What the panel ordered
The WCAB granted defendant's petition for reconsideration, rescinded the WCJ's Findings of Fact and Orders of November 5, 2024, and issued a new decision finding no industrial injury to the teeth; all other issues were deferred.
Defendant sought reconsideration of the WCJ's Findings of Fact and Orders of November 5, 2024, which found industrial injury to multiple body parts including teeth; the WCAB granted reconsideration and rescinded the WCJ's decision.
What was disputed, and how it came out
Each issue the panel decided, with the reasoning it gave. An outcome is what this panel did on this record — not a rule, and not a prediction.
The lien claimant did not prove by a preponderance of the evidence that applicant sustained dental injury; Dr. Schames's opinion lacked substantial evidence and adequate explanation linking dental injury to industrial exposure.
From the decision · page 5We thus find that lien claimant did not prove by a preponderance of the evidence that applicant sustained dental injury. Since this is the only body part relevant to lien claimant's medical treatment lien, we need not consider whether applicant sustained injury to any other body part. We will grant reconsideration, issue a finding that applicant did not sustain industrial injury to the teeth, and defer all other issues. If any other body part is relevant to any future issue in this case, the issue can be raised by a relevant party at the trial level.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Dr. Schames's medical opinion lacked substantial evidence and did not adequately explain how applicant's dental problems were worsened by industrial exposure.
Favours Defendant prevailed
The WCAB found the opinion insufficient to prove industrial injury to the teeth by a preponderance of the evidence, leading to reversal of the WCJ's finding.
From the decision · page 5In this matter, Dr. Schames's reporting does not constitute substantial medical evidence of dental injury. Dr. Schames did not take a detailed history of applicant's prior dental history or review applicant's prior dental records. Thus, Dr. Schames does not adequately explain if applicant's dental problems were worsened by industrial exposure. He ascribes applicant's dental injury to stress due to industrial "emotional stressors" without describing these emotional stressors in any detail. Dr. Schames explains that "the scientific literature has documented that a person can have bruxism... in response to pain as well as in response to stress" (June 17, 2021 at p. 11) but does not sufficiently explain why applicant's specific history, complaints, and clinical presentation make it medically probable that applicant's work contributed to his bruxism.
What the panel did with the medical opinions
The role the physician served, and the weight the opinion carried. Physicians are named here as the decision names them; we do not score them.
Found clinical evidence of bruxism and dental inflammation possibly aggravated by industrial factors but did not provide substantial evidence linking dental injury to industrial exposure due to lack of detailed history and explanation.
The opinion lacked a solid underlying basis, did not take detailed prior dental history, and failed to explain the medical probability of industrial causation.
From the decision · page 5In this matter, Dr. Schames's reporting does not constitute substantial medical evidence of dental injury. Dr. Schames did not take a detailed history of applicant's prior dental history or review applicant's prior dental records. Thus, Dr. Schames does not adequately explain if applicant's dental problems were worsened by industrial exposure. He ascribes applicant's dental injury to stress due to industrial "emotional stressors" without describing these emotional stressors in any detail. Dr. Schames explains that "the scientific literature has documented that a person can have bruxism... in response to pain as well as in response to stress" (June 17, 2021 at p. 11) but does not sufficiently explain why applicant's specific history, complaints, and clinical presentation make it medically probable that applicant's work contributed to his bruxism.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Labor Code sections 5705 and 3202.5
The burden of proof rests on the party or lien claimant holding the affirmative of the issue (Labor Code, 5705; see 3202.5).
The lien claimant bears the burden of proving by a preponderance of the evidence that the claim is industrial.
From the decision · page 4"In workers' compensation matters, the burden of proof rests on the party or lien claimant `holding the affirmative of the issue.' (Lab. Code, § 5705; see § 3202.5.)... [T]he lien claimant bears the burden of establishing the... entitlement to benefits and the reasonable value of the
What proof carried it
The evidence the panel weighed, by kind.
Dr. Schames did not take a detailed history of applicant's prior dental history or review prior dental records, and did not adequately explain industrial causation of dental injury.
From the decision · page 5In this matter, Dr. Schames's reporting does not constitute substantial medical evidence of dental injury. Dr. Schames did not take a detailed history of applicant's prior dental history or review applicant's prior dental records. Thus, Dr. Schames does not adequately explain if applicant's dental problems were worsened by industrial exposure. He ascribes applicant's dental injury to stress due to industrial "emotional stressors" without describing these emotional stressors in any detail. Dr. Schames explains that "the scientific literature has documented that a person can have bruxism... in response to pain as well as in response to stress" (June 17, 2021 at p. 11) but does not sufficiently explain why applicant's specific history, complaints, and clinical presentation make it medically probable that applicant's work contributed to his bruxism.
The same issues, filtered across the whole corpus — or paste your own facts and let the search rank by factor match.
About this page
- A published decision of the California Workers' Compensation Appeals Board, taken apart by what it turned on. The Board publishes the decision itself; this page adds the extraction and quotes the passage behind every claim.
- The injured worker is not named here, and the case caption is not printed. Physicians appear as the decision names them, because a medical opinion is an act in a public proceeding.
- Issues, outcomes and weights were extracted by AI and released only where the source passage checked. Read the official decision before relying on anything here. Not legal advice.
- If you are named in this decision and want this page removed, write to privacy@similarcase.com.