Olivarez: An Employee Dental Benefit Connected an Off-Duty Injury to Work

Clocking out can make an injury feel disconnected from work, even when it happens at the workplace during a benefit your employer offered. If a claim is denied for that reason, the useful questions concern the benefit itself, the reason you remained and the medical evidence connecting the incident to the injury.

In Olivarez v. Chico Dental Arts, No. ADJ13479589 (WCAB Dec. 16, 2025), a dental receptionist was injured during an implant procedure after clocking out. The Workers’ Compensation Appeals Board found that the employee dental benefit connected the treatment with her employment. It confirmed industrial injury to her teeth and deferred the other claimed injuries for further development of the medical record.

The dental treatment was part of an employee benefit

Linda Olivarez worked as a receptionist for David C. Kyle, DDS, Inc., doing business as Chico Dental Arts. According to the hearing evidence discussed in Olivarez, she had been told when hired that, if her spouse had dental insurance, her copayments and deductibles for treatment provided by the employer would be waived. Other employees received the same benefit.

She had used the arrangement for crowns, cleanings and fillings. Her testimony described receiving dental care from the employer without having to pay the remaining charges herself. Treatment was voluntary; employees were free to obtain it elsewhere.

On January 17, 2018, she worked but clocked out before receiving a left-side dental implant. The Board’s account described an injury from an implant placed too deeply. A dental evaluator later connected left-jaw nerve symptoms, including loss of some sensory and motor abilities, to that procedure.

The work-injury claim was disputed. The employer argued that the procedure was elective, occurred off duty and was neither required by employment nor beneficial to the employer. Olivarez’s evidence about the agreed benefit and its actual use supplied the context for evaluating that position.

The Board examined how the treatment connected with employment

The employment-connection analysis in Olivarez applied Labor Code section 3600. A work injury must arise out of employment and occur in the course of employment. The Board examined those as related but separate questions.

“In the course of employment” concerns the time, place and circumstances. The opinion explained that activities expressly or impliedly permitted by the employment relationship can fall within that relationship. “Arising out of employment” concerns the causal connection between employment and the injury. Employment can contribute to the injury without being its only cause.

The Board then applied the personal-comfort doctrine. It discussed Price v. Workers’ Compensation Appeals Board, 37 Cal.3d 559, 567–568 (1984), in explaining that activities reasonably contemplated by employment can remain incidental to work even when they serve a personal need.

The deciding facts in Olivarez’s case included the workplace location and an established employment benefit she was using there. She stayed for treatment under the same copayment-and-deductible arrangement she had used previously. The Board evaluated that arrangement as part of the employment relationship, alongside the fact that she had clocked out.

An employee-discount case helped explain the connection

The comparison with Herrera v. Ross Stores helped explain the Board’s reasoning. In the February 6, 2024 decision, No. ADJ16049965, the employee was shopping after clocking out on an employee double-discount day when she fell.

As described in Olivarez, those special days offered employees and their spouses a 40-percent discount. Employees were advised to shop after clocking out, and the store used the events to clear outdated or less desirable inventory. The activity was reasonably contemplated by the employment relationship.

The Board applied that reasoning to the dental benefit. Receiving the discounted care was an anticipated part of Olivarez’s employment arrangement. On the day of the injury, she remained at the office for treatment with the understanding that her share of the charges would be waived as before.

The connection came from evidence about the particular benefit and how it operated. That evidence explained why the activity belonged in the work-injury analysis despite serving an employee’s personal health needs.

The account records supported the promised benefit

The employer disputed whether it benefited from providing the procedure. The account-history discussion in Olivarez identified insurance payments to the dental practice and waiver of the remaining charges. The Board reasoned that the arrangement helped retain the employee while generating payment for services the practice supplied.

The employer also argued that the charge for the January 2018 procedure had been waived only after Olivarez reported a suspected injury. The Board found no supporting evidence, including testimony from Dr. Kyle, for that account. It contrasted the argument with records showing copayment waivers throughout her employment.

Those records mattered because they supported an existing employee benefit. They gave the Board a way to evaluate the parties’ competing explanations of the same dental visit.

For a similar review, keep the benefit terms and the records of how the arrangement was actually used. A written policy may help, while testimony about an oral agreement, earlier account statements and records of comparable treatment can supply different pieces of the employment history.

The medical evidence supported a finding about the teeth

The employment connection was one part of the claim. The medical discussion in Olivarez addressed a separate question: Which injury did the treatment cause?

Dental panel qualified medical evaluator Dr. Jason A. Scorza examined Olivarez on October 15, 2020. His report linked an injury to the left IA nerve, affecting sensation and movement in the left jaw, to the implant placed to replace tooth number 19. The Board accepted his opinion as substantial medical evidence supporting industrial injury to the teeth.

The claim also included other body parts and conditions. By March 2025, the application included claims involving hearing, the jaw joint (TMJ), vertigo and chewing (mastication). The Board specifically called for further medical development concerning the claimed circulatory system, internal system, neck and back injuries. Its formal order deferred injury to other body parts, separating the teeth injury already established from the additional claims still requiring resolution.

That distinction helps organize the records for a claim review. Identify the injury the evaluator actually addressed, the symptoms and findings supporting that opinion, and each additional condition for which a work connection is claimed. Keep the medical reports with the precise findings and orders so their respective roles remain clear.

The order preserved the teeth finding and deferred the remaining injuries

The operative order in Olivarez amended the judge’s finding to state that the January 17, 2018 injury to the teeth arose out of and occurred in the course of employment. It deferred injury to other body parts and otherwise affirmed the findings and order.

The opinion’s procedural history also described an earlier civil malpractice action. According to the trial judge’s account quoted by the Board, the superior court had determined that the claim belonged in workers’ compensation, and that determination had not been appealed. The Board then addressed the employment connection and the medical basis for the claimed industrial injuries.

For Olivarez, the employee benefit, past account treatment and evaluator’s opinion supported the teeth finding. The further medical work concerned the remaining claimed injuries. The result shows why the benefit agreement and the injury evidence need to be developed together.

Preserve the benefit terms and the actual treatment record

Bring the employee-benefit terms, enrollment information, relevant communications and account statements. Identify who explained the arrangement, whether it was used before and how the charges were handled. Keep the time record and appointment information showing when and why you remained at the workplace.

Add the treatment records, medical-evaluation reports, claim applications and actual decisions. Distinguish the injuries already found industrial from those deferred or disputed. If there was a civil action, include its orders and procedural history so counsel can evaluate the available forum from the actual record.

Our Delgado analysis addresses another clocked-out activity: retrieving lunch during an authorized break. Olivarez turns on an employer-provided dental benefit and the evidence linking that benefit and treatment to the injury. Those concrete employment arrangements are the starting point for a focused review.