COURT OF APPEALS OF VIRGINIA
Present: Judges Benton, Coleman and Lemons ∗
Argued at Richmond, Virginia
GEORGIA-PACIFIC CORPORATION
OPINION BY
v. Record No. 1644-99-2 JUDGE JAMES W. BENTON, JR.
MARCH 21, 2000
MICHALENE L. ROBINSON
FROM THE VIRGINIA WORKERS' COMPENSATION COMMISSION
S. Vernon Priddy III (Patsy L. Mundy; Sands,
Anderson, Marks & Miller, on brief), for
appellant.
Jeremy C. Sharp (Geoffrey R. McDonald &
Associates, on brief), for appellee.
Georgia-Pacific Corporation contends the Workers'
Compensation Commission erred when it ruled that Michalene L.
Robinson's psychiatric condition was causally related to her
injury by accident. For the reasons that follow, we affirm the
commission's award.
I.
Michalene L. Robinson sustained a work-related injury on
January 11, 1995, when her thumb was caught in a machine. The
next day, Dr. Richard Holm, an orthopedist, performed surgery on
Robinson to repair a deep laceration and fracture of her right
∗
Justice Lemons participated in the hearing and decision of
this case prior to his investiture as a Justice of the Supreme
Court of Virginia.
thumb. He released her to light duty to begin on January 16,
1995, instructing her not to use her right hand at work. When
Robinson visited Dr. Holm on January 20, he returned her to work
beginning January 23 and "with the restriction that she do no
work with her right thumb." He also recommended physical
therapy and informed her "that it may be a year before [she]
obtain[s] a fixed and stable medical condition."
In March, Dr. Holm noted that Robinson "was extremely
concerned as she was having increasing pain." Dr. Holm also
noted that her pain resulted from "over use" and notified
Georgia-Pacific that Robinson was to avoid unnecessary heavy
gripping. Early in May, Robinson, Dr. Holm, and a
Georgia-Pacific representative "had a very extended discussion
. . . concerning [Robinson's] treatment course . . . [and] the
goal of her recovery." Dr. Holm again asked Georgia-Pacific "to
restrict heavy lifting, gripping and pulling activities with
[her] right hand." He gave Robinson additional medication for
her pain.
Robinson fainted at work on May 20, 1995, and was
hospitalized. Robinson reported to the attending physician that
she had "been in good health . . . until January . . . when she
injured her thumb." Robinson said she had stress at work
because of a conflict with a supervisor and her inability to use
her hand; she also mentioned the death of a grandchild, which
occurred May 19. The treating physician gave her medication for
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anxiety, admitted her to the hospital, and diagnosed her as
having syncopal episode, hypokalemia, and moderate stress
anxiety.
Two days after her hospitalization, Dr. Holm recommended
that Robinson consult with Dr. Bryan Spader, a psychiatrist. In
that report, Dr. Holm noted that Robinson "is having a great
deal of difficulty returning to her job" and noted that
"[d]iscussions have been held with [Georgia-Pacific] to try to
modify her work environment." Dr. Holm further stated that
"Robinson continues to have problems with what appears to be a
relatively minor injury causing a major change in her
life-style." Several days later, Dr. Holm again evaluated
Robinson and expressed the "concern . . . that [Robinson] is
having a post-traumatic stress reaction." He found Robinson
unfit for work pending her psychiatric examination.
The record reveals that Robinson was evaluated by three
psychiatrists -- Dr. Bryan Spader, Dr. Merritt Foster, and Dr.
James Corcoran. The commission considered various reports from
these psychiatrists and found that Robinson's psychiatric
treatment resulted from and was necessitated by her injury by
accident. Georgia-Pacific contends that no credible evidence
supports the commission's findings.
II.
By statutory mandate, "an award of the Commission . . .
shall be conclusive and binding as to all questions of fact."
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Code § 65.2-706(A). Thus, we have often expressed our standard
of review as follows:
In reviewing the commission's decision,
we are guided by well-settled principles.
"[I]t is fundamental that a finding of fact
made by the [c]ommission is conclusive and
binding upon this court on review." "[T]hat
contrary evidence may be in the record is of
no consequence if there is credible evidence
to support the [c]ommission's findings."
Sneed v. Morengo, 19 Va. App. 199, 204, 450 S.E.2d 167, 171
(1994) (citations omitted). "The scope of a judicial review of
the fact finding function of a workers' compensation commission
[, therefore,] is 'severely limited, partly in deference to the
agency's expertise in a specialized field.'" Metropolitan
Cleaning Corp. v. Crawley, 14 Va. App. 261, 266, 416 S.E.2d 35,
38 (1992).
Applying equally well-settled principles, the Supreme Court
has held that the "question [of causation] raised by
'conflicting expert medical opinions' is one of fact." Eccon
Constr. Co. v. Lucas, 221 Va. 786, 790, 273 S.E.2d 797, 799
(1981). Thus, the commission's "finding upon conflicting
medical evidence that a certain condition does or does not exist
is . . . a conclusive finding of fact." McPeak v. P.W.& W. Coal
Co., 210 Va. 185, 188, 169 S.E.2d 443, 445 (1969). "The
deference that we give to the commission's fact finding on
medical questions is based upon the 'unwisdom of an attempt by
. . . [courts] uninitiated into the mysteries [of the medical
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science debate] to choose between conflicting expert medical
opinions.'" Stancill v. Ford Motor Co., 15 Va. App. 54, 58, 421
S.E.2d 872, 874 (1992) (citation omitted).
Given these principles of appellate review, we have held
that "[t]he commission's findings are binding even if the weight
of the evidence is contrary to those findings." Kane Plumbing
v. Small, 7 Va. App. 132, 136, 371 S.E.2d 828, 831 (1988). We
apply this standard because "[a] greater number of medical
opinions does not necessarily constitute a preponderance of the
evidence." Island Creek Coal Co. v. Honaker, 9 Va. App. 336,
339, 388 S.E.2d 271, 273 (1990). "The probative weight to be
accorded [medical] evidence is for the Commission to decide; and
if it is in conflict with other medical evidence, the Commission
is free to adopt that view 'which is most consistent with reason
and justice.'" C.D.S. Const. Services v. Petrock, 218 Va. 1064,
1070, 243 S.E.2d 236, 240 (1978). In its review of this case,
the commission decided that the opinions of Dr. Spader and Dr.
Corcoran were "entitled to greater weight" than those of Dr.
Foster. Honaker, 9 Va. App. at 339, 388 S.E.2d at 273.
Dr. Spader noted in his initial report on May 5, 1995, that
Robinson expressed anxiety about difficulties performing routine
tasks with her hand after her injury. She also expressed
lifestyle difficulties, such as loss of libido, loss of sleep,
irritability, and thoughts of suicide following the accident.
Robinson believed that, within her limitations, she was "doing
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her job well" after her injury, yet, "was being harassed by
supervisors." Dr. Spader also reported other events in
Robinson's life about which she was concerned.
In his evaluation report, Dr. Spader expressed a belief
that Robinson was suffering from "Major Depression, single
episode . . . [,] symptoms suggestive of [Post-traumatic stress
disorder], and there may be some symptoms suggestive of
dysthymia and an Axis II Disorder." In a letter to Dr. Holm,
Dr. Spader stated that his "evaluation suggested presence of a
Major Depression with sleep and appetite disturbance,
irritability, crying more readily, loss of energy and some
suicidal thoughts shortly after the accident began."
By letter of June 14, 1995, Dr. Holm informed
Georgia-Pacific that Robinson's psychiatric condition placed
Robinson and potentially her fellow workers at risk. He
reiterated that he had "nothing to indicate this is not a
reaction to her injury of January 1995."
At Georgia-Pacific's request, Dr. Foster examined Robinson
on two occasions. In an extensive report on June 16, Dr. Foster
opined that Robinson's emotional illness had its genesis "two to
three years prior to her recent illness." He further opined
"that her emotional illness culminated in her inability to
accept criticism and adopt corrective measures, finally
resulting in the injury to her right hand which precipitated the
current evaluation." Thus, he concluded "that the injury to her
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right hand . . . [did not cause] her current emotional
symptomatology [but] was rather a product of her emotional
illness."
On August 18, 1995, Dr. Holm reported that the fracture of
Robinson's thumb had healed, that her joint was arthritic, that
Robinson "clinically is having pain in her thumb," and that "she
is complaining of pain over the crush wound site and also
proximal to the radial styloid." He continued to restrict her
from work until he could learn "whether . . . she is
psychologically able to return to work." On October 13, 1995,
Dr. Holm noted that Robinson continued to have "tenderness in
her laceration site consistent with a radial sensory nerve
injury." Although he recommended that she return to work, he
again placed restrictions on heavy lifting, gripping, and
pulling. Dr. Holm also noted that her psychiatric condition
remained untreated.
Robinson began treatment with Dr. Corcoran in October 1995.
In a letter of October 16, 1997, Dr. Foster reported that he had
reviewed Dr. Corcoran's reports, which opined that Robinson
suffers from Post-traumatic stress disorder and that her
disability is a consequence of her January 11, 1995 injury. Dr.
Foster stated that "Robinson's injury . . . does not fit the
PTSD diagnosis . . . [and that] there is no evidence in the
records of the usual litany of purely subjective symptoms,
irrespective of the provable objective signs such as the
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characteristic phobic avoidance." He reiterated his opinion
"that the injury to her right thumb occurring in an accident on
. . . January 11, 1995, was a product of her emotional illness
rather than a cause of whatever emotional symptomatology is
currently present."
Over a period of a year and one-half, Dr. Corcoran treated
Robinson and maintained his diagnosis of PTSD. He opined "that
Ms. Robinson's disability is related to her work-related injury
of January 11, 1995, and that as a result of that injury she is
disabled from all work." He further noted that "while she may
indeed have had some difficulties prior to her injury the
present disability was clearly set in motion as a result of her
work-related injury."
Dr. Foster again examined Robinson in April 1998 and
reported that his opinion remained that Robinson's injury "was a
product of her emotional illness rather than a cause of whatever
symptomatology is currently present." He also stated that
Robinson "does not now and has never demonstrated enough of the
characteristic symptomatology to warrant a diagnosis of
Post-Traumatic Stress Disorder."
On May 11, 1998, Dr. Corcoran reported that his "opinion
has not changed." He stated that Robinson "more than adequately
meets criteria for post traumatic stress disorder, a diagnosis
made not only by myself, but also by previous psychiatrists who
saw her shortly after her injury." He concluded that "[o]verall
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her behavior, her complaints and my clinical findings are quite
consistent with a post traumatic stress disorder coupled with a
paranoid personality."
III.
Evaluating this evidence, the commission made the following
findings:
After a careful review of Dr. Corcoran's
treatment notes, it is clear that [Robinson]
presented for psychiatric treatment that was
related to her injury. Dr. Foster's account
of Dr. Corcoran's February 20, 1996, office
visit noted that Dr. Corcoran observed that
[Robinson] was "very focused on . . . her
injury." On January 29, 1997, Dr. Corcoran
noted that [Robinson] was "told she could
not use hand as previously." On April 7,
1997, Dr. Corcoran noted that [Robinson]
"attributes all of her difficulty to her
injury." On May 13, 1997, Dr. Corcoran
noted that [Robinson] "remains focused on
her accident and how this has affected her."
By June 30, 1997, Dr. Corcoran's notes began
reflecting [Robinson's] frustration she was
experiencing in waiting for a decision about
her entitlement to benefits. However, on
February 27, 1998, Dr. Corcoran noted that
the "process [was] set in motion by injury."
Although Dr. Foster disagreed with Dr.
Corcoran's analysis and opinion, instead
stating that [Robinson's] condition was
established long before the accident, we are
persuaded that [Robinson's] treatment with
Dr. Spader and Dr. Corcoran was necessitated
by the January 11, 1995, accident. No
evidence has been presented that
[Robinson's] treatment was unnecessary, nor
has any evidence been presented opining
whether the treatment would have been the
same had the accident not happened.
[Robinson] admitted to her troubles with
management, which cannot result in a
compensable disability. Dr. Corcoran
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factored in this component of [Robinson's]
condition, however, and opined that the
injury triggered the extent of her
condition. We agree . . . .
When the medical evidence conflicts, we do not re-weigh the
preponderance of the evidence after the commission has done so.
See Westmoreland Coal Co. v. Russell, 31 Va. App. 16, 20, 520
S.E.2d 839, 841 (1999); Wagner Enterprises v. Brooks, 12 Va.
App. 890, 894, 407 S.E.2d 32, 35 (1991). Our review is limited
to determining whether the record contains credible evidence to
support the commission's findings. See id. The record contains
more than ample credible evidence to support the findings.
Accordingly, we affirm the award.
Affirmed.
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