Nat. Industrial, etc., et al. v Edward L. Williams

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.
*Pursuant to Code § 17-116.010 this opinion is not
designated for publication.
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

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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.