ADJ9219469 · July 21, 2026

The WCJ found that the reports of Superior Chiropractic Care do not constitute substantial medical evidence and struck them from the record, but the WCAB amended to admit the reports into evidence while affirming that they do not constitute substantial evidence.

From the decision · page 1We previously granted reconsideration to study the factual and legal issues of this case. This is our Opinion and Decision After Reconsideration. Lien clamant Superior Chiropractic Care seeks reconsideration of the Joint Findings of Fact and Order (F&O) issued on July 12, 2022, wherein the workers’ compensation administrative law judge (WCJ) found, in pertinent part, that (1) while employed by defendant on January 30, 2010, applicant sustained injury arising out of and in the course of employment (AOE/COE) to the back, respiratory, upper extremities, hands, nerves, and fingers and lien claimant Del Carmen disputes injury to respiratory and nerves (ADJ7174695); (2) while employed by defendant during the period of August 1, 1996 through May 1, 2012, applicant sustained injury AOE/COE to the back, respiratory, upper extremities, hands, nerves, and fingers, and lien claimant Del Carmen disputes injury to respiratory and nerves (ADJ92l9469); (3) lien claimant Del Carmen’s exhibits 3 through 32 (Dr.

Reports of Superior Chiropractic Care exhibits 1-4 (Dr. Drakhshani's reports) do not constitute substantial medical evidence

Favours Defendant prevailed

This led to the WCJ striking the reports from the record, but the WCAB amended to admit them while affirming their lack of substantiality.

From the decision · page 3For the above reasons, none of the reporting of Dr. Drakhshani constitutes substantial medical evidence and shall be stricken from the record.

Reports do not constitute substantial medical evidence due to lack of reasonable medical probability, inadequate medical history, and lack of detailed analysis of job duties and injury causation.

Reports fail to frame conclusions in terms of reasonable medical probability, lack pertinent facts, and lack reasoning to support conclusions.

From the decision · page 3(Exhibit 4 Superior Chiropractic Care) Dr. Drakhshani notes in her description of applicant's job duties while working for Steno Enterprises, applicant "sometimes would lift items that weighed between 400 to 450 lbs." (Id. p. 2) Dr. Drakhshani apparently found this credible. This is the only narrative report in evidence. There is no review of records, although Dr. Drakhshani notes that applicant was taken to Valley Presbyterian Hospital and received X-rays.... Medical causation notes the specific injury to the left ring finger (crush injury), and chronic pain in the neck, left shoulder, left upper extremity and low back. Causation is industrial. The report neglects to opine on the 'how and why' of this diagnosis. Certainly, lifting 400 to 450 pounds may have something to do with it.

Medical report addressed to Dr. Drakhshani as PTP; lack of 4600 election letter not conclusive on PTP status; report not reviewed or incorporated by Drakhshani.

Report not reviewed or incorporated by PTP, affecting substantiality but not admissibility.

From the decision · page 3Defendant objected to the Superior Chiropractic Care exhibits 1 - 4, which were admitted over defendant's objection. Defendant's objection was based upon the lack of a 4600 election letter, and the lack of review and incorporation by Dr. Drakhshani. The Medical report of Steven Brourman, M.D., dated 11/20/13 was addressed to Dr. Drakhshani as a primary treating physician. The lack of a 4600 letter is not conclusive on the issue of who the primary treating physician is. There is evidence that Dr. Drakhshani was the PTP. More importantly, the lack of review and incorporation by Dr. Drakhshani would go to the substantiality of those reports. Whether a medical report is substantial medical evidence goes to the weight of the evidence not the admissibility of the evidence.... The Brourman report was not reviewed or incorporated even though Dr. Drakhshani apparently referred applicant to Dr. Brourman pursuant to Exhibit 2 (Del Carmen Medical Center)... Pursuant to the Initial medical report from Superior Chiropractic, dated 9/11/2013.

Lab. Code § 5705; Lab. Code § 3202.5; Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604; Hegglin v. Workmen's Comp. Appeals Bd. (1971) 4 Cal. 3d 162

Burden of proving injury AOE/COE rests with applicant or lien claimant by preponderance of evidence; medical opinion must be framed in terms of reasonable medical probability and based on pertinent facts and adequate examination and history

The WCJ and WCAB applied these standards to evaluate the substantiality of medical reports submitted by lien claimants.

From the decision · page 4The burden of proving injury AOE/COE rests with the applicant or the lien claimant, who steps into the shoes of the applicant. (Lab. Code § 5705 1; see, e.g., LaTourette v. Workers' Comp. Appeals Bd. (1998) 17 Cal.App.4th 644, 650 [63 Cal.Comp.Cases 253] (citing McAllister v. Workmen's Comp. Appeals Bd. (1968) 69 Cal.2d 408, 413 [33 Cal.Comp.Cases 660].) The parties and lien claimants shall meet the evidentiary burden of proof by a preponderance of the evidence. (§ 3202.5.) The weight accorded the evidence, including of the medical-legal reporting in evidence, is a matter to be determined by the WCJ and by the Appeals Board. (Garza v. Workmen's Comp. Appeals Bd. (1970) 3 Cal.3d 312, 317 [35 Cal.Comp.Cases 500]; Lundberg v. Workmen's Comp. Appeals Bd. (1968) 69 Cal.2d 436, 440 [33 Cal.Comp.Cases 656].) All findings of the WCJ and the Appeals Board, including of injury AOE/COE, must be based on substantial evidence. (Le Vesque v. Workmen's Comp. Appeals Bd. (1970) 1 Cal.3d 627, 637 [35 Cal.Comp.Cases 16]; Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 620 [Appeals Bd. en banc].) To constitute substantial evidence “..

Lack of review and incorporation of Dr. Pietruszka's reports by PTP Drakhshani

From the decision · page 1Pietruszka's reports) were not reviewed and incorporated by the PTP Drakhshani pursuant to California Code of Regulations section 9785(e)(4) and Labor Code section 4061.5, and the reports of Dr. Pietruszka are not admissible and are stricken from the evidentiary record; (4) lien claimant Del Carmen Medical Center disputes injury to respiratory, TBS, and nerves, and failed to prove injury AOE/COE to respiratory, IBS, and nerves on January 30, 2010, and during the period of August 1, 1996 through May 1, 2012; and (5) the reports of lien claimant Superior Chiropractic Care’s exhibits 1 through 4 (Dr. Drakhshani’s reports) do not constitute substantial medical evidence and are stricken from the record.

Reports of Dr. Drakhshani do not constitute substantial medical evidence due to inadequate medical history and lack of detailed analysis

From the decision · page 3(Exhibit 4 Superior Chiropractic Care) Dr. Drakhshani notes in her description of applicant's job duties while working for Steno Enterprises, applicant "sometimes would lift items that weighed between 400 to 450 lbs." (Id. p. 2) Dr. Drakhshani apparently found this credible. This is the only narrative report in evidence. There is no review of records, although Dr. Drakhshani notes that applicant was taken to Valley Presbyterian Hospital and received X-rays.... Medical causation notes the specific injury to the left ring finger (crush injury), and chronic pain in the neck, left shoulder, left upper extremity and low back. Causation is industrial. The report neglects to opine on the 'how and why' of this diagnosis. Certainly, lifting 400 to 450 pounds may have something to do with it.