UNPUBLISHED

DECISION AWARDING DAMAGES1

NORA BETH DORSEY, Chief Special Master.

On September 27, 2017, petitioner 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 from a left shoulder injury related to vaccine administration ("SIRVA") as a result of receiving the influenza ("flu") vaccine on November 2, 2016. Petition at 1. The case was assigned to the Special Processing Unit of the Office of Special Masters.

On April 30, 2019, a ruling on entitlement was issued, finding petitioner entitled to compensation for SIRVA. On August 30, 2019, respondent filed a proffer on award of compensation ("Proffer") indicating petitioner should be awarded $$50,053.96 ($50,000.00 for pain and suffering and $53.96 for unreimbursed expenses) and funds to satisfy the State of Pennsylvania Medicaid lien in the amount of $2,446.70. Proffer at 1-2. In the Proffer, respondent represented that petitioner agrees with the proffered award. Id. Based on the record as a whole, the undersigned finds that petitioner is entitled to an award as stated in the Proffer.

Pursuant to the terms stated in the attached Proffer, the undersigned awards petitioner:

The clerk of the court is directed to enter judgment in accordance with this decision.3

IT IS SO ORDERED.

RESPONDENT'S PROFFER OF DAMAGES

I. Procedural History

On April 19, 2019, respondent filed a Vaccine Rule 4(c) report concluding that petitioner suffered an injury that is compensable under the National Childhood Vaccine Injury Act of 1986, as amended, 42 U.S.C. §§300aa-10 to -34. Accordingly, on April 30, 2019, the Chief Special Master issued a Ruling on Entitlement, finding that petitioner was entitled to vaccine compensation for her Shoulder Injury Related to Vaccine Administration ("SIRVA") as a result of the influenza vaccine she received on November 2, 2016.

II. Items of Compensation and Form of the Award

Based upon the evidence of record, respondent proffers, and the parties recommend, that compensation be made through a lump sum as described below, and request that the Chief Special Master's decision and the Court's judgment award the following:

A. Medicaid Lien

Respondent proffers that M.P. should be awarded funds to satisfy the State of Pennsylvania Medicaid lien in the amount of $2,446.70, which represents full satisfaction of any right of subrogation, assignment, claim, lien, or cause of action the State of Pennsylvania may have against any individual as a result of any Medicaid payments that the State of Pennsylvania has made to or on behalf of petitioner from the date of her eligibility for benefits through the date of judgment in this case as a result of her vaccine-related injury suffered on or about November 2, 2016, under Title XIX of the Social Security Act. Reimbursement of the State of Pennsylvania lien shall be made through a lump sum payment of $2,446.70, representing compensation for satisfaction of the State of Pennsylvania lien, payable jointly to petitioner and

Petitioner agrees to endorse this payment to the Department of Human Services.

B. Pain and Suffering and Out-of-Pocket Expenses

Based upon the evidence of record, respondent proffers that petitioner should be awarded $50,053.96 ($50,000.00 for pain and suffering and $53.96 for unreimbursed expenses).

This represents all elements of compensation to which petitioner would be entitled under 42 U.S.C. § 300aa-15(a).1 Petitioner agrees. Petitioner is a competent adult. Evidence of guardianship is not required in this case.