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⚙Case ConfigurationKhan · 221060326

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TRISTAR Insurance Group — Brea

Confidential — prepared for medical-legal evaluation purposes

May 13, 2026

Basil R. Besh, MD

Qualified Medical Evaluator — Orthopaedic Surgery, Hand

81767 Doctor Carreon Blvd, Ste. 204, Indio, CA 92201-5599

RE: Medical-Legal Evaluation — Record Transmittal

Employee: Shamima Khan

Claim Number: 221060326

Date of Injury: 09/20/2022

Date of Evaluation: June 4, 2026

Location: 39180 Farwell Dr., Ste. 211, Fremont, CA 94538

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