COURT OF APPEALS OF VIRGINIA
Present: Chief Judge Moon, Judge Coleman and Senior Judge Cole
Argued at Richmond, Virginia
WAL-MART STORES, INC. AND
INSURANCE COMPANY OF THE STATE
OF PENNSYLVANIA
MEMORANDUM OPINION * BY
v. Record No. 2196-96-2 JUDGE SAM W. COLEMAN III
APRIL 29, 1997
CAROLYN R. RICHARDS
FROM THE VIRGINIA WORKERS' COMPENSATION COMMISSION
Monica L. Taylor (Christopher M. Kite;
Gentry, Locke, Rakes & Moore, on brief),
for appellants.
C. Waverly Parker for appellee.
Wal-Mart Stores, Inc. and its insurer (employer) contend
that the Workers' Compensation Commission erred in finding that
the claimant's somatoform pain disorder and anxiety disorder were
causally related to her injury by accident. Finding no error, we
affirm the commission's award.
On appeal, we view the evidence in the light most favorable
to the prevailing party. R.G. Moore Bldg. Corp. v. Mullins, 10
Va. App. 211, 212, 390 S.E.2d 788, 788 (1990). So viewed, the
evidence proves that, shortly after reporting to work on March
28, 1995, the claimant slipped and fell on a heavily waxed floor,
injuring her right shoulder and back.
Dr. Robert Brown, an internist and psychiatrist, diagnosed
*
Pursuant to Code § 17-116.010 this opinion is not
designated for publication.
the claimant as suffering from an anxiety disorder and a
somatoform pain disorder, a condition in which the patient has
more complaints of pain than can be accounted for by physiologic
parameters. Dr. Brown opined that the claimant's anxiety
disorder was caused by the March 1995 accident and that her
somatoform pain disorder was a preexisting condition, but that it
worsened as a result of the March 1995 accident and her physical
injuries. Based on the claimant's reports of "passing out" and
feeling "woozy-like," Dr. Brown assumed that the claimant had
suffered a closed head injury as a result of her fall. However,
he testified that "[e]ven if we take the head injury completely
away, we've got a lady with a somatoform pain disorder . . . . I
think she's disabled by A, which is the somatoform pain disorder.
I think she's disabled by B, which is the anxiety disorder."
Dr. James L. Levenson, who conducted an independent medical
examination at the employer's request, agreed that the claimant
suffered from a somatoform pain disorder and an anxiety disorder.
However, because he could not find any evidence of a head injury
and because her disorders predated her accident, Dr. Levenson
concluded that the March 1995 accident did not cause her
psychological condition.
The commission held that the claimant's anxiety disorder and
the aggravation of her somatoform pain disorder were caused by
the injuries she sustained in the accident. The commission
relied on Dr. Brown's opinion and held that whether the claimant
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had a head injury was not significant because Dr. Brown's opinion
regarding causation was not based on the claimant sustaining a
head injury. Furthermore, Dr. Levenson's opinion did not address
whether the claimant's physical injuries had aggravated her
preexisting psychological problems.
In order to establish entitlement to workers' compensation
benefits, a claimant must prove by a preponderance of the
evidence a causal connection between a work-related accident and
the injury. Classic Floors, Inc. v. Guy, 9 Va. App. 90, 95, 383
S.E.2d 761, 764 (1989). "The actual determination of causation
is a factual finding that will not be disturbed on appeal if
there is credible evidence to support the finding." Ingersoll-
Rand Co. v. Musick, 7 Va. App. 684, 688, 376 S.E.2d 814, 817
(1989). However, "the standards required to prove causation and
whether the evidence is sufficient to meet those standards are
legal issues which [the appellate court] must determine."
Hercules, Inc. v. Gunther, 13 Va. App. 357, 361, 412 S.E.2d 185,
187 (1991).
Credible evidence in the record supports the commission's
award. Dr. Brown's testimony that the claimant's anxiety
disorder was caused by her March 1995 fall and that her
preexisting somatoform pain disorder was aggravated by the fall
and her physical injuries constitutes sufficient credible
evidence to support the commission's decision. "Questions raised
by conflicting medical opinions must be decided by the
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commission." Penley v. Island Creek Coal Co., 8 Va. App. 310,
318, 381 S.E.2d 231, 236 (1989). "The fact that there is
contrary evidence in the record is of no consequence if there is
credible evidence to support the commission's finding." Wagner
Enters., Inc. v. Brooks, 12 Va. App. 890, 894, 407 S.E.2d 32, 35
(1991).
The employer contends that Dr. Brown's opinion as to
causation should be disregarded because he based it on the faulty
assumption that the claimant suffered a closed head injury as a
result of her fall. See Sneed v. Morengo, Inc., 19 Va. App. 199,
204, 450 S.E.2d 167, 171 (1994) ("Whenever a physician's
diagnosis flows from an assumption that rests upon a faulty
premise, such as misinformation provided by a claimant, the
commission may refuse, and often will be required to refuse, to
attribute any weight to that opinion."). However, the commission
found that Dr. Brown's opinion regarding causation of the
somatoform pain and anxiety disorders was not based upon the
claimant sustaining a head injury. Although he stated that the
head injury was significant, he testified that it was not the
sole factor, or a necessary factor, in his finding that the
claimant's March 1995 accident aggravated her psychological
conditions. Therefore, Dr. Brown's opinion is not based upon a
faulty premise and his opinion is credible evidence upon which
the commission was entitled to base its decision.
Accordingly, we affirm the commission's award.
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Affirmed.
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