VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_22-vv-00700
Package ID: USCOURTS-cofc-1_22-vv-00700
Petitioner: Danielle Polzin
Filed: 2022-06-22
Decided: 2025-11-07
Vaccine: tetanus-diphtheria (Td)
Vaccination date: 2019-12-16
Condition: left shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 116569.43

AI-assisted case summary:
On June 22, 2022, Danielle Polzin filed a petition alleging that a tetanus-diphtheria vaccine administered on December 16, 2019 caused a left shoulder injury related to vaccine administration. The public materials identify her as an adult petitioner but do not state her exact age.

Respondent contested entitlement, focusing on whether onset occurred within 48 hours and whether the six-month severity requirement was met. Respondent pointed to a first medical visit 29 days after vaccination and a long gap after February 2020, including later medical visits for other issues that did not mention the shoulder. Ms. Polzin relied on her affidavit, home exercise efforts, and the later medical record to support the injury's continuity.

Chief Special Master Corcoran found entitlement on April 28, 2025 but recognized that the sparse treatment record affected damages. On November 7, 2025, he awarded $116,569.43: $110,000.00 for pain and suffering, $3,388.62 for past unreimbursed expenses, and $3,180.81 for lost wages.

Theory of causation field:
Td vaccine December 16, 2019 causing left SIRVA in adult petitioner. COMPENSATED. Respondent contested onset within 48 hours and six-month severity because first care was 29 days post-vaccination and records showed a long treatment gap. Petitioner relied on affidavit/home PT and medical records. Entitlement April 28, 2025; damages November 7, 2025. Award $116,569.43 ($110,000 pain/suffering + $3,388.62 expenses + $3,180.81 lost wages). Petition filed June 22, 2022.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_22-vv-00700-0
Date issued/filed: 2025-05-28
Pages: 8
Docket text: PUBLIC ORDER/RULING (Originally filed: 04/28/2025) regarding 30 Ruling on Entitlement, Order on Motion for Ruling on the Record ( Signed by Chief Special Master Brian H. Corcoran. )(mpj) Service on parties made.
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Case 1:22-vv-00700-UNJ Document 32 Filed 05/28/25 Page 1 of 8
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 22-0700V
DANIELLE POLZIN, Chief Special Master Corcoran
Petitioner, Filed: April 28, 2025
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Randall G. Knutson, Knutson & Casey Law Firm, Mankato, MN, for Petitioner.
Tyler King, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On June 22, 2022, Danielle Polzin 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 she suffered a shoulder injury related to vaccine
administration (“SIRVA”) following a tetanus vaccine she received on December 16, 2019.
Petition at 1. The case was assigned to the Special Processing Unit of the Office of
Special Masters.
For the reasons set forth below, I find that Petitioner more likely than not suffered
the residual effects of her injury for more than six months, that she has provided
preponderant evidence of onset within forty-eight hours, and that she has satisfied all of
1 Because this Ruling contains a reasoned explanation for the action taken in this case, it must be made
publicly accessible and will be posted 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 E-Government
Act of 2002. 44 U.S.C. § 3501 note (2018) (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 (2018).

Case 1:22-vv-00700-UNJ Document 32 Filed 05/28/25 Page 2 of 8
the other requirements of a Table SIRVA claim. Petitioner is therefore entitled to
compensation under the Vaccine Act.
I. Relevant Procedural History
On September 28, 2023, about 15 months after the case was initiated, Respondent
filed his Rule 4(c) Report opposing entitlement. See ECF No. 23. Respondent argues that
Petitioner has failed to establish that her shoulder pain began within forty-eight hours of
her vaccination, and that she cannot satisfy the statutory severity requirement because
she did not see treatment for approximately one year after her initial treatment. Rule 4(c)
Report at 5-7. Thereafter, Petitioner filed a Motion for Ruling on the Record and
Memorandum (“Memo.”) on November 30, 2023 and Respondent filed a response
(“Resp.”) on January 23, 2024. ECF No. 24-25, 27.
The matter is now ripe for adjudication.
II. Factual History
The parties agree that Petitioner had no history of left shoulder pain or dysfunction
prior to vaccination. See Memo. at 1; Resp. at 2. Petitioner received a tetanus vaccine in
her left deltoid on December 16, 2019, during a visit with her primary care provider
(“PCP”) in Mankato, MN. Ex. 3 at 1, Ex. 4 at 146-149.
On January 14, 2020 (29 days after her vaccination), Petitioner returned to her
PCP practice with complaints of left upper arm pain from her tetanus shot. Ex. 4 at 143.
She explained that the pain “started immediately” with the injection and that she “had
quite a bit of pain” when walking out of the appointment.” Id. She stated that “she has not
injured her arm or shoulder in any way and said this occurred immediately after the
injection.” Id. On exam, she had tenderness to palpation and discomfort with abduction
and internal rotation. Id. at 144. She was diagnosed with a post-vaccination reaction and
rotator cuff tendinitis, encouraged to use ibuprofen, and referred to physical therapy. Id.
at 144-145.
Petitioner thereafter had an initial physical therapy evaluation on February 13,
2020. Ex. 4 at 219. She stated that her symptoms began following a recent vaccination
in mid-December 2019, with pain being “persistent . . . over the past few weeks.” Id. at
220. On exam, she had reduced range of motion and positive impingement testing. Id. at
219. Treatment was planned for twice a week for eight weeks. Id. at 222. She returned
for an additional two treatments on January 31, 2020 and February 13, 2020. Id. at 211-
218. Petitioner states that she was ill and missed her last scheduled appointment on
February 26, 2020, and then did not return for further physical therapy due to the Covid-
19 Pandemic. Petitioner’s Affidavit, ECF No. 26 at ¶5. She recalled that she was taught
2

Case 1:22-vv-00700-UNJ Document 32 Filed 05/28/25 Page 3 of 8
exercises during her physical therapy sessions, which she continued to perform them at
home during this time. Id. at ¶6.
On January 30, 2020, Petitioner had a consultation with an endocrinologist for her
Graves disease. Ex. 4 at 135. She returned for follow up appointments on April 29, 2020
and July 29, 2020. Id. at 122, 129. On September 17, 2020, Petitioner saw her
ophthalmologist for an eye exam on the recommendation of her endocrinologist. Id. at
116. Petitioner obtained follow-up care for her Graves disease on October 15, 2020, and
January 21, 2021. Ex. 4 at 102, 107. These records do not mention Petitioner’s shoulder
pain.
On October 5, 2020, Petitioner saw her PCP, via telemedicine, due to a Covid-19
infection exposure. Ex. 4 at 112. Petitioner was diagnosed with Covid-19, and she recalls
being “very sick at this time.” ECF No. 26 at ¶7. The record does not mention shoulder
pain.
Petitioner returned to her PCP on February 2, 2021 for an annual exam. Ex. 4 at
96. She now reported “ongoing pain” in her left shoulder after her tetanus shot more than
a year before. Id. She stated that the physical therapy had helped, but she still had pain
and limited range of motion. Id. On exam, Petitioner had full range of motion with pain
and positive impingement testing. Id. at 99. She was referred to orthopedics. Id. at 100.
On February 24, 2021, Petitioner was evaluated in the sports medicine
department. Ex. 4 at 92. Petitioner reported that she received a tetanus vaccine on
12/16/2019 and that “pain has been consistently present since 2019.” Id. On exam,
Petitioner had limited internal and external rotation and positive impingement testing. Id.
at 93-94. X-rays were normal. Id. at 94. Petitioner was referred to physical therapy. Id. at
95.
Petitioner returned to physical therapy on March 5, 2021. Ex. 4 at 204. She
completed ten sessions through June 3, 2021. Id. at 168-208.
Over six months later, Petitioner saw a new orthopedist on October 14, 2021. Ex.
5 at 4. She reported shoulder pain for approximately two years, which began “after
receiving a tetanus shot in her left arm.” Id. The doctor suspected biceps pathology and
recommended a corticosteroid injection. Id. at 5. Petitioner continued to treat her shoulder
pain through at least September 2022.
III. Applicable Legal Standards
Pursuant to Vaccine Act Section 13(a)(1)(A), a petitioner must prove by a
preponderance of the evidence the matters required in the petition by Vaccine Act Section
11(c)(1). The Vaccine Act also requires that a petitioner demonstrate that “residual effects
or complications” of a vaccine-related injury continued for more than six months. Vaccine
3

Case 1:22-vv-00700-UNJ Document 32 Filed 05/28/25 Page 4 of 8
Act §11(c)(1)(D)(i). A petitioner cannot establish the length or ongoing nature of an injury
merely through self-assertion unsubstantiated by medical records or medical opinion.
§13(a)(1)(A). “[T]he fact that a petitioner has been discharged from medical care does not
necessarily indicate that there are no remaining or residual effects from her alleged
injury.” Morine v. Sec’y of Health & Human Servs., No. 17-1013V, 2019 WL 978825, at
*4 (Fed. Cl. Spec. Mstr. Jan. 23, 2019); see also Herren v. Sec’y of Health & Human
Servs., No. 13-1000V, 2014 WL 3889070, at *3 (Fed. Cl. Spec. Mstr. July 18, 2014).
Pursuant to Vaccine Act Section 13(a)(1)(A), a petitioner must prove, by a
preponderance of the evidence, the matters required in the petition by Section 11(c)(1).
A special master must consider, but is not bound by, any diagnosis, conclusion, judgment,
test result, report, or summary concerning the nature, causation, and aggravation of
petitioner’s injury or illness that is contained in a medical record. Section 13(b)(1).
“Medical records, in general, warrant consideration as trustworthy evidence. The records
contain information supplied to or by health professionals to facilitate diagnosis and
treatment of medical conditions. With proper treatment hanging in the balance, accuracy
has an extra premium. These records are also generally contemporaneous to the medical
events.” Cucuras v. Sec’y of Health & Human Servs., 993 F.2d 1525, 1528 (Fed. Cir.
1993).
Accordingly, where medical records are clear, consistent, and complete, they
should be afforded substantial weight. Lowrie v. Sec’y of Health & Human Servs., No. 03-
1585V, 2005 WL 6117475, at *20 (Fed. Cl. Spec. Mstr. Dec. 12, 2005). However, this rule
does not always apply. In Lowrie, the special master wrote that “written records which
are, themselves, inconsistent, should be accorded less deference than those which are
internally consistent.” Lowrie, at *19. And the Federal Circuit recently “reject[ed] as
incorrect the presumption that medical records are accurate and complete as to all the
patient’s physical conditions.” Kirby v. Sec’y of Health & Human Servs., 997 F.3d 1378,
1383 (Fed. Cir. 2021).
The United States Court of Federal Claims has recognized that “medical records
may be incomplete or inaccurate.” Camery v. Sec’y of Health & Human Servs., 42 Fed.
Cl. 381, 391 (1998). The Court later outlined four possible explanations for
inconsistencies between contemporaneously created medical records and later
testimony: (1) a person’s failure to recount to the medical professional everything that
happened during the relevant time period; (2) the medical professional’s failure to
document everything reported to her or him; (3) a person’s faulty recollection of the events
when presenting testimony; or (4) a person’s purposeful recounting of symptoms that did
not exist. La Londe v. Sec’y of Health & Human Servs., 110 Fed. Cl. 184, 203-04 (2013),
aff’d, 746 F.3d 1335 (Fed. Cir. 2014).
4

Case 1:22-vv-00700-UNJ Document 32 Filed 05/28/25 Page 5 of 8
The Court has also said that medical records may be outweighed by testimony that
is given later in time that is “consistent, clear, cogent, and compelling.” Camery, 42 Fed.
Cl. at 391 (citing Blutstein v. Sec’y of Health & Human Servs., No. 90-2808, 1998 WL
408611, at *5 (Fed. Cl. Spec. Mstr. June 30, 1998). The credibility of the individual offering
such testimony must also be determined. Andreu v. Sec’y of Health & Human Servs., 569
F.3d 1367, 1379 (Fed. Cir. 2009); Bradley v. Sec’y of Health & Human Servs., 991 F.2d
1570, 1575 (Fed. Cir. 1993).
The special master is obligated to fully consider and compare the medical records,
testimony, and all other “relevant and reliable evidence contained in the record.” La
Londe, 110 Fed. Cl. at 204 (citing Section 12(d)(3); Vaccine Rule 8); see also Burns v.
Sec’y of Health & Human Servs., 3 F.3d 415, 417 (Fed. Cir. 1993) (holding that it is within
the special master's discretion to determine whether to afford greater weight to medical
records or to other evidence, such as oral testimony surrounding the events in question
that was given at a later date, provided that such determination is rational).
The Vaccine Act requires that a petitioner demonstrate that “residual effects or
complications” of a vaccine-related injury continued for more than six months. Vaccine
Act § 11(c)(1)(D)(i). A petitioner cannot establish the length or ongoing nature of an injury
merely through self-assertion unsubstantiated by medical records or medical opinion. §
13(a)(1)(A). “[T]he fact that a petitioner has been discharged from medical care does not
necessarily indicate that there are no remaining or residual effects from her alleged
injury.” Morine v. Sec’y of Health & Human Servs., No. 17-1013V, 2019 WL 978825, at
*4 (Fed. Cl. Spec. Mstr. Jan. 23, 2019); see also Herren v. Sec’y of Health & Human
Servs., No. 13-1000V, 2014 WL 3889070, at *3 (Fed. Cl. Spec. Mstr. July 18, 2014).
A special master may find that the first symptom or manifestation of onset of an
injury occurred “within the time period described in the Vaccine Injury Table even though
the occurrence of such symptom or manifestation was not recorded or was incorrectly
recorded as having occurred outside such period.” Section 13(b)(2). “Such a finding may
be made only upon demonstration by a preponderance of the evidence that the onset [of
the injury] . . . did in fact occur within the time period described in the Vaccine Injury
Table.” Id.
5

Case 1:22-vv-00700-UNJ Document 32 Filed 05/28/25 Page 6 of 8
IV. Findings of Fact
A. Severity
To establish six months of residual effects in this case, Ms. Polzin must
demonstrate that her symptoms more likely than not continued until at least June 16,
2020. There is no dispute that Petitioner sought treatment for her shoulder pain through
February 13, 2020, but then did not seek treatment again for almost one year – until
February 2, 2021. Respondent argues that “this large gap calls into question whether
Petitioner’s alleged vaccine injury lasted more than six months.” Resp. at 7. Respondent
also points to “six different medical examinations, including one with her PCP,” during the
gap that do not reflect Petitioner’s shoulder pain. Id.
I agree that the record is thin on this issue, but I find there is preponderant support
for the finding that Petitioner’s symptoms likely continued for at least six months from
onset. The record reveals that as of Petitioner’s final PT visit in mid-February 2020 (Ex.
4 at 211), she had expected two more sessions, but they were missed due to illness. See
Ex. 4 at 211; ECF No. 26 at ¶5. Thereafter, Petitioner did not continue to seek care for
her shoulder pain at that time due to the Covid-19 Pandemic. ECF No. 26 at ¶5. Petitioner
explained that, as healthcare worker, she was “asked to avoid over-taxing the healthcare
system, to only utilize them if absolutely necessary.” Id. She also noted that she “was
required to quarantine at times due to working in a healthcare environment.” Id. Petitioner
maintains that during the gap in treatment for her shoulder, she continued to perform
exercises she learned in physical therapy “to try to help with the pain and mobility issues.”
Id. at ¶6. I deem this a credible explanation for why she did not seek further treatment
until the worst of the Pandemic had passed.
Further, the six intervening medical visits cited by Respondent were not
necessarily occasions on which Petitioner would have been expected to complain of her
shoulder problem. Four of those appointments (on April 29, 2020, July 29, 2020, October
15, 2020, and January 21, 2021) were with an endocrinologist for treatment of Petitioner’s
Graves disease, which requires ongoing management with medication. See Ex. 4 at 102,
107, 122, 129. A fifth appointment was with an ophthalmologist. Id. at 116. Neither of
these specialists would reasonably be expected to treat Petitioner’s shoulder pain.
Petitioner’s PCP visit on October 5, 2020 (conducted via telemedicine), was for treatment
of Covid-19. Ex. 4 at 112; ECF No. 26 at ¶7. This was not a situation where an individual
would be expected to report shoulder pain, particularly considering her understanding, as
a healthcare professional, to seek care only when “absolutely necessary.” See ECF No.
26 at ¶5.
6

Case 1:22-vv-00700-UNJ Document 32 Filed 05/28/25 Page 7 of 8
Thus, after consideration of the entire record, I find that the evidence
preponderates in Petitioner’s favor on this issue. (Of course, the fact that Petitioner clearly
could have obtained shoulder treatment in the gap timeframe undercuts damages severity
– and it is something I will factor in when determining damages in this case).
B. Onset
Respondent next argues that Petitioner has not established Table onset because
she “did not seek care for shoulder pain until twenty-nine days” after her vaccination, and
“has not provided any proof that she missed work between her vaccination and her first
treatment. Resp. at 9. Respondent quotes Petitioner’s affidavit, where she states “it is
unclear what other evidence is able to be provided, other than my word of my experience.”
Id. However, Respondent omits the remainder of Petitioner’s affidavit statement – where
she referenced the record of her January 14, 2020 appointment, during which she
reported immediate onset of shoulder pain after vaccination. See ECF No. 26 at ¶4. The
record of that appointment includes Petitioner’s report that the pain “started immediately”
with the injection, and that “ever since has been very sore there and that “she has not
injured her arm or shoulder in any way and said this occurred immediately after the
injection.” Ex. 4 at 143. Petitioner also reported that her symptoms began on December
16, 2019, the day of her vaccination, on her intake form for physical therapy. Ex. 4 at 224.
Both of these records clearly corroborate onset with in 48 hours after vaccination.
Further, Petitioner consistently related her shoulder pain to her vaccination during
her treatment and there is no evidence suggesting a different onset. See e.g., Ex. 4 at
92, 96, 219; Ex. 5 at 4. Accordingly, I find there is preponderant evidence to conclude that
the onset of Petitioner’s pain began within forty-eight hours of her vaccination.
V. Ruling on Entitlement
A. Requirements for Table SIRVA
I have found that Petitioner has preponderantly established that her pain began
within 48 hours after her vaccination. 42 C.F.R. § 100.3(c)(10)(ii). Respondent has not
contested Petitioner’s proof on the remaining elements of a Table SIRVA. See 42 C.F.R.
§ 100.3(c)(10)(i), (iv). Therefore, I find that Petitioner has provided preponderant evidence
to establish that she suffered a Table SIRVA injury.
B. Additional Requirements for Entitlement
Because Petitioner has satisfied the requirements of a Table SIRVA, she need not
prove causation. Section 11(c)(1)(C). However, she must satisfy the other requirements
7

Case 1:22-vv-00700-UNJ Document 32 Filed 05/28/25 Page 8 of 8
of Section 11(c) regarding the vaccination received, the duration and severity of injury,
and the lack of other award or settlement. Section 11(c)(A), (B), and (D).
The vaccine record shows that Petitioner received a tetanus vaccine in her left
deltoid on December 16, 2019 in Mankato, Montana. Ex. 3 at 1; Ex. 4 at 146-149; Section
11(c)(1)(A) (requiring receipt of a covered vaccine); Section 11(c)(1)(B)(i) (requiring
administration within the United States or its territories). Additionally, Petitioner has stated
that she has not filed any civil action or received any compensation for her vaccine-related
injury, and there is no evidence to the contrary. See Ex. 2 at ¶9; Section 11(c)(1)(E) (lack
of prior civil award). And as noted above, I have found that severity has been established.
See Section 11(c)(1)(D)(i) (statutory six-month requirement). Therefore, Petitioner has
satisfied all requirements for entitlement under the Vaccine Act.
Conclusion
Based on the entire record in this case, I find that Petitioner has provided
preponderant evidence satisfying all requirements for a Table SIRVA. Petitioner is
entitled to compensation in this case. A separate damages order will be issued.
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
8

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DOCUMENT 2: USCOURTS-cofc-1_22-vv-00700-1
Date issued/filed: 2025-12-08
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 11/07/2025) regarding 40 DECISION Stipulation/Proffer ( Signed by Chief Special Master Brian H. Corcoran. )(mpj) Service on parties made.
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Case 1:22-vv-00700-UNJ Document 44 Filed 12/08/25 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 22-0700V
DANIELLE POLZIN, Chief Special Master Corcoran
Petitioner, Filed: November 7, 2025
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Randall G. Knutson, Knutson & Casey Law Firm, Mankato, MN, for Petitioner.
Tyler King, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On June 22, 2022, Danielle Polzin 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 she suffered a shoulder injury related to vaccine
administration (“SIRVA”) following a tetanus vaccination she received on December 16,
2019. Petition at 1. The case was assigned to the Special Processing Unit of the Office
of Special Masters.
On April 28, 2025, a ruling on entitlement was issued, finding Petitioner entitled to
compensation for her SIRVA. On November 6, 2025, Respondent filed a proffer on award
of compensation (“Proffer”) indicating Petitioner should be awarded $116,569.43,
comprised of $110,000.00 for pain and suffering, $3,388.62 for past unreimbursable
expenses, and $3,180.81 for past lost wages. 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.
1 Because this Decision contains a reasoned explanation for the action taken in this case, it must be made
publicly accessible and will be posted 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 E-Government
Act of 2002. 44 U.S.C. § 3501 note (2018) (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 (2018).

Case 1:22-vv-00700-UNJ Document 44 Filed 12/08/25 Page 2 of 5
Pursuant to the terms stated in the attached Proffer, I award Petitioner a lump
sum payment of $116,569.43, comprised of $110,000.00 for pain and suffering,
$3,388.62 for past unreimbursable expenses, and $3,180.81 for past lost wages, to
be paid through an ACH deposit to Petitioner’s counsel’s IOLTA account for
prompt disbursement 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 1:22-vv-00700-UNJ Document 44 Filed 12/08/25 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
DANIELLE POLZIN,
Petitioner,
v. No. 22-700V
Chief Special Master Brian H. Corcoran
SECRETARY OF HEALTH AND ECF
HUMAN SERVICES,
Respondent.
PROFFER ON AWARD OF COMPENSATION1
On June 22, 2022, Danielle Polzin (“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 she suffered a left Shoulder Injury
Related to Vaccine Administration (“SIRVA”) as a result of a Tetanus-Diphtheria (“Td”)
vaccination that she received on December 16, 2019. Petition (“Pet.”) at 1. On September 28,
2023, respondent filed a Rule 4(c) Report asserting that petitioner had failed to demonstrate
entitlement to compensation. See ECF No. 23. On April 28, 2025, Chief Special Master
Corcoran issued a ruling on entitlement, finding petitioner entitled to compensation for a SIRVA
Table injury. See ECF No. 30.
I. Items of Compensation
Based upon the evidence of record, respondent proffers that petitioner should be awarded
the following:
1 This Proffer does not include attorneys’ fees and costs, which the parties intend to address after
the Damages Decision is issued.

Case 1:22-vv-00700-UNJ Document 44 Filed 12/08/25 Page 4 of 5
A. Pain and Suffering
Respondent proffers that petitioner should be awarded $110,000.00 in pain and suffering.
See 42 U.S.C. § 300aa-15(a)(4). Petitioner agrees.
B. Past Unreimbursable Expenses
Evidence supplied by petitioner documents that she incurred past unreimbursable
expenses related to her vaccine-related injury. Respondent proffers that petitioner should be
awarded past unreimbursable expenses in the amount of $3,388.62. See 42 U.S.C. § 300aa-
15(a)(1)(B). Petitioner agrees.
C. Lost Earnings
Evidence supplied by petitioner documents that she incurred lost earnings related to her
vaccine-related injury. Respondent proffers that petitioner should be awarded past lost wages in
the amount of $3,180.81. 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
The parties recommend that compensation provided to petitioner should be made through
a lump sum payment, as described below, and request that the Chief Special Master’s decision
and the Court’s judgment award the following:2
A lump sum payment of $116,569.43 to be paid through an ACH deposit to petitioner’s
counsel’s IOLTA account for prompt disbursement to petitioner, Danielle Polzin.
Petitioner is a competent adult. Proof of guardianship is not required in this case.
2 Should petitioner die prior to entry of judgment, respondent would oppose any award for future
medical expenses, future lost earnings, and future pain and suffering, and the parties reserve the
right to move the Court for appropriate relief.
2

Case 1:22-vv-00700-UNJ Document 44 Filed 12/08/25 Page 5 of 5
Respectfully submitted,
BRETT A. SHUMATE
Assistant Attorney General
C. SALVATORE D’ALESSIO
Director
Torts Branch, Civil Division
HEATHER L. PEARLMAN
Deputy Director
Torts Branch, Civil Division
VORIS E. JOHNSON, JR.
Assistant Director
Torts Branch, Civil Division
/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: November 6, 2025
3