Dishner v. Accurate Die Cutting, Inc., et al.

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TENNESSEE BUREAU OF WORKERS’ COMPENSATION
WORKERS’ COMPENSATION APPEALS BOARD
FILED
Oct 13, 2026
01:49 PM(CT)
TENNESSEE
WORKERS' COMPENSATION
APPEALS BOARD
Mary Dishner
v.
Accurate Die Cutting, Inc., et al.
Appeal from the Court of Workers’
Compensation Claims
Brian K. Addington, Judge
Docket No. 	2025-20-8193
State File No. 	45318-2025
Affirmed and Remanded
In this interlocutory appeal, the employee questions the trial court’s finding that she has
not come forward with sufficient proof to show a likelihood of proving at trial the statutory
requirements necessary to establish a compensable hernia. 	The employee alleges she
suffered a hernia when, as she was carrying a tray of tiles, she tripped over a pallet on the
floor, causing her to stumble and feel a pull in her abdomen. The employer filed an expert
medical opinion addressing the cause of the hernia, and the employee filed an opinion from
her primary care physician. The trial court found the medical evidence was insufficient to
meet the employee’s burden of proof, and the employee has appealed. 	Having carefully
reviewed the record, we affirm the trial court’s order and remand the case.
Presiding Judge Timothy W. Conner delivered the opinion of the Appeals Board in which
Judge Pele I. Godkin and Judge Meredith B. Weaver joined.
Mary Dishner, employee-appellant, pro se
C. Christopher Brown, Knoxville, Tennessee, for the employer-appellee, Accurate Die
Cutting, Inc.
Memorandum Opinion 1
Mary Dishner (“Employee”) worked for Accurate Die Cutting, Inc. (“Employer”).
Her job required her to carry and restock trays of tiles for the production line. On June 25,
2025, Employee was carrying a tray of tiles to restock the production line when she tripped
1 This decision is being filed pursuant to Tenn. Comp. R. and Regs. 0800-02-22-.03(1) (2023).

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over a pallet on the floor, causing her to stumble. 	She described feeling a pull in her
abdomen and, later, being able to feel bulges when she placed her hand on the area that
was painful. 	Employee initially saw her primary care physician, Dr. Scott Denham.
Thereafter, on December 2, 2025, Employee underwent surgery performed by Dr. Carlos
Floresguerra to repair one or more incisional hernias. 2
Employer declined to provide any workers’ compensation benefits. On September
12, 2025, it obtained a medical records review from Dr. Amir Karni, a Texas physician,
who noted evidence of prior abdominal surgeries that had placed Employee at increased
risk for incisional hernias. He also noted that she had seen Dr. Denham in 2022 to address
an area of concern around one of her surgical incisions. Dr. Denham had suspected a hernia
and ordered a CT scan at that time, but Employee did not undergo that scan. 	Dr. Karni
opined that the 2022 evaluation indicated she likely had an incisional hernia before the
2025 work incident. He stated it was “very likely” that her incisional hernia was related to
a 2017 abdominal procedure and developed sometime between 2017 and 2022. Although
he believed the hernia preexisted the 2025 work incident, he felt the 2025 work incident
likely exacerbated symptoms related to the hernia.
Employee filed a petition for benefit determination on December 26, 2025, and a
mediator issued a dispute certification notice (“DCN”) on January 29, 2026. The various
disputes described on the DCN relate to the same underlying issue: whether Employee’s
hernia satisfies the statutory requirements of a compensable hernia.
In support of her claim, Employee filed correspondence from her primary care
physician, Dr. Denham, dated March 18, 2026, in which he addressed the cause of
Employee’s hernias. 	He stated that there was “no current evidence that [Employee]
definitely had [] pre-existing multiple hernias to this extent.” 	He also noted that “[t]he
bulges I was able to palpate in 2025 were not in the area of concern from her 2022 exam.
So, in my opinion, the work-related incident contributed greatly to the presentation of the
dual ventral hernia.”
After an expedited hearing, the trial court issued an order on July 27, 2026, denying
Employee’s interlocutory request for benefits. 	The court found that Employee had not
submitted sufficient evidence to establish a compensable, work-related hernia. Employee
has appealed, asserting: (1) that the trial court erred in denying benefits; and (2) that the
evidence presented at the hearing did not establish that her hernia(s) preexisted the work
incident.
2 The record on appeal contains few medical reports, so we have gleaned much of Employee’s medical
history from the parties’ filings and the court’s expedited hearing order. Certain medical records indicate
that Employee may have had two related hernias or a “dual ventral hernia” at the time of the 2025 surgery.

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Unlike 	most 	other 	types 	of 	work-related 	injuries, 	the 	Tennessee 	Workers’
Compensation Law sets out specific criteria an injured worker must satisfy to establish the
existence of a compensable hernia. Tennessee Code Annotated section 50-6-212 expressly
applies to claims for hernias “resulting from injury by accident arising primarily out of and
in the course and scope of the employee’s employment” and includes the following five
criteria that must be “definitely proven to the satisfaction of the court”:
(1) 	There was an injury resulting in hernia or rupture;
(2) 	The hernia or rupture appeared suddenly;
(3) 	It was accompanied by pain;
(4) 	The hernia or rupture immediately followed the accident; and
(5) 	The hernia or rupture did not exist prior to the accident for which
compensation is claimed.
Tenn. Code Ann. § 50-6-212(a)(1)-(5) (2026). 	Thus, at this stage of the litigation,
Employee must show that she is likely to prevail at trial in establishing each of these
elements. The trial court concluded she did not come forward with sufficient evidence to
indicate she was likely to establish that the hernia did not exist prior to the 2025 work
incident. We agree.
The Tennessee Supreme Court addressed a similar scenario in Magic Chef Co. v.
Haney, No. 03S01-9501-CV-00001, 1995 Tenn. LEXIS 428 (Tenn. Workers’ Comp. Panel
Aug. 8, 1995). There, the employee worked as a press operator in a factory, which required
repetitive lifting of heavy parts. 	Id. at *1. 	He had undergone a prior non-work-related
surgery to repair a paraesophageal hernia, which the treating surgeon described as being
located in the diaphragm, “[s]imilar to where a hiatal hernia is.” Id. at *2. Thereafter, the
employee developed an incisional hernia that required two surgeries to repair. Id. at *2-3.
After recovering from these surgeries, the employee returned to work and, about two years
later, was diagnosed with another incisional hernia. 	Id. at *4. 	Employee alleged this
recurrent hernia was caused by a specific incident of lifting at work that resulted in a “sharp
pain in his stomach.” Id. at *7. Although the trial court awarded benefits for the alleged
work-related hernia, the Supreme Court’s Special Workers’ Compensation Appeals Panel
reversed. Id. at *9. In support of its holding, the Appeals Panel stated, “[The employee’s]
allegedly new hernia does not meet ‘all the criteria of the statute’ because he failed to show
his hernia did not exist prior to the [work] accident.” Id. at *11. The Panel then explained:
We think the legislature clearly intended to place certain limitations and
restrictions upon the right to recover compensation for injuries causing a
hernia and also to the aggravation or enlargement of a pre-existing hernia.
The statute undertakes to point out and distinguish the injuries that are
compensable and those that are non-compensable, and for the injured
employee to recover he must bring his case within the provisions of
the . . . act.

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Id. at *12 (quoting F.H. Lawson Co. v. Rambo, 465 S.W.2d 732, 735 (Tenn. 1971)). Thus,
both the Tennessee Supreme Court and its Special Workers’ Compensation Appeals Panel
have made clear that the burden of proof is on the employee to “definitely prove[] to the
satisfaction of the court” the criteria listed in Tennessee Code Annotated section 50-6-212.
Id. at *10.
Here, although Employee provided Dr. Denham’s opinion that the work incident
“contributed greatly to the presentation of” the hernia, that opinion is not sufficient to
establish each of the five statutory factors identified above. Dr. Denham stated that there
was “no current evidence” showing Employee had “pre-existing multiple hernia[s] to this
extent.” 	(Emphasis added.) 	The trial court interpreted that sentence to mean that Dr.
Denham believes a preexisting hernia was likely worsened by the incident at work, and we
conclude the preponderance of the evidence supports that interpretation. 	However, that
evidence falls short of what the statute requires. Moreover, Employer’s expert, Dr. Karni,
also believed that the hernia(s) preexisted and were made worse by the work accident.
Thus, the medical proof submitted to date suggests Employee’s hernia(s) likely preexisted
the incident at work but were exacerbated or made worse by the June 25, 2025 work
incident. As such, we agree with the trial court that Employee has not come forward with
sufficient evidence to show a likelihood of proving that “[t]he hernia or rupture did not
exist prior to the accident for which compensation is claimed,” Tennessee Code Annotated
section 50-6-212(a)(5), and we conclude the trial court did not err at this interlocutory stage
of the case.
For the foregoing reasons, we affirm the decision of the trial court and remand the
case. Costs on appeal are taxed to Employee.