In the United States Court of Federal Claims OFFICE OF SPECIAL MASTERS No. 20-2049V
BELKIS DIAZ, Chief Special Master Corcoran Petitioner, v. Filed: November 27, 2023 SECRETARY OF HEALTH AND HUMAN SERVICES,
Respondent.
Laura Levenberg, Muller Brazil, LLP, Dresher, PA, for Petitioner.
Joseph Adam Lewis, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION ON JOINT STIPULATION1
On December 30, 2020, Belkis Diaz 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 a tetanus, diphtheria, and acellular pertussis (“Tdap”) vaccine she received in her right arm on April 9, 2019. Petition at 1; Stipulation, filed at November 24, 2023, ¶¶ 1-4. Petitioner further alleges that she experienced the residual effects of this condition for more than six months. Petition at 3; Stipulation at ¶ 4. “Respondent denies that petitioner sustained a SIRVA Table injury; denies that the 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 November 24, 2023, 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). Pursuant to the terms stated in the attached Stipulation, I award the following compensation:
A lump sum of $35,000.00, in the form of a check payable 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 Vinesign Document ID: E5E83D37-6907483E-87FF-C28923521 B50
IN THE UNITED STATES COURT OF FEDERAL CLAIMS OFFICE OF SPECIAL MASTERS
BELKIS DIAZ,
Petitioner, No. 20-2049V Chief Special Master Corcoran v. ECF
SECRETARY OF HEALTH AND HUMAN SERVICES,
STIPULATION
The parties hereby stipulate to the following matters:
I . Belkis Diaz ("petitioner"), filed a petition for vaccine compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. § 300aa-lO to 34 (the "Vaccine
Program"). The petition seeks compensation for injuries allegedly related to petitioner's receipt
of a tetanus, diphtheria. and acellular pertussis ("Tdap") vaccine, which vaccine is contained in
the Vaccine Injury Table (the ..Table"), 42 C.F.R. § I00.3(a)
2. Petitioner received a Tdap vaccine on April 9, 2019, in her right ann.
3. The vaccine was administered within the United States.
4. Petitioner alleges that she sustained a shoulder injury related to vaccine administration
("SIRVA") within the time period set forth in the Table. She further 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 on her behalf as a result of her alleged injury.
The signed document can be validated at https://app.vinesign.comNerify 6. Respondent denies that petitioner sustained a SIRVA Table injury; denies that the
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 ofjudgment reflecting a decision consistent with
the tenns of this Stipulation, and after petitioner has filed an election to receive compensation
pursuant to 42 U.S.C. § 300aa-21(a)(l), the Secretary of Health and Human Services will issue
the following vaccine compensation payment:
A lump sum of $35,000.00 in the form of a check payable 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 ofjudgment 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-2l(a)(l), 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-l5(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 ·l l . 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
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In the United States Court of Federal Claims OFFICE OF SPECIAL MASTERS No. 20-2049V
BELKIS DIAZ, Chief Special Master Corcoran Petitioner, v. Filed: November 27, 2023 SECRETARY OF HEALTH AND HUMAN SERVICES,
Respondent.
Laura Levenberg, Muller Brazil, LLP, Dresher, PA, for Petitioner.
Joseph Adam Lewis, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION ON JOINT STIPULATION1
On December 30, 2020, Belkis Diaz 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 a tetanus, diphtheria, and acellular pertussis (“Tdap”) vaccine she received in her right arm on April 9, 2019. Petition at 1; Stipulation, filed at November 24, 2023, ¶¶ 1-4. Petitioner further alleges that she experienced the residual effects of this condition for more than six months. Petition at 3; Stipulation at ¶ 4. “Respondent denies that petitioner sustained a SIRVA Table injury; denies that the 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 November 24, 2023, 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). Pursuant to the terms stated in the attached Stipulation, I award the following compensation:
A lump sum of $35,000.00, in the form of a check payable 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 Vinesign Document ID: E5E83D37-6907483E-87FF-C28923521 B50
IN THE UNITED STATES COURT OF FEDERAL CLAIMS OFFICE OF SPECIAL MASTERS
BELKIS DIAZ,
Petitioner, No. 20-2049V Chief Special Master Corcoran v. ECF
SECRETARY OF HEALTH AND HUMAN SERVICES,
STIPULATION
The parties hereby stipulate to the following matters:
I . Belkis Diaz ("petitioner"), filed a petition for vaccine compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. § 300aa-lO to 34 (the "Vaccine
Program"). The petition seeks compensation for injuries allegedly related to petitioner's receipt
of a tetanus, diphtheria. and acellular pertussis ("Tdap") vaccine, which vaccine is contained in
the Vaccine Injury Table (the ..Table"), 42 C.F.R. § I00.3(a)
2. Petitioner received a Tdap vaccine on April 9, 2019, in her right ann.
3. The vaccine was administered within the United States.
4. Petitioner alleges that she sustained a shoulder injury related to vaccine administration
("SIRVA") within the time period set forth in the Table. She further 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 on her behalf as a result of her alleged injury.
The signed document can be validated at https://app.vinesign.comNerify 6. Respondent denies that petitioner sustained a SIRVA Table injury; denies that the
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 ofjudgment reflecting a decision consistent with
the tenns of this Stipulation, and after petitioner has filed an election to receive compensation
pursuant to 42 U.S.C. § 300aa-21(a)(l), the Secretary of Health and Human Services will issue
the following vaccine compensation payment:
A lump sum of $35,000.00 in the form of a check payable 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 ofjudgment 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-2l(a)(l), 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-l5(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 ·l l . 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 attorney's fees and litigation costs, and past unreimbursable 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-1S(a) and (d), and subject to the conditions of 42 U.S.C.
§ 300aa-l 5(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. § 300aa-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 Tdap vaccination administered on April 9, 2019, as
alleged in a petition for vaccine compensation filed on or about December 30, 2020, in the
United States Court of Federal Claims as petition No. 20-2049V.
l 4. If petitioner should die prior to entry ofjudgment, this agreement shall be voidable
upon proper notice to the Court on behalf of either or both of the parties.
3 15. If the special master fails to issue a decision in complete confonnity with the tenns
of this Stipulation or if the Court of Federal Claims fails to enter judgment in confonnity 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 Tdap vaccine caused petitioner's alleged injury
or any other injury or her current disabilities, 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
4 Respectfully submitted,
PETITIONER:
BELKIS DIAZ
ATTORNEY OF RECORD FOR AUTHORIZED REPRESENTATIVE
;c::~ LAURAJ.LEVENBERG MULLER BRAZIL ~
h HEATHER L. PEARLMAN 4'- Deputy Director GENERAL:
"'/11t,2\\yL f< , W,s 1411'\a,1 t4,-r.,c. ~ - - ' T ' ( 'J?~C',Toll,
715 Twinning Road, Ste. 208B Torts Branch Dresher, PA 19025 Civil Division (215) 885•1655 U.S. Department ofJustice amy@mullerbrazil.com P.O. Box 146 Benjamin Franklin Station Washington, DC 20044-0146
AUTIIORIZED REPRESENTATIVE ATTORNEY OF RECORD FOR OFTHESECRETARYOFBEALTH RESPONDENT: AND HUMAN SERVICES: Oigitally>ignedbyHent)'P, Henry P• Mcmillan •SS by Mcmillan -S5 :~2021.11.1s1s:26:11
CDR GEORGE REED GRIMES, MD, MPH Director, Division of Injury al Attorney Compensation Programs Torts Branch Health Systems Bureau Civil Division Health Resources and Services Administration U.S. Department of Justice U.S. Department of Health and P.O. Box 146 Human Services Benjamin Franklin Station 5600 Fishers Lane, 08W-25A Washington, DC 20044-0146 Rockville, MD 20857 (202) 451•7495 joseph.a.lewis@usdoj.gov
s Vinesign
..,/ Verification Complete 1h...: docum e m h11s oeen omc,,,ll'f vl;'nfic:-d . • Documait Status "' Signed & Verified Document N•me Stipulation • Diaz Sender Name MuUerBrazil Document Key E5E83037-6907-483£-87FF-C28923521B50
RKlplent1 IP Address s11nature Belkis Diaz 8.20.97.26 kalynsofta@gmaff.com (305} 924-2967 (Uy Order 1
Document History
Aetlvlty Date6Time fledplent Acdvlty Oecalls
11121/2023 00:21 UTC Belkis Diaz Signed by Belkis Olaz ((305) 924-2967) lllodcchlln !lode WlfHelk2jllh39ZSpMTNiTO/KYc8jpTy51Yanp7dlP Document Completed l>oalfflefttHah 12216SEC5S02ASD9E27CA78ACS1560879F37Ef871486F4198'763F6EFF88212E Mi&i& Tirn-p 11121nonoo21 urc
11/21/202300:19 UTC Belkis Diaz Vi~ by Bellcls o·,az ((30S) 924-2967)
Document Viewed
4 11120/2023 20:S5 UTC Sent out via emaU to Bellcls Diaz (kalynsofi.a@gmall.com)
Document Sent
4 11/20/2023 20:55 UTC Belkis Diaz Sent out via text to Belkis Diaz ((305} 924-2967)
11/20/2023 20:55 UTC Cre.ited by Muller Brazil (medlcalrecords@myvacclnelawyer.com)
Document Created