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, )
A nd ) )
AMERICAN ZURICH INS. CO. , ) Judge Dale Tipps

Insurance Carrier

. )

EXPEDITED HEARING ORDER
DENYING BENEFITS ( DECISION ON THE RECORD )

Th e Court considered th is case on November 2 2 , 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 h e 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 tr anslated 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

CLAIMSTaylor s ubmitted written statements from Mr. Abdelshahaed ’s co

- workers and

supervisors, as well as a police report

. The statements consistently recount a dispute
bet ween Mr. Abdelshahaed and his supervisor, but none of them mention s 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 oppos ed 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) (202 1 ); 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

- rel ated incident, or specific set of incidents, identifiable by t ime 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 lik ely 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 medic al and temporary disability benefits are denied at this time.

2. This case is set for a Scheduling Hearing on January 26, 2022 , at 9: 3 0 a.m. You
must call toll

- free at 855

- 874

- 0473 to participate. Failure to call might result in a
determination of the issu es 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
Jun e 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 A mo 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 Statemen tCERTIFICATE 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.govFor 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 f ile 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 B ureau 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 fully

complete d 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 busine ss 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 Appe als 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 mu st 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 sta tement. 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’ 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

- 21

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

__ ____________________________________________ [Signature of appellant or attorney for appellant]