VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_24-vv-00577
Package ID: USCOURTS-cofc-1_24-vv-00577
Petitioner: Rlanda Bellamy
Filed: 2024-04-15
Decided: 2025-05-16
Vaccine: influenza
Vaccination date: 2022-10-22
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 49500

AI-assisted case summary:
Rlanda Bellamy filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging that she suffered a shoulder injury related to vaccine administration (SIRVA) after receiving an influenza vaccine on October 22, 2022. She further alleged that her injury lasted for more than six months. The respondent, the Secretary of Health and Human Services, denied that Ms. Bellamy sustained a SIRVA Table injury, denied that the flu vaccine caused her alleged shoulder injury or any other injury, and denied that her current condition was a sequela of a vaccine-related injury. Despite these denials, the parties filed a joint stipulation agreeing that the case should be settled and that compensation should be awarded. The court adopted the stipulation as its decision, awarding Ms. Bellamy a lump sum of $49,500.00. This amount represents compensation for all items of damages available under Section 15(a) of the Vaccine Act. The case proceeded as a Table claim, as SIRVA is listed on the Vaccine Injury Table. The stipulation was signed by Rlanda Bellamy and her counsel, as well as counsel for the respondent.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_24-vv-00577-0
Date issued/filed: 2025-05-16
Pages: 8
Docket text: PUBLIC DECISION (Originally filed: 04/11/2025) regarding 21 DECISION Stipulation/Proffer. Signed by Chief Special Master Brian H. Corcoran. (kle) Service on parties made.
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Case 1:24-vv-00577-UNJ Document 27 Filed 05/16/25 Page 1 of 8
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 24-0577V
RLANDA BELLAMY,
Chief Special Master Corcoran
Petitioner,
v. Filed: April 11, 2025
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Joseph P. Shannon, Shannon Law Group, P.C., Woodridge, IL, for Petitioner.
Mary Eileen Holmes, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION ON JOINT STIPULATION1
On April 15, 2024, Rlanda Bellamy 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”) as a result of receiving an influenza (“flu”) vaccine to her right
shoulder on October 22, 2022. Petition at 1; Stipulation, filed at April 9, 2025, ¶¶ 1-4.
Petitioner further alleges that her injury lasted for more than six months. Petition at 9;
Stipulation at ¶ 4. “Respondent denies that petitioner sustained a SIRVA Table injury;
denies that the flu vaccine caused petitioner’s alleged shoulder injury, or any other injury;
and denies that her current condition is a sequela of a vaccine-related injury.” Stipulation
at ¶ 6.
Nevertheless, on April 9, 2025, the parties filed the attached joint stipulation,
stating that a decision should be entered awarding compensation. I find the stipulation
reasonable and adopt it as my decision awarding damages, on the terms set forth therein.
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 1:24-vv-00577-UNJ Document 27 Filed 05/16/25 Page 2 of 8
Pursuant to the terms stated in the attached Stipulation, I award the following
compensation:
A lump sum of $49,500.00, to be paid through an ACH deposit to Petitioner’s
counsel’s IOLTA account for prompt disbursement to Petitioner. Stipulation
at ¶ 8. This amount represents compensation for all items of damages that would
be available under Section 15(a). Id.
I approve the requested amount for Petitioner’s compensation. In the absence of
a motion for review filed pursuant to RCFC Appendix B, 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 1:24-vv-00577-UNJ Document 27 Filed 05/16/25 Page 3 of 8
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
RLANDA BELLAMY,
Petitioner, No. 24-577v
Chief Special Master Corcoran
v. ECF
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
STIPULATION
The parties hereby stipulate to the following matters:
1. On April 15, 2024, Rlanda Bellamy (“petitioner”) filed a petition for vaccine
compensation under the National Vaccine Injury Compensation Program, 42 U.S.C. §300aa-10
to -34 (the “Vaccine Program”). The petition seeks compensation for injuries allegedly related to
petitioner’s receipt of an influenza (“flu”) vaccine, which vaccine is contained in the Vaccine
Injury Table (the “Table”), 42 C.F.R. § 100.3(a).
2. Petitioner received the flu vaccine on October 22, 2022.
3. The vaccine was administered within the United States.
4. Petitioner alleges that she suffered from a shoulder injury related to vaccine
administration (“SIRVA”) within the time period set forth in the Table following administration
of the vaccine. Petitioner alleges that she experienced the residual effects of this condition for
more than six months.
5. Petitioner represents that there has been no prior award or settlement of a civil action
for damages as a result of her condition.
1

Case 1:24-vv-00577-UNJ Document 27 Filed 05/16/25 Page 4 of 8
6. Respondent denies that petitioner sustained a SIRVA Table injury; denies that the flu
vaccine caused petitioner’s alleged shoulder injury, or any other injury; and denies that her
current condition is a sequela of a vaccine-related injury.
7. Maintaining their above-stated positions, the parties nevertheless now agree that the
issues between them shall be settled and that a decision should be entered awarding the
compensation described in paragraph 8 of this Stipulation.
8. As soon as practicable after an entry of judgment reflecting a decision consistent with
the terms of this Stipulation, and after petitioner has filed an election to receive compensation
pursuant to 42 U.S.C. § 300aa-21(a)(1), the Secretary of Health and Human Services will issue
the following vaccine compensation payment:
A lump sum of $49,500.00 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 42 U.S.C.
§ 300aa-15(a).
9. As soon as practicable after the entry of judgment on entitlement in this case, and after
petitioner has filed both a proper and timely election to receive compensation pursuant to 42
U.S.C. § 300aa-21(a)(1), and an application, the parties will submit to further proceedings before
the special master to award reasonable attorneys’ fees and costs incurred in proceeding upon this
petition.
10. Petitioner and her attorney represent that compensation to be provided pursuant to
this Stipulation is not for any items or services for which the Program is not primarily liable
under 42 U.S.C. § 300aa-15(g), to the extent that payment has been made or can reasonably be
expected to be made under any State compensation programs, insurance policies, Federal or
State health benefits programs (other than Title XIX of the Social Security Act (42 U.S.C.
§ 1396 et seq.)), or by entities that provide health services on a pre-paid basis.
2

Case 1:24-vv-00577-UNJ Document 27 Filed 05/16/25 Page 5 of 8
11. Payment made pursuant to paragraph 8 and any amounts awarded pursuant to
paragraph 9 of this Stipulation will be made in accordance with 42 U.S.C. § 300aa-15(i), subject
to the availability of sufficient statutory funds.
12. The parties and their attorneys further agree and stipulate that, except for any award
for attorneys’ fees and litigation costs, and past unreimbursed expenses, the money provided
pursuant to this Stipulation will be used solely for the benefit of petitioner as contemplated by a
strict construction of 42 U.S.C. §300aa-15(a) and (d), and subject to the conditions of 42 U.S.C.
§ 300aa-15(g) and (h).
13. In return for the payments described in paragraphs 8 and 9, petitioner, in her
individual capacity, and on behalf of her heirs, executors, administrators, successors or assigns,
does forever irrevocably and unconditionally release, acquit and discharge the United States and
the Secretary of Health and Human Services from any and all actions or causes of action
(including agreements, judgments, claims, damages, loss of services, expenses and all demands
of whatever kind or nature) that have been brought, could have been brought, or could be timely
brought in the Court of Federal Claims, under the National Vaccine Injury Compensation
Program, 42 U.S.C. § 300 aa-10 et seq., on account of, or in any way growing out of, any and all
known or unknown, suspected or unsuspected personal injuries to or death of petitioner resulting
from, or alleged to have resulted from, the flu vaccination administered on October 22, 2022, as
alleged by petitioner in a petition for vaccine compensation filed on or about April 15, 2024, in
the United States Court of Federal Claims as petition No. 24-577V.
14. If petitioner should die prior to entry of judgment, this agreement shall be voidable
upon proper notice to the Court on behalf of either or both of the parties.
3

Case 1:24-vv-00577-UNJ Document 27 Filed 05/16/25 Page 6 of 8
15. If the special master fails to issue a decision in complete conformity with the terms
of this Stipulation or if the Court of Federal Claims fails to enter judgment in conformity with a
decision that is in complete conformity with the terms of this Stipulation, then the parties’
settlement and this Stipulation shall be voidable at the sole discretion of either party.
16. This Stipulation expresses a full and complete negotiated settlement of liability and
damages claimed under the National Childhood Vaccine Injury Act of 1986, as amended, except
as otherwise noted in paragraph 9 above. There is absolutely no agreement on the part of the
parties hereto to make any payment or to do any act or thing other than is herein expressly stated
and clearly agreed to. The parties further agree and understand that the award described in this
Stipulation may reflect a compromise of the parties’ respective positions as to liability and/or
amount of damages, and further, that a change in the nature of the injury or condition or in the
items of compensation sought, is not grounds to modify or revise this agreement.
17. This Stipulation shall not be construed as an admission by the United States or the
Secretary of Health and Human Services that the flu vaccine caused petitioner’s alleged shoulder
injury or any other injury or petitioner’s current condition, or that petitioner suffered an injury
contained in the Vaccine Injury Table.
18. All rights and obligations of petitioner hereunder shall apply equally to petitioner’s
heirs, executors, administrators, successors, and/or assigns.
END OF STIPULATION
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4

Case 1:24-vv-00577-UNJ Document 27 Filed 05/16/25 Page 7 of 8
Respectfully submitted,
PETmONER:
~ ..ddltvru;
RLANDA BELLAMY
'T'T,ADIUEY OF RECORD FOR AUTHORIZED REPRESENTATIVE
NER: OF THE ATTORNEY GENERAL:
~ ~~
PEA
HEATHER L. MAN
our, P.C Deputy Director
n Valley Drive, Suite 101 Torts Branch
, IL 60517 Civil Division
578-9501 U.S. Department of Justice
J annonlawgroup.com P.O. Box 146
Benjamin Franklin Station
Washington, DC 20044-0146
AUTHORIZED REPRESENTATIVE ATTORNEY OF RECORD FOR
OF THE SECRETARY OF HEALTH RESPONDENT:
AND HUMAN SERVICES:
BRITTANY B. Olgltaltj slgntd b1 BRITTANY B.
IIJZEK•SIO ~s~
RIZEK-S10
Date: 2025.03.28 10:41:01 -OIW
CAPT GEORGE REED GRIMES, MD, MPH
Director, Division of Injury Trial Attorney
Compensation Programs Torts Branch, Civil Division
Health Systems Bureau U.S. Department of Justice
Health Resources and Services P.O. Box 146
Administration Benjamin Franklin Station
U.S. Department of Health Washington, DC 20044-0146
and Human Services Tel: (202) 616-5022
5600 Fishers Lane, 08W-25A Mary.E.Holmes@usdoj.gov
Rockville, MD 20857
5
ENV06810048-6143-EFQC..7259-EFED
04/04/2025 20:37 PM UTC

Case 1:24-vv-00577-UNJ Document 27 Filed 05/16/25 Page 8 of 8
Envelope Data
Subject: Shannon Law Group • Rlanda Bellamy • Stipulation • Signature Request
Documents: Bellamy 24-0577 Stipulation Signed by HHS.pelf
Document Hash: DccF /SUqRYGHsfGpjNtWP6uxlcAxlNB3F4iZM30C90o•
Envelope ID: ENV06810048·6143•EFDC•n59·EFED
Sender: Admln Shannon Law Group
Sent: 04/04/2025 16:25 PM UTC
Status: Completed Access Authentication: None
Status Date: 04/04/2025 20:37 PM UTC Email Acce5s Code: Not Enabled
Email Verification: Not enabled
Recipients / Roles
Name/ Role Email a Type
Admin Shannon Law Group aclmin@shannonlawgroup.com Sender
Rlanda Bellamy alinda1952@gmail.com Signer
Document Events
Name/ Roles Email IP Address Date Event
Admin Shannon Law Grou 04/04/2025 16
admin@shannonlawgroup.com 99.114.247.233 Created
'D :25 PMUTC
04/04/2025 20
Rlanda Bellamy alinda 1952@gmail.com 99.114.247.233 Resent
:04 PMUTC
04/04/2025 20
Rlanda Bellamy alinda1952@gmail.com 152.44.116.75 Signed
:37PMUTC
04/04/2025 20
! Status • Completed
:37PMUTC
Signer Signatures
Signer Name / Roles Signature Initials
~ f ) ~
Rlanda Bellamy