Amoco Foam Products Company v. Essie L. Johnson , 26 Va. App. 267 ( 1997 )

COURT OF APPEALS OF VIRGINIA
Present: Chief Judge Fitzpatrick, * Judges Baker and Annunziata
Argued at Alexandria, Virginia
AMOCO FOAM PRODUCTS COMPANY
OPINION BY
v. Record No. 0324-97-4 CHIEF JUDGE JOHANNA L. FITZPATRICK
DECEMBER 30, 1997
ESSIE L. JOHNSON
FROM THE VIRGINIA WORKERS' COMPENSATION COMMISSION
Benjamin J. Trichilo (Trichilo, Bancroft,
McGavin, Horvath & Judkins, P.C., on briefs),
for appellant.
Nikolas E. Parthemos (Prosser, Parthemos &
Bryant, P.C., on brief), for appellee.
Amoco Foam Products Company (employer) argues on appeal that
the Workers' Compensation Commission erred as a matter of law in
awarding benefits for an injury caused by a compensable
consequence. We disagree, and we affirm the commission.
I.
On July 14, 1992, Essie L. Johnson (claimant) sustained a
compensable left ankle injury which required a lengthy course of
treatment, including surgery by Dr. John H. Zoller on June 7,
1994. Claimant received temporary total disability benefits from
June 7 through August 25, 1994 and temporary partial disability
benefits beginning August 26 through October 19, 1994 as a result
of her ankle injury. 1
*
On November 19, 1997, Judge Fitzpatrick succeeded Chief
Judge Moon as chief judge.
1
After claimant achieved maximum medical improvement, the
parties stipulated to a 7% loss of function to the left foot.
On August 20, 1994, while recovering from the surgery,
claimant's left ankle gave way and she fell, damaging her right
knee. Dr. Zoller diagnosed her injury as internal derangement of
the right knee, and he performed an arthroscopy on November 22,
1994. The deputy commissioner awarded claimant benefits for her
knee injury, finding that "employer is responsible for this right
knee injury as a compensable consequence of the original injury."
The full commission affirmed the deputy's decision and found
that claimant's "testimony is sufficient to establish the link
between her serious ankle injury and her fall onto her knee."
This finding was not challenged.
On November 12, 1995, claimant again fell and filed a claim
seeking compensation for an additional injury to her right knee.
Dr. Zoller, in an April 9, 1996 letter, expressed his view:
I tend to think that this was largely due to
the injury of August 1994. She was having
pain at the time of November 1995 following
the injury of August 1994 and her knee
"buckled" on her. I tend to think that her
continued pain is what actually caused her to
buckle, and that this is all causily [sic]
related to the August 1994 injury.
Dr. Joseph D. Linehan examined claimant at employer's
request. He opined that claimant suffered a "degenerative
process in the right knee" and "the right knee problem is in no
way related to the sprained left ankle and its subsequent
surgery." In a May 8, 1996 letter, Dr. Linehan wrote that "the
Claimant received permanent partial disability compensation
accordingly.
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fall of November 13, 1995 is not related to the left ankle injury
of July 14, 1992."
Upon review of the evidence, the deputy commissioner gave
"great weight" to Dr. Zoller's opinion that the November 1995
fall "was caused by pain in the knee resulting from the August,
1994 accident which caused the claimant to feel that it buckled
under her." The deputy commissioner found the November 1995 knee
injury was a compensable consequence of the August 1994 knee
injury and thus a compensable consequence of the original ankle
injury.
The full commission affirmed, making the following specific
findings and conclusions:
The knee injury originally sustained on
August 20, 1994, is treated as if it occurred
in the course of and arising out of the
claimant's employment. Moreover, the
doctrine of compensable consequences is
applicable both to an aggravation of a prior
compensable injury and a new injury.
Therefore, the claimant is entitled to
benefits for disability related to her
compensable knee injury.
Dr. Zoller, the claimant's treating
physician, relates the November 12, 1995,
fall to the August 20, 1994, injury. We find
his opinion persuasive . . . . Dr. Linehan's
report, which focuses on an irrelevant issue,
was properly discounted by the Deputy
Commissioner.
II.
Viewed in the light most favorable to the claimant, who
prevailed before the commission, see Fairfax County v. Espinola,
11 Va. App. 126, 129, 396 S.E.2d 856, 858 (1990), the record
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reflects conflicting medical testimony from Dr. Zoller and Dr.
Linehan regarding the relationship between claimant's 1995 knee
injury and her ankle injury. It was Dr. Zoller's view that the
November 1995 fall and knee injury were causally related to the
August 1994 knee injury. Dr. Linehan opined that claimant
suffered from a degenerative knee process and that the November
1995 knee injury was unrelated to the original ankle injury.
"A question raised by conflicting medical opinion is a
question of fact." Department of Corrections v. Powell, 2 Va.
App. 712, 714, 347 S.E.2d 532, 533 (1986). "Decisions 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. Farrar, 13 Va. App. 227, 229, 409 S.E.2d 824,
826 (1991). "The fact that there is contrary evidence in the
record is of no consequence." Wagner Enters., Inc. v. Brooks, 12
Va. App. 890, 894, 407 S.E.2d 32, 35 (1991) (citation omitted).
See also American Filtrona Co. v. Hanford, 16 Va. App. 159, 428
S.E.2d 511 (1993). The commission gave greater weight to the
opinion of claimant's treating physician and found that her 1995
knee injury was related to her 1994 knee injury, an original
compensable consequence of the ankle injury. See Fingles Co. v.
Tatterson, 22 Va. App. 638, 641, 472 S.E.2d 646, 647 (1996)
(citing Pilot Freight Carriers, Inc. v. Reeves, 1 Va. App. 435,
439, 339 S.E.2d 570, 572 (1986)) (the opinion of a treating
physician is entitled to great weight). We therefore affirm the
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commission's finding of a causal relationship between claimant's
1995 and 1994 knee injuries. 2
The determination that the 1994 knee injury was a
compensable consequence of claimant's ankle injury is res
judicata. It is undisputed that claimant's original 1992 injury
was not the immediate cause of her 1995 injury. Consequently,
the issue before us is whether as a matter of law the commission
may award benefits for an injury caused by a compensable
consequence, or, in other words, whether a claimant may recover
for a compensable consequence of a compensable consequence.
III.
This issue is one of first impression in the Commonwealth,
but has been addressed by a sister state. In Roseburg Forest
Products v. Zimbelman, 900 P.2d 1089 (Or. Ct. App. 1995), the
Court of Appeals of Oregon considered the claim of an employee
who developed an emotional condition after suffering a
compensable injury. The stress of his emotional condition led to
a fatal heart attack. The court found that "a compensable
consequential condition is itself a compensable injury" and that
the claimant's recovery depended upon proof of causal
relationships between the first and second and the second and
third injuries. Id. at 1091. The court did not require proof
2
The commission did not specify whether claimant's 1995
injury was a new injury or an aggravation of her 1994 injury
because the doctrine of compensable consequences applies to both.
See Bartholow Drywall Co. v. Hill, 12 Va. App. 790, 407 S.E.2d 1
(1991).
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that the original work-related injury was the immediate cause of
the heart attack. Id. "[I]f the emotional condition is a
compensable injury because it is a compensable consequence of the
[work-related injury], and if the heart attack was caused in
major part by the emotional condition, then the heart attack is
compensable." Id.
In Virginia, the doctrine of compensable consequences "is
well established and has been in existence for many years."
Williams Indus., Inc. v. Wagoner, 24 Va. App. 181, 186, 480
S.E.2d 788, 790 (1997).
This doctrine, also known as the chain of
causation rule, provides that "where the
chain of causation from the original
industrial injury to the condition for which
compensation is sought is direct, and not
interrupted by any intervening cause
attributable to the employee's own
intentional conduct, then the subsequent
condition should be compensable."
Food Distribs. v. Estate of Ball, 24 Va. App. 692, 697,
485 S.E.2d 155, 158 (1997) (quoting
Leadbetter, Inc. v. Penkalski, 21 Va. App.
427, 432, 464 S.E.2d 554, 556 (1995))
(emphasis added). [W]hen the question is
whether compensability should be extended to
a subsequent injury or aggravation related in
some way to the primary injury, the rules
that come into play are essentially based
upon the concepts of direct and natural
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results, and the claimant's own conduct as an
independent intervening cause.
Williams Indus., Inc., 24 Va. App. at 186, 480 S.E.2d at 790
(citation omitted) (emphasis added). "The simplest application
of this principle is the rule that all the medical consequences
and sequelae that flow from the primary injury are compensable."
American Filtrona Co. v. Hanford, 16 Va. App. 159, 163, 428
S.E.2d 511, 513 (1993) (citation omitted) (emphasis added).
Employer contends that, because claimant failed to establish
an immediate causal relationship between the original ankle
injury and her 1995 knee injury, as a matter of law, we must
reverse the commission's award. However, employer advocates a
more narrow view of causation than that contemplated by the
enumerated principles. The phrases "chain of causation," "direct
and natural results," and "all the medical consequences and
sequelae" anticipate the possibility of more than just one event;
the doctrine of compensable consequences is not limited to merely
one immediate consequence of an industrial injury.
Compensable consequences include injuries sustained not as
an immediate result of the original injury but as a result of
some intermediate event which was itself a result of the original
injury. See Immer & Co. v. Brosnahan, 207 Va. 720, 152 S.E.2d
254 (1967) (injuries sustained in car accident while traveling to
treatment for original injury are compensable); Food Distribs.,
24 Va. App. at 699-700, 485 S.E.2d at 159 ("suicide is
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compensable if the [work-related] injury produces mental
derangement and the mental derangement produces suicide");
Imperial Trash Serv. v. Dotson, 18 Va. App. 600, 602, 445 S.E.2d
716, 718 (1994) (death was compensable where claimant "died as a
result of cardiac arrest caused by [work-related] heatstroke");
American Filtrona Co., 16 Va. App. at 164, 428 S.E.2d at 514
(employer responsible for costs of "hepatitis . . . found to have
resulted from a blood transfusion or any other medical treatment
necessitated by the original industrial injury"). See also Code
§ 65.2-605 (consequences of treatment provider malpractice are
compensable as part of the original injury). We see no reason to
deviate from these principles when the intermediate event is a
compensable consequence.
We find additional support in cases which treat the first
compensable consequence as if it were the primary injury.
"When the primary injury is shown to have
arisen out of and in the course of
employment, every natural consequence that
flows from the injury likewise arises out of
the employment, unless it is the result of an
independent intervening cause attributable to
claimant's own intentional conduct."
Imperial Trash Serv., 18 Va. App. at 606-07, 445 S.E.2d at 720
(quoting Morris v. Badger Powhatan/Figgie Int'l, Inc., 3 Va. App.
276, 283, 348 S.E.2d 876, 879 (1986)). "In other words, where a
causal connection between the initial compensable injury and the
subsequent injury is established . . . the subsequent injury is
treated as if it occurred in the course of and arising out of the
8
employee's employment." Bartholow Drywall Co. v. Hill, 12 Va.
App. 790, 794, 407 S.E.2d 1, 3 (1991) (citations omitted). This
reasoning underscores the causal connection between the primary
and consequential injuries. An employer may be held responsible
for a later injury resulting from a compensable consequence if
the claimant establishes the requisite causal relationship
between the two events.
In the instant case, the evidence established that
claimant's 1995 knee injury was causally related to her 1994 knee
injury which was causally related to her initial ankle injury.
This chain of causation is direct and natural, and there is no
evidence of any intervening cause attributable to claimant's
conduct. Furthermore, claimant's 1994 compensable consequence
knee injury becomes a primary injury, and the injury it caused in
1995 is clearly a compensable consequence of it. We hold that
claimant's November 1995 knee injury is a compensable consequence
of her 1994 knee injury and of her 1992 ankle injury. For the
foregoing reasons, we affirm the commission.
Affirmed.
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