VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_24-vv-01319
Package ID: USCOURTS-cofc-1_24-vv-01319
Petitioner: Ann Heiden
Filed: 2024-08-27
Decided: 2026-04-10
Vaccine: influenza
Vaccination date: 2022-10-10
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: entitlement_granted_pending_damages
Award amount USD: 

AI-assisted case summary:
Ann Heiden filed a petition for compensation under the National Vaccine Injury Compensation Program on August 27, 2024, alleging she suffered a shoulder injury related to vaccine administration (SIRVA) as a result of an influenza vaccine administered on October 10, 2022. The respondent argued that the medical records did not preponderantly establish the alleged injury began within 48 hours of vaccination, as required for a Table SIRVA claim. The decision focuses on the onset of Petitioner's shoulder pain. Petitioner reported left upper arm pain starting on October 11, 2022, the day after her flu shot, which progressed to sharp stabbing pain. She sought treatment approximately nine weeks later, reporting pain onset the day after vaccination. Subsequent medical records consistently corroborated this timeline, with multiple providers noting the injury began shortly after the October 10, 2022 vaccination. The court found that Petitioner provided preponderant evidence that the onset of her shoulder pain occurred within 48 hours of vaccination. The case is proceeding to damages, with the court noting that the injury appears moderate and likely warrants a modest award. The respondent is to file a status report by May 11, 2026.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_24-vv-01319-0
Date issued/filed: 2026-05-12
Pages: 8
Docket text: PUBLIC ORDER/RULING (Originally filed: 04/10/2026) regarding 22 Findings of Fact & Conclusions of Law. Signed by Chief Special Master Brian H. Corcoran. (cr) Service on parties made.
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Case 1:24-vv-01319-UNJ Document 24 Filed 05/12/26 Page 1 of 8
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 24-1319V
ANN HEIDEN, Chief Special Master Corcoran
Petitioner,
v. Filed: April 10, 2026
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Leah VaSahnja Durant, Law Offices of Leah V. Durant, PLLC, Washington, DC, for
Petitioner.
Jeremy Mauritzen, U.S. Department of Justice, Washington, DC, for Respondent.
FACT RULING ON ONSET1
On August 27, 2024, Ann Heiden filed a petition for compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. §300aa-10, et seq.2 (the
“Vaccine Act”), alleging that she suffered a shoulder injury related to vaccine
administration (“SIRVA”) as a result of an influenza (“flu”) vaccine administered to her on
October 10, 2022. See Pet. at 1, ECF No. 1. The case was assigned to the Special
Processing Unit of the Office of Special Masters.
For the reasons set forth below, I find it more likely than not that the onset of
Petitioner’s shoulder pain occurred within 48 hours of vaccination, as alleged.
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 1:24-vv-01319-UNJ Document 24 Filed 05/12/26 Page 2 of 8
I. Relevant Procedural History
Though the parties made a tentative effort to settle this claim, they were ultimately
unsuccessful. ECF Nos. 13-14, 17, 19. Respondent filed his Rule 4(c) Report on August
18, 2025, arguing that the medical records do not preponderantly establish the alleged
injury began within 48 hours of the subject vaccination, as required for a Table SIRVA.
Id. at 6 (internal citations omitted). Petitioner has not filed any documents in response.
The issue of onset is ripe for resolution.
II. Authority
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). “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 & Hum. 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 & Hum. 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, 2005 WL 6117475, at *19.
The United States Court of Federal Claims has recognized that “medical records
may be incomplete or inaccurate.” Camery v. Sec’y of Health & Hum. 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 & Hum. Servs., 110 Fed. Cl. 184, 203-04 (2013), aff’d, 746 F.3d 1335 (Fed. Cir.
2014). 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 & Hum. Servs., No. 90-2808, 1998 WL
408611, at *5 (Fed. Cl. Spec. Mstr. June 30, 1998)).
2

Case 1:24-vv-01319-UNJ Document 24 Filed 05/12/26 Page 3 of 8
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.
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 § 12(d)(3); Vaccine Rule 8); see also Burns v. Sec’y of
Health & Hum. 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).
III. Relevant Factual Evidence
I make this finding of fact after a complete review of the record, including all
medical records, declarations, and additional evidence filed. I emphasize the following:
• Petitioner received the subject flu vaccine in her left deltoid on October 10,
2022, through the employee health department at the local hospital where
she worked. Ex. 1 at 1.
• On December 14, 2022 (approximately nine weeks post vaccination),
Petitioner saw a pain management specialist for left shoulder pain. Ex. 2 at
134. She reported her “left upper arm pain . . . started on 10/11/22 after
getting a flu shot into the left arm.” Id. at 135. Petitioner explained that “[t]he
day of the procedure, she noted that pain was more significant during the
flu shot then [sic] previously in past” and “[t]he day after starting [sic] noticing
achiness in the left upper lateral arm which then progressed into sharp
stabbing . . . with certain movements.” Id. Petitioner also described ‘“zingers’
starting from the area of the lateral upper arm and radiating into the left
elbow[.]” Id.
• A physical examination performed during this visit showed tenderness to
palpation over the left deltoid and triceps, plus pain with range of motion
(“ROM”). Ex. 2 at 138. The treater assessed Petitioner with tendinopathy of
the left upper extremity, neuralgia, and myalgia (“other site[,]” unspecified).
Id. at 139. The treater described Petitioner’s injury and noted “left upper arm
3

Case 1:24-vv-01319-UNJ Document 24 Filed 05/12/26 Page 4 of 8
pain status post flu injection on 10/11/22.” Id. And, the treater opined that
Petitioner’s “[s]ymptoms seem to be related to possible trauma induced
tendinitis/myofascial inflammation vs. neuritis of axillary posterior circumflex
humeral, superior lateral cutaneous nerve of the arm or possibly radial
nerve. Etiology still elusive.” Id. The treater prescribed a Medrol Dosepak
and encouraged Petitioner to stretch. Id.
• Petitioner returned to her pain management specialist on January 4, 2023,
reporting a slight improvement in her left shoulder pain following medication.
Ex. 2 at 148. She noted ongoing pain with ROM, a “ping” with severe pain,
and difficulties sleeping on her left side; she rated her pain at a 2/10 at best
but 10/10 intermittently. Id. An examination was consistent with tenderness
over the left deltoid. Id. at 150. The treater’s impression remained
unchanged but now included SIRVA, specifically.3 Id. at 150-51.
• On January 6, 2023, Petitioner filled out a “first report of injury or disease”
form in connection with her worker’s compensation claim. Ex. 7 at 51. She
noted her injury date as “10-10-22” at “9:00AM” when she “got flu shot in
left arm.” Id. She reported that her “pain developed at injection site and has
persisted intermittently since.” Id.
• Petitioner sought care with an orthopedist on February 8, 2023. Ex. 5 at 9.
She stated that “[o]n 10/10/2022 she received her flu vaccine at the
[hospital] where she works. She experienced immediate pain following this
injection and has been struggling with symptoms since.” Id. Petitioner
explained that she “thought her symptoms would improve on their own so
she did not officially report this until December [2022] when her pain began
to significantly worsen.” Id. She also complained of loss of ROM, which was
confirmed by her treater upon examination. Id. at 9-10. The orthopedist
assessed Petitioner with left shoulder adhesive capsulitis “secondary to
work-related flu vaccine administration on 10/10/2022[,]” and administered
Petitioner a steroid injection. Id. at 10.
• The following week (on February 14, 2023), Petitioner attended her physical
therapy (“PT”) evaluation. Ex. 2 at 185. Petitioner reported that “after she
received her flu shot on 10/10/22, she developed pain and stiffness and
weakness and has eventually been diagnosed with adhesive capsulitis.” Id.
at 186. She complained of ongoing pain with reaching backwards,
3 More so, during a February 1, 2023 pain management follow-up visit to review the results of EMG studies,
the treater encouraged Petitioner to “research SIRVA experts[.]” Ex. 2 at 178. The EMG was normal. Ex. 2
at 172-73; Ex. 4 at 3.
4

Case 1:24-vv-01319-UNJ Document 24 Filed 05/12/26 Page 5 of 8
overhead, and lifting; she noted she “has not been exercising the left
shoulder, but is active with yoga/pilates.” Id. She rated her pain at an 8/10
with activity. Id. Petitioner attended 14 PT sessions (through April 12, 2023).
• In pursuit of her worker’s compensation claim, Petitioner’s file contains a
note (dated February 17, 2023). Ex. 7 at 13. The note states that it
“seem[ed] odd” to Petitioner’s employer that she “didn’t report this timely”
because “[i]f a nerve was hit with the shot, it would have been excruciating
and instant pain” and she is “claiming pain developed over time[.]” Id. The
employer stated that the vaccine administrator was “very experienced” and
administers vaccines on a daily basis; it would therefore be unlikely for the
administrator to have made a mistake. Id. The employer thus sought
Petitioner’s charts to “make sure treatment is related and appropriate for the
mechanism of injury.”4 Id.
• On April 7, 2023,5 Petitioner followed up with her orthopedist and reported
“doing much better” following treatment with PT. Ex. 5 at 13. The orthopedist
noted Petitioner “ha[d] no concerns.” Id. An examination showed limited
passive ROM, mildly reduced strength due to pain, and tenderness over the
acromioclavicular (“AC”) joint. Id. The orthopedist recommended ongoing
stretching. Id. at 14.
• Petitioner had an orthopedic follow-up visit on June 2, 2023. Ex. 7 at 202.
She complained of “worsening stiffness and pain” of her left shoulder, which
the treater noted began “following a flu vaccine.” Id. The orthopedist wrote
that while Petitioner “did extremely well with [treatment] initially, she has
regressed over the past couple of weeks.” Id. The treater maintained the
assessment of SIRVA and administered Petitioner a repeat steroid
injection. Id. at 203.
• Petitioner’s care thereafter included additional orthopedic follow-up visits
throughout October 2023, and an MRI with mild findings.6 See, e.g., Ex. 8
at 3-4, 27. While her orthopedist opined that Petitioner ultimately was a
candidate for arthroscopic capsular release (see id. at 4), Petitioner did not
undergo surgery. By late October, with new complaints of “searing, stabbing
4 Ultimately, Petitioner’s worker’s compensation claim was rejected without recovery for her alleged injury.
Ex. 7 at 3-4.
5 Notably, Petitioner appears to have retained counsel to initiate the instant claim on April 5, 2023 – thus
two days prior to this visit. Ex. 2 at 7.
6 The MRI showed mild AC joint degenerative changes and trace glenohumeral joint effusion. Ex. 8 at 27.
5

Case 1:24-vv-01319-UNJ Document 24 Filed 05/12/26 Page 6 of 8
on [her] shoulder blade” and constant throbbing and aching down to the
elbow and into the hand, the orthopedist recommended a cervical spine
workup. Id. at 12-13.
• On February 9, 2024, Petitioner sought care with a neurologist and pain
specialists for continued shoulder pain and decreased ROM. Ex. 9 at 8. She
reported her belief that she was “experiencing SIRVA after vaccine
administration while receiving an influenza vaccine at work almost 2 years
ago.” Id. She endorsed pain since the time of vaccination. Id. The treater
assessed Petitioner with frozen shoulder, neuralgia and neuritis, and
(unrelated) tension headaches. Id. at 9. Petitioner received prolotherapy
injections into the left shoulder through January 2025. See id. at 5-6; see
also Ex. 12 at 6-20.
• Petitioner has filed a signed declaration in support of her claim. Petitioner
recalls her October 10, 2022 vaccination hurting “more than you would
expect one to hurt, and the next day, the pain intensified to a sharp, knife-
like stabbing combined with a constant throbbing.” Ex. 10 ¶ 1.
• No other medical record or declaration evidence regarding the onset of
Petitioner’s post-vaccination shoulder injury has been filed.
IV. Finding of Fact Regarding Onset
A petitioner alleging a SIRVA claim must show that she experienced the first
symptom or onset of pain within 48 hours of vaccination. 42 C.F.R. § 100.3(a)(XIV)(B);
42 C.F.R. § 100.3(c)(10)(ii) (QAI criteria). As noted, Respondent contends that Petitioner
cannot establish this criterion because she delayed seeking care for over two months
post vaccination, and because when she reported her injury to her worker’s compensation
administrator she stated her pain had “developed over time.” Rule 4(c) Report at 6 (citing
Ex. 2 at 133; Ex. 7 at 13). And, while she reported intermittent pain rated at a severe level
of 10/10, she did not seek treatment for months and continued to engage in “rigorous
activities,” including yoga. Id. (citing Ex. 2 at 133). Respondent thus argues that the only
record support for Petitioner’s onset contentions comes from her word alone, and is
otherwise unsupported by the records. Id.
The totality of the evidence favors Petitioner’s onset contentions. The
aforementioned medical records establish that Petitioner consistently reported to treaters
an onset close-in-time to vaccination, and that she indeed was experiencing symptoms
in the relevant timeframe.
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Case 1:24-vv-01319-UNJ Document 24 Filed 05/12/26 Page 7 of 8
The additional fact that Petitioner sought treatment within two months of the
subject vaccination (on December 14, 2022), actually somewhat helps Petitioner in
establishing Table-consistent onset. In other cases, even much greater delays have not
undermined an otherwise-preponderantly-established onset showing consistent with the
Table. See, e.g., Tenneson v. Sec’y of Health & Hum. Servs., No. 16-1664V, 2018 WL
3083140, at *5 (Fed. Cl. Spec. Mstr. Mar. 30, 2018), mot. for rev. denied, 142 Fed. Cl.
329 (2019) (finding a 48-hour onset of shoulder pain despite a nearly six-month delay in
seeking treatment); Williams v. Sec’y of Health & Hum. Servs., No. 17-830V, 2019 WL
1040410, at *9 (Fed. Cl. Spec. Mstr. Jan. 31, 2019) (noting a delay in seeking treatment
for five-and-a-half months because a petitioner underestimated the severity of her
shoulder injury). The delay here is not nearly as long.
In addition, some delay in seeking treatment itself is never per se evidence of a
non-conforming onset. As I have previously noted, SIRVA petitioners often put off seeking
shoulder-related care based on the reasonable assumption that the pain is normal and
will resolve on its own over time, especially since patients are often told by medical
providers at the time of vaccination to expect some soreness and pain. This appears to
have been (at least partially) the case here, with Petitioner explaining that she “thought
her symptoms would improve on their own so she did not officially report this until
December [2022] when her pain began to significantly worsen.” Ex. 5 at 9.
Also supporting onset is the fact that Petitioner affirmatively and repeatedly linked
her shoulder pain to the subject flu vaccine – beginning with the December 14, 2022
treatment encounter, at which time she reported pain in the left shoulder pain that “started
on 10/11/22 after getting a flu shot into the left arm.” Ex. 2 at 134-35. She specifically
placed onset as beginning the day after vaccination (at the latest), by explaining further
that “[t]he day after” the vaccination, she began “noticing achiness in the left upper lateral
arm which then progressed into sharp stabbing . . . with certain movements.” See id. This
entry thus provides strong support for a showing of two-day onset consistent with the
Table.
More so, subsequent medical records consistently corroborate this entry with the
same level of detail, and thus bolster Petitioner’s ability to establish Table-consistent
onset. See, e.g., Ex. 7 at 51 (a January 6, 2023 report made in pursuit of Petitioner’s
worker’s compensation claim, that her injury occurred on “10-10-22” when she “got flu
shot in left arm.”); Ex. 5 at 9 (a February 8, 2023 orthopedic report that her injury began
“[o]n 10/10/2022 [when] she received her flu vaccine . . . . She experienced immediate
pain following this injection and has been struggling with symptoms since.”); Ex. 2 at 185-
86 (a February 14, 2023 PT report of pain beginning “after she received her flu shot on
10/10/22[.]”). These records, taken together, provide preponderant support in favor of an
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Case 1:24-vv-01319-UNJ Document 24 Filed 05/12/26 Page 8 of 8
onset that occurred extremely close in time to vaccination and not an injury that
“developed over time” as Respondent contends (Rule 4(c) Report at 6). To rule otherwise,
the record would need to contain instances of contrary reporting, or that describing an
onset that occurred later than two days after vaccination. But such evidence is lacking in
this case.
Conclusion
Petitioner has provided preponderant evidence that the onset of her shoulder pain
occurred within 48 hours of vaccination.
I encourage the parties to make a final re-attempt at informal resolution (of
settlement or damages). Respondent shall file, by no later than Monday, May 11,
2026, a status report concerning how he intends to proceed, including, if appropriate,
whether he would like to file an amended Rule 4(c) Report or whether he is otherwise
willing to entertain a renewed settlement demand from Petitioner.
In the event Respondent is open to informal resolution of either settlement or
damages, and to aid in those discussions, the parties should keep in mind that the record
supports a moderate injury overall, requiring fairly conservative treatment for a limited
duration. Petitioner participated in 14 PT sessions, received two steroid injections, did not
undergo surgery; and by October 2023, she began reporting a new constellation of
symptoms that required treatment with a neurologist (at least partially), and her diagnoses
after that time included neuralgia and neuritis – thus somewhat inconsistent with a typical
SIRVA. See, e.g., Ex. 5 at 9-10; Ex. 7 at 202-03; Ex. 8 at 12-13; Ex. 9 at 9. Petitioner
should thus not expect more than a modest award, even at full value of this case.
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
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