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### TENNESSEE BUREAU OF WORKERS’ COMPENSATION IN THE COURT OF WORKERS’ COMPENSATION CLAIMS AT MURFREESBORO

SANTOS AREVALO , ) Docket No

. 2020

- 0 5

- 0 992 Employee, )

v. ) State File No. 67126

- 2020 STEVE HOOD, ) Uninsured Employer

. ) Judge Robert Durham

COMPENSATION ORDER DENYING BENEFITS

This Court h eld a Compensation H earing 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 t o state a claim

. Notice s 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 an d 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, THERE FORE, 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

CLAIMS2 

### 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.govFor self

- represented litigants: Help from an Ombudsman is available at 800

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- 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 f ile 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 an y Bureau office) seeking a waiver of the filing fee. You must file the fully

completed 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 o f 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 testi mony 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 transmi ts 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

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- 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

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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’ Co mpensation 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 fil ed 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: _______________________________________________________

_ Ph one: ___________________ Email: __________________________________________________________ Attorney’s Na me:

_____________________________________________ _ BPR#: _______________________ Attorney’s E mail: _____________________________________________

_ Phone: _______________________ Attorney’s Ad dress:

_________________________________________________________________________ * 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 App ellee’s Address:

_____________________________________________ _ Phone:

_ ___________________ Email: _________________________________________________________ Attorney’s Na me:

_____________________________________________ B PR#: ________________________ Attorney’s E mail: _____________________________________________ Phone:

_______________________ Attorney’s Ad dress:

_________________________________________________________________________ * 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

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, to all parties and/or their attorneys in this case on this the __________ day of ___________________________________, 20 ____.

__ ____________________________________________ [Signature of appellant or attorney for appellant]