COURT OF APPEALS OF VIRGINIA
Present: Judges Benton, Bumgardner and Frank
Argued at Richmond, Virginia
DAN RIVER, INC.
MEMORANDUM OPINION* BY
v. Record No. 3020-99-2 JUDGE RUDOLPH BUMGARDNER, III
JUNE 20, 2000
SAMMY TERRY
FROM THE VIRGINIA WORKERS' COMPENSATION COMMISSION
Martha White Medley (Daniel, Vaughan,
Medley & Smitherman, P.C., on brief), for
appellant.
J. Gregory Webb (Michie, Hamlett, Lowry,
Rasmussen & Tweel, P.C., on brief), for
appellee.
Dan River, Inc. appeals an award of benefits to Sammy Terry
by the Workers' Compensation Commission. The employer argues
the commission erred in finding the employee established a
causal connection between the accident and injury, and in
finding he sustained his burden of proving a compensable injury
by accident. The employer argues that it is just as likely that
the employee's disabling condition was caused by his poorly
controlled diabetes as by his work-related injury. Finding no
error, we affirm.
* Pursuant to Code § 17.1-413, recodifying Code
§ 17-116.010, this opinion is not designated for publication.
On appeal, we view the evidence, and all reasonable
inferences deducible therefrom, in the light most favorable to
the prevailing party below. See R.G. Moore Bldg. Corp. v.
Mullins, 10 Va. App. 211, 212, 390 S.E.2d 788, 788 (1990). The
factual findings by the commission that are supported by
credible evidence are conclusive and binding upon this Court.
See Code § 65.2-706; Manassas Ice & Fuel Co. v. Farrar, 13 Va.
App. 227, 229, 409 S.E.2d 824, 826 (1991).
The employee was a diabetic dependent on insulin for twenty
years. While working for the employer, he tripped on a 3 by 1/2
inch bolt that protruded from the floor. The employee noted his
great toe was sore but found nothing visibly wrong. He
inspected his foot again that evening and the next morning
before returning to work, but again he found nothing wrong. The
employee regularly checked his feet and two days later observed
a black spot on the underside of his toe. The employee went to
the emergency room and advised the nurse that his toe had been
red and swollen and he "possibly hit [his] foot." He was
admitted to the hospital.
The admitting doctor, Dr. Thomas M. Alabanza, diagnosed
cellulitis, a severe infection, of the left toe. The doctor
wrote the cellulitis seemed to stem from "what appears to be a
sore at the bottom of the big toe. . . . Patient has a sore at
the bottom of [his] toe where there might have been a break in
the skin." A bone scan revealed the employee had osteomyelitis,
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inflammation of the bone. Dr. Alabanza wrote: "it is highly
unlikely for cellulitis to develop without trauma or injury.
Diabetics are not at high risk of developing cellulitis without
trauma," and trauma "is a most common cause" of cellulitis.
Dr. Cesar S. Guanzon amputated the employee's left toe. He
noted that cellulitis could develop several days after blunt
trauma and that breaking the skin is not necessary for an
infection to develop because sometimes there is an "internal
break that you can't see right away." Dr. Guanzon stated that
diabetics were prone to develop infection after blunt trauma
more often than the general population. Dr. John Harrelson, who
treated the employee after the amputation, noted the employee
experienced "no other specific foot problems until Thanksgiving
Day 1997 when he struck his foot on an iron pipe at work and
developed an ulcer over the left great toe."
The employee must prove his injury was caused by the
work-related injury. See Westmoreland Coal Co. v. Russell, 31
Va. App. 16, 19-20, 520 S.E.2d 839, 840-41 (1999). "'The actual
determination of causation is a factual finding,' and '[t]he
testimony of a claimant may . . . be considered in determining
causation, especially where the medical evidence is
inconclusive.'" Russell Stover Candies v. Alexander, 30 Va.
App. 812, 826, 520 S.E.2d 404, 411 (1999) (citations omitted).
Where the evidence, or the reasonable inferences drawn
therefrom, support the commission's findings, they will not be
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disturbed on review, even though some evidence supports a
contrary finding. See id. at 825, 520 S.E.2d at 411.
The employee had no problems with his feet before he
tripped and hit his toe at work. At first, he did not notice
any problems, but evidence proved that cellulitis could develop
several days after blunt trauma and was unlikely to occur
without trauma. The evidence also showed that diabetics were
more prone than the general population to develop infection.
The record supports the commission's finding that the employee
injured his toe at work and his diabetes aggravated the injury
to the extent of requiring amputation. Diabetes affected the
employee's recovery from the injury, but diabetes did not cause
the condition.
The employer cites Kings Market v. Porter, 227 Va. 478, 317
S.E.2d 146 (1984), and argues that mere conjecture is not
sufficient to establish a causal connection between an initial
injury and a current disability. In Porter, the employee filed
a change in condition application thirteen years after the
initial injury. The application was supported by a doctor's
opinion that she was unable to work because of the changed
condition. The Supreme Court reversed the award of benefits
because there was no proof of a causal connection between the
changed condition and the work injury. See id. at 484, 317
S.E.2d at 149. The instant case does not entail linking a
changed condition with an earlier accident. To the contrary,
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the amputation occurred within two weeks of the injury, and
medical evidence established the causal connection. The record
supports the award of benefits. Accordingly, we affirm the
award of benefits.
Affirmed.
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