Nat. Industrial, etc. v. Edward L. Williams ( 1996 )


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  •                      COURT OF APPEALS OF VIRGINIA
    Present: Judges Willis, Fitzpatrick and Overton
    Argued at Salem, Virginia
    NATIONAL INDUSTRIAL CONSTRUCTORS, INC. AND
    CONTINENTAL CASUALTY COMPANY
    v.          Record No. 2009-95-3         MEMORANDUM OPINION * BY
    JUDGE NELSON T. OVERTON
    EDWARD LEE WILLIAMS                           MAY 14, 1996
    FROM THE VIRGINIA WORKERS' COMPENSATION COMMISSION
    Monica L. Taylor (Dale W. Webb; Gentry,
    Locke, Rakes & Moore, on brief), for
    appellants.
    Richard M. Thomas (Rider, Thomas, Cleaveland,
    Ferris & Eakin, on brief), for appellee.
    National Industrial Constructors and its insurer
    (collectively "National") appeal the decision of the Workers'
    Compensation Commission awarding benefits to the claimant, Edward
    Lee Williams.    National contends that the commission erroneously
    found that the treating physician gave a medical opinion linking
    Williams' injury with his work.    Finding no error, we affirm the
    commission's award.
    The parties are fully conversant with the record, and we
    recite only those facts necessary to the disposition of this
    appeal.
    The dispute arises over the language in the treating
    physician's medical report. The doctor opined in relevant part:
    The patient raises the question of a
    *
    Pursuant to Code § 17-116.010 this opinion is not
    designated for publication.
    relationship between his left elbow
    epicondylitis and the ongoing problems he has
    had with his right elbow, all along. . . .
    It is his opinion that he is attempting to
    guard overall use of his right elbow and
    therefore putting more pressure and strain on
    the left elbow, causing that elbow to become
    more problematic. I feel there clearly is
    some merit in his opinion regarding this.
    Again, there is not one episode of injury
    that has produced this problem, it was more
    an overuse effort over a period of time that
    produced this epicondylitis.
    The full commission found that this phrasing indicated that the
    doctor had adopted the opinion of the claimant that his current
    condition in his left elbow was related to a prior work-related
    injury in his right elbow.   Because of this medical opinion, the
    commission awarded benefits.
    "When the primary injury is shown to have risen 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. v.
    Dotson, 
    18 Va. App. 600
    , 606-07, 
    445 S.E.2d 716
    , 720 (1994)
    (quoting Morris v. Badger Powhatan/Figgie Int'l, Inc., 
    3 Va. App. 276
    , 283, 
    348 S.E.2d 876
    , 879 (1986)); 1 A. Larson, The Law of
    Workmen's Compensation § 13.00 (1995).    The claimant must
    demonstrate that his present injury flows from the primary injury
    to a reasonable degree of medical certainty, a standard that
    would require the doctor to conclude that it is more probable
    than not.    See Ross Lab. v. Barbour, 
    13 Va. App. 373
    , 377, 412
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    S.E.2d 205, 208 (1991).   The exact words used to articulate this
    conclusion hold little significance, if in the correct context
    they express sufficient medical certainty.    Wells v. Virginia
    Dep't of Transp., 
    15 Va. App. 561
    , 565, 
    425 S.E.2d 536
    , 538-39
    (1993).
    In this case the doctor ultimately agreed with the claimant
    and adopted the conclusion that the claimant's current condition
    was a natural result of his earlier injury.   The doctor offered
    no other possible cause for the current condition and cast no
    doubt upon the claimant's theory.   The commission did not err in
    finding that, in the context of this report, the doctor's
    language evinced a belief in causation to a reasonable degree of
    medical certainty.
    Accordingly, the decision is affirmed.
    Affirmed.
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