VICP Registry Case Source Bundle Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_23-vv-00068 Package ID: USCOURTS-cofc-1_23-vv-00068 Petitioner: R.H. Filed: 2023-01-19 Decided: 2025-04-21 Vaccine: influenza Vaccination date: 2020-02-20 Condition: chronic osteomyelitis Outcome: compensated Award amount USD: 155589 AI-assisted case summary: On January 19, 2023, Tiffany Huettl, as the natural guardian and legal representative of her minor son, R.H., filed a petition seeking compensation under the National Vaccine Injury Compensation Program. The petition alleged that an influenza vaccine administered to R.H. on February 20, 2020, caused him to develop chronic osteomyelitis. R.H. had a medical history including asthma, atopic dermatitis, and bronchiolitis due to RSV, but no prior issues with his left lower extremities. Four days after receiving the influenza vaccine in his left thigh, on February 24, 2020, R.H. began experiencing pain and swelling in his left knee, which extended up his thigh, accompanied by a fever that was unresponsive to Tylenol or ibuprofen. The Department of Health and Human Services' Division of Injury Compensation Programs reviewed the medical records and determined that R.H.'s chronic osteomyelitis was more likely than not caused by the influenza vaccine. The Special Master, Christian J. Moran, issued a ruling on September 6, 2023, finding R.H. entitled to compensation, acknowledging that the injury satisfied the statutory requirement of lasting at least six months or resulting in inpatient hospitalization and surgical intervention. Subsequently, on March 26, 2025, the respondent filed a Proffer on Award of Compensation, which the petitioner agreed to. The court awarded R.H. a total of $155,589.40. This amount included $150,000.00 for pain and suffering, with any projected pain and suffering award reduced to net present value. Additionally, $5,589.40 was awarded for first-year life care expenses. Future life care expenses will be covered by an annuity purchased by the respondent. The annuity payments are contingent on R.H. remaining alive at the time a particular payment is due. The annuity payments are to be made to the petitioner, Tiffany Huettl, as R.H.'s court-appointed guardian or conservator, provided she submits documentation of her appointment. If she is not authorized, payments will be made to the legally appointed guardian or conservator. The annuity payments will grow at a four percent annual rate for non-medical life care items and a five percent annual rate for medical life care items, compounded annually from the date of judgment. The parties were represented by Lawrence R. Cohan of Saltz Mongeluzzi & Bendesky, PA, for the petitioner, and Jamica Marie Littles of the U.S. Department of Justice, for the respondent. The decision was issued by Special Master Christian J. Moran on April 21, 2025. Theory of causation field: Petitioner Tiffany Huettl alleged that an influenza vaccine administered on February 20, 2020, to her minor son, R.H., caused him to develop chronic osteomyelitis. R.H. experienced left knee pain and swelling four days post-vaccination, accompanied by fever. The Department of Health and Human Services' Division of Injury Compensation Programs determined that the chronic osteomyelitis was more likely than not caused by the vaccine, satisfying the statutory requirement for injury duration or severity. The Special Master, Christian J. Moran, ruled in favor of entitlement on September 6, 2023. A Proffer on Award of Compensation was filed on March 26, 2025, and agreed to by the petitioner. The award included $150,000.00 for pain and suffering and $5,589.40 for first-year life care expenses, with future life care expenses to be provided via a life-contingent annuity. The public decision does not detail the specific medical experts consulted, the mechanism of injury, or the specific diagnostic tests performed. Petitioner was represented by Lawrence R. Cohan and respondent by Jamica Marie Littles. The final decision and award were issued on April 21, 2025. Public staged source text: ================================================================================ DOCUMENT 1: USCOURTS-cofc-1_23-vv-00068-0 Date issued/filed: 2023-09-28 Pages: 2 Docket text: PUBLIC ORDER/RULING (Originally filed: 9/6/2023) regarding 27 Ruling on Entitlement Signed by Special Master Christian J. Moran. (dksc) Service on parties made. -------------------------------------------------------------------------------- Case 1:23-vv-00068-UNJ Document 31 Filed 09/28/23 Page 1 of 2 In the United States Court of Federal Claims OFFICE OF SPECIAL MASTERS * * * * * * * * * * * * * * * * * * * * * * * * * TIFFANY HUETTL, * No. 23-68V as natural guardian and legal representative* of her minor son, R.H. * * Petitioner, * * Special Master Christian J. Moran v. * * Filed: September 6, 2023 SECRETARY OF HEALTH * AND HUMAN SERVICES, * * Respondent. * * * * * * * * * * * * * * * * * * * * * * * * * * Lawrence R. Cohan, Saltz Mongeluzzi & Bendesky, PA, for petitioner; Jamica Marie Littles, United States Dep’t of Justice, Washington, DC, for respondent. RULING FINDING ENTITLEMENT TO COMPENSATION1 Tiffany Huettl alleges that an influenza (“flu”) vaccination caused her son, R.H., to develop chronic osteomyelitis and seeks compensation on his behalf. Pet., filed Jan. 19, 2023. The evidence preponderates in favor of entitlement. Before receiving the flu vaccine, R.H. had asthma, atopic dermatitis, and bronchiolitis due to respiratory syncytial virus (“RSV”). Exhibit 2 at 121. R.H’s medical history before the flu vaccine did not indicate any problems in his left lower extremities. Id. On February 20, 2020, R.H. received the flu vaccine in his left thigh. Four days later, on February 24, 2020, R.H. started having left knee pain and swelling. See Exhibit 1 at 36. The swelling radiated up to the left thigh. Id. R.H. also developed a fever that was not responsive to Tylenol or ibuprofen. Id. Medical personnel in the Division of Injury Compensation Programs at the Department 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), the parties have 14 days to identify and move to redact medical or other information, the disclosure of which would constitute an unwarranted invasion of privacy. Any changes will appear in the document posted on the website. Case 1:23-vv-00068-UNJ Document 31 Filed 09/28/23 Page 2 of 2 Health and Human Services (“DICP”) reviewed the medical documents and determined that R.H.’s chronic osteomyelitis was more likely than not caused by the flu vaccine. Resp’t’s Rep. at 11. The Secretary recognized that “petitioner has satisfied the statutory requirement that R.H.’s injury lasted for at least six months, or resulted in ‘inpatient hospitalization and surgical intervention’ as required by 42 U.S.C. § 300aa-11(c)(1)(D)(i),(iii).” Id. Special masters may determine whether a petitioner is entitled to compensation based upon the record. A hearing is not required. 42 U.S.C. § 300aa-13; Vaccine Rule 8(d). Based upon a review of the record as a whole, the undersigned finds that Ms. Huettl has established that she, on behalf of R.H., is entitled to compensation for his injury. Accordingly, Ms. Huettl, on behalf of R.H., is entitled to compensation for his injury. Ms. Huettl remains obligated to submit a status report regarding her demand by Friday, September 22, 2023. See order, issued Aug. 15, 2023. Any questions may be directed to my law clerk, Debbie Chu, at (202) 357-6360. IT IS SO ORDERED. s/Christian J. Moran Christian J. Moran Special Master 2 ================================================================================ DOCUMENT 2: USCOURTS-cofc-1_23-vv-00068-1 Date issued/filed: 2025-04-21 Pages: 10 Docket text: PUBLIC DECISION (Originally filed: 03/28/2025) regarding 66 DECISION Stipulation/Proffer. Signed by Special Master Christian J. Moran. (jjb) Service on parties made. -------------------------------------------------------------------------------- Case 1:23-vv-00068-UNJ Document 67 Filed 04/21/25 Page 1 of 10 In the United States Court of Federal Claims OFFICE OF SPECIAL MASTERS * * * * * * * * * * * * * * * * * * * * * * * * * TIFFANY HUETTL, * No. 23-68V as natural guardian and legal representative* of her minor son, R.H. * * Petitioner, * Special Master Christian J. Moran v. * * Filed: March 28, 2025 SECRETARY OF HEALTH * AND HUMAN SERVICES, * * Respondent. * * * * * * * * * * * * * * * * * * * * * * * * * * Lawrence Cohan, Saltz Mongeluzzi & Bendesky, Philadelphia, PA, for Petitioner; Jamica Marie Littles, United States Dep’t of Justice, Washington, D.C., for Respondent. UNPUBLISHED DECISION AWARDING DAMAGES1 On January 19, 2023, petitioner Tiffany Huettl filed a petition on behalf of her minor child R.H. for compensation under the National Vaccine Injury Compensation Program, 42 U.S.C. § 300aa-10 to -34 et seq. (“Vaccine Act” or “Act”). Petitioner alleged that an influenza (“flu”) vaccine administered to R.H. on February 20, 2020, caused chronic osteomyelitis. Pet. at 1. On September 5, 2023, the undersigned ruled that petitioner is entitled to compensation under the Vaccine Act. On March 26, 2025, respondent filed a Proffer on Award of Compensation, to which petitioner agrees. Based upon the record as a whole, the undersigned finds the Proffer reasonable and that petitioner is entitled to an award as stated in the Proffer. Pursuant to the attached Proffer the court awards petitioner: 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), the parties have 14 days to identify and move to redact medical or other information, the disclosure of which would constitute an unwarranted invasion of privacy. Any changes will appear in the document posted on the website. Case 1:23-vv-00068-UNJ Document 67 Filed 04/21/25 Page 2 of 10 Respondent proffers that R.H. should be awarded $150,000.00 in actual and projected pain and suffering. This amount reflects that any award for projected pain and suffering has been reduced to net present value. A lump sum payment of $155,589.40, representing compensation for life care expenses in the first year after judgment ($5,589.40), and pain and suffering ($150,000.00), to be paid through an ACH deposit to petitioner’s counsel’s IOLTA account for prompt disbursement to petitioner as guardian/conservator of the estate of R.H., for the benefit of R.H. No payments shall be made until petitioner provides respondent with documentation establishing that she has been appointed as the guardian/conservator of R.H.’s estate. If petitioner is not authorized by a court of competent jurisdiction to serve as guardian/conservator of the estate of R.H., any such payment shall be made to the party or parties appointed by a court of competent jurisdiction to serve as guardian(s)/conservator(s) of the estate of R.H. upon submission of written documentation of such appointment to the Secretary. An amount sufficient to purchase the annuity contract, subject to the conditions described below, that will provide payments for the life care items contained in the life care plan, as illustrated by the chart at Tab A attached hereto, paid to the life insurance company from which the annuity will be purchased. Compensation for Year Two (beginning on the first anniversary of the date of judgment) and all subsequent years shall be provided through respondent’s purchase of an annuity, which annuity shall make payments directly to petitioner only so long as R.H. is alive at the time a particular payment is due. At the Secretary’s sole discretion, the periodic payments may be provided to petitioner in monthly, quarterly, annual or other installments. The “annual amounts” set forth in the chart as Tab A describe only the total yearly sum to be paid to petitioner and do not require that the payment be made in one annual installment. Respondent proffers that a four percent (4%) growth rate should be applied to all non-medical life care items, and a five percent (5%) growth rate should be applied to all medical life care items. Thus, the benefits illustrated in the chart at Tab A that are to be paid through annuity payments should grow as follows: four percent (4%) compounded annually from the date of judgment for non-medical items, and five percent (5%) compounded annually from the date of judgment for medical items. The petitioner will continue to receive the annuity payments from the Life Insurance Company only so long as R.H. is alive at the time that a particular payment is due. Written notice shall be provided to the Secretary of Health and Human Services and the Life Insurance Company within twenty (20) days of R.H.’s death. 2 Case 1:23-vv-00068-UNJ Document 67 Filed 04/21/25 Page 3 of 10 No payments shall be made until petitioner provides respondent with documentation establishing that she has been appointed as the guardian(s)/conservator(s) of R.H.’s estate. If petitioner is not authorized by a court of competent jurisdiction to serve as guardian(s)/conservator(s) of the estate of R.H., any such payment shall be made to the party or parties appointed by a court of competent jurisdiction to serve as guardian(s)/conservator(s) of the estate of R.H. upon submission of written documentation of such appointment to the Secretary. In the absence of a motion for review filed pursuant to RCFC, Appendix B, the clerk is directed to enter judgment in case 23-68V according to this decision and the attached proffer.2 Any questions regarding this order may be directed to my law clerk, Josh Baker, at (202) 357-6360. IT IS SO ORDERED. s/Christian J. Moran Christian J. Moran Special Master 2 Pursuant to Vaccine Rule 11(a), the parties can expedite entry of judgment by each party filing a notice renouncing the right to seek review by a United States Court of Federal Claims judge. 3 Case 1:23-vv-00068-UNJ Document 67 Filed 04/21/25 Page 4 of 10 IN THE UNITED STATES COURT OF FEDERAL CLAIMS OFFICE OF SPECIAL MASTERS ) TIFFANY HUETTL, as natural guardian and ) legal representative of her minor son, R.H., ) ) Petitioner, ) ) v. ) No. 23-68V ) Special Master Moran SECRETARY OF HEALTH AND ) ECF HUMAN SERVICES, ) ) Respondent. ) ) RESPONDENT’S PROFFER ON AWARD OF COMPENSATION On January 19, 2023, Tiffany Huettl (“petitioner”), on behalf of her minor child, R.H., filed a petition for compensation under the National Childhood Vaccine Injury Act of 1986, 42 U.S.C. §§ 300aa-1 to -34 (“Vaccine Act” or “Act”), alleging that as a result of receiving an influenza (“flu”) vaccine on February 20, 2020, R.H. suffered from chronic osteomyelitis. Petition, ECF No. 1 at 1. On September 5, 2023, respondent filed his Rule 4(c) Report conceding that petitioner is entitled to compensation in this case. ECF No. 26. Accordingly, on September 6, 2023, the Special Master issued a Ruling on Entitlement, finding that petitioner is entitled to vaccine compensation. ECF No. 31. I. Items of Compensation A. Life Care Items Respondent engaged life care planner Linda Curtis, RN, MS, CCM, CLCP, and petitioner engaged Roberta Hurley, Hurly Consulting, to provide an estimation of R.H.’s future vaccine- injury related needs. For the purposes of this proffer, the term “vaccine related” is as described in the respondent’s Rule 4(c) Report. All items of compensation identified in the life care plan Case 1:23-vv-00068-UNJ Document 67 Filed 04/21/25 Page 5 of 10 are supported by the evidence and are illustrated by the chart entitled Appendix A: Items of Compensation for R.H., attached hereto as Tab A.1 Petitioner agrees. B. Pain and Suffering Respondent proffers that R.H. should be awarded $150,000.00 in actual and projected pain and suffering. This amount reflects that any award for projected pain and suffering has been reduced to net present value. See 42 U.S.C. § 300aa-15(a)(4). Petitioner agrees. II. Form of the Award The parties recommend that the compensation provided to R.H. should be made through a combination of lump sum payments and future annuity payments as described below, and request that the Special Master’s decision and the Court’s judgment award the following:2 A. A lump sum payment of $155,589.40, representing compensation for life care expenses in the first year after judgment ($5,589.40), and pain and suffering ($150,000.00), to be paid through an ACH deposit to petitioner’s counsel’s IOLTA account for prompt disbursement to petitioner as guardian/conservator of the estate of R.H., for the benefit of R.H. No payments shall be made until petitioner provides respondent with documentation establishing that she has been appointed as the guardian/conservator of R.H.’s estate. If petitioner is not authorized by a court of competent jurisdiction to serve as guardian/conservator of the estate of R.H., any such payment shall be made to the party or parties appointed by a court of competent jurisdiction to 1 The chart at Tab A illustrates the annual benefits provided by the life care plan. The annual benefit years run from the date of judgment up to the first anniversary of the date of judgment, and every year thereafter up to the anniversary of the date of judgment. 2 Should R.H. 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 medical expenses, lost future earnings, and future pain and suffering. 2 Case 1:23-vv-00068-UNJ Document 67 Filed 04/21/25 Page 6 of 10 serve as guardian(s)/conservator(s) of the estate of R.H. upon submission of written documentation of such appointment to the Secretary. B. An amount sufficient to purchase the annuity contract,3 subject to the conditions described below, that will provide payments for the life care items contained in the life care plan, as illustrated by the chart at Tab A attached hereto, paid to the life insurance company4 from which the annuity will be purchased.5 Compensation for Year Two (beginning on the first anniversary of the date of judgment) and all subsequent years shall be provided through respondent’s purchase of an annuity, which annuity shall make payments directly to petitioner 3 In respondent’s discretion, respondent may purchase one or more annuity contracts from one or more life insurance companies. The parties further agree that the annuity payments cannot be assigned, accelerated, deferred, increased, or decreased by the parties and that no part of any annuity payments called for herein, nor any assets of the United States or the annuity company, are subject to execution or any legal process for any obligation in any manner. Petitioner and petitioner’s heirs, executors, administrators, successors, and assigns do hereby agree that they have no power or right to sell, assign, mortgage, encumber, or anticipate said annuity payments, or any part thereof, by assignment or otherwise, and further agree that they will not sell, assign, mortgage, encumber, or anticipate said annuity payments, or any part thereof, by assignment or otherwise. 4 The Life Insurance Company must have a minimum of $250,000,000 capital and surplus, exclusive of any mandatory security valuation reserve. The Life Insurance Company must have one of the following ratings from two of the following rating organizations: a. A. M. Best Company: A++, A+, A+g, A+p, A+r, or A+s; b. Moody’s Investor Service Claims Paying Rating: Aa3, Aa2, Aa1, or Aaa; c. Standard and Poor’s Corporation Insurer Claims-Paying Ability Rating: AA-, AA, AA+, or AAA; d. Fitch Credit Rating Company, Insurance Company Claims Paying Ability Rating: AA-, AA, AA+, or AAA. 5 Petitioner authorizes the disclosure of certain documents filed by the petitioner in this case consistent with the Privacy Act and the routine uses described in the National Vaccine Injury Compensation Program System of Records, No. 09-15-0056. 3 Case 1:23-vv-00068-UNJ Document 67 Filed 04/21/25 Page 7 of 10 only so long as R.H. is alive at the time a particular payment is due. At the Secretary’s sole discretion, the periodic payments may be provided to petitioner in monthly, quarterly, annual or other installments. The “annual amounts” set forth in the chart at Tab A describe only the total yearly sum to be paid to petitioner and do not require that the payment be made in one annual installment. 1. Growth Rate Respondent proffers that a four percent (4%) growth rate should be applied to all non- medical life care items, and a five percent (5%) growth rate should be applied to all medical life care items. Thus, the benefits illustrated in the chart at Tab A that are to be paid through annuity payments should grow as follows: four percent (4%) compounded annually from the date of judgment for non-medical items, and five percent (5%) compounded annually from the date of judgment for medical items. Petitioner agrees. 2. Life-Contingent Annuity The petitioner will continue to receive the annuity payments from the Life Insurance Company only so long as R.H. is alive at the time that a particular payment is due. Written notice shall be provided to the Secretary of Health and Human Services and the Life Insurance Company within twenty (20) days of R.H.’s death. 3. Guardianship No payments shall be made until petitioner provides respondent with documentation establishing that she has been appointed as the guardian(s)/conservator(s) of R.H.’s estate. If petitioner is not authorized by a court of competent jurisdiction to serve as guardian(s)/ conservator(s) of the estate of R.H., any such payment shall be made to the party or parties 4 Case 1:23-vv-00068-UNJ Document 67 Filed 04/21/25 Page 8 of 10 appointed by a court of competent jurisdiction to serve as guardian(s)/conservator(s) of the estate of R.H. upon submission of written documentation of such appointment to the Secretary. III. Summary of Recommended Payments Following Judgment A. Lump Sum paid to the court-appointed guardian(s)/ conservator(s) of the estate of R.H. for the benefit of R.H.: $155,589.40 B. An amount sufficient to purchase the annuity contract described above in section II. B. Respectfully submitted, YAAKOV M. ROTH Acting Assistant Attorney General C. SALVATORE D’ALESSIO Director Torts Branch, Civil Division HEATHER L. PEARLMAN Deputy Director Torts Branch, Civil Division LARA E. ENGLUND Assistant Director Torts Branch, Civil Division /s/ Jamica M. Littles JAMICA M. LITTLES Trial Attorney Torts Branch, Civil Division U. S. Department of Justice P.O. Box l46, Benjamin Franklin Station Washington, D.C. 20044-0146 Tel: (202) 305-4014 Email: jamica.m.littles@usdoj.gov Dated: March 26, 2025 5 Case 1:23-vv-00068-UNJ Document 67 Filed 04/21/25 Page 9 of 10 Appendix A: Items of Compensation for R. H. Page 1 of 2 Lump Sum Compensation Compensation Compensation Compensation Compensation Compensation Compensation ITEMS OF COMPENSATION G.R. * M Year 1 Years 2-5 Year 6 Years 7-8 Year 9 Year 10 Years 11-17 2025 2026-2029 2030 2031-2032 2033 2034 2035-2041 Insurance Maximum out of Pocket 5% 4,000.00 4,000.00 4,000.00 4,000.00 4,000.00 4,000.00 5,000.00 Medicare Part B Deductible 5% Medigap 5% M Orthopedist 5% * Physiatrist 5% * X-rays of Left Leg 5% * X-rays of Lower Back, Hips, Knees 5% * MRI/CT 5% * EMG 5% * Surgery Left Leg 5% * Mileage 4% 554.40 554.40 554.40 554.40 554.40 8,316.00 Tolls 4% 40.00 40.00 40.00 40.00 40.00 600.00 Prescritions Pre & Post Leg Surgery 5% * Tylenol 4% 12.47 Counseling 4% * Physical Therapy 4% * Special Shoes w/Lifts 4% 600.00 600.00 600.00 600.00 Walker 4% * Manual Wheelchair 4% * Leg Length Blocks 4% 395.00 Q-Tips 4% 47.28 Portable Ramp 4% 135.82 Tearaway Pants 4% 107.91 Spinal Injections 5% * Hip & Lower Back Surgery 5% * Pain and Suffering 150,000.00 Annual Totals 155,589.40 5,194.40 5,497.88 5,194.40 4,594.40 12,916.00 5,000.00 Note: Compensation Year 1 consists of the 12 month period following the date of judgment. Compensation Year 2 consists of the 12 month period commencing on the first anniversary of the date of judgment. As soon as practicable after entry of judgment, respondent shall make the following payment to petitioner pain and suffering ($150,000.00) and Yr 1 life care expenses ($5,589.40): $155,589.40. Annual amounts payable through an annuity for future Compensation Years follow the anniversary of the date of judgment. Annual amounts shall increase at the rates indicated in column "G.R." above, compounded annually from the date of judgment. Items denoted with an asterisk (*) covered by health insurance and/or Medicare. Items denoted with an "M" payable in 12 monthly installments at the discretion of respondent. Case 1:23-vv-00068-UNJ Document 67 Filed 04/21/25 Page 10 of 10 Appendix A: Items of Compensation for R. H. Page 2 of 2 Compensation Compensation ITEMS OF COMPENSATION G.R. * M Years 18-56 Years 57-Life 2042-2080 2081-Life Insurance Maximum out of Pocket 5% 4,500.00 Medicare Part B Deductible 5% 257.00 Medigap 5% M 1,458.72 Orthopedist 5% * Physiatrist 5% * X-rays of Left Leg 5% * X-rays of Lower Back, Hips, Knees 5% * MRI/CT 5% * EMG 5% * Surgery Left Leg 5% * Mileage 4% Tolls 4% Prescritions Pre & Post Leg Surgery 5% * Tylenol 4% Counseling 4% * Physical Therapy 4% * Special Shoes w/Lifts 4% Walker 4% * Manual Wheelchair 4% * Leg Length Blocks 4% Q-Tips 4% Portable Ramp 4% Tearaway Pants 4% Spinal Injections 5% * Hip & Lower Back Surgery 5% * Pain and Suffering Annual Totals 4,500.00 1,715.72 Note: Compensation Year 1 consists of the 12 month period following the date of judgment. Compensation Year 2 consists of the 12 month period commencing on the first anniversary of the date of judgment. As soon as practicable after entry of judgment, respondent shall make the following payment to petitioner pain and suffering ($150,000.00) and Yr 1 life care expenses ($5,589.40): $155,589.40. Annual amounts payable through an annuity for future Compensation Years follow the anniversary of the date of judgment. Annual amounts shall increase at the rates indicated in column "G.R." above, compounded annually from the date of judgment. Items denoted with an asterisk (*) covered by health insurance and/or Medicare. Items denoted with an "M" payable in 12 monthly installments at the discretion of respondent.