COM./CENTRAL VA. TRAINING CENTER v. Cordle

COURT OF APPEALS OF VIRGINIA

Present: Judges Willis, Elder and Annunziata
Argued at Richmond, Virginia

COMMONWEALTH OF VIRGINIA/
CENTRAL VIRGINIA TRAINING CENTER
OPINION BY
v. Record No. 0458-01-2 JUDGE JERE M. H. WILLIS, JR.
DECEMBER 18, 2001
DOROTHY McGEE CORDLE

FROM THE VIRGINIA WORKERS' COMPENSATION COMMISSION

Scott John Fitzgerald, Assistant Attorney
General (Mark L. Earley, Attorney General;
Judith Williams Jagdmann, Deputy Attorney
General; Gregory E. Lucyk, Senior Assistant
Attorney General; Catherine Crooks Hill,
Assistant Attorney General, on brief), for
appellant.

Craig B. Davis (Geoffrey R. McDonald &
Associates, on brief), for appellee.

The Central Virginia Training Center and the Commonwealth

of Virginia (jointly referred to as "employer") appeal a

decision of the Workers' Compensation Commission awarding

benefits to Dorothy McGee Cordle for aggravation of an earlier

compensable knee injury. The employer contends that the

commission erred in holding that Cordle's October, 1999 injury

was a compensable consequence or change in condition of her

August, 1998 compensable knee injury. It argues that the

medical evidence failed to prove a causal connection between the

two injuries. We affirm the commission's decision.
 I. BACKGROUND

On appeal, "[d]ecisions of the commission as to questions

of fact, if supported by credible evidence, are conclusive and

binding on this Court." Manassas Ice & Fuel Co. v. Federated

Mutual Ins. Co., 13 Va. App. 227, 229, 409 S.E.2d 824, 826

(1991) (citing Code § 65.1-98; McCaskey v. Patrick Henry Hosp.,

225 Va. 413, 415, 304 S.E.2d 1, 2 (1983)). 1 "The fact that

contrary evidence may be found in the record is of no

consequence if credible evidence supports the commission's

finding." Id. (citing Russell Loungewear v. Gray, 2 Va. App.

90, 95, 341 S.E.2d 824, 826 (1986)). We view the evidence in

the light most favorable to the party prevailing below. Creedle

Sales Co. v. Edmonds, 24 Va. App. 24, 26, 480 S.E.2d 123, 124

(1997).

A. THE INJURIES

On August 14, 1998, while working at the Central Virginia

Training Center, Cordle injured her left knee when she caught a

falling patient. On August 24, 1998 Dr. Gautham Gondi diagnosed

a symptomatic plica, chondromalacia of the patella, and lateral

patellofemoral compression syndrome. On September 23, 1998 he

also diagnosed a medial meniscal tear. On September 28, 1998

Dr. Gondi released Cordle to regular work. Cordle stated that

1
Code § 65.1-98 was recodified in 1991. The present
provision can be found at Code § 65.2-706.
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her knee was much better at that time and denied any giving way

or buckling. Nevertheless, she continued to experience some

discomfort. Her last medical treatment for that injury was in

December, 1998 or January, 1999.

On October 21, 1999, Cordle's knee popped and buckled as

she carried a mop and bucket up a stairway. She fell to the

floor. She went to the emergency room and returned to

Dr. Gondi's care.

During examination by Dr. Gondi, Cordle described the pain

as different from the pain she had experienced in August, 1998.

Although it was in the same location, it was more severe, and

she was unable to walk. Dr. Gondi diagnosed left knee

patellofemoral chondromalacia and bilateral patellofemoral

compression syndrome. He reported that "[the] event that she

describes from October 21, 1999 did cause an aggravation of her

previous left knee injury. It was not a new diagnosis, but it

was a new event." On December 21, 1999, he returned Cordle to

medium work with restrictions.

On January 12, 2000, after the employer denied her

benefits, Cordle stopped treating with Dr. Gondi. She began

seeing Dr. Anthony J. Shaia, whom she chose from a panel of

physicians furnished by the employer. Dr. Shaia agreed with

Dr. Gondi's diagnosis. On April 6, 2000, he placed Cordle on

restricted duty.

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 On May 4, 2000, Dr. Shaia reviewed the results of a recent

MRI, which revealed a torn medial meniscus and the absence of an

anterior cruciate ligament. Dr. Shaia concluded that

arthroscopic surgery would be appropriate, but actual

reconstruction would not be necessary. Cordle was removed from

work from May 4, 2000 to May 25, 2000.

A second opinion was requested by the employer, and Cordle

was examined by Dr. John A. Cardea on June 16, 2000. Dr. Cardea

agreed with Dr. Shaia's diagnosis. He reported that Cordle's

"medial meniscus problem [relates] to the initial injury.

. . . [T]his is an exacerbation of a pre-existing condition or

it may even be the first symptoms of a pre-existing condition."

He concluded that Cordle should have arthroscopic surgery to

remove the damaged portion of the medial meniscus.

B. PROCEDURAL HISTORY

On April 19, 1999 Cordle received an award of temporary

total disability benefits for the August 14, 1998 injury.

Following the October 21, 1999 injury, she filed for temporary

total disability benefits, claiming (1) that she had suffered a

compensable change in condition of the August 14, 1998 injury;

or, in the alternative (2) that she had suffered a new

compensable injury on October 21, 1999.

The deputy commissioner held that on October 21, 1999,

Cordle "was exposed to no specific risk of her employment" and

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that she did not suffer on that occasion an injury by accident

within the scope of the Workers' Compensation Act. Based on the

recorded medical history and the various diagnoses between

October, 1999 and April 6, 2000, the deputy commissioner found

that changes had occurred in the condition of Cordle's left

knee. However, he concluded that those changes were not the

proximate result of the August 14, 1998 incident. He denied

benefits for the October 21, 1999 incident.

On appeal, the full commission affirmed the deputy's

finding that the October 21, 1999 incident was not a new

compensable injury. However, it held that the October, 1999

incident aggravated Cordle's prior compensable injury. It

remanded the case to the deputy commissioner to enter an award

for the appropriate time periods. The employer appeals.

II. ANALYSIS

The issue on appeal is whether the October, 1999 knee

injury caused a change of condition by aggravation of Cordle's

compensable August, 1998 injury. If so, Cordle is entitled to

compensation. The employer contends that the medical evidence

is insufficient to establish this causal connection.

When an employee files a change of condition application

seeking reinstatement of disability benefits, two questions

arise:

(1) has there been a change in the
employee's capacity to work; [and] (2) if
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 so, is the change due to a condition
causally connected with the injury
originally compensated.

Kings's Market v. Porter, 227 Va. 478, 483, 317 S.E.2d 146, 148

(1984). Unquestionably, Cordle's capacity to work changed as a

result of the October, 1999 injury. On April 6, 2000, she was

placed on restricted work duty, and was removed from work duty

for the period of May 4 to May 25, 2000. The issue is whether

this disability was causally connected to her original

compensable injury.

When a primary injury . . . is shown to have
arisen out of the course of employment,
every natural consequence that flows from
the injury is compensable if it is a direct
and natural result of a primary injury.

Leonard v. Arnold, 218 Va. 210, 214, 237 S.E.2d 97, 99 (1977).

Credible evidence supports the commission's finding that

Cordle's disability following the October, 1999 injury was a

natural consequence flowing from her compensable August, 1998

injury. Cordle had no knee problems prior to the August, 1998

accident. Following the completion of treatment for that

injury, she continued to have pain in her knee when climbing

stairs or when standing for long periods. Dr. Gondi stated

unequivocally that the October, 1999 incident was an aggravation

of Cordle's original injury.

Dr. Cardea, an independent examiner selected by the

employer, wrote that Cordle's pain flared when she returned to

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full duty work and that "this is an exacerbation of a

pre-existing condition or it may even be the first symptoms of a

pre-existing condition." These facts viewed as a whole support

the commission's determination that the October, 1999 incident

was an aggravation of Cordle's 1998 injury.

The commission's determination of causation is a factual

finding that will not be disturbed on appeal if supported by

credible evidence. Corning, Inc. v. Testerman, 25 Va. App. 332,

339, 488 S.E.2d 642, 645 (1997). The decision of the commission

is affirmed.

Affirmed.

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