Dinwiddie Custodial v. Lois J Ferrell ( 2003 )


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  •                         COURT OF APPEALS OF VIRGINIA
    Present: Chief Judge Fitzpatrick, Judges Benton and Kelsey
    Argued at Richmond, Virginia
    DINWIDDIE (COUNTY OF) CUSTODIAL AND
    VIRGINIA MUNICIPAL GROUP
    SELF-INSURANCE ASSOCIATION
    MEMORANDUM OPINION * BY
    v.   Record No. 1518-02-2                    JUDGE D. ARTHUR KELSEY
    FEBRUARY 11, 2003
    LOIS J. FERRELL
    FROM THE VIRGINIA WORKERS' COMPENSATION COMMISSION
    Ralph L. Whitt, Jr. (Michael P. Del Bueno;
    Whitt & Associates, on briefs), for
    appellants.
    B. Mayes Marks, Jr. (Marks and Williams,
    P.C., on brief), for appellee.
    The Workers' Compensation Commission awarded Lois Ferrell
    benefits for physical and psychological injuries arising as a
    compensable consequence of an earlier injury by accident.       On
    appeal, the employer and its insurance carrier claim Ferrell's
    psychological injuries cannot be fairly traced to her injury by
    accident.       Finding that the commission's causation ruling rests
    on credible evidence, we affirm.
    *
    Pursuant to Code § 17.1-413, this opinion is not
    designated for publication.
    I.
    On appeal, "we view the evidence in the light most
    favorable to the prevailing party" before the commission.          Tomes
    v. James City (County Of) Fire, 
    39 Va. App. 424
    , 429, 
    573 S.E.2d 312
    , 315 (2002); Grayson County Sch. Bd. v. Cornett, 
    39 Va. App. 279
    , 281, 
    572 S.E.2d 505
    , 506 (2002).
    In 1990, Ferrell's abusive husband held Ferrell, her
    daughter, and her grandchildren hostage at gunpoint.      Ferrell's
    daughter struggled with him and, in the process, fatally shot him.
    Despite witnessing this traumatic event, for the next ten years
    Ferrell led a "relatively normal lifestyle."      She remained
    consistently employed and did not seek out or receive any
    psychological treatment.
    In 2000, Ferrell worked for Dinwiddie County as a custodian
    at the Dinwiddie Courthouse.   On April 26, 2000, she was buffing a
    floor in the courthouse when the buffer "jerked and swung her into
    a wall and a table countertop striking her right side."      As a
    result, Ferrell sustained an injury to her neck and right arm.
    The parties stipulated that Ferrell's physical injuries were
    compensable.
    The physical injuries caused Ferrell to be out of work until
    June 29, 2000, and resulted in continuing treatment by various
    physicians through at least May 2001.       During that time she
    underwent surgery for a "significant lunotriquetral ligament tear"
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    in her right wrist and received continuing pain management for an
    unresolving neck sprain and myofascial pain.
    On July 20, 2000, Ferrell's treating physician, Dr. Kathryn
    Holloway, noticed that Ferrell appeared very depressed.     She
    referred Ferrell to Dr. P. Jagan Reddy, a psychiatrist.     On August
    9, Dr. James Carr, an orthopedic physician treating Ferrell's
    wrist injury, also "noted that her post-injury treatment was
    complicated by her depression."
    Ferrell consulted Dr. Reddy on August 21, 2000.     Dr. Reddy
    diagnosed Ferrell "as suffering from major depression and
    post-traumatic stress disorder [PTSD] as a result of the
    compensable injury."   Dr. Reddy noted that Ferrell "was having
    problems dealing with the pain from her injury, she was not
    sleeping well and she had no money to support herself."     Ferrell
    was also having "anxiety attacks" and was "losing control of [her]
    bladder."   Dr. Reddy took Ferrell off light duty status,
    recommending that she not work in any capacity.
    On August 21, 2000, Dr. Reddy admitted Ferrell to Poplar
    Springs Hospital for major depression and severe PTSD.    Poplar
    Springs discharged Ferrell on September 8, 2000, and Dr. Reddy
    continued treating Ferrell through at least June 2001.    Dr. Reddy
    has "never released her to work in any capacity."
    Based on continuing complaints of pain, in April 2001,
    Ferrell was referred to Dr. Daniel C. Martin, an anesthesiologist
    -   3   -
    who practices "interventional pain management."   Dr. Martin
    diagnosed Ferrell with "chronic pain syndrome, sympathetically
    maintained pain of the right upper extremity and depression."     He
    testified that Ferrell not only has "anatomically correct
    complaints, but she also has multiple other confounding
    psychological problems that would make her response to even
    appropriate therapy indiscernible or not discernable to the
    patient."
    Ferrell filed her initial claim for benefits with the
    commission on August 1, 2000.   She later withdrew her claim,
    resulting in a dismissal without prejudice.   On February 8, 2001,
    Ferrell filed an "Application for Hearing/Claim for Benefits" with
    the commission, but this application, likewise, was dismissed
    without prejudice when the employer submitted forms agreeing to
    pay temporary total and partial disability payments.   In April
    2001, Dinwiddie filed an application for hearing alleging that
    Ferrell "failed to cooperate with vocational rehabilitation
    efforts" relating to her physical injuries and requesting that the
    commission "adjudicate the issue of whether Ferrell's alleged
    psychological disability was causally related to her April 26,
    2000 incident."   The matter was heard by the deputy commissioner
    on September 5, 2001.
    Dr. Reddy testified by deposition that he was aware of the
    hostage incident and shooting death of Ferrell's husband ten years
    -   4   -
    earlier and he "admitted that such a trauma could certainly
    produce post-traumatic stress disorder."      He attributed her
    current condition, however, to the April 26 accident stating "that
    the significance of any event and its effect on a person is
    dictated by their action after the event."      He noted that Ferrell
    "spent nearly eleven years" after the hostage incident "conducting
    a relatively normal lifestyle."      Dr. Reddy concluded "that there
    had to be a triggering event that caused her major depression and
    post-traumatic stress disorder and he stated that for the claimant
    the triggering event was the injury on April 26, 2000."
    On August 13, 2001, at her employer's request, Ferrell
    submitted to a psychiatric examination by Dr. Daniel E. Knowler.
    Dr. Knowler found Ferrell to have "significant symptoms of a
    depressive illness" and stated that the "traumatic nightmares and
    memories that were stirred would have appropriately been diagnosed
    as a PTSD with delayed onset."       Though Dr. Knowler did not think
    that the PTSD revealed symptoms "from the recent injuring event,"
    he concluded that "the injuries sustained by Mrs. Ferrell set off
    a cascade of events that have led to her current depressive
    symptoms."
    The deputy commissioner found these causation opinions of
    Dr. Reddy and Dr. Knowler to be credible and persuasive.      Noting
    the axiom that "the employer takes the employee as it finds her,"
    see Williams Indus., Inc. v. Wagoner, 
    24 Va. App. 181
    , 187-88, 480
    -   5   -
    S.E.2d 788, 791 (1997), the deputy commissioner concluded that the
    injury on April 26, 2000, "'triggered,' 'set off a cascade of
    events,' 'contributed,' or 'caused' the claimant's psychological
    problems."    The full commission concurred with this finding and
    affirmed the award for permanent, partial disability and medical
    benefits for Ferrell's PTSD and depression.
    II.
    On appeal, we defer to the commission in its role as fact
    finder.     VFP, Inc. v. Shepherd, 
    39 Va. App. 289
    , 292, 
    572 S.E.2d 510
    , 511-12 (2002).    If supported by credible evidence, the
    commission's factual findings are "binding on appeal," Tomes, 
    39 Va. App. at 430
    , 
    573 S.E.2d at 315
     (citation omitted), "even
    though there is evidence in the record to support a contrary
    finding."     S.P. Terry Co., Inc. v. Rubinos, 
    38 Va. App. 624
    ,
    632, 
    567 S.E.2d 584
    , 588 (2002).
    When "determining whether credible evidence exists," we
    cannot "retry the facts, reweigh the preponderance of the
    evidence, or make [our] own determination of the credibility of
    the witnesses."     Wagner Enters. v. Brooks, 
    12 Va. App. 890
    , 894,
    
    407 S.E.2d 32
    , 35 (1991).    In addition, the commission's
    "conclusions upon conflicting inferences, legitimately drawn
    from proven facts, are equally binding on appeal."     Watkins v.
    Halco Eng'g, Inc., 
    225 Va. 97
    , 101, 
    300 S.E.2d 761
    , 763 (1983).
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    Absent the need for statutory interpretation or other
    exposition of legal principle, the "actual determination of
    causation" constitutes a finding of fact.       K&G Abatement Co. v.
    Keil, 
    38 Va. App. 744
    , 756-57, 
    568 S.E.2d 416
    , 422 (2002) (quoting
    Ingersoll-Rand Co. v. Musick, 
    7 Va. App. 684
    , 688, 
    376 S.E.2d 814
    ,
    817 (1989)) (internal quotations omitted).       This is particularly
    true when the commission's opinion rests on the results of a
    medical diagnosis.    See, e.g., Caskey v. Dan River Mills, Inc.,
    
    225 Va. 405
    , 411, 
    302 S.E.2d 507
    , 510 (1983).
    III.
    A.
    In its opening brief, Dinwiddie devotes much of its argument
    to the assertion that "there is no credible evidence that Ferrell
    suffers from PTSD" and that the facts "do not support the
    diagnosis of PTSD."   At oral argument, however, Dinwiddie withdrew
    this contention and challenged only the sufficiency of the
    commission's finding of causation.
    To be compensable, a psychological injury must be "causally
    related to a physical injury or to a sudden shock or fright
    arising in the course of employment."        Owens v. Virginia Dept. of
    Transp., 
    30 Va. App. 85
    , 88, 
    515 S.E.2d 348
    , 349 (1999); see also
    Anthony v. Fairfax County Dept. of Family, 
    36 Va. App. 98
    , 
    548 S.E.2d 273
     (2001).    Under the compensable consequences doctrine,
    when the "primary injury is shown to have arisen out of and in the
    -    7   -
    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)) (internal quotations marks
    omitted).   The issue "is essentially one of whether the medical
    evidence proves a causal connection between the primary injury and
    the subsequent occurrence."    Williams Indus., Inc., 24 Va. App.
    at 188, 480 S.E.2d at 791; see also Leonard v. Arnold, 
    218 Va. 210
    , 214, 
    237 S.E.2d 97
    , 100 (1977). 1
    In this case, Dinwiddie focuses on the PTSD condition and
    largely overlooks the parallel evidence demonstrating Ferrell's
    major depression diagnosis.   Though closely related, however,
    major depression and PTSD represent clinically different
    psychiatric diagnoses.
    Three physicians treating Ferrell's physical injuries
    (Dr. Holloway, Dr. Carr, and Dr. Martin) noted Ferrell's
    1
    "Where a psychological injury is at issue, the fact that
    the condition manifests itself symptomatically at a time later
    than that at which the causative incident occurred is of no
    moment, provided that circumstances show an 'identifiable
    incident [occurring] at a reasonably definite time' which causes
    the emotional injury." Hercules, Inc. v. Gunther, 
    13 Va. App. 357
    , 364, 
    412 S.E.2d 185
    , 189 (1991) (quoting Morris v. Morris,
    
    238 Va. 578
    , 589, 
    385 S.E.2d 858
    , 865 (1989)).
    -   8   -
    depression.   Both Ferrell's treating psychiatrist as well as the
    psychiatrist hired by the appellants (Dr. Reddy and Dr. Knowler)
    observed her to have "significant symptoms" of "major depression."
    These medical opinions cannot be dismissed as "inherently
    incredible" or "inconsistent with other facts in the record."
    Hercules, Inc. v. Gunther, 
    13 Va. App. 357
    , 361, 
    412 S.E.2d 185
    ,
    187 (1991).
    On the causation issue, Dr. Reddy and Dr. Knowler both linked
    Ferrell's depression to her physical injuries and, by extension,
    to the April 26, 2000 accident.    Dr. Reddy stated that the
    accident was the "triggering event that caused her major
    depression," while Dr. Knowler stated that the injuries Ferrell
    suffered in the accident "set off a cascade of events that have
    led to her current depressive symptoms."
    With respect to the PTSD diagnosis, Dr. Knowler agreed that
    the "traumatic nightmares and memories that were stirred would
    have appropriately been diagnosed as a PTSD with delayed onset."
    Dr. Reddy addressed the causation issue, finding that Ferrell
    suffered from PTSD "as a result of the compensable injury" and
    that the injury "triggered" the PTSD.      Accepting this opinion, the
    commission held:   "It is clear that the injury of April 26, 2000,
    was the triggering event which caused and/or contributed to the
    claimant's psychological problems."
    -   9   -
    Viewed in the light most favorable to Ferrell, credible
    evidence supports the commission's finding that Ferrell suffers
    both from major depression and PTSD —— two related, but distinct,
    compensable consequences caused by the April 26, 2000 accident.
    B.
    Ferrell requests that we award attorney fees to her under
    Code § 65.2-713(A), which grants us the authority to assess
    against Dinwiddie "the whole cost" of these proceedings "including
    a reasonable attorney's fee" if we find that these "proceedings
    have been brought, prosecuted, or defended without reasonable
    grounds."   See, e.g., Lowes of Short Pump Virginia v. Campbell, 
    38 Va. App. 55
    , 62, 
    561 S.E.2d 757
    , 760 (2002) (awarding fees against
    employer for appealing "without reasonable grounds").          The actual
    calculation of such costs, if awarded, should be "fixed by the
    Commission."   Code § 65.2-713(A).
    We find this an appropriate case for a partial award of costs
    and fees.   A significant portion of Dinwiddie's brief contested
    the legitimacy of Dr. Reddy's diagnosis of PTSD.          In its opening
    brief, however, Dinwiddie failed to mention that the physician it
    hired to perform an independent medical exam, Dr. Knowler, agreed
    with Dr. Reddy's PTSD diagnosis.           Though Dinwiddie rightly
    conceded away this issue at oral argument, the concession came too
    late to save Ferrell the costs of briefing the issue and preparing
    to refute it at oral argument.       On the question whether credible
    -   1 0    -
    facts support Ferrell's PTSD diagnosis, we hold that Dinwiddie
    challenged the commission's findings on appeal without reasonable
    grounds.   We remand this matter to the commission to assess a fair
    proportion of Ferrell's costs and fees, related to the PTSD
    diagnosis issue, against Dinwiddie pursuant to Code § 65.2-713(A).
    IV.
    In sum, credible evidence supports the commission's factual
    findings in this case.   We thus affirm the commission and remand
    for assessment of costs and reasonable attorney's fees.
    Affirmed.
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