VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_21-vv-01133
Package ID: USCOURTS-cofc-1_21-vv-01133
Petitioner: Roman Gelevan
Filed: 2021-03-29
Decided: 2022-05-23
Vaccine: influenza
Vaccination date: 2019-11-04
Condition: Guillain-Barre syndrome (GBS)
Outcome: compensated
Award amount USD: 79560

AI-assisted case summary:
Roman Gelevan filed a petition for compensation under the National Vaccine Injury Compensation Program on March 29, 2021, alleging that he suffered Guillain-Barre syndrome (GBS) as a result of an influenza vaccine administered on November 4, 2019. He stated that he received the vaccine in the United States, his symptoms have continued for more than six months, and he has not received prior compensation. Respondent filed a Rule 4(c) report conceding that Petitioner is entitled to compensation, finding that Petitioner satisfied the criteria for flu-vaccine related GBS on the Vaccine Injury Table. A ruling on entitlement was issued on February 16, 2022, finding Petitioner entitled to compensation. On April 11, 2022, Respondent filed a proffer on award of compensation, stating that Petitioner should be awarded $79,560.20, comprised of $70,000.00 for actual pain and suffering and $9,560.20 for past lost wages. Petitioner agreed with the proffered award. The decision dated May 23, 2022, awarded Petitioner a lump sum payment of $79,560.20.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_21-vv-01133-0
Date issued/filed: 2022-03-21
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 02/16/2022) regarding 26 Ruling on Entitlement Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:21-vv-01133-UNJ Document 29 Filed 03/21/22 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-1133V
UNPUBLISHED
ROMAN GELEVAN, Chief Special Master Corcoran
Petitioner, Filed: February 16, 2022
v.
Special Processing Unit (SPU);
SECRETARY OF HEALTH AND Ruling on Entitlement; Concession;
HUMAN SERVICES, Table Injury; Influenza (Flu) Vaccine;
Guillain-Barre Syndrome (GBS)
Respondent.
John Robert Howie, Howie Law, PC, Dallas, TX, for Petitioner.
Kimberly Shubert Davey, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On March 29, 2021, Roman Gelevan 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 Guillain-Barre syndrome (“GBS”) as a
result of an influenza (“flu”) vaccine administered on November 4, 2019. Petition at 1.
Petitioner further alleges that he received the vaccine in the United States, that his
symptoms have continued for more than six months, and that he has not received
compensation in the form of an award or settlement for his injuries. Petition at 1, 10. The
case was assigned to the Special Processing Unit of the Office of Special Masters.
On February 15, 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 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-01133-UNJ Document 29 Filed 03/21/22 Page 2 of 2
1. Specifically, Respondent has reviewed the petitioner and medical records, and has
concluded that Petitioner has satisfied the criteria set forth in the Vaccine Injury Table
and the Qualifications and Aids to Interpretation for flu-vaccine related GBS. Id. at 6.
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-01133-1
Date issued/filed: 2022-05-23
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 04/15/2022) regarding 31 DECISION Stipulation/Proffer Signed by Chief Special Master Brian H. Corcoran. (sw) Service on parties made.
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Case 1:21-vv-01133-UNJ Document 38 Filed 05/23/22 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-1133V
UNPUBLISHED
ROMAN GELEVAN, Chief Special Master Corcoran
Petitioner, Filed: April 15, 2022
v.
Special Processing Unit (SPU);
SECRETARY OF HEALTH AND Damages Decision Based on Proffer;
HUMAN SERVICES, Influenza (Flu) Vaccine; Guillain-
Barre Syndrome (GBS)
Respondent.
John Robert Howie, Howie Law, PC, Dallas, TX, for Petitioner.
Kimberly Shubert Davey, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On March 29, 2021, Roman Gelevan 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 Guillain-Barre syndrome (“GBS”) as a
result of an influenza vaccine administered on November 4, 2019. Petition at 1. The case
was assigned to the Special Processing Unit of the Office of Special Masters.
On February 16, 2022, a ruling on entitlement was issued, finding Petitioner
entitled to compensation for GBS. On April 11, 2022, Respondent filed a proffer on award
of compensation (“Proffer”) indicating Petitioner should be awarded $79,560.20
comprised of $70,000.00 in actual pain and suffering and $9,560.20 in past lost wages.
Proffer at 1-2. In the Proffer, Respondent represented that Petitioner agrees with the
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-01133-UNJ Document 38 Filed 05/23/22 Page 2 of 5
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 $79,560.20 (representing $70,000.00 for actual pain and suffering
and $9,560.20 for lost wages) 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.
2

Case 1:21-vv-01133-UNJ Document 38 Filed 05/23/22 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
__________________________________________
)
ROMAN GELEVAN, )
)
Petitioner, )
) No. 21-1133V (ECF)
v. ) Chief Special Master Corcoran
)
SECRETARY OF HEALTH )
AND HUMAN SERVICES, )
)
Respondent. )
__________________________________________)
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
On March 29, 2021, Roman Gelevan (“petitioner”) filed a petition for compensation
under the National Childhood Vaccine Injury Act of 1986, as amended (“the Vaccine Act” or
“the Act”), 42 U.S.C. §§ 300aa-1 to -34. Petitioner alleges that he suffered Guillain-Barre
syndrome (“GBS”) as a result of an influenza vaccine administered to him on November 4, 2019.
Petition at 1. On February 15, 2022, the Secretary of Health and Human Services (“respondent”)
filed a Rule 4(c) Report recommending that compensation be awarded. ECF No. 25. On
February 16, 2022, the Chief Special Master issued a Ruling on Entitlement finding petitioner
entitled to compensation. ECF No. 26.
I. Items of Compensation
A. Pain and Suffering
Respondent proffers that petitioner should be awarded $70,000.00 in actual pain and
suffering. See 42 U.S.C. § 300aa-15(a)(4). Petitioner agrees.

Case 1:21-vv-01133-UNJ Document 38 Filed 05/23/22 Page 4 of 5
B. Lost Wages
Evidence supplied by petitioner documents that he incurred past lost wages related to his
vaccine-related injury. Respondent proffers that petitioner should be awarded past lost wages in
the amount of $9,560.20. See 42 U.S.C. § 300aa-15(a)(3)(A). 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 following: a lump sum payment of $79,560.20, representing
compensation for actual pain and suffering ($70,000.00) and lost wages ($9,560.20) in the form
of a check payable to petitioner, Roman Gelevan. Petitioner agrees.
III. Summary of Recommended Payments Following Judgment
Lump sum payable to petitioner, Roman Gelevan: $ 79,560.20
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
ALEXIS B. BABCOCK
Assistant Director
Torts Branch, Civil Division
2

Case 1:21-vv-01133-UNJ Document 38 Filed 05/23/22 Page 5 of 5
/s/ Kimberly S. Davey
KIMBERLY S. DAVEY
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) 307-1815
Kimberly.Davey@usdoj.gov
DATED: April 11, 2022
3