Sender v. Secretary of Health and Human Services, 20-0172V

Petitioner Lee Ann Sender alleged that she suffered a left shoulder injury (SIRVA) following a flu vaccine administered on October 4, 2017, and filed for compensation under the National Vaccine Injury Compensation Program.
She claimed intense, immediate shoulder pain after administration, supported by witness affidavits, but delayed seeking medical treatment until over four months post-vaccination.
Multiple post-vaccination medical visits for unrelated conditions within this period did not reference shoulder pain.
February 13, 2018, was the first documented medical complaint associating her shoulder injury to the vaccine, with subsequent records consistently attributing her ongoing pain to the October 2017 shot.
The government disputed whether onset of pain, a core criterion for SIRVA compensation, began within 48 hours post-vaccination as required by the Vaccine Injury Table.
The court found it more likely than not that onset occurred within 48 hours, but noted unresolved issues about the true scope and cause of SIRVA, encouraging settlement or further litigation.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether onset of shoulder pain was within 48 hours of vaccination	Sender claims pain started immediately post-vaccination, supported by affidavits	Onset not established within 48 hours due to delayed treatment and lack of early complaint in medical records	Court found onset occurred within 48 hours by preponderant evidence
Credibility of affidavits and self-reporting without early medical support	Affidavits consistently corroborate immediate post-vaccine pain	Affidavits should not outweigh absence of complaints at intervening medical visits	Court credited affidavits given explanation for delay and subsequent consistent reporting
Impact of intervening medical visits for other conditions with no mention of shoulder pain	Visits were unrelated to the shoulder injury, so silence not probative	Failure to mention pain at these visits weighs against credibility of immediate onset claim	Court found it reasonable not to mention shoulder in unrelated specialist visits
Sufficiency of the petitioner’s linking injury to vaccine via research and later knowledge	Realization of SIRVA via research explained treatment delay and documented onset	Knowledge of SIRVA post-factum suggests fabrication or post-hoc rationalization	Court did not find research timing undermined credibility of onset claim

Cucuras v. Sec’y of Health & Hum. Servs., 993 F.2d 1525 (Fed. Cir. 1993) (medical records are generally considered trustworthy evidence)
La Londe v. Sec’y of Health & Hum. Servs., 110 Fed. Cl. 184 (Fed. Cl. 2013), aff’d, 746 F.3d 1335 (Fed. Cir. 2014) (explains reasons for inconsistencies between medical records and later testimony)
Burns v. Sec’y of Health & Hum. Servs., 3 F.3d 415 (Fed. Cir. 1993) (special master has discretion to weigh medical records versus later testimony)