concurring.
I concur in the portion of the majority opinion addressing the sufficiency of the commission’s order. I also agree with the majority that the circuit court erred in reversing the commission. I write separately to address what I believe is the basis of the circuit court’s ruling that Investigator Martinez’ employment conditions were extraordinary and unusual. The circuit court did not rule on the basis of a lack of substantial evidence supporting the commission’s factual finding. Rather, the circuit court reversed the commission on a question of law, finding the commission “failed to conduct the proper analysis.” I also write to explain that the circuit court erred in reversing the commission’s finding of a lack of proximate cause.
A. “Unusual or Extraordinary” Conditions of Employment
The circuit court reversed the commission’s determination that Investigator Martinez’ stressful employment conditions were not extraordinary and unusual based on a point of law, not based on the sufficiency of the evidence. In the introductory section of the order, before even describing the facts, the circuit court stated “the decision of this Court is that the Order from the Full Commission should be reversed because the analysis ... is flawed by misapplying, as a matter of law, the ‘unusual or extraordinary conditions of employment’ test for determining compensability of mental injuries.” (emphasis added). The circuit court made several other statements that it was ruling on a point of law and ultimately concluded: “The Commission’s Order in the present case is void of [the analysis required by Doe v. SCDDSN4] and, therefore, as a matter of law, is reversed.” The circuit court never mentioned the substantial evidence standard nor even attempted to explain that the evidence was not sufficient to support the commission’s decision. As Appellant stated in its brief, “the Circuit *236Court never addressed the Commission’s findings of fact and never determined whether the findings were supported by substantial evidence.” Rather, the circuit court ruled that the commission committed a legal error in its analysis of whether Investigator Martinez’ conditions of employment were extraordinary and unusual.
The circuit court erred in reversing the commission on this point of law. Its ruling is based on a misapplication of the reasoning of Doe to the facts of this case. The only aspect of Investigator Martinez’ employment conditions alleged to be extraordinary and unusual is the nature and character of the April 4, 2005 investigation. Otherwise, there is no suggestion that she encountered anything extraordinary or unusual in her work. Specifically, Investigator Martinez does not allege any change in her employment conditions over the long term.
Doe, on the other hand, was based on a change in the claimant’s long-term employment conditions. The claimant in Doe was employed by the South Carolina Department of Disabilities and Special Needs as a licensed practical nurse. 377 S.C. at 348, 660 S.E.2d at 261. After she worked there for approximately eighteen years, the Department began to make changes in the operation of her facility, resulting in a dramatic increase in the level of noise and violence in her unit. Id.
As a result [of the changes], the patient population in Claimant’s unit changed from being a passive group to a mixed group of passive and aggressive patients. The record indicates Claimant’s unit went from being “a fairly pleasant unit to work in” to being “kind of a dumping ground” where none of the other nurses wanted to work.
Id. The supreme court found that the conditions of the claimant’s employment were extraordinary and unusual as a result of the changes at her facility. The supreme court discounted the fact that many of the individual incidents in the claimant’s new environment were the same as before and focused on what was different about the new environment. The court stated:
The record indicates that in the spring of 1997, with the new mix of passive and aggressive patients in Claimant’s unit, behavior problems escalated because of the “domino effect” created when an aggressive patient acted out. *237Claimant had never before worked with a mix of passive and aggressive patients. No other unit had a mix of passive and aggressive patients. In fact, Department made changes after a DHEC survey criticized Department for housing diverse patients together.
377 S.C. at 350, 660 S.E.2d at 262.
The supreme court faulted the commission and the court of appeals for focusing on the fact that nurses had always dealt with aggressive patients and had even been injured by them before. Id. Thus, the supreme court rejected an analysis of similarities in individual incidents and focused instead on the differences caused by changes in long-term conditions. Id. (“A review of the record, however, indicates that the testimony [of similarities in individual incidents] relied upon is taken completely out of context and does not support the Court of Appeals’ conclusion.”). Focusing on the changes in overall, long-term employment conditions, the supreme court noted that neither of the two witnesses relied on by the court of appeals testified “that it was usual for a nurse to deal with a mix of passive and aggressive patients.” 377 S.C. at 350-51, 660 S.E.2d at 262 (emphasis added). The supreme court found the overall, long-term changes in employment conditions resulting in a “mix of passive and aggressive patients” was an extraordinary and unusual condition of employment which caused the claimant’s mental-mental injury and instructed the commission to award benefits. 377 S.C. at 351-52, 660 S.E.2d at 262-63.
Here, the commission applied the proper test for determining whether Investigator Martinez’ conditions of employment were extraordinary and unusual. See Shealy v. Aiken Cnty., 341 S.C. 448, 459, 535 S.E.2d 438, 444 (2000) (holding the standard to be applied is whether the conditions of employment were extraordinary or unusual compared to the normal conditions of claimant’s employment); see also Doe, 377 S.C. at 349-50, 660 S.E.2d at 262 (discussing Shealy). The commission described some of the investigations which “were a usual and ordinary part of [Investigator Martinez’] job.” Those investigations included one “in which a child’s head had been run over by a dump truck” and “an automobile accident in which an injured teenager had died in her arms.” The majority described other similar investigations conducted by *238Investigator Martinez. Describing how she conducted investigations such as those, the commission made this factual finding:
7. When claimant went to a crime scene, she would take up to 100 photographs and move the body to investigate anything underneath the body. She also took measurements and put up barriers to prevent people from seeing the accident scene. This was a part of her usual and ordinary job.
The commission then focused on whether what she did on April 4, 2005, was extraordinary and unusual compared to her usual and ordinary job and made this factual finding:
10. [Captain] Steve Denton testified that the accident scene of the child’s death on April 4, 2005 was a terrible sight but that Claimant was doing her ordinary job that day in investigating the death of the child. [Captain] Denton required the Claimant to stay and perform the accident investigation because that was her job. The fact that the death scene involved the death of a child of a former Spartanburg County Deputy Sheriff did not remove the situation from being a part of her regular job.
In Doe, the supreme court ruled that despite the similarities in individual incidents, there were changes in the overall, long-term conditions of the claimant’s employment, making the conditions which caused the injury extraordinary and unusual. 377 S.C. at 349-50, 660 S.E.2d at 262. Here, Investigator Martinez does not argue that there were any long-term changes. Rather, she argues that her mental-mental injury arose out of a single investigation. When she finished this particular investigation, she continued working on the same type of cases in the same manner as before. Had she been switched to an overall pattern of investigating only particularly traumatic cases, then perhaps the reasoning of Doe would apply. Under these facts, however, it does not.
Finally, I emphasize that one particular event in a claimant’s work environment can constitute extraordinary and unusual conditions such that any resulting mental-mental injury would be compensable. See, e.g., Powell v. Vulcan Materials Co., 299 S.C. 325, 326, 384 S.E.2d 725, 725 (1989) (affirming commission’s award of benefits where claimant suffered “men*239tal, emotional, and psychological injury” following a single-incident verbal altercation vrith a supervisor). In such a case, however, whether the individual event meets the test for extraordinary and unusual set forth by the supreme court in Shealy is a question of fact for the commission to decide. On appeal from the commission’s decision, if substantial evidence supports it, an appellate court must affirm. Forrest v. A.S. Price Mech., 373 S.C. 303, 306, 644 S.E.2d 784, 785-86 (Ct. App.2007). In this case, the circuit court never ruled as to whether substantial evidence supports the commission’s decision that Investigator Martinez’ conditions of employment were not extraordinary and unusual. As the majority has explained, the commission’s decision is supported by substantial evidence.
B. Proximate Cause
The circuit court also reversed the commission’s finding of a lack of proximate cause. The circuit court stated:
[T]he Commission’s finding [as to proximate cause] is clearly erroneous, applying the substantial evidence standard of review, because the only conclusion that can be drawn from the medical information is that there exists the necessary showing of proximate cause to link the accident investigation of her friend’s child’s death and her mental breakdown.
In making this statement, the circuit court ignored the following findings of fact made by the commission:
8. Claimant had other stressors in April 2005 that were not work related, including the death from AIDS of her ex-husband’s cousin with whom she was very close. Claimant was treated for anxiety, insomnia, and depression from these non-work related situational stressors including medications and hospitalization.
9. Claimant did not mention the investigation involving the death of a child on April 4, 2005 until approximately four months later after being hospitalized for an emotional breakdown.
16. Claimant failed to prove that the accident investigation on April 4, 2005 was the proximate cause of her mental breakdown, said finding being based on all the evidence in the record.
*240The record contains ample evidence to support these findings. For example, on April 19, 2005, two weeks after Investigator Martinez’ investigation into the death of her fellow officer’s child, she went to her family doctor for stress. In the medical note for that visit, the doctor wrote:
She is very upset and crying. A very close friend and relative, a cousin with whom she was very close over the years, passed away yesterday. She is very upset about it. They were very close ever since they were little kids. She is very upset that she did not get to the hospital in time to say goodbye before he passed away.
Investigator Martinez returned to her family doctor on eight occasions between April 25 and June 24, 2005, and did not mention stress from the April 4 investigation even once. On August 7, 2005, Investigator Martinez was admitted to Spartanburg Regional Medical Center for “behavior suggesting psychiatric problems.” Her treating psychiatrist diagnosed her with Benzodiazepine withdrawal delirium, depression, and anxiety disorder. In the discharge summary on August 9, 2005, the psychiatrist stated: “The patient apparently had recent problems with uncontrollable hypertension and also had problems with anxiety, insomnia and depression related to the death of her best friend who apparently was a male cousin.” Martinez was admitted to the Carolina Center for Behavioral Health for a psychiatric evaluation on August 10, 2005. One of the forms filled out for this admission contains a section entitled “Precipitating Events,” in which it is noted that Martinez stated: “My cousin died mid April 2005 and I took Xanax for my nerves. I stopped taking Xanax 1-2 weeks ago and became psychotic.”
These medical records contain no mention of the April 4, 2005 investigation or any other job-related stress. In light of these facts, the commission’s determination that the claimant failed to prove proximate cause is supported by substantial evidence. The circuit court erred in reversing the finding.
. Doe v. S.C. Dep’t of Disabilities & Special Needs, 377 S.C. 346, 660 S.E.2d 260 (2008).