TENNESSEE BUREAU OF WORKERS’ COMPENSATION CLAIMS

IN THE COURT OF WORKERS’ COMPENSATION CLAIMS

AT MURFREESBORO

REAZKALLAH ABDELSHAHAED, ) Docket No. 2021-05-0273

 Employee, )

v. )

)

TAYLOR FRESH FOODS, INC., ) State File No. 800173-2021

 Employer, )

And )

)

AMERICAN ZURICH INS. CO., ) Judge Dale Tipps

 Insurance Carrier. )

EXPEDITED HEARING ORDER

DENYING BENEFITS

(DECISION ON THE RECORD)

The Court considered this case on November 22, 2021, for an Expedited Hearing 

on the record without an in-person hearing. The issue is whether Mr. Abdelshahaed is 

likely to prove at a hearing on the merits that he suffered a compensable injury and is 

entitled to medical and temporary disability benefits. Because he has not shown that he 

was injured at work, the Court holds that he did not meet this burden and denies the 

requested benefits.

History of Claim

While working at Taylor, Mr. Abdelshahaed claims he twisted and sprained his knee

on October 16, 2020, when his supervisor pushed him and caused him to fall.

Mr. Abdelshahaed submitted Work Status Reports, the earliest dated August 6, 

2020, signed by Dr. William Mayfield.

1

 The first two reports give a diagnosis of right knee 

strain. The 2021 reports simply say “bilateral knee.”

1 He also submitted a translated statement he gave to Taylor on November 4, 2020. However, this statement 

references a finger injury, not the knee injury at issue in this claim.

FILED

Nov 29, 2021

09:29 AM(CT)

TENNESSEE COURT OF

WORKERS' COMPENSATION

CLAIMS
Taylor submitted written statements from Mr. Abdelshahaed’s co-workers and 

supervisors, as well as a police report. The statements consistently recount a dispute 

between Mr. Abdelshahaed and his supervisor, but none of them mentions any physical 

contact or a fall. Instead, they show that after Mr. Abdelshahaed was told to go home, he 

went outside and called the police.

The investigating officer’s report states that he spoke to Mr. Abdelshahaed and his 

son.2 He also spoke to two witnesses who observed the incident. They reported that the 

supervisor never touched or pushed Mr. Abdelshahaed.

Mr. Abdelshahaed filed an Expedited Hearing request seeking a hearing on the 

record under Rule 0800-02-21-.15(1)(e). Taylor opposed that request but filed no 

argument supporting its position. The Court determined that a review of the written 

materials without an evidentiary hearing was appropriate.

Findings of Fact and Conclusions of Law

Mr. Abdelshahaed must provide sufficient evidence from which this Court might 

determine he is likely to prevail at a hearing on the merits. See Tenn. Code Ann. § 50-6-

239(d)(1) (2021); McCord v. Advantage Human Resourcing, 2015 TN Wrk. Comp. App. 

Bd. LEXIS 6, at *7-8, 9 (Mar. 27, 2015).

To prove a compensable injury, Mr. Abdelshahaed must show that his alleged 

injuries arose primarily out of and in the course and scope of his employment. This 

includes the requirement that he must establish a work-related incident, or specific set of 

incidents, identifiable by time and place of occurrence. Tenn. Code Ann. § 50-6-

102(14)(A).

Regarding the requirement to identify a work-related incident, the only evidence 

supporting Mr. Abdelshahaed’s version of events is his Rule 72 declaration. His claim that 

his supervisor pushed him is contradicted by several written statements, as well as the 

police report. Further, the medical records do not support his contention that he suffered a 

discrete, identifiable injury on October 16, 2020, as one of Dr. Mayfield’s reports of knee 

strain is dated August 6, over two months before the alleged incident. Under these 

circumstances, the Court cannot find at this time that Mr. Abdelshahaed is likely prove the 

existence of the “work-related incident” required by section 50-6-102(14)(A).

2 Mr. Abdelshahaed speaks little English, so his son was interpreting for him.
IT IS, THEREFORE, ORDERED as follows:

1. Mr. Abdelshahaed’s claims against Taylor Fresh Foods, Inc. for medical and 

temporary disability benefits are denied at this time.

2. This case is set for a Scheduling Hearing on January 26, 2022, at 9:30 a.m. You 

must call toll-free at 855-874-0473 to participate. Failure to call might result in a 

determination of the issues without your further participation. All conferences are 

set using Central Time.

ENTERED November 29, 2021.

_____________________________________

Judge Dale Tipps

Court of Workers’ Compensation Claims

APPENDIX

Exhibits:

1. Mr. Abdelshahaed’s September 29, 2021 Rule 72 Declaration Under Penalty of 

Perjury

2. Wage Statement filed on June 25, 2021, by Taylor Fresh

3. Separation Notice dated November 9, 2020

4. Hughston Clinic Work Status Reports dated August 6 and November 19, 2020, and 

June 6 and October 5, 2021

5. Mr. Abdelshahaed’s November 4, 2020 written statement, translated by Neama 

Eriby

6. Written statement of Carmen Colon

7. Written statement of Ahmed Hussein

8. Written statement of Amo Lloyd

9. Written statement of Bernardo Martinez

10.October 16, 2020 Investigation Report of Officer M. W. Richert

Technical record:

1. Petition for Benefit Determination 

2. Dispute Certification Notice

3. Request for Expedited Hearing

4. Docketing Notice

5. Taylor Fresh Foods’s Position Statement
CERTIFICATE OF SERVICE

I certify that a copy of the Expedited Hearing Order was sent as indicated on

November 29, 2021.

Name Certified 

Mail

Email Service sent to:

Reazkallah Abdelshahaed,

Employee

X X 456 Cedar Park Circle

Lavergne, TN 37086

reazkallahabdelshahaed@yahoo.com

Peter Rosen,

Employer’s Attorney

X Prosen@vkbarlaw.com

______________________________________

PENNY SHRUM, COURT CLERK

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

Expedited Hearing Order Right to Appeal:

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

Compensation Appeals Board. To appeal an expedited hearing order, 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 seven business days of the 

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

serve a copy upon all parties. 

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 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 the 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. If a transcript of 

the proceedings is to be filed, a licensed court reporter must prepare the transcript and file 

it with the court clerk within ten business days of the filing the Notice of 

Appeal. Alternatively, you may file a statement of the evidence prepared jointly by both 

parties within ten business 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 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. If you wish to file a position statement, you must file it with the court clerk within ten

business days after the deadline to file a transcript or statement of the evidence. The 

party opposing the appeal may file a response with the court clerk within ten business 

days after you file your position statement. All position statements should include: (1) a 

statement summarizing the facts of the case from the evidence admitted during the 

expedited hearing; (2) a statement summarizing the disposition of the case as a result of 

the expedited hearing; (3) a statement of the issue(s) presented for review; and (4) an 

argument, citing appropriate statutes, case law, or other authority.
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]