According to The Wrestling Observer, following another medical evaluation of John Cena on Monday afternoon, the decision was made by WWE to give Ryback the title shot at Hell in a Cell against CM Punk.
Although the results of Cena's evaluation were positive, and the evaluation revealed that Cena's hand has "improved significantly," doctors could not assure WWE officials that he would be ready to go on 10/28, the date of the Hell in a Cell PPV.
Two different scripts were reportedly written for Raw this past Monday night, one in which Cena was built up as Punk's challenger, and the other with Ryback as Punk's challenger. Ryback also faced Punk at this past weekend's WWE house show events in preparation of the possibility that he would face the WWE Champ at the PPV.