# In the United States Court of Federal Claims

OFFICE OF SPECIAL MASTERS

No. 19

- 1475 V

UNPUBLISHED

DANIEL VAN DOREN

,

Petitioner,

v.

SECRETARY OF HEALTH AND

HUMAN SERVICES,

Respondent. Chief Special Master Corcoran

Filed: February 12, 2021

Special Processing Unit (SPU) ;
Rul ing on Entitlement; Concession;
Table Injury; Influenza (Flu) Vaccine; Shoulder Injury Related to Vaccine Administration (SIRVA)

Paul R. Brazil, Muller Brazil, LLP, Dresher, PA , for petitioner.

Terrence Kevin Mangan, Jr. , U.S. Department of Justice, Washington, DC, for

respondent.

RULING ON ENTITLEMENT 1

On September 25, 2019

, Daniel Van Doren filed a petition for compensation under the National Vaccine Injury Compensation Program, 42 U.S.C. §300aa

- 10, et seq

. 2 (the “Vaccine Act”). Petitioner alleges that he suffered a Table Injury

– Shoulder Injury Related to Vaccine Administration (“SIRVA”)

– as a result of his January 30, 2018 influneza ( “ flu ” )

vaccination . Petit ion at 1 . The case was assigned to the Special Processing Unit of the Office of Special Masters.

On February 11, 2021

, R espondent filed his Rule 4(c) report in which he concedes

that P etitioner is entitled to compensa tion in this case. Respondent’s Rule 4(c) Report at

1 Because this unpublished ruling contains a reasoned explanation for the action in this case, I am required
to post it on the United States Court of Federal Claims' website in accordance with the E

- Government Act

of 2002. 44 U.S.C. § 3501 note (2012) (Federal Management and Promotion of Electronic Government Services). This means the ruling will be available to anyone with access to the internet. In accordance with Vaccine Rule 18(b), Petitioner has 14 days to identify and move to redact medical or other information,

the disclosure of which would constitute an unwarranted invasion of privacy. If, upon review, I agree that
the identified material fits within this definition, I will redact such material from public access.

2 National Childhood Vaccine Injury Act of 1986, Pub. L. No. 99

- 660, 100 Stat. 3755

. Hereinafter, for ease of citation, all “§” references to the Vaccine Act will be to the pertinent subpara graph of 42 U.S.C. § 300aa (2012 ).2 1. Specifically, R espondent indicates that

DICP [ Division of Injury Compensation Programs, Department of Health

and Human Services ] has concluded that petitioner’s alleged injury meets

the requirements of a Table injury claim for a left SIRVA stemming from the

flu vaccina tion on January 30, 2018. DICP did not identify any other causes for petitioner’s left arm injury, and records show that he suffered the sequela of this injury for more than six months. Based on the medical records outlined above, petitioner has met the st atutory requirements for entitlement

to compensation. See 42 U.S.C. § 300aa

- 13(a)(1)(B); 42 U.S.C. § 300aa

11(c)(1)(D)

.

Id. at 5 . Respondent further agrees that “ based on the record as it now stands, petitioner has satisfied all legal prerequisites for compensation under the Act

. ” Id.

In view of R espondent’s position and the evidence of record, I find that

P etitioner is entitle d to compensation.

IT IS SO ORDERED.

s/ Brian H. Corcoran

Brian H. Corcoran

Chief Special Master