CW/Central VA Training Center v Dorothy M. Cordle

COURT OF APPEALS OF VIRGINIA
Present: 	Judges Willis, Elder and Annunziata
Argued at Richmond, Virginia
COMMONWEALTH OF VIRGINIA/
CENTRAL VIRGINIA TRAINING CENTER
OPINION BY
v. 	Record No. 0458-01-2 	JUDGE JERE M. H. WILLIS, JR.
DECEMBER 18, 2001
DOROTHY McGEE CORDLE
FROM THE VIRGINIA WORKERS' COMPENSATION COMMISSION
Scott John Fitzgerald, Assistant Attorney
General (Mark L. Earley, Attorney General;
Judith Williams Jagdmann, Deputy Attorney
General; Gregory E. Lucyk, Senior Assistant
Attorney General; Catherine Crooks Hill,
Assistant Attorney General, on brief), for
appellant.
Craig B. Davis (Geoffrey R. McDonald &
Associates, on brief), for appellee.
The Central Virginia Training Center and the Commonwealth
of Virginia (jointly referred to as "employer") appeal a
decision of the Workers' Compensation Commission awarding
benefits to Dorothy McGee Cordle for aggravation of an earlier
compensable knee injury. 	The employer contends that the
commission erred in holding that Cordle's October, 1999 injury
was a compensable consequence or change in condition of her
August, 1998 compensable knee injury. 	It argues that the
medical evidence failed to prove a causal connection between the
two injuries. 	We affirm the commission's decision.

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I. 	BACKGROUND
On appeal, "[d]ecisions 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. Federated
Mutual Ins. Co., 13 Va. App. 227, 229, 409 S.E.2d 824, 826
(1991) (citing Code § 65.1-98; McCaskey v. Patrick Henry Hosp.,
225 Va. 413, 415, 304 S.E.2d 1, 2 (1983)).1 "The fact that
contrary evidence may be found in the record is of no
consequence if credible evidence supports the commission's
finding." 	Id. (citing Russell Loungewear v. Gray, 2 Va. App.
90, 95, 341 S.E.2d 824, 826 (1986)). 	We view the evidence in
the light most favorable to the party prevailing below. 	Creedle
Sales Co. v. Edmonds, 24 Va. App. 24, 26, 480 S.E.2d 123, 124
(1997).
A. 	THE INJURIES
On August 14, 1998, while working at the Central Virginia
Training Center, Cordle injured her left knee when she caught a
falling patient. 	On August 24, 1998 Dr. Gautham Gondi diagnosed
a symptomatic plica, chondromalacia of the patella, and lateral
patellofemoral compression syndrome. 	On September 23, 1998 he
also diagnosed a medial meniscal tear. 	On September 28, 1998
Dr. Gondi released Cordle to regular work. 	Cordle stated that
1 Code § 65.1-98 was recodified in 1991. 	The present
provision can be found at Code § 65.2-706.

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her knee was much better at that time and denied any giving way
or buckling. 	Nevertheless, she continued to experience some
discomfort. 	Her last medical treatment for that injury was in
December, 1998 or January, 1999.
On October 21, 1999, Cordle's knee popped and buckled as
she carried a mop and bucket up a stairway. 	She fell to the
floor. 	She went to the emergency room and returned to
Dr. Gondi's care.
During examination by Dr. Gondi, Cordle described the pain
as different from the pain she had experienced in August, 1998.
Although it was in the same location, it was more severe, and
she was unable to walk. 	Dr. Gondi diagnosed left knee
patellofemoral chondromalacia and bilateral patellofemoral
compression syndrome. 	He reported that "[the] event that she
describes from October 21, 1999 did cause an aggravation of her
previous left knee injury. 	It was not a new diagnosis, but it
was a new event." 	On December 21, 1999, he returned Cordle to
medium work with restrictions.
On January 12, 2000, after the employer denied her
benefits, Cordle stopped treating with Dr. Gondi. 	She began
seeing Dr. Anthony J. Shaia, whom she chose from a panel of
physicians furnished by the employer. 	Dr. Shaia agreed with
Dr. Gondi's diagnosis. 	On April 6, 2000, he placed Cordle on
restricted duty.

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On May 4, 2000, Dr. Shaia reviewed the results of a recent
MRI, which revealed a torn medial meniscus and the absence of an
anterior cruciate ligament. 	Dr. Shaia concluded that
arthroscopic surgery would be appropriate, but actual
reconstruction would not be necessary. 	Cordle was removed from
work from May 4, 2000 to May 25, 2000.
A second opinion was requested by the employer, and Cordle
was examined by Dr. John A. Cardea on June 16, 2000. 	Dr. Cardea
agreed with Dr. Shaia's diagnosis. 	He reported that Cordle's
"medial meniscus problem [relates] to the initial injury.
. . . [T]his is an exacerbation of a pre-existing condition or
it may even be the first symptoms of a pre-existing condition."
He concluded that Cordle should have arthroscopic surgery to
remove the damaged portion of the medial meniscus.
B. 	PROCEDURAL HISTORY
On April 19, 1999 Cordle received an award of temporary
total disability benefits for the August 14, 1998 injury.
Following the October 21, 1999 injury, she filed for temporary
total disability benefits, claiming (1) that she had suffered a
compensable change in condition of the August 14, 1998 injury;
or, in the alternative (2) that she had suffered a new
compensable injury on October 21, 1999.
The deputy commissioner held that on October 21, 1999,
Cordle "was exposed to no specific risk of her employment" and

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that she did not suffer on that occasion an injury by accident
within the scope of the Workers' Compensation Act. 	Based on the
recorded medical history and the various diagnoses between
October, 1999 and April 6, 2000, the deputy commissioner found
that changes had occurred in the condition of Cordle's left
knee. 	However, he concluded that those changes were not the
proximate result of the August 14, 1998 incident. 	He denied
benefits for the October 21, 1999 incident.
On appeal, the full commission affirmed the deputy's
finding that the October 21, 1999 incident was not a new
compensable injury. 	However, it held that the October, 1999
incident aggravated Cordle's prior compensable injury. 	It
remanded the case to the deputy commissioner to enter an award
for the appropriate time periods. 	The employer appeals.
II. 	ANALYSIS
The issue on appeal is whether the October, 1999 knee
injury caused a change of condition by aggravation of Cordle's
compensable August, 1998 injury. 	If so, Cordle is entitled to
compensation. 	The employer contends that the medical evidence
is insufficient to establish this causal connection.
When an employee files a change of condition application
seeking reinstatement of disability benefits, two questions
arise:
(1) has there been a change in the
employee's capacity to work; [and] (2) if

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so, is the change due to a condition
causally connected with the injury
originally compensated.
Kings's Market v. Porter, 227 Va. 478, 483, 317 S.E.2d 146, 148
(1984). 	Unquestionably, Cordle's capacity to work changed as a
result of the October, 1999 injury. 	On April 6, 2000, she was
placed on restricted work duty, and was removed from work duty
for the period of May 4 to May 25, 2000. 	The issue is whether
this disability was causally connected to her original
compensable injury.
When a primary injury . . . is shown to have
arisen out of the course of employment,
every natural consequence that flows from
the injury is compensable if it is a direct
and natural result of a primary injury.
Leonard v. Arnold, 218 Va. 210, 214, 237 S.E.2d 97, 99 (1977).
Credible evidence supports the commission's finding that
Cordle's disability following the October, 1999 injury was a
natural consequence flowing from her compensable August, 1998
injury. 	Cordle had no knee problems prior to the August, 1998
accident. 	Following the completion of treatment for that
injury, she continued to have pain in her knee when climbing
stairs or when standing for long periods. 	Dr. Gondi stated
unequivocally that the October, 1999 incident was an aggravation
of Cordle's original injury.
Dr. Cardea, an independent examiner selected by the
employer, wrote that Cordle's pain flared when she returned to

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full duty work and that "this is an exacerbation of a
pre-existing condition or it may even be the first symptoms of a
pre-existing condition." 	These facts viewed as a whole support
the commission's determination that the October, 1999 incident
was an aggravation of Cordle's 1998 injury.
The commission's determination of causation is a factual
finding that will not be disturbed on appeal if supported by
credible evidence. 	Corning, Inc. v. Testerman, 25 Va. App. 332,
339, 488 S.E.2d 642, 645 (1997). 	The decision of the commission
is affirmed.
Affirmed.