1

TENNESSEE BUREAU OF WORKERS’ COMPENSATION

IN THE COURT OF WORKERS’ COMPENSATION CLAIMS

AT MURFREESBORO

SANTOS AREVALO, ) Docket No. 2020-05-0992

Employee, )

v. ) State File No. 67126-2020

STEVE HOOD, )

 Uninsured Employer. ) Judge Robert Durham

COMPENSATION ORDER DENYING BENEFITS

This Court held a Compensation Hearing on February 17, 2022. Although Mr. 

Arevalo participated in a Scheduling Hearing, he did not attend the Compensation Hearing. 

He also did not participate in the post-discovery mediation, nor did he attend the hearing 

on January 5 on Mr. Hood’s motion to dismiss for failure to state a claim. Notices for these 

proceedings were sent to the last address Mr. Arevalo provided to the Court.

Given that Mr. Arevalo failed to produce any evidence at the Compensation 

Hearing, the Court holds that he did not meet his burden of proof and thus denies his claim 

for benefits. Mr. Hood renewed his request for attorney’s fees under Tennessee Rules of 

Civil Procedure 12.02(6) for failure to state a claim. The Court denies Mr. Hood’s motion 

for the reasons stated in its January 18 order. 

IT IS, THEREFORE, ORDERED that:

1. Mr. Arevalo’s claim for benefits is denied.

2. This Compensation Order constitutes a final adjudication upon the merits of Mr. 

Arevalo’s claim for benefits and unless appealed becomes final thirty days after entry.

3. Mr. Arevalo shall pay court costs of $150.00 to the Court Clerk within five business 

days of this order becoming final.

FILED

Feb 18, 2022

12:42 PM(CT)

TENNESSEE COURT OF

WORKERS' COMPENSATION

CLAIMS
2 

ENTERED February 18, 2022

 

 

 ___________________________ 

 ROBERT DURHAM, JUDGE

 Court of Workers’ Compensation Claims 

CERTIFICATE OF SERVICE

I certify that a copy of this order was sent on February 18, 2022. 

Name Certified 

Mail

Fax Email Service sent to:

Santos Arevalo X 906 Hunt Street

Murfreesboro, TN 27130

Daniel Marshall X daniel@marshallaw.online

_____________________________________ 

Penny Shrum, Court Clerk 

WC.CourtClerk@tn.gov 
For self-represented litigants: Help from an Ombudsman is available at 800-332-2667.

Compensation Hearing Order Right to Appeal:

If you disagree with this Compensation Hearing Order, you may appeal to the Workers’ 

Compensation Appeals Board or the Tennessee Supreme Court. To appeal to the Workers’ 

Compensation Appeals Board, you must:

1. Complete the enclosed form entitled: “Notice of Appeal,” and file the form with the 

Clerk of the Court of Workers’ Compensation Claims within thirty calendar days of the 

date the compensation hearing order was filed. When filing the Notice of Appeal, you 

must serve a copy upon the opposing party (or attorney, if represented). 

2. You must pay, via check, money order, or credit card, a $75.00 filing fee within ten 

calendar days after filing of the Notice of Appeal. Payments can be made in-person at 

any Bureau office or by U.S. mail, hand-delivery, or other delivery service. In the 

alternative, you may file an Affidavit of Indigency (form available on the Bureau’s 

website or any Bureau office) seeking a waiver of the filing fee. You must file the fullycompleted Affidavit of Indigency within ten calendar days of filing the Notice of 

Appeal. Failure to timely pay the filing fee or file the Affidavit of Indigency will 

result in dismissal of your appeal.

3. You bear the responsibility of ensuring a complete record on appeal. You may request 

from the court clerk the audio recording of the hearing for a $25.00 fee. A licensed court 

reporter must prepare a transcript and file it with the court clerk within fifteen calendar 

days of the filing the Notice of Appeal. Alternatively, you may file a statement of the 

evidence prepared jointly by both parties within fifteen calendar days of the filing of the 

Notice of Appeal. The statement of the evidence must convey a complete and accurate 

account of the hearing. The Workers’ Compensation Judge must approve the statement 

of the evidence before the record is submitted to the Appeals Board. If the Appeals 

Board is called upon to review testimony or other proof concerning factual matters, the 

absence of a transcript or statement of the evidence can be a significant obstacle to 

meaningful appellate review.

4. After the Workers’ Compensation Judge approves the record and the court clerk transmits 

it to the Appeals Board, a docketing notice will be sent to the parties. The appealing 

party has fifteen calendar days after the date of that notice to submit a brief to the 

Appeals Board. See the Practices and Procedures of the Workers’ Compensation 

Appeals Board. 

To appeal your case directly to the Tennessee Supreme Court, the Compensation Hearing 

Order must be final and you must comply with the Tennessee Rules of Appellate 

Procedure. If neither party timely files an appeal with the Appeals Board, the trial court’s 

Order will become final by operation of law thirty calendar days after entry. See Tenn. 

Code Ann. § 50-6-239(c)(7).
LB-1099 rev. 01/20 Page 1 of 2 RDA 11082 

NOTICE OF APPEAL 

Tennessee Bureau of Workers’ Compensation

www.tn.gov/workforce/injuries-at-work/ 

wc.courtclerk@tn.gov | 1-800-332-2667 

Docket No.: ________________________

State File No.: ______________________ 

Date of Injury: _____________________ 

___________________________________________________________________________ 

Employee

v.

___________________________________________________________________________ 

Employer

Notice is given that ____________________________________________________________________ 

[List name(s) of all appealing party(ies). Use separate sheet if necessary.]

appeals the following order(s) of the Tennessee Court of Workers’ Compensation Claims to the 

Workers’ Compensation Appeals Board (check one or more applicable boxes and include the date filestamped on the first page of the order(s) being appealed):

□ Expedited Hearing Order filed on _______________ □ Motion Order filed on ___________________

□ Compensation Order filed on__________________ □ Other Order filed on_____________________

issued by Judge _________________________________________________________________________. 

Statement of the Issues on Appeal 

Provide a short and plain statement of the issues on appeal or basis for relief on appeal: 

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

Parties

Appellant(s) (Requesting Party): _________________________________________ ☐Employer ☐Employee 

Address: ________________________________________________________ Phone: ___________________ 

Email: __________________________________________________________ 

Attorney’s Name: ______________________________________________ BPR#: _______________________ 

Attorney’s Email: ______________________________________________ Phone: _______________________ 

Attorney’s Address: _________________________________________________________________________ 

* Attach an additional sheet for each additional Appellant *
LB-1099 rev. 01/20 Page 2 of 2 RDA 11082 

Employee Name: _______________________________________ Docket No.: _____________________ Date of Inj.: _______________ 

Appellee(s) (Opposing Party): ___________________________________________ ☐Employer ☐Employee 

Appellee’s Address: ______________________________________________ Phone: ____________________ 

Email: _________________________________________________________ 

Attorney’s Name: _____________________________________________ BPR#: ________________________ 

Attorney’s Email: _____________________________________________ Phone: _______________________ 

Attorney’s Address: _________________________________________________________________________ 

* Attach an additional sheet for each additional Appellee *

CERTIFICATE OF SERVICE 

I, _____________________________________________________________, certify that I have forwarded a 

true and exact copy of this Notice of Appeal by First Class mail, postage prepaid, or in any manner as described 

in Tennessee Compilation Rules & Regulations, Chapter 0800-02-21, to all parties and/or their attorneys in this 

case on this the __________ day of ___________________________________, 20 ____. 

 ______________________________________________ 

[Signature of appellant or attorney for appellant]