ADJ12013613 · December 8, 2025

The Appeals Board found the medical opinion of PQME Dr. Olga Voroshilovsky, who reviewed all evidence including extensive medical records, to be substantial evidence supporting no industrial injury causation, while rejecting the consult Dr. Marvin Pietruszka's opinion for failing to consider the full medical record and relying on inaccurate history from the widow.

From the decision · page 11INJURY AOE/COE; CAUSATION; THE MEDICAL REPORTING OF PQME OLGA VOROSHILOVSKY, M.D. AND CONSULT MARVIN PIETRUSZKA, M.D.

PQME Dr. Olga Voroshilovsky reviewed over 1,000 pages of medical records and found no industrial injury causation for the decedent's heart and cardiovascular system or hypertension.

Favours Defendant prevailed

Her opinion was the only substantial medical evidence and was relied upon by the Appeals Board to deny the petition.

From the decision · page 17There is no other conclusion for the court to reach. The only medical reports and conclusions that constitute substantial evidence are those of the PQME, Dr. Olga Voroshilovsky.

Consult Dr. Marvin Pietruszka failed to review the extensive medical records and relied on inaccurate history from the widow, leading to his opinion being rejected as not substantial evidence.

Favours Defendant prevailed

His opinion was rejected for failing to meet the standard of substantial medical evidence, undermining the applicant's claim.

From the decision · page 12Further complicating Dr. Pietruszka's analysis is that he objects to the orthopedic apportionment provided, even though he is not an orthopedist. Moreover, he goes on to discuss and then make findings regarding the applicant's stressors at work and his psychiatric condition, despite not being a psychiatrist or psychologist. There is no reason for him to step outside his field of expertise to opine as he did. The grasping at straws is obvious, especially when he does not address the decedent's poorly-controlled hypertension, high cholesterol, hyperlipidemia, longstanding tobacco and alcohol abuse (at times 18 beers in a single night), medication non-compliance, and obesity. The 15 years of records tell a completely different story of the decedent's lifestyle and habits than does the version provided to Dr. Pietruszka. To completely ignore such a lengthy history of complications and treatment that is directly at issue in this case causes his opinions to fail the standard of substantial medical evidence. The applicant takes the position that Dr. Pietruszka reviewed all records, just not in their original form. That is a stretch.

The widow's testimony and history were contradicted and impeached by the medical records, undermining the applicant's evidence.

Favours Defendant prevailed

The Appeals Board found the widow's version unreliable and favored the medical records and PQME's conclusions.

From the decision · page 14The widow's deposition testimony and history provided to Dr. Pietruskza are impeached by the medical records that he did not review. Dr. Voroshilovsky is the only physician who reviewed all evidence and did not solely rely on the widow's inaccurate history. The widow's testimony and history are self-serving. That fact, in and of itself, is not necessarily all-important. But it is when over 1,000 pages of medical records prove a much different scenario of the decedent than she lead Dr. Pietruszka to believe. Although admissible, her testimony and history, without speculation or conjecture, are both contradicted and impeached by the more-reliable medical records. The court cannot believe her history a history that Dr. Pietruszka's uses to arrive at his conclusions. The facts in this case therefore must support a finding consistent with Dr. Voroshilovsky's conclusions.

Reviewed all evidence including extensive medical records and concluded no industrial injury causation for heart and cardiovascular system or hypertension; her opinion was found to be substantial evidence.

Her report reviewed over 1,000 pages of medical records and was supported after cross-examination, constituting substantial medical evidence.

From the decision · page 17There is no other conclusion for the court to reach. The only medical reports and conclusions that constitute substantial evidence are those of the PQME, Dr. Olga Voroshilovsky.

Consulted but failed to review extensive medical records and relied on inaccurate history from the widow; his opinion was rejected as not substantial evidence.

He did not review over 1,000 pages of medical records and relied on inaccurate history, failing to meet the standard of substantial medical evidence.

From the decision · page 12Further complicating Dr. Pietruszka's analysis is that he objects to the orthopedic apportionment provided, even though he is not an orthopedist. Moreover, he goes on to discuss and then make findings regarding the applicant's stressors at work and his psychiatric condition, despite not being a psychiatrist or psychologist. There is no reason for him to step outside his field of expertise to opine as he did. The grasping at straws is obvious, especially when he does not address the decedent's poorly-controlled hypertension, high cholesterol, hyperlipidemia, longstanding tobacco and alcohol abuse (at times 18 beers in a single night), medication non-compliance, and obesity. The 15 years of records tell a completely different story of the decedent's lifestyle and habits than does the version provided to Dr. Pietruszka. To completely ignore such a lengthy history of complications and treatment that is directly at issue in this case causes his opinions to fail the standard of substantial medical evidence. The applicant takes the position that Dr. Pietruszka reviewed all records, just not in their original form. That is a stretch.

Labor Code 3202, 3202.5

The burden of proof on all issues is by a preponderance of the evidence, with injury AOE/COE requiring the applicant to prove work-related connection to death.

Applicant must prove injury AOE/COE by preponderance of evidence.

From the decision · page 11Although Labor Code § 3202 mandates that workers' compensation laws "...shall be liberally construed by the courts with the purpose of extending their benefits for the protection of persons injured in the course of their employment", Labor Code § 3202.5 provides that "[a]ll parties and lien claimants shall meet the evidentiary burden of proof on all issues by a preponderance of the evidence in order that all parties are considered equal before the law." Injury AOE/COE is at issue, and it is therefore the applicant who maintains the burden of proving a work-related connection to the death.

Widow's deposition testimony and history provided to Dr. Pietruszka were contradicted and impeached by over 1,000 pages of medical records showing a different lifestyle and habits of the decedent.

From the decision · page 14The widow's deposition testimony and history provided to Dr. Pietruskza are impeached by the medical records that he did not review. Dr. Voroshilovsky is the only physician who reviewed all evidence and did not solely rely on the widow's inaccurate history. The widow's testimony and history are self-serving. That fact, in and of itself, is not necessarily all-important. But it is when over 1,000 pages of medical records prove a much different scenario of the decedent than she lead Dr. Pietruszka to believe. Although admissible, her testimony and history, without speculation or conjecture, are both contradicted and impeached by the more-reliable medical records. The court cannot believe her history a history that Dr. Pietruszka's uses to arrive at his conclusions. The facts in this case therefore must support a finding consistent with Dr. Voroshilovsky's conclusions.