STREHL v. SECRETARY OF HEALTH AND HUMAN SERVICES

In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 23-0795V
REBECCA STREHL,
Petitioner,
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Chief Special Master Corcoran
Filed: October 8, 2025
David John Carney, Green & Schafle LLC, Philadelphia, PA, for Petitioner.
Catherine Elizabeth Stolar, U.S. Department of Justice, Washington, DC, for
Respondent.
DECISION AWARDING DAMAGES1
On May 31, 2023, Rebecca Strehl 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 alleged that she suffered a shoulder injury related to vaccine
administration (“SIRVA”) as the result of an influenza (“flu”) vaccination received on
September 23, 2021. Petition at 1. The case was assigned to the Special Processing Unit
of the Office of Special Masters.
For the following reasons, I find that Petitioner has established past pain and
suffering warranting an award of $140,000.00.
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).
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I. Procedural History
The case was assigned to SPU in October 2023 (ECF No. 10), and Respondent
conceded entitlement in April 2024 (ECF No. 18). Three months later, Petitioner reported
an impasse in damages discussions, and I permitted the parties were to submit any
additional evidence and briefing (ECF No. 25). See Petitioner’s Damages Brief filed Aug.
22, 2024 (ECF No. 26) (seeking $150,000.00 for past pain and suffering); Respondent’s
Brief, filed Nov. 7, 2024 (ECF No. 29) (countering $87,500.00); Petitioner’s Exs. 17-18
and Reply filed Nov. 25, 2024 (ECF Nos. 30-31). Supplemental submissions were also
permitted: specifically, Respondent’s Sur-Reply filed Dec. 13, 2024 (ECF No. 33)
(addressing the updated medical records at Exs. 17-18); Petitioner’s Ex. 19 and Sur-
Reply filed Apr. 28, 2025 (ECF Nos. 35-38) (addressing a pre-vaccination civil action).
The matter is now ripe for adjudication.
II. Authority
In another recent decision, I discussed at length the legal standard to be
considered in determining SIRVA damages, taking into account prior compensation
determinations within SPU. I fully adopt and hereby incorporate my prior discussion in
Sections I and II of Matthews v. Sec'y of Health & Hum. Servs., No. 22-1396V, 2025 WL
2606607 (Fed. Cl. Spec. Mstr. Aug. 13, 2025).
In sum, compensation awarded pursuant to the Vaccine Act shall include “[f]or
actual and projected pain and suffering and emotional distress from the vaccine-related
injury, an award not to exceed $250,000.” Section 15(a)(4). The petitioner bears the
burden of proof with respect to each element of compensation requested. Brewer v. Sec’y
of Health & Hum. Servs., No. 93-0092V, 1996 WL 147722, at *22-23 (Fed. Cl. Spec. Mstr.
Mar. 18, 1996). Factors to be considered when determining an award for pain and
suffering include: 1) awareness of the injury; 2) severity of the injury; and 3) duration of
the suffering.3
3 I.D. v. Sec’y of Health & Hum. Servs., No. 04-1593V, 2013 WL 2448125, at *9 (Fed. Cl. Spec. Mstr. May
14, 2013) (quoting McAllister v. Sec’y of Health & Hum. Servs., No 91-1037V, 1993 WL 777030, at *3 (Fed.
Cl. Spec. Mstr. Mar. 26, 1993), vacated and remanded on other grounds, 70 F.3d 1240 (Fed. Cir. 1995)).
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III. Evidence4
A. Pre-Vaccination
Ms. Strehl was born in 1954. She was retired, and living with a long-term boyfriend,
at the time of vaccination. Ex. 3 at 85. Her medical history included lower back pain and
sciatica, anxiety, and insomnia – for which she took Xanax (alprazolam). See, e.g., Ex. 3
at 78-80 (primary care record); see also Ex. 6 at 3-4 (lumbar spine MRI); id. at 10-19
(orthopedic evaluations).
On November 24, 2019, Petitioner slipped on a grocery store’s wet floor, falling
onto her right side and forward. Ex. 14 at 3. She declined urgent medical attention but
developed new pain primarily in her left knee and right shoulder. See Ex. 14 at 3-5
(chiropractor); Ex. 3 at 51-54 (primary care provider (“PCP”)).
On January 2, 2020 at Orthopedic Health of Kansas City, Paul Christopher Cowan
M.D., met with Petitioner as a new patient. Ex. 6 at 6. Dr. Cowan noted that her remote
history of right shoulder pain seven years earlier. Id. But since her recent slip and fall, she
had new right shoulder pain and decreased range of motion (“ROM”). Id. at 6-8. Dr.
Cowan diagnosed rotator cuff arthropathy,5 noting that she could apply Voltaren
(diclofenac sodium)6 up to 4 times daily. Id. at 7-8. She was “not a candidate for reverse
total shoulder arthroplasty [at that time, because] she ha[d] excellent range of motion and
very minimal pain.” Id. at 8. The right shoulder complaint, with pain rating 4/10, was last
documented at a January 31, 2020 chiropractic appointment. Ex. 14 at 12.
Later in 2020, Steven Smith M.D. at Northlands Orthopedics treated Petitioner
regarding the slip and fall injuries particularly to her left knee – assessed as a lateral
meniscus tear and treated with a steroid injection followed by surgery and physical
therapy (“PT”). Ex. 7 at 4-6, 13-14, 23-37.
4 While I have not specifically addressed every medical record, or all arguments presented in the parties’
briefs, I have fully considered all records as well as all arguments presented by both parties.
5 Arthropathy is defined as “any joint disease.” Dorland’s Medical Dictionary Online (hereinafter “Dorland’s”),
Arthropathy, https://www.dorlandsonline.com/dorland/definition?id=4273&searchterm=arthropathy (last
accessed Oct. 1, 2025).
6 Voltaren (diclofenac sodium) is listed as an ongoing medication, in the context of appointments for
Petitioner’s left elbow and left knee, the at-issue left shoulder, and back pain. See e.g., Ex. 7 at 4, 23, 27,
38, 48; Ex. 4 at 134; Ex. 15 at 3, 27-28.
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In June 2021, Petitioner through attorney Phillip Holloway sued the grocery store
regarding her slip and fall, in the Circuit Court of Platte County, Missouri. She specifically
alleged a “left knee injury requiring surgery, along with injuries to her neck, back, left
elbow, and right shoulder.” Ex. 19 at 1-2; see also id. at 6, 8 (reflecting February 2023
settlement in which the grocery store paid Petitioner $50,000.00 for a left knee injury).
The evidence does not establish any history of pre-vaccination left shoulder pain
or dysfunction. See e.g., Ex. 3 at 10-12; Ex. 4 at 178-83; accord Response at 2.7
B. Post-Vaccination
On September 23, 2021, Petitioner received the at-issue flu vaccine in her left
deltoid, at a pharmacy. Ex. 1 at 3.
Twelve (12) days later,8 on October 5, 2021, John C. Swab, D.O. at Northlands
Orthopedics evaluated Petitioner – first noting that she had no current right shoulder
issues. Ex. 7 at 38-39. She had a new9 left shoulder injury that “interfered with sleep,”
was “present at rest,” “aggravated by lifting the arm above the head, strenuous activity,
and activities of daily living,” and not significantly relieved by ice, rest, or NSAIDs. Id. On
exam, the left shoulder displayed deltoid tenderness; reduced range of motion (“ROM”);10
“pain-related weakness” of 4/5; and positive Hawkins and Neers’ impingement signs. Id.
at 39. Dr. Swab tentatively assessed a rotator cuff syndrome and administered a
subacromial steroid injection. Id.
On October 28, 2021, the PCP documented the ongoing left shoulder injury. Ex. 4
at 134-35. On exam, Petitioner could not lift her arm past 30 to 45 degrees in anterior or
lateral directions; she could move posteriorly with some pain. Id. The PCP prescribed 10
7 This is despite certain post-vaccination records suggesting a pre-vaccination left-sided injury, potentially
associated with the slip and fall. See, e.g., Ex. 4 at 134 (October 2021 record); Ex. 12 at 3. These records
are likely inaccurate. They are not corroborated by any pre-vaccination, contemporaneous medical records
or other evidence.
8 Petitioner states that her “first report” of injury was on the day of vaccination, at the pharmacy. Brief at 4,
32. But that was not documented contemporaneously – only reported by Petitioner at a primary care
encounter one month later. Ex. 4 at 134.
9 The orthopedist Dr. Swab recorded that Petitioner’s left shoulder pain had been present for “one week”
and not associated with any injury, Ex. 7 at 38. But on a new patient questionnaire, Petitioner wrote that
the injury began “2 weeks ago” and was “getting worse” Id. at 42, which is more consistent with the onset
required for a Table SIRVA (which Respondent has already conceded).
1010 Specifically active range of motion (“AROM”) was forward flexion (“FF”) to 80 degrees; external rotation
(“ER”) 25 degrees; and internal rotation (“IR”) to L3. Passive range of motion (“PROM”) was FF to 150
degrees; ER 45 degrees; ER “90: 70”; and IR “90: 60.” Ex. 7 at 39.
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days’ worth of Vicodin (hydrocodone-acetaminophen) for “a more comfortable night
sleep.” Id. at 136.11 The PCP also ordered a November 4, 2021 MRI of the left shoulder,
which showed:
1. Complex posterior and superior labral tear that involves the biceps origin.
2. Grade 2 strain [in] the infraspinatus muscle.
3. Small partial-thickness tear of the subscapularis tendon, superimposed on
moderate tendinopathy.
4. Mild to moderate supraspinatus and infraspinatus tendinopathy with
undersurface fraying.
5. Moderate acromioclavicular osteoarthritis.
Ex. 10 at 48.
On November 9, 2021, Dr. Swab recorded that Petitioner was experiencing
“unacceptable” left shoulder pain. Ex. 7 at 49-50. Dr. Swab reviewed the MRI findings
including “a moderate amount of glenohumeral osteoarthritis with degenerative changes
noted over both the glenoid and humeral head.” Id. at 50. He assessed primary
osteoarthritis in the glenohumeral joint, which he targeted with a steroid injection. Id. at
46, 50. Petitioner did not return to Dr. Swab. Id. at 50.
Instead on January 12, 2022, she established care at OSI Orthopedics Sports
Medicine. Ex. 8 at 25. She first met with a physician’s assistant (“PA”) who recorded her
10/10 pain rating, and exam findings of decreased ROM due to pain and weakness, as
well as positive Hawkin’s, Neer’s, empty can, and drop arm tests. Id. at 26. The PA
assessed superior labrum anterior to posterior (“SLAP”) and partial-thickness rotator cuff
tears. Id. at 27.
Two days later, OSI orthopedic surgeon Michael A. Boin, M.D. assessed “left
shoulder pain due to rotator cuff tear, subacromial impingement, superior labral tear, and
AC joint arthritis,” for which he planned surgical intervention. Ex. 8 at 29.
11 This October 28, 2021 record contains two potential inconsistencies. First, its history of present illness
states that Petitioner “took a fall a couple of years ago and injured the left elbow and shoulder but before
the vaccination last month had fairly good range of motion.” Ex. 4 at 134 (emphasis added). But the records
contemporaneous to that fall only indicate a right shoulder injury. Second, the October 28th record suggests
current “bilateral pain.” Ex. 4 at 134. This may be a reference to Petitioner’s prior right-sided shoulder issues
– because the record does not document any active right shoulder pain or other symptoms.
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On February 21, 2022, Dr. Boin performed Petitioner’s left shoulder arthroscopy
with rotator cuff repair, arthroscopic biceps tenodesis, subacromial decompression, distal
clavicle resection, and extensive debridement. Ex. 9 at 77. She went home that same day
with a limited prescription for Norco, and an immobilizer sling. Ex. 9 at 63, 67-68.
At the two-week post-operative follow-up, Dr. Boin recorded that Petitioner’s left
shoulder pain was “improving” and she was doing home pendulum exercises. She would
continue wearing the sling and start formal PT. Ex. 8 at 16. But since the left-sided
surgery, she was experiencing new or at least worsened right shoulder pain warranting
an MRI and PT evaluation. Id. at 16, 19.
At the March 7, 2022 Select PT initial evaluation, Petitioner had bilateral shoulder
pain rated 7/10, and limited ROM.12 The records further explain that the immobilizer
prevented any “functional use of the left arm,” requiring complete reliance on her right
side. Ex. 13 at 3-5.
A March 14, 2022 MRI of Petitioner’s right shoulder showed:
1. Marked attenuation of the superior rotator cuff limiting evaluation. Full-
thickness, partial-width tear of the anterior supraspinatus footprint. Probable
additional subacromial high-grade bursal-sided tear. Delaminating tear of the
infraspinatus tendon. No definite tendinous retraction. Diffuse rotator cuff fatty
atrophy sparing the teres minor.
2. Moderate to severe degenerative changes of the glenohumeral joint. Mild
degenerative changes of the acromioclavicular joint.
3. Large glenohumeral effusion with evidence of chronic synovitis. Multiple intra-
articular bodies.
4. Subacromial/subdeltoid and sub coracoid bursitis.
5. Full thickness tear or previous tenotomy13 of the long head biceps tendon.
Ex. 11 at 7.
At the one-month post-operative follow-up, Dr. Boin recorded that Petitioner was
doing well, her pain was well-controlled, she was attending PT, and she could stop
immobilizing her left shoulder. Ex. 8 at 12. Dr. Boin’s record does not address her right
12 Specifically the left shoulder’s PROM was flexion to 82 degrees, abduction 62 degrees, and external
rotation 10 degrees. The right shoulder’s AROM was flexion to 115 degrees, abduction 135 degrees, and
external rotation 55 degrees. Ex. 13 at 4.
13 There is no evidence that Petitioner ever underwent right shoulder surgery.
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shoulder complaints – but four days later at PT, Petitioner reported a right-sided “torn
RTC and biceps,” and her plan to defer any surgical repair “until late summer or early fall.”
Ex. 13 at 35.
On April 19, 2022, Petitioner attended her 13th session at Select PT. She was
apparently unhappy with her progress, and therefore decided to transfer care to a different
facility. Ex. 13 at 51. From April 28 – May 11, 2022, Petitioner attended four sessions at
Preferred PT. See generally Ex. 12. At the last session, her worst pain had decreased
from 10 to 8/10, and her ROM was still abnormal. Id. at 18.14 Afterwards, Petitioner
transitioned from formal PT to home exercises. Id.
At a May 13, 2022 follow-up, Dr. Boin recorded that Petitioner’s left shoulder was
doing well, with no issues with pain. Ex. 8 at 8. An exam found: “Slightly decreased range
of motion than expected at this point post-operatively. 130/50/L5. Good rotator cuff
strength.” Id. Dr. Boin assessed that the left shoulder’s “slight post-operative stiffness…
continues to improve.” Dr. Boin also noted, but deferred evaluation, of the ongoing right
shoulder issues. Ex. 8 at 8.
On August 25, 2022, Dr. Boin reiterated that Petitioner’s left shoulder was “doing
very well” with “no complaints” and PT “done.” Ex. 8 at 3. An exam confirmed that
Petitioner’s left shoulder had regained full ROM and strength. Id. at 4. Petitioner’s right
shoulder also had full ROM – but pain with overhead motion, 3+/5 strength, and positive
impingement signs. Id. After reviewing the imaging, Dr. Boin assessed right-sided “rotator
cuff tear arthropathy” – and utilized more specific diagnostic codes for rotator cuff tear
and secondary osteoarthritis. Id. He administered a right-sided subacromial steroid
injection, and discussed other treatment options including surgery if the right-sided
symptoms did not improve. Id. at 4-5.
On October 13, 2022, Petitioner returned to the Orthopedic Health of Kansas City
practice, meeting with C. Craig Satterlee M.D.15 Petitioner reported “continued trouble”
with her left shoulder, neck, headaches, and back. Ex. 17 at 4. However, those areas
were not evaluated or assessed. Id. at 4-6. Her chief complaint was right shoulder pain;
despite a past diagnosis of rotator cuff arthropathy, she “had good function without a lot
of pain” until about March 2022. Id. Despite the recent PT, steroid injection, and daily
ibuprofen, the right shoulder had ongoing pain of 7-9/10, decreased ROM, and atrophy.
14 Specifically, the left shoulder had active flexion to 90 degrees and external rotation was 40 degrees.
Passive flexion was 120 degrees, external rotation was 45 degrees, and strength was -3/5. Ex. 12 at 18.
15 Petitioner was referred to the October 2022 orthopedic appointment by cardiologist Steven K. Starr, M.D.
Ex. 17 at 4, 6. No corresponding records from Dr. Starr have been filed. But see e.g., Ex. 10 at 387 (June
2021 annual appointment with Dr. Starr).
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Id. at 4-5. Dr. Satterlee assessed a right-sided “significant chronic rotator cuff tear with
developing osteoarthritis of the glenohumeral joint, so-called rotator cuff arthropathy,” for
which he suggested a reverse total shoulder replacement. Id. at 6.
At a March 2023 annual wellness visit, the PCP recorded that Petitioner was doing
well except for “continue[d…] problems with right shoulder, right knee, and low back pain.”
Ex. 15 at 17. She reported riding a stationary bike and walking for exercise. Id. No positive
physical exam findings were recorded. Id. at 20-21. The PCP prescribed Meloxicam 15mg
for her low back pain. Id. at 21.
Roughly seven months later, in October 2023, the PCP recorded that Meloxicam
had not been very helpful for Petitioner’s worsening back pain. Ex. 15 at 26. CT scans
found degenerative changes throughout the cervical and thoracic spine. Id. The PCP
suggested different medications, pain management consultation, and PT for her back
complaints. Id. at 26-28.
At a March 2024 annual wellness visit, Petitioner’s chief concern was
“[C]ontinue[d] significant limitation of the left shoulder due to history of rotator cuff surgery.
She still has weakness in that arm and cannot lift past 75-90 degrees forward and lateral
but “manages. Diclofenac remains helpful for any MSK discomforts.” Ex. 15 at 3. On
exam, the left shoulder’s ROM was “somewhat limited past 90 degrees of elevation,
otherwise strength normal and tone intact.” Id. at 8. The PCP suggested following up with
an orthopedist as needed for this complaint. Id.
Instead five months later, Petitioner returned to Preferred PT (after a two-year
absence). The therapist recorded that their previous four sessions had delivered “slight
progress in terms of mobility and pain reduction, and [Petitioner] opted to continue on
home basis.” Ex. 18 at 25. As of the August 8, 2024 reevaluation, Petitioner had 9/10
pain, decreased ROM, and “significant difficulty with reaching OH [overhead] and lifting
light items at home.” Id. at 25-27. By the fourth session on August 23rd, she achieved
“slightly increased” PROM but “significant pain at end ranges.” Id. at 31.
On September 16, 2024, Petitioner returned to the Orthopedic Health of Kansas
City practice, meeting with Dr. Cowan. Ex. 17 at 8. The recorded history of present illness
focuses on her left shoulder but incorrectly states that she underwent surgery on the right
side. Id. The exam and assessment document bilateral shoulder pain, decreased ROM
and weakness. Id. at 8-9. Dr. Cowan reviewed that a repeat MRI of the left shoulder found
“no change in moderate tendinopathy of the supraspinatus, infraspinatus, and
subscapularis tendons without discrete tears” – but the previously-seen “glenohumeral
arthritis has worsened, now moderate to severe.” Id. at 9. Dr. Cowan’s assessment
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repeats: “She had a recent MRI showing moderate to severe glenohumeral degenerative
joint disease,” for which he provided a glenohumeral joint steroid injection with the
consideration of a total shoulder replacement at least 3 to 6 months later. Id. at 10, 12.
Dr. Cowan also assessed the right shoulder with “known right shoulder rotator cuff
arthropathy,” also warranting a future total shoulder replacement. Id. at 10. No further
records have been filed.
I have also reviewed Petitioner’s testimonial statements. In part, she describes that
her right shoulder had “healed,” but was then re-injured due to her left-sided SIRVA with
surgical intervention and immobilization. Ex. 2 at ¶ 18; Ex. 16 at ¶ 4. As of July 2024,
Petitioner reports ongoing bilateral shoulder injuries which continue to disrupt her daily
activities including getting dressed, using the computer, lifting weights and cardiovascular
exercise, and sleep. Ex. 16 at ¶¶ 4-6.16 She also faults her left shoulder pain and tension
for secondary neck pain, back pain, and headaches. Id. at ¶ 7. As of July 2024, she was
planning to undergo additional PT due to hesitance about additional surgery at her age –
but remained concerned that her bilateral shoulder injuries are permanent. Id. at ¶¶ 9-10.
IV. Appropriate Compensation for Petitioner’s Pain and Suffering
In this case, awareness of the injury is not disputed. The record reflects that at all
times Petitioner was a competent adult with no impairments that would impact his
awareness of her injury. Therefore, I analyze principally the severity and duration of
Petitioner’s injury.
When performing the analysis in this case, I review the record as a whole to include
the medical records, declarations, affidavits, and all other filed evidence, plus the parties’
briefs and other pleadings. I consider prior awards for pain and suffering in both SPU and
non-SPU SIRVA cases and rely upon my experience adjudicating these cases. However,
I base my determination on the circumstances of this case.
A full review of the record demonstrates that the September 23, 2021 vaccine
administration was followed by a left-sided SIRVA that was severe, but somewhat limited
in duration. As a preliminary matter, it is emphasized that despite most likely inaccurate
medical records indicating otherwise, I have not found preponderant evidence of any prior
left shoulder pain or dysfunction. And the vaccination led to formal medical treatment
beginning just 12 days later, and consistently thereafter. Petitioner repeatedly rated her
pain towards the top of a ten-point scale, and had moderately limited ROM, despite over-
16 Petitioner also says that her injuries “made it difficult for me to perform… work.” Ex. 2 at ¶ 3. But upon
the at-issue vaccination in October 2021, she was 67 years old and already retired. See, e.g., Ex. 3 at 16;
Ex. 4 at 135.
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the-counter pain medications and two steroid injections.
And despite Respondent’s objection (Response at 11), I conclude that Petitioner’s
pre-existing insomnia was exacerbated by the SIRVA in its acute phase – as evidenced
by the new short-term prescription of Vicodin “for a more comfortable night’s sleep” (Ex.
4 at 136). Her consultations with multiple orthopedists, arthroscopic shoulder surgery five
months into the course, and 17 PT sessions across two facilities also underscore the
acute injury’s severity.
However, the following damages award also recognizes that Petitioner initially
deferred formal PT – instead attempting more conservative home exercises, in the injury’s
early phase. And she has not established above-average disruptions to her personal life
– as a retired individual without significant professional or personal obligations.
I recognize that upon transitioning from formal PT to a home exercise program in
mid-May 2022, Petitioner still had high pain ratings and had not met her goals –
supporting the conclusion that her left SIRVA had not substantially resolved by that time.
However, Petitioner concedes that her orthopedic surgeon documented full ROM
and strength in her left shoulder on August 25, 2022 (11 months post-vaccination). Brief
at 15, citing Ex. 8 at 2. Afterwards, there is no objective documentation or formal treatment
of a left shoulder injury for roughly eighteen months. Compare Ex. 17 at 4 (October 2022
report by Petitioner of ongoing left shoulder “trouble” - but no corresponding exam,
assessment, or treatment of the left shoulder by a different orthopedist); Ex. 15 at 17-21
(March 2023 primary care annual exam with no ongoing left shoulder injury documented);
Ex. 15 at 26-26 (October 2023 primary care appointment). A left shoulder injury is later
documented objectively, and related back to the vaccination by Petitioner – but her
providers did not expressly endorse that link. See, e.g., Ex. 15 at 3-8; Ex. 18 at 25-27.
Most importantly in September 2024, the orthopedic surgeon Dr. Cowan assessed her
left shoulder glenohumeral joint arthritis as “worsened,” currently “moderate to severe,”
and the appropriate focus of treatment with a steroid injection. Ex. 17 at 9-12.
Here, while Respondent conceded entitlement for a Table SIRVA, he contends
that the corresponding damages should be limited – and particularly should not include
later complaints attributed to worsening osteoarthritis, which is not a vaccine-caused
condition. Response at 1-2, citing Agate v. Sec’y of Health & Hum. Servs., No. 18-1397V,
2024 WL 4164241 (Fed. Cl. Spec. Mstr. Aug. 7, 2024) (dismissing a Table SIRVA, and
an alternative causation-in-fact claim, due to treaters’ and experts’ opinions regarding
similar chronic degenerative changes). Indeed, another special master recently found that
similar findings precluded an entitlement ruling of a Table SIRVA. Specifically: “Both
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parties’ experts agree that [the Pulsipher] petitioner’s ultimate treatment for her condition
– her reverse shoulder replacement – was indicated due to the presence of osteoarthritis
that failed conservative treatment for her condition – her reverse shoulder replacement –
was indicated due to the presence of osteoarthritis that failed conservative treatment
measures. Given all this, petitioner [in Pulsipher] cannot reasonably assert that her
glenohumeral osteoarthritis ‘would not’ explain her symptoms.” Pulsipher v. Sec’y of
Health & Hum. Servs., No. 21-2133V, 2025 WL 1364203, at *10 (Fed. Cl. Spec. Mstr.
Apr. 24, 2025), mot. for rev. den’d, -- Fed. Cl. – (slip op. Sept. 3, 2025). Petitioner has not
offered any response on this point. Thus, SIRVA damages award cannot be extended to
these more attenuated and likely-unrelated complaints.
In contrast, I find preponderant evidence of an overuse injury to the opposing right
shoulder that can reasonably be viewed as a sequela of the left SIRVA. Despite some
prior history, Petitioner’s right shoulder had not been actively treated for roughly two years
pre-vaccination, and it was apparently pain-free with normal ROM and strength. See, e.g.,
Ex. 4 at 181; Ex. 7 at 38, 50. The left SIRVA’s surgical intervention was followed by one
month of complete immobilization, requiring Petitioner to rely entirely on her opposing
right side, and she was promptly documented to have a new right-sided injury. Ex. 8 at
16-19; Ex. 13 at 3-5. Petitioner persuasively notes that her medical providers recorded
this explanation, even if they did not expressly endorse it. Reply at 11.17 That likely
explains the right shoulder’s inclusion in her formal PT course, and treatment with one
subacromial steroid injection, in 2022. Notably at that time, the right shoulder MRI findings
included tearing and bursitis. See Ex. 11 at 7. However, there is insufficient explanation
for how the left-sided SIRVA would explain Petitioner’s long-term right-sided complaints,
especially in light of her providers’ focus, again, on degenerative changes which would
justify a total shoulder replacement.
Turning to a specific valuation of past pain and suffering, Petitioner seeks
$150,000.00, but Respondent supports nearly 50% less - $87,500.00. Respondent’s cited
cases are not informative, however. Upon awarding $97,500.00 in Shelton, I balanced a
more extensive treatment course (with three steroid injections, and PT both before and
after surgical intervention) against significant treatment delays (three months, and
17 Accord McDorman v. Sec’y of Health & Hum. Servs., No. 19-814V, 2021 WL 5504698, at *3 (Fed. Cl.
Spec. Mstr. Oct. 18, 2021) (reflecting an orthopedist’s assessment that the petitioner’s “right shoulder pain
was most likely a direct result of having to rely on it following her left shoulder surgery and throughout the
duration of her post-operative recovery”); compare with, e.g., Havis v. Sec’y of Health & Hum. Servs., No.
21-0583V, 2024 WL 5039036, at *4 (Fed. Cl. Spec. Mstr. Nov. 1, 2024) (not accepting allegation of an
overuse injury first documented over eight months after substantial recovery from the SIRVA) and
Richardson v. Sec’y of Health & Hum. Servs., No. 20-0674V, 2023 WL 6180813, at * (Fed. Cl. Spec. Mstr.
Aug. 16, 2023) (17-month gap between the SIRVA’s acute course and new complaints regarding the
opposite shoulder).
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another five months) and low pain levels. See Response at 15, citing Shelton v. Sec’y of
Health & Hum. Servs., No. 19-279V, 2021 WL 2550093 at *7-8 (Fed. Cl. Spec. Mstr. May
21, 2021). Ms. Strehl has documented a more consistently severe acute injury, warranting
a higher award.
Similarly my award of $95,000.00 in Hunt recognized that petitioner’s 26 PT
sessions and three steroid injections, but also significant periods of pain relief from the
latter. Response at 15, citing Hunt v. Sec’y of Health & Hum. Servs., No. 19-1003V, 2022
WL 2826662, at *8-9 (Fed. Cl. Spec. Mstr. June 16, 2022). Ms. Strehl attended fewer PT
sessions (just 17), but her pain was not relieved by steroid injections or other prescription
medication, she began treatment sooner (12 days, versus 18 days), and she underwent
surgery sooner – all indicating that the SIRVA was more severe in its initial period
(notwithstanding my finding of a substantial recovery post-surgery).
Finally, I reject Respondent’s request to apply an offset for the settlement of
Petitioner’s prior civil action (Sur-Reply at n. 4), because that settlement was for a
surgically corrected knee injury. Ex. 19 at 6, 8; see also e.g., Ex. 7 at 4-6, 13-14, 23-37.
Petitioner’s valuation and cited cases are more helpful. See generally Petitioner’s
Brief; Reply; and Sur-Reply. In particular, she persuasively argues for a “floor” of the
$130,000.00 awarded in Anglewicz – which also involved formal treatment beginning less
than one month post-vaccination and consistently thereafter; OTC and prescription pain
medications; two steroid injections without significant pain relief; an MRI finding both
tearing and osteoarthritis; surgical intervention at about six months post-vaccination, and
substantial recovery within a year. See Reply at 16-17, citing Anglewicz v. Sec’y of Health
& Hum. Servs., No. 20-1504V, 2024 WL 2702415, at *4-5 (Fed. Cl. Spec. Mstr. Feb. 8,
2024). Even recognizing that the Anglewicz petitioner deferred post-surgical formal PT
because of the emerging Pandemic, which was not implicated here, Ms. Strehl had a
somewhat more extensive treatment course for her SIRVA, which also resulted in
temporary overuse of the opposing shoulder.
However, Petitioner’s award should be less severe than that in cases like Gao – in
which I awarded $155,000.00 to a petitioner who had undergone surgery, received six
steroid injections, attended 64 formal PT sessions, and experienced residual effects for
at least 21 months. Gao v. Sec’y of Health & Hum. Servs., No. 21-1884V, 2023 WL
6182455 (Fed. Cl. Spec. Mstr. Aug. 18, 2023).
Based on my review of the evidence, these case comparisons, and my
experience overall, I find that a fair and appropriate award for Petitioner’s past pain
and suffering is $140,000.00.
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Conclusion
For all the reasons discussed above and based on consideration of the entire
record, Petitioner is entitled to damages in the form of a lump sum payment of
$140,000.00, 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 Section 15(a). The Clerk of the Court is directed to enter judgment in accordance
with this Decision.18, 19
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
18 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.
19 Finally, I note the representation that “If Petitioner undergoes an additional surgery, Petitioner will move
for leave to file an additional reply brief to amend Petitioner’s position on damages to account for the
additional surgery related to Petitioner’s pain and suffering analysis.” Reply (ECF No. 31) at n. 1, and Sur-
Reply (ECF No. 37) at n. 1 (emphasis added). I am not inclined to grant any such motion out of the general
interest of achieving final judgments (indeed, Petitioner has “confirmed that this case is ripe for a decision…”
and requested its adjudication without further delay, see Sur-Reply, accord Informal Communication
entered Sept. 24, 2025), as well as my case-specific analysis that Petitioner’s SIRVA was of limited duration
and that her subsequent complaints are likely unrelated.
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