VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_21-vv-00777
Package ID: USCOURTS-cofc-1_21-vv-00777
Petitioner: Shafiq Imani
Filed: 2021-01-21
Decided: 2022-10-05
Vaccine: Tdap
Vaccination date: 2018-06-19
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 62500

AI-assisted case summary:
Shafiq Imani filed a petition for compensation on January 21, 2021, alleging he suffered a shoulder injury related to vaccine administration (SIRVA) after receiving a Tdap vaccine on June 19, 2018. He stated that the injury was a defined Table injury and that he experienced residual effects for more than six months. Respondent filed a Rule 4(c) report conceding that Mr. Imani is entitled to compensation, agreeing that his condition met the criteria for a Tdap Table injury and that he satisfied all legal prerequisites for compensation. A ruling on entitlement was issued on August 2, 2022, finding Mr. Imani entitled to compensation. Subsequently, on August 26, 2022, Respondent filed a proffer on award of compensation, proposing an award of $62,500.00, which Petitioner agreed to. The Chief Special Master issued a decision awarding Mr. Imani a lump sum payment of $62,500.00 for all damages available under Section 15(a) of the Act.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_21-vv-00777-0
Date issued/filed: 2022-09-12
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 08/02/2022) regarding 29 Ruling on Entitlement Signed by Chief Special Master Brian H. Corcoran. (kp) Service on parties made.
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Case 1:21-vv-00777-UNJ Document 33 Filed 09/12/22 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-0777V
UNPUBLISHED
SHAFIQ IMANI, Chief Special Master Corcoran
Petitioner, Filed: August 2, 2022
v.
Special Processing Unit (SPU);
SECRETARY OF HEALTH AND Ruling on Entitlement; Concession;
HUMAN SERVICES, Table Injury; Tetanus Diphtheria
acellular Pertussis (Tdap) Vaccine;
Respondent. Shoulder Injury Related to Vaccine
Administration (SIRVA)
Jerome A. Konkel, Samster, Konkel & Safran, S.C., Milwaukee, WI, for Petitioner.
Tyler King, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On January 21, 2021, Shafiq Imani 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
injury (“SIRVA”), a defined Table injury, after receiving the diphtheria, tetanus, and
pertussis (Tdap) vaccine on June 19, 2018. Petition at 1, ¶¶ 3, 20. Petitioner further
alleges that he received the vaccine within the United States, that he suffered the residual
effects of his SIRVA injury for more than six months, and that neither he nor any other
party has filed a civil action or received compensation for his SIRVA injury. Petition at ¶¶
3, 20-22. 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 1:21-vv-00777-UNJ Document 33 Filed 09/12/22 Page 2 of 2
On August 1, 2022, Respondent filed his Rule 4(c) in which he concedes that
Petitioner is entitled to compensation in this case. Respondent’s Rule 4(c) Report at 1.
Specifically, Respondent believes “that [P]etitioner has satisfied the criteria set forth in
the Vaccine Injury Table (“Table”) and the Qualifications and Aids to Interpretation for a
Tdap Table injury.” Id. at 5. Respondent further agrees that “based on the record as it
now stands, [P]etitioner has satisfied all legal prerequisites for compensation under the
Act.” 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_21-vv-00777-1
Date issued/filed: 2022-10-05
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 08/26/2022) regarding 32 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (kp) Service on parties made.
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Case 1:21-vv-00777-UNJ Document 36 Filed 10/05/22 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-0777V
UNPUBLISHED
SHAFIQ IMANI, Chief Special Master Corcoran
Petitioner, Filed: August 26, 2022
v.
Special Processing Unit (SPU);
SECRETARY OF HEALTH AND Damages Decision Based on Proffer;
HUMAN SERVICES, Tetanus Diphtheria acellular
Pertussis (Tdap) Vaccine; Shoulder
Respondent. Injury Related to Vaccine
Administration (SIRVA)
Jerome A. Konkel, Samster, Konkel & Safran, S.C., Milwaukee, WI, for Petitioner.
Tyler King, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On January 21, 2021, Shafiq Imani 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
injury (“SIRVA”), a defined Table injury, after receiving the diphtheria, tetanus, and
pertussis (Tdap) vaccine on June 19, 2018. Petition at 1, ¶¶ 3, 20. The case was assigned
to the Special Processing Unit of the Office of Special Masters.
On August 2, 2022, a ruling on entitlement was issued, finding Petitioner entitled
to compensation for his SIRVA. On August 26, 2022, Respondent filed a proffer on award
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 1:21-vv-00777-UNJ Document 36 Filed 10/05/22 Page 2 of 5
of compensation (“Proffer”) indicating Petitioner should be awarded $62,500.00.3 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 $62,500.00 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.4
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
3 Respondent does not indicate the specific categories and amounts of compensation agreed upon by the
parties, but provides only a total agreed upon amount. Proffer at 2. In the future, Respondent should
provide this information in his proffer, if possible.
4 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 1:21-vv-00777-UNJ Document 36 Filed 10/05/22 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
SHAFIQ IMANI,
Petitioner,
v. No. 21-777V
Chief Special Master Corcoran
SECRETARY OF HEALTH AND ECF
HUMAN SERVICES,
Respondent.
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION1
I. Procedural History
On January 21, 2021, Shafiq Imani (“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. He alleges that he sustained a Shoulder Injury Related to Vaccine
Administration (“SIRVA”), as defined in the Vaccine Injury Table, within the Table time
period following administration of a tetanus, diphtheria, and acellular pertussis (“Tdap”)
vaccine he received on June 19, 2018. See Petition. On August 1, 2022, respondent filed his
Vaccine Rule 4(c) report, indicating that this case is appropriate for compensation under the
terms of the Act for a SIRVA Table injury. ECF No. 28. On August 2, 2022, the Chief
Special Master issued a ruling on entitlement, finding that petitioner was entitled to
compensation for a SIRVA Table injury. ECF No. 29.
1 This Proffer does not include attorneys’ fees and costs, which the parties intend to address
after the Damages Decision is issued.

Case 1:21-vv-00777-UNJ Document 36 Filed 10/05/22 Page 4 of 5
II. Items of Compensation
Based upon the evidence of record, respondent proffers that petitioner should be
awarded a lump sum of $62,500.00. This amount represents all elements of compensation to
which petitioner is entitled under 42 U.S.C. § 300aa-15(a). Petitioner agrees.
III. 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 following2: a lump sum payment of $62,500.00, in the
form of a check payable to petitioner.
IV. Summary of Recommended Payment Following Judgment
Lump sum payable to petitioner, Shafiq Imani: $62,500.00
Respectfully submitted,
BRIAN M. 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
TRACI R. PATTON
Assistant Director
Torts Branch, Civil Division
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 pain
and suffering.

Case 1:21-vv-00777-UNJ Document 36 Filed 10/05/22 Page 5 of 5
s/ Tyler C. King
TYLER C. KING
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) 305-0730
Tyler.King@usdoj.gov
Dated: August 26, 2022