ADJ13080332 · February 8, 2024

Applicant's credible testimony and QME Dr. Mirzaians' reports constitute substantial evidence of injury AOE/COE to cervical and lumbar spine.

From the decision · page 5applicant's description of his job duties resulted in QME Dr. Mirzaians determining that the left shoulder, cervical spine, and lumbar spine were "directly arising from his occupational demands." (Joint Exh. 3, p. 16.) Subsequently, on two separate occasions, Dr. Mirzaians was provided medical records to review. (See Joint Exh. 4 and App. Exh. 5.) Review of those records did not change Dr. Mirzaians' opinions regarding the cause of applicant's cervical and lumbar spine injuries. Thus, as to those issues, we agree with the WCJ that applicant's testimony and the reports from Dr. Mirzaians constitute substantial evidence that applicant sustained injury AOE/COE to his cervical and lumbar spine. (Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604 (Appeals Board en banc).)

Inconsistencies in the medical record and lack of substantial evidence regarding shoulder and fingers injuries; issues deferred for further development of the record.

From the decision · page 5It appears that Dr. Mirzaians is awaiting additional diagnostics and a re-evaluation of applicant before he addresses the issues of permanent disability and apportionment. However, it also must be noted that in his November 1, 2021 supplemental report Dr. Mirzaians discussed various inconsistencies in the record as to whether applicant sustained injury to his right shoulder, left shoulder, or both shoulders. (Joint Exh. 4, pp. 6 § 7.) To be substantial evidence, a medical opinion must be based on pertinent facts, on an adequate examination and on an accurate history. (Escobedo v. Marshalls, supra.) The inconsistencies in the medical record, as discussed by Dr. Mirzaians, render his earlier opinions not substantial evidence as to applicant's shoulder injury. Review of the record also indicates that Dr. Mirzaians did not review any medical records pertaining to, and did not provide an opinion as to, the claimed "fingers" injury.4 Therefore, the record does not contain substantial evidence regarding that issue.

Applicant's credible testimony and QME Dr. Mirzaians' reports supported finding of injury AOE/COE to cervical and lumbar spine.

Favours Applicant prevailed

These were relied upon as substantial evidence for compensability of cervical and lumbar spine injuries.

From the decision · page 5applicant's description of his job duties resulted in QME Dr. Mirzaians determining that the left shoulder, cervical spine, and lumbar spine were "directly arising from his occupational demands." (Joint Exh. 3, p. 16.) Subsequently, on two separate occasions, Dr. Mirzaians was provided medical records to review. (See Joint Exh. 4 and App. Exh. 5.) Review of those records did not change Dr. Mirzaians' opinions regarding the cause of applicant's cervical and lumbar spine injuries. Thus, as to those issues, we agree with the WCJ that applicant's testimony and the reports from Dr. Mirzaians constitute substantial evidence that applicant sustained injury AOE/COE to his cervical and lumbar spine. (Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604 (Appeals Board en banc).)

Inconsistencies in medical records regarding shoulder injury and lack of review for fingers injury.

Favours neutral

Led to deferral of issues for further development of the record.

From the decision · page 5It appears that Dr. Mirzaians is awaiting additional diagnostics and a re-evaluation of applicant before he addresses the issues of permanent disability and apportionment. However, it also must be noted that in his November 1, 2021 supplemental report Dr. Mirzaians discussed various inconsistencies in the record as to whether applicant sustained injury to his right shoulder, left shoulder, or both shoulders. (Joint Exh. 4, pp. 6 § 7.) To be substantial evidence, a medical opinion must be based on pertinent facts, on an adequate examination and on an accurate history. (Escobedo v. Marshalls, supra.) The inconsistencies in the medical record, as discussed by Dr. Mirzaians, render his earlier opinions not substantial evidence as to applicant's shoulder injury. Review of the record also indicates that Dr. Mirzaians did not review any medical records pertaining to, and did not provide an opinion as to, the claimed "fingers" injury.4 Therefore, the record does not contain substantial evidence regarding that issue.

Found industrial causation for left shoulder, cervical spine, and lumbar spine; later noted inconsistencies regarding shoulder injury and deferred opinion on fingers due to lack of records.

Relied upon for finding injury AOE/COE to cervical and lumbar spine; not substantial evidence for shoulder/fingers due to inconsistencies and lack of review.

From the decision · page 5applicant's description of his job duties resulted in QME Dr. Mirzaians determining that the left shoulder, cervical spine, and lumbar spine were "directly arising from his occupational demands." (Joint Exh. 3, p. 16.) Subsequently, on two separate occasions, Dr. Mirzaians was provided medical records to review. (See Joint Exh. 4 and App. Exh. 5.) Review of those records did not change Dr. Mirzaians' opinions regarding the cause of applicant's cervical and lumbar spine injuries. Thus, as to those issues, we agree with the WCJ that applicant's testimony and the reports from Dr. Mirzaians constitute substantial evidence that applicant sustained injury AOE/COE to his cervical and lumbar spine. (Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604 (Appeals Board en banc).)

Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604

To be substantial evidence, a medical opinion must be based on pertinent facts, on an adequate examination and on an accurate history.

Applied to determine sufficiency of QME's opinion regarding shoulder and fingers injuries.

From the decision · page 5It appears that Dr. Mirzaians is awaiting additional diagnostics and a re-evaluation of applicant before he addresses the issues of permanent disability and apportionment. However, it also must be noted that in his November 1, 2021 supplemental report Dr. Mirzaians discussed various inconsistencies in the record as to whether applicant sustained injury to his right shoulder, left shoulder, or both shoulders. (Joint Exh. 4, pp. 6 § 7.) To be substantial evidence, a medical opinion must be based on pertinent facts, on an adequate examination and on an accurate history. (Escobedo v. Marshalls, supra.) The inconsistencies in the medical record, as discussed by Dr. Mirzaians, render his earlier opinions not substantial evidence as to applicant's shoulder injury. Review of the record also indicates that Dr. Mirzaians did not review any medical records pertaining to, and did not provide an opinion as to, the claimed "fingers" injury.4 Therefore, the record does not contain substantial evidence regarding that issue.

Lab. Code § 5952(d)

Any award, order, or decision of the Appeals Board must be supported by substantial evidence.

Applied to determine whether the record supported injury AOE/COE findings.

From the decision · page 4DISCUSSION We first note that the Policy and Procedural Manual Index Number 1.135 Transcript Requests, Administrative Director rules 9990 and 9991, and Appeals Board rule 10800, contain specific rules and instructions to be followed by a party requesting a trial transcript. Cal. Code Regs., tit. 8, § 9990 and 9991; Policy and Procedural Manual Index Number 1.135.) Having reviewed the entire record including all documents in the Electronic Adjudication Management System (EAMS) ADJ file, we see no indication that defendant complied with any of the requirements applicable to the making of a request for a trial transcript. Based thereon, there is no legal support for defendant's argument that because it did not receive a trial transcript, its due process rights were "absolutely violated." (Petition, p. 6.) In fact, defendant's failure to comply with the various procedures required in order to receive a trial transcript from the court reporter/ transcript clerk, renders the issue moot. Any award, order, or decision of the Appeals Board must be supported by substantial evidence. (Lab. Code, § 5952(d); Lamb v. Workmen's Comp. Appeals Bd.

Garza v. Workmen's Comp. Appeals Bd. (1970) 3 Cal.3d 312

A WCJ's opinion regarding witness credibility is entitled to great weight.

Applied to credit applicant's testimony regarding injury mechanism.

From the decision · page 4(1974) 11 Cal.3d 274, 281 [39 Cal.Comp.Cases 310]; Garza v. Workmen's Comp. Appeals Bd. (1970) 3 Cal.3d 312, 317 [35 Cal.Comp.Cases 500].) In the Opinion on Decision the WCJ stated that the finding of injury AOE/COE was based on applicant's "credible" testimony, and the November 1, 2021 report from QME Dr. Mirzaians. (F&A, p. 3, Opinion on Decision.) It is well established that a WCJ's opinion regarding witness credibility is entitled to great weight. (Garza v. Workmen's Comp. Appeals Bd., supra, at 319.) Also, it is important to note that when deciding a medical issue, such as whether an applicant sustained a cumulative injury, the WCJ must utilize expert medical opinion. (See Insurance Company of North America v. Workers' Comp. Appeals Bd. (Kemp) (1981) 122 Cal.App.3d 905 [46 Cal.Comp.Cases 913].) Here, the physical examination of applicant and

Applicant's testimony regarding job duties and injury mechanism was found credible and relied upon for finding injury AOE/COE to cervical and lumbar spine.

From the decision · page 4(1974) 11 Cal.3d 274, 281 [39 Cal.Comp.Cases 310]; Garza v. Workmen's Comp. Appeals Bd. (1970) 3 Cal.3d 312, 317 [35 Cal.Comp.Cases 500].) In the Opinion on Decision the WCJ stated that the finding of injury AOE/COE was based on applicant's "credible" testimony, and the November 1, 2021 report from QME Dr. Mirzaians. (F&A, p. 3, Opinion on Decision.) It is well established that a WCJ's opinion regarding witness credibility is entitled to great weight. (Garza v. Workmen's Comp. Appeals Bd., supra, at 319.) Also, it is important to note that when deciding a medical issue, such as whether an applicant sustained a cumulative injury, the WCJ must utilize expert medical opinion. (See Insurance Company of North America v. Workers' Comp. Appeals Bd. (Kemp) (1981) 122 Cal.App.3d 905 [46 Cal.Comp.Cases 913].) Here, the physical examination of applicant and

QME Dr. Mirzaians' medical reports and review of records supported finding of industrial causation for cervical and lumbar spine injuries.

From the decision · page 5applicant's description of his job duties resulted in QME Dr. Mirzaians determining that the left shoulder, cervical spine, and lumbar spine were "directly arising from his occupational demands." (Joint Exh. 3, p. 16.) Subsequently, on two separate occasions, Dr. Mirzaians was provided medical records to review. (See Joint Exh. 4 and App. Exh. 5.) Review of those records did not change Dr. Mirzaians' opinions regarding the cause of applicant's cervical and lumbar spine injuries. Thus, as to those issues, we agree with the WCJ that applicant's testimony and the reports from Dr. Mirzaians constitute substantial evidence that applicant sustained injury AOE/COE to his cervical and lumbar spine. (Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604 (Appeals Board en banc).)

Inconsistencies in medical records regarding shoulder injury and lack of review for fingers injury led to deferral of those issues.

From the decision · page 5It appears that Dr. Mirzaians is awaiting additional diagnostics and a re-evaluation of applicant before he addresses the issues of permanent disability and apportionment. However, it also must be noted that in his November 1, 2021 supplemental report Dr. Mirzaians discussed various inconsistencies in the record as to whether applicant sustained injury to his right shoulder, left shoulder, or both shoulders. (Joint Exh. 4, pp. 6 § 7.) To be substantial evidence, a medical opinion must be based on pertinent facts, on an adequate examination and on an accurate history. (Escobedo v. Marshalls, supra.) The inconsistencies in the medical record, as discussed by Dr. Mirzaians, render his earlier opinions not substantial evidence as to applicant's shoulder injury. Review of the record also indicates that Dr. Mirzaians did not review any medical records pertaining to, and did not provide an opinion as to, the claimed "fingers" injury.4 Therefore, the record does not contain substantial evidence regarding that issue.