributed [sic? attributed?] it to the normal soreness from the flu shot but
symptoms continued to persist. Reports significant increase in pain on
Monday 12/23 when trying to push open a door – that’s when she finally
went to the MD.
Id. at 377. The pain rated at 6/10 currently; ranged from 1 – 9/10; was aggravated by
activity; and eased by rest, heat, and ibuprofen. Id. An exam found pain and reduced
ROM. Id. at 380. The therapist considered diagnoses of tendinitis or bursitis, with “likely
exacerbat[ion] by lack of use… over the past month.” Id. at 381.
2 The PCP did not sign the December 23, 2019, record until three months later. Ex. 1 at 410. But other
notations indicate that the encounter occurred at about 5:00 p.m. Id. at 404, 406.
3

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On December 30, 2019, Petitioner was placed on temporary total disability from
work. Ex. 7 at. 2. The next day (December 31, 2019), a primary care physician’s assistant
(“PA”) recorded that Petitioner had “left shoulder pain that started after a flu shot in that
arm… She had been severely restricting her ROM of the left shoulder due to the pain and
it was worsening.” Ex. 1 at 354. The pain was worse with computer work, driving, and
sleeping. Id. Petitioner was told to continue conservative pain measures (e.g., heat, OTC
medications). Id. at 356. As of December 30, 2019, Petitioner was placed on temporary
total disability leave from her medical research job. Ex. 7 at 2.
Petitioner attended PT sessions on December 31, 2019, and January 2 and 3,
2020. Ex. 1 at 337-39, 321-23, 303-8 (organized chronologically). At a January 6, 2020
follow-up, the PCP reviewed that Petitioner had experienced post-vaccination site pain,
followed by pain-protective behavior of the left shoulder, and decreased ROM which he
believed was “secondary to weeks of immobilization.” Ex. 1 at 283. These “symptoms and
time course to development of pathology [were] consistent with frozen shoulder or
adhesive capsulitis.” Id. Because PT was causing “significant discomfort,” the PCP
ordered an MRI of the shoulder to ensure there was no other internal derangement,
significant rotator cuff pathology, or other inflammatory disease. Id. The MRI visualized
an intact rotator cuff and glenoid labrum, but trace fluid in the subacromial/ subdeltoid
bursa. Ex. 3 at 18. Accordingly, the PCP instructed Petitioner to continue PT. Ex. 1 at
283. While working, she should sit in a high-backed chair and reconfigure her workstation
to better support her shoulder and neck. Id. at 297. That same date, Petitioner was moved
to temporary partial disability. Ex. 7 at 2. She attended further PT sessions on January 7
and 9, 2020. Ex. 1 at 267 – 69, 250 – 52.
On January 12, 2020, Petitioner’s temporary partial disability ended. Ex. 7 at 2.
Around this time, she resigned from work because of her ongoing shoulder injury, and
because she was ineligible for unpaid medical leave. See, e.g., Ex. 1 at 195. As a result,
she lost her employer-sponsored health insurance, and was dependent on workers’
compensation to cover any further medical treatment of her shoulder. Ex. 5 at ¶ 26; Ex.
15 at ¶ 9. At further PT sessions on January 14, 16, 21, 23, and 28, 2020, the physical
therapist recommended orthopedic evaluation and a steroid injection. Ex. 1 at 232 – 36,
214 – 17, 195 – 99, 176 – 80, 160 - 63.
On January 29, 2020, upon establishing care with an orthopedic surgeon,
Petitioner reported that the vaccine she had received had caused immediate pain, and
by the following day she could not abduct her arm. Ex. 2 at 6. She was “miserable,” and
was “uninterested in returning back to physical therapy as she could not tolerate her
therapy.” Id. A physical exam found “smooth” passive ROM, rotator cuff strength with
forward flexion and abduction that was “mildly limited due to pain,” and positive
4

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impingement signs. Id. at 7. The orthopedist assessed SIRVA, rotator cuff bursitis, and
adhesive capsulitis, and administered a subacromial steroid injection. Id.
At further PT sessions on February 4 and 6, 2020, Petitioner was assessed to have
impaired tolerance to exercises for strengthening and stabilization, but improved ROM
and pain levels – which Petitioner attributed to rest, not working, and the recent steroid
injection. Ex. 1 at 144 – 47, 127 – 31.
At a February 11, 2020, primary care appointment, Petitioner reported that her left
shoulder was “finally improving.” Ex. 1 at 106. The PA confirmed “significantly increased
ROM from 1 month ago,” prescribed Celebrex (because Petitioner reported stomach
discomfort and sedation with the ibuprofen she had been taking for months), and
discouraged driving for more than 1 hour at a time. Id. at 106 – 08, 122.
Petitioner attended further PT sessions on February 11, 13, 18, and 25, and March
9, 2020. The records reflect pain “flaring” with activity and improved with rest. Ex. 1 at 87
– 90, 67 – 70, 49 – 52, 31 – 34, 13 -17. After March 9, 2020, Petitioner discontinued
formal PT without achieving her goals, and there is no formal discharge summary.3
At a March 11, 2020, orthopedic follow-up, Petitioner confirmed that the steroid
injection had temporarily relieved her shoulder pain, but she had two flareups which
dictated pauses in her therapy; she had significant fatigue and tiredness after very little
activity. Ex. 2 at 10. The orthopedist assessed that despite a “slight loss of terminal
internal land external rotation,” and ongoing “discomfort with rotator cuff testing and
strength,” the shoulder was “significant[ly] improved.” Id. at 11. He recommended home
exercises for strengthening, plus prescription meloxicam and cyclobenzaprine. Id.
On May 15, 2020, Petitioner reported increasing pain, and her orthopedist
administered a second subacromial steroid injection. Ex. 2 at 13 – 14. Three months later
(on August 14, 2020), Petitioner reported that a workers’ compensation independent
medical examination (“IME”) that day had “really flared up her shoulder.” Ex. 2 at 17.4 Her
3 Petitioner does not allege that the COVID-19 Pandemic had any impact on her treatment course. See
generally Exs. 5, 15; Brief; Reply.
4 Starting in August 2020, the IME physician (also an orthopedic surgeon) opined that Petitioner’s vaccine
injury (which he characterized as “deltoid inflammation”) had resolved within six months, and that any
ongoing deficits and treatment were unrelated and should not be covered by workers’ compensation. See,
e.g., Ex. 7 at 43, 9 (organized chronologically). However, that individual was focused on scrutinizing, and
limiting the scope, of her workers’ compensation claim. I also note that Respondent has not seriously
argued that the injury resolved this quickly – which would endanger Petitioner’s basic eligibility for the
5

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orthopedist’s exam found crepitus; weakness; painful and limited ROM; and positive
impingement signs. Id. X-rays showed a “possible impinging lesion.” Id. The orthopedist
assessed Petitioner with rotator cuff impingement syndrome and extensive subacromial
bursitis secondary to SIRVA with recalcitrance to physical therapy; temporary relief from
steroid injections; and continued “relapse[s].” Id. The orthopedist did not support repeated
steroid injections for Petitioner’s “young age” and clinical picture, or renew the
prescriptions for meloxicam and cyclobenzaprine – instead recommending surgical
bursectomy and subacromial decompression. Id.
Workers’ compensation denied any further coverage of Petitioner’s injury. Ex. 2 at
20; Ex. 10 at 5 – 7, 24 – 29. That coincided with a seven-month gap in medical treatment
(for her shoulder or other concerns). Petitioner avers that in or around March 2021, she
started working again as a clinical research project manager. Ex. 5 at ¶ 14. She also
gathered up some money for reevaluation of her shoulder, while waiting for her employer-
sponsored health insurance to kick in. Id.
At a March 29, 2021, orthopedic follow-up, Petitioner reported that her left shoulder
had been “slowly worsening since” the last appointment. Ex. 10 at 5. An exam found
passive ROM limited “in all planes… most limited in external-internal rotation,” and mild
weakness due to pain. Id. X-rays were unremarkable, but the orthopedist maintained his
previous assessments of SIRVA, subacromial bursitis, and adhesive capsulitis; still
recommended surgery; and prescribed cyclobenzaprine 10 mg nightly for pain. Id. at 6.
On April 27, 2021, Petitioner complained: “the IME keeps stating her original
[January 2020] MRI is unremarkable and does not acknowledge her adhesive capsulitis.”
Ex. 10 at 39. Accordingly, three days later, she underwent a repeat MRI. Id. at 30. On
May 3, 2021, the orthopedist wrote that the repeat MRI’s images “demonstrate[d] a
notable thickening of the inferior glenohumeral ligament,” as well as “ongoing rotator cuff
tendinosis and bursitis.” Id. at 12. He administered a glenohumeral joint steroid injection,
in addition to recommending ongoing home exercises and laser therapy – which she
started on May 11, 2021. Ex. 10 at 12; see also Ex. 8 at 7 – 17.
At a July 6, 2021, follow-up, the orthopedist’s exam found “stiff[ness] in total
rotation in her left shoulder, but… improve[ment].” Ex. 10 at 15. He administered a second
glenohumeral joint steroid injection. Id. at 16.
Over the next four months, Petitioner consistently attended PT (at a different
practice than before) totaling 13 sessions total, concluding on November 17, 2021. She
Program, under Vaccine Act Section 11(c)(1)(D). More credible is the treating orthopedic surgeon who was
focused on the accurate diagnosis and treatment of her ongoing complaints.
6

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also attended additional laser therapy, for 30 sessions total, concluding on November 23,
2021. See generally Exs. 8, 9. Those therapies were somewhat beneficial, but did not
fully resolve her shoulder injury. The last PT record states that she was still unable to
reach fully overhead and behind her back; unable to shop for, carry, and put away
groceries; and unable to perform deskwork for 60 minutes. Ex. 9 at 35. In November 2021,
in light of her shoulder injury, Petitioner resigned from her job (that she had started in
March 2021) and consequently lost her health insurance again. Ex. 15 at ¶ 19.
Next, on March 4, 2022, Petitioner (still unemployed, as a “self-pay patient,” Ex.
15 at ¶ 20), followed up with her orthopedist. Ex. 10 at 21. The orthopedist assessed that
her left shoulder ROM was “much improved” but she “still experience[s] mild stiffness with
internal and external rotation in addition to pain,” for which he authorized further laser
therapy sessions. Id. at 22.
That was followed by an eighteen (18) month gap in any medical records relating
to Petitioner’s shoulder (or any other complaints). She avers that in “early 2022,” a motor
vehicle accident totaled her car. Ex. 15 at ¶ 22. Her car insurer paid for some PT sessions
for a resulting lower back injury,5 but she could not afford further medical appointments
(and the associated transportation costs) for her shoulder. Id. Instead, she continued
near-daily home exercises, rest, and OTC pain medications for her shoulder. Id. at ¶¶ 23
– 27. Over time her shoulder improved, and in February 2023, she secured a new medical
research position that could be performed remotely – allowing her to manage the ongoing
pain. Id. at ¶ 28.
.
On November 7, 2023, Petitioner returned for reevaluation of her left shoulder,
which was conducted by an orthopedics PA. Ex. 12 at 9. She reported ongoing “pain and
weakness with basic functions including reaching above her head to put things in the
microwave, etc.” Id. wished to avoid surgery, in favor of continued conservative care
specifically laser therapy. Id. She was taking ibuprofen for pain. Id. at 10. On exam, the
left shoulder had “slight[ly] decreased internal and external rotation, and slightly painful,
nearly normal strength when tested. Id. at 9. The orthopedics PA assessed that Petitioner
was “much better” except for “remnant posterior capsular contracture with secondary
impingement, and I am optimistic this will improve with further therapy.” Id. at 10. The
provider did not impose any work restrictions, but noted Petitioner’s own concern about
pain with lifting and repetitive tasks. Id. Petitioner attended another five laser therapy
sessions in January – February 2024. See generally Ex. 13.
5 Petitioner has not filed any evidence to corroborate the motor vehicle accident, lower back injury, or related
PT.
7

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III. Entitlement
A. Authority
Before compensation can be awarded under the Vaccine Act, a petitioner must
demonstrate, by a preponderance of evidence, all matters required under Section
11(c)(1), including the factual circumstances surrounding his claim. Section 13(a)(1)(A).
In making this determination, the special master or court should consider the record as a
whole. Section 13(a)(1). Petitioner’s allegations must be supported by medical records or
by medical opinion. Id.
To resolve factual issues, the special master must weigh the evidence presented,
which may include contemporaneous medical records and testimony. See Burns v. Sec'y
of Health & Hum. Servs., 3 F.3d 415, 417 (Fed. Cir. 1993) (explaining that a special
master must decide what weight to give evidence including oral testimony and
contemporaneous medical records). Contemporaneous medical records are presumed to
be accurate. See Cucuras v. Sec’y of Health & Hum. Servs., 993 F.2d 1525, 1528 (Fed.
Cir. 1993). To overcome the presumptive accuracy of medical records testimony, a
petitioner may present testimony which is “consistent, clear, cogent, and compelling.”
Sanchez v. Sec'y of Health & Hum. Servs., No. 11–685V, 2013 WL 1880825, at *3 (Fed.
Cl. Spec. Mstr. Apr. 10, 2013) (citing Blutstein v. Sec'y of Health & Hum. Servs., No. 90–
2808V, 1998 WL 408611, at *5 (Fed. Cl. Spec. Mstr. June 30, 1998)).
In addition to requirements concerning the vaccination received, the duration and
severity of petitioner’s injury, and the lack of other award or settlement,6 a petitioner must
establish that she suffered an injury meeting the Table criteria, in which case causation
is presumed, or an injury shown to be caused-in-fact by the vaccination she received.
Section 11(c)(1)(C).
The most recent version of the Table, which can be found at 42 C.F.R. § 100.3,
identifies the vaccines covered under the Program, the corresponding injuries, and the
time period in which the particular injuries must occur after vaccination. Section 14(a).
Pursuant to the Vaccine Injury Table, a SIRVA is compensable if it manifests within 48
hours of the administration of a flu vaccine. 42 C.F. R. § 100.3(a)(XIV)(B). The criteria
establishing a SIRVA under the accompanying QAI are as follows:
6 In summary, a petitioner must establish that he received a vaccine covered by the Program, administered
either in the United States and its territories or in another geographical area but qualifying for a limited
exception; suffered the residual effects of his injury for more than six months, died from his injury, or
underwent a surgical intervention during an inpatient hospitalization; and has not filed a civil suit or collected
an award or settlement for her injury. See Section 11(c)(1)(A)(B)(D)(E).
8

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Shoulder injury related to vaccine administration (SIRVA). SIRVA manifests
as shoulder pain and limited range of motion occurring after the
administration of a vaccine intended for intramuscular administration in the
upper arm. These symptoms are thought to occur as a result of unintended
injection of vaccine antigen or trauma from the needle into and around the
underlying bursa of the shoulder resulting in an inflammatory reaction.
SIRVA is caused by an injury to the musculoskeletal structures of the
shoulder (e.g. tendons, ligaments, bursae, etc.). SIRVA is not a neurological
injury and abnormalities on neurological examination or nerve conduction
studies (NCS) and/or electromyographic (EMG) studies would not support
SIRVA as a diagnosis (even if the condition causing the neurological
abnormality is not known). A vaccine recipient shall be considered to have
suffered SIRVA if such recipient manifests all of the following:
(i) No history of pain, inflammation or dysfunction of the affected shoulder
prior to intramuscular vaccine administration that would explain the alleged
signs, symptoms, examination findings, and/or diagnostic studies occurring
after vaccine injection;
(ii) Pain occurs within the specified time frame;
(iii) Pain and reduced range of motion are limited to the shoulder in which
the intramuscular vaccine was administered; and
(iv) No other condition or abnormality is present that would explain the
patient’s symptoms (e.g., NCS/EMG or clinical evidence of radiculopathy,
brachial neuritis, mononeuropathies, or any other neuropathy).
42 C.F.R. § 100.3(c)(10) (2017).
B. Analysis
The sole disputed issue bearing on entitlement for a Table SIRVA is whether
Petitioner’s left shoulder pain began within forty-eight (48) hours of vaccination. 42 C.F.R.
§§ 100.3(a)(XIV)(B), (c)(10)(ii).
Respondent argues that insufficient evidence exists to support such a finding –
chiefly based on his argument that the December 23, 2019, medical record notation of
“[t]his began 3 to 4 weeks after having a flu vaccine administered,” Ex. 1 at 410 (emphasis
added), refers to the onset of pain. Entitlement Response at 8.
9

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In contrast, Petitioner argues that the “this began…” phrasing is imprecise and
ambiguous. The record goes on to more specifically describe “tenderness at the site of
vaccination” – allowing for an inference of onset of shoulder pain that was within 48 hours
post-vaccination - which was followed by “weeks of disuse” of the shoulder, resulting in
decreased range of motion by the time of the December 23rd encounter (six weeks post-
vaccination). Brief at 13; Reply at 3.
Petitioner’s explanation of this medical record is credible – and it is corroborated
by her December 23, 2019, workplace incident report, in which Petitioner reported that
the injury occurred on November 11th at 10:47 a.m., upon receiving the vaccine. Ex. 11
at 1. Respondent objects that the workplace incident report was “not a medical opinion
from a treating physician… rather a statement made by Petitioner.” Entitlement Response
at 8. But Petitioner was capable of describing her own injury, and her workplace incident
report is equally contemporaneous to the first medical record. It is therefore entitled to
similar weight (absent any specific showing why it should be doubted, which Respondent
has not done here).
Moreover, the conclusion that onset occurred within 48 hours of vaccination is
supported by numerous (albeit slightly later) medical records. See, e.g., Ex. 1 at 377 (PT
initial evaluation record, stating “immediate onset of shoulder pain”); id. at 282 (PCP’s
notation of “decreased range of motion in the shoulder over the ensuing month and a half”
post-vaccination); Ex. 2 at 22 (orthopedics record of pain within one day). Even the
workers’ compensation physician, who disputed Petitioner’s ongoing injury and need for
treatment, accepted the “immediate onset of left shoulder pain,” Ex. 7 at 40. Petitioner’s
later recollections simply supplement the medical records. See, e.g., Ex. 5 at ¶¶ 6 – 8
(stating that she relied on her medical degree, obtained prior to moving to the United
States, upon initially hoping that the post-vaccination inflammation would resolve with
time and conservative pain measures). Accordingly, Petitioner has preponderantly
established the Table SIRVA onset requirement.
Respondent has voiced no further objections to compensation, and I find Petitioner
has otherwise satisfied all criteria for a Table SIRVA injury following receipt of the flu
vaccine. There is no evidence of prior left shoulder pain, inflammation, or dysfunction or
an alternative cause for Petitioner's symptoms. C.F.R. § 100.3(c)(10)(i) and (iv). Her pain
and reduced ROM were limited to her left, injured shoulder. C.F.R. § 100.3(c)(10)(iii). The
injury persisted for more than six months. See 42 Section 11(c)(1)(D)(i). Additionally, she
received a seasonal flu vaccine within the United States. Section 11(c)(1)(A); Section
11(c)(1)(B)(i). And there is no evidence that Petitioner has collected a civil award for her
injury. See Section 11(c)(1)(E). Thus, Petitioner has satisfied all requirements for
entitlement under the Vaccine Act.
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IV. Appropriate Compensation for Petitioner’s Pain and Suffering
A. Authority
In another recent decision, I discussed at length the legal standard to be
considered in determining SIRVA damages, taking into account prior compensation
determinations within SPU. I fully adopt and hereby incorporate my prior discussion in
Section II of Yodowitz v. Sec'y of Health & Hum. Servs., No. 21-370V, 2024 WL 4284926,
at *12-22 (Fed. Cl. Spec. Mstr. Aug. 23, 2024).
In sum, compensation awarded pursuant to the Vaccine Act shall include “[f]or
actual and projected pain and suffering and emotional distress from the vaccine-related
injury, an award not to exceed $250,000.” Section 15(a)(4). The petitioner bears the
burden of proof with respect to each element of compensation requested. Brewer v. Sec’y
of Health & Hum. Servs., No. 93-0092V, 1996 WL 147722, at *22-23 (Fed. Cl. Spec. Mstr.
Mar. 18, 1996). Factors to be considered when determining an award for pain and
suffering include: 1) awareness of the injury; 2) severity of the injury; and 3) duration of
the suffering.7
B. Analysis
In this case, awareness of the injury is not disputed. The record reflects that at all
times Petitioner was a competent adult with no impairments that would impact her
awareness of her injury. Therefore, I analyze principally the injury’s severity and duration.
When performing the analysis in this case, I review the record as a whole to include
the medical records, declarations, affidavits, and all other filed evidence, plus the parties’
briefs and other pleadings. I consider prior awards for pain and suffering in both SPU and
non-SPU SIRVA cases and rely upon my experience adjudicating these cases. However,
I base my determination on the circumstances of this case.
I conclude that Petitioner’s pain and suffering from the November 11, 2019,
vaccination was moderately severe for two years. The initial injury was mild – given that
it was self-managed with conservative measures (e.g., rest, ice, over-the-counter pain
medications) for the first six weeks. But by that point, Petitioner had moderately severe
pain (ranging from 1 – 9/10) and objectively reduced ROM (assessed as adhesive
capsulitis), justifying temporary leave from her medical research job.
7 I.D. v. Sec’y of Health & Hum. Servs., No. 04-1593V, 2013 WL 2448125, at *9 (Fed. Cl. Spec. Mstr. May
14, 2013) (quoting McAllister v. Sec’y of Health & Hum. Servs., No 91-1037V, 1993 WL 777030, at *3 (Fed.
Cl. Spec. Mstr. Mar. 26, 1993), vacated and remanded on other grounds, 70 F.3d 1240 (Fed. Cir. 1995)).
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Case 1:21-vv-00441-UNJ Document 70 Filed 02/10/25 Page 12 of 14
In mid-January 2020, Petitioner was ordered to return to work full-time – but she
instead resigned in light of the difficulties with her ongoing shoulder injury. Workers’
compensation covered some subsequent medical treatment, including primary care and
orthopedic evaluations, imaging, 16 PT sessions, prescription pain medications, and two
steroid injections. Those medical records reflect overall moderate pain levels (fluctuating,
with several “flares”) and moderately reduced ROM throughout spring and summer 2020.
Her treating orthopedic surgeon recommended surgical intervention (specifically a
bursectomy and subacromial decompression) to treat the shoulder injury beginning in
August 2020. The former employer’s refusal to cover surgery or other additional medical
treatment, and Petitioner’s lack of other resources, help to explain the August 2020 –
March 2021 treatment gap. Afterwards, the treating orthopedist confirmed that Petitioner
had moderately reduced ROM and pain – prompting two additional steroid injections; 13
additional PT sessions; and 30 laser therapy sessions through to November 2021. And
Petitioner’s shoulder was assessed to be “much improved” by the orthopedics follow-up
in March 2022.
At the same time, this treatment course was followed by a substantial treatment
gap of eighteen (18 months), followed by medical assessments that Petitioner’s shoulder
had significantly improved. Petitioner acknowledges an intervening and unrelated lower
back injury, and she has not furnished any evidence to corroborate that her shoulder
injury continued to be a significant concern. Therefore, the pain and suffering award will
be based on the conclusion that Petitioner’s SIRVA was moderately severe, lasting
approximately two years.
In contending that T.S.’s pain and suffering was merely “mild to moderate,” see
Damages Response at 13, Respondent does not adequately recognize the unique facts
surrounding the resignation from her job and her former employer’s refusal to cover
ongoing treatment, including surgery, despite her treating orthopedist’s recommendation.
It appears more likely than not that Petitioner would have undergone surgical intervention
if the cost had been covered by workers’ compensation (or health insurance). This is
distinct from a petitioner without any apparent obstacles standing in the way of surgical
intervention.8 And the cases cited by Respondent, awarding between $60,000.00 -
$65,000.00, are distinguishable for additional reasons. Damages Response at 13.9
8 See, e.g., Acetta v. Sec’y of Health & Hum. Servs., No. 17-1731V, 2021 WL 1718202 at * 5 (Fed. Cl.
Spec. Mstr. Mar. 31, 2021) (noting that the petitioner herself had decided against surgery).
9 Allner v. Sec’y of Health & Hum. Servs., No. 19-1048V, 2022 WL 6962656, at *5 – 6 (Fed. Cl. Spec. Mstr.
Sept. 9, 2022) (holding that the petitioner’s SIRVA was “mild” - emphasizing a three-month initial treatment
delay, only eight PT sessions, no recommendation of surgery, “multiple, lengthy” treatment gaps, and no
“unique personal factors” that would have enhanced the petitioner’s pain and suffering); Klausen v. Sec’y
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Petitioner’s request for a past pain and suffering award of $95,000.00 is
reasonable based on her own evidence and citation to past cases. Brief at 20 – 24.10 For
example, Meagher similarly included an individual with some medical knowledge who
self-treated a SIRVA for approximately two months prior to seeking formal treatment –
which included similar numbers of therapeutic injections and formal therapy sessions.
And Special Master Horner found that the Meagher petitioner’s “medical records largely
suggest that her right shoulder pain resolved” after her third steroid injection, which was
about two years into the course. Meagher, 2023 WL 8713607 at *12.11 Here I conclude
that T.S.’s SIRVA substantially improved within a similar timeframe – but she also
underwent one additional steroid injection, resigned from her job as a result of her injury,
and financial obstacles stood in the way of her recommended shoulder surgery. In light
of all of the above, $95,000.00 represents a reasonable award for her pain and suffering.
Conclusion
As explained above, I conclude that Petitioner has established onset and all
other entitlement requirements for a Table SIRVA. Thus, Petitioner is entitled to
compensation in this case.
of Health & Hum. Servs., No. 19-1977V, 2023 WL 2368823, at *5 -6 (Fed. Cl. Spec. Mstr. Feb. 2, 2023)
(reflecting a three-month initial treatment delay, just 16 PT sessions and no alternative treatment efforts
(such as the laser therapy reflected in T.S.’s case), and limited available evidence in light of the petitioner’s
death from unrelated causes while the case was pending); Murray v. Sec’y of Health & Hum. Servs., No.
18-534V, 2020 WL 4522483, at *4 – 5 (Fed. Cl. Spec. Mstr. July 6, 2020) (reflecting that the petitioner’s
preexisting medical issues were equally if not more disruptive than her SIRVA – and the latter involved less
than 20 PT sessions, no surgical intervention, and “was largely resolved within twelve months of
vaccination”).
10 Acetta, 2021 WL 1718202 (awarding $95,000.00 for past pain and suffering); Parsons v. Sec’y of Health
& Hum. Servs., No. 19-1150V, 2023 WL 9069490 (Fed. Cl. Spec. Mstr. Nov. 30, 2023) ($90,000.00);
Meagher v. Sec’y of Health & Hum. Servs., No. 18-1572V, 2023 WL 8713607 (Fed. Cl. Spec. Mstr. Nov.
17, 2023) ($90,000.00).
11 Respondent stated that “[t]he Meagher petitioner suffered the effects of her shoulder injury for over seven
years.” Damages Response at 16, citing 2023 WL 8713607 at *10 (summary of the petitioner’s reply brief
– not the special master’s conclusion as to how long the injury lasted). Similarly, Respondent stated that
the Accetta petitioner suffered “debilitating ongoing sequelae.” Damages Response at 15, but that decision
actually emphasizes that the Accetta petitioner’s ongoing pain was “mild… manageable[, and she] was able
to return to many of [her] regular activities.” 2021 WL 1718202, at *5. For those reasons, T.S.’s experience
seems at least comparable, if not worse, than what was established in those cases.
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Furthermore, I award Petitioner a lump sum payment of $97,672.00
(representing $95,000.00 for actual pain and suffering,12 plus $2,672.00 for actual
unreimbursable expenses).13 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.14
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
12 Since this amount is being awarded for actual, rather than projected, pain and suffering, no reduction to
net present value is required. See Section 15(f)(4)(A); Childers v. Sec’y of Health & Hum. Servs., No. 96-
0194V, 1999 WL 159844, at *1 (Fed. Cl. Spec. Mstr. Mar. 5, 1999) (citing Youngblood v. Sec’y of Health &
Hum. Servs., 32 F.3d 552 (Fed. Cir. 1994)).
13 The parties stipulated to the expenses. Brief at 24; Damages Response at n. 1.
14 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.
14