WESTPOINT STEVENS, INC.
JUNE 17, 1997
Record No. 0008-97-2
BRANCH/WESTPOINT STEVENS, INC.
AND TRAVELERS INDEMNITY COMPANY
BY JUDGE LARRY G. ELDER
FROM THE VIRGINIA WORKERS’ COMPENSATION COMMISSION
Present: Judges Benton, Elder and Overton
Argued at Richmond, Virginia
Warren H. Britt (Britt & Gnapp, P.C., on briefs), for
Robert L. Flax (Rhetta M. Daniel, on brief), for appellee.
Westpoint Stevens-Drakes Branch and Travelers Indemnity
Company of Illinois (appellants) appeal an order of the Workers’
Compensation Commission (commission) awarding medical benefits to
Dorothy Davis (claimant). Appellants argue that the evidence was
insufficient as a matter of law to prove that claimant suffered
an "injury by accident." Specifically, appellants argue
that the evidence does not support the commission’s factual
finding that claimant’s slip at work on March 13, 1995 caused the
injuries to claimant’s knee, ankle, and back that were
subsequently diagnosed by her treating physician. For the reasons
that follow, we affirm.
"In order to recover on a workers’ compensation claim, a
claimant must prove: (1) an injury by accident, (2) arising out
of and (3) in the course of his employment." Kane
Plumbing, Inc. v. Small, 7 Va. App. 132, 135, 371 S.E.2d 828,
830 (1988) (citations omitted); see Code ? 65.2-101. An "injury
by accident" requires proof of "(1) an identifiable
incident; (2) that occurs at some reasonably definite time;
(3) an obvious sudden mechanical or structural change in the
body; and (4) a causal connection between the incident and the
bodily change." Chesterfield County v. Dunn, 9
Va. App. 475, 476, 389 S.E.2d 180, 181 (1990) (citing Lane Co.
v. Saunders, 229 Va. 196, 199, 326 S.E.2d 702, 703 (1985))
Appellants do not argue that claimant failed to prove that an
identifiable incident occurred at a definite time on March 13 or
that Drs. Cook and Ragonesi diagnosed the existence of a bodily
change. Instead, they contend that the evidence was insufficient
to prove that claimant’s slip on March 13 caused the injuries to
her knee, ankle, and back.
"Causation is an essential element which must be proven
by claimant in order to receive an award of compensation for an
injury by accident." AMP, Inc. v. Ruebush, 10 Va.
App. 270, 274, 391 S.E.2d 879, 881 (1990). "To establish by
a preponderance of the evidence a causal connection between the
incident and the claimed disability, the ‘proof must go beyond
conjecture.’" Ratliff v. Rocco Farm Foods, 16 Va.
App. 234, 237, 429 S.E.2d 39, 41 (1993) (quoting Southall v.
Elridge Reams, Inc., 198 Va. 545, 548, 95 S.E.2d 145, 147
On review, we construe the evidence in the light most
favorable to the party prevailing below. R.G. Moore Bldg.
Corp. v. Mullins, 10 Va. App. 211, 212, 390 S.E.2d 788, 788
(1990). Factual findings of the commission will be upheld on
appeal if supported by credible evidence. James v. Capitol
Steel Constr. Co., 8 Va. App. 512, 515, 382 S.E.2d 487, 488
(1989). The determination whether or not a particular incident
caused a particular structural or mechanical change in the body
is a factual finding. See Ingersoll-Rand Co. v. Musick,
7 Va. App. 684, 688, 376 S.E.2d 814, 817 (1989).
We hold that the evidence was sufficient to prove that
claimant suffered an "injury by accident" when she
slipped on March 13. Dr. Ragonesi expressly opined in a report
dated March 23, 1995 that claimant’s strains of her knee, ankle,
and back were caused when she slipped and caught herself on the
repairman’s tool cabinet. Although claimant did not experience
pain in her knee, ankle, and back until the day following her
slip, "pain does not have to be contemporaneous with the
accident to be an injury by accident." Ratliff, 16
Va. App. at 239, 429 S.E.2d at 42.
Appellants argue that Dr. Ragonesi’s medical opinion regarding
the causation of claimant’s injuries is not credible evidence and
that the commission was therefore left to speculate about the
existence of a causal relationship between claimant’s slip and
the diagnosed strain of her knee, ankle, and back. They assert
that Dr. Ragonesi’s medical opinion of March 23, 1995 is
incredible because his letter of January 29, 1996 certifying that
he treated claimant shows that his understanding of claimant’s
accident was inaccurate. We disagree.
Dr. Ragonesi’s letter of January 29, 1996 does not render his
medical opinion of March 23, 1995 incompetent. The commission
errs when it attributes any weight to a medical opinion based on
a faulty premise or misinformation provided by a claimant. Clinchfield
Coal Co. v. Bowman, 229 Va. 249, 252, 329 S.E.2d 15, 16
(1985); Sneed v. Morengo, Inc., 19 Va. App. 199, 205, 450
S.E.2d 167, 171 (1994). Although the summary of claimant’s
accident contained in Dr. Ragonesi’s letter conflicted with
claimant’s testimony at the hearing that she did not actually
fall to the floor, the letter does not indicate that Dr.
Ragonesi’s understanding of claimant’s accident was flawed at the
time he formed and gave his opinion in March, 1995.
Instead, the record indicates that Dr. Ragonesi’s
understanding of claimant’s accident at the time he rendered his
opinion was consistent with claimant’s testimony at the hearing.
Claimant testified that she slipped and caught herself on the
repairman’s tool cabinet before falling to the floor and that she
began experiencing pain the following morning. Contrary to
appellants’ assertion, claimant did not testify about
either the direction in which her body fell or the movements of
her knee, ankle, and back during the slip. In his written medical
opinion of March 23, 1995, Dr. Ragonesi summarized his
understanding of claimant’s slip:
Description of accident by patient[Claimant] was walking on concrete floor in the factory and
slipped on a piece of plastic from one of the machines, fell
backwards, catching herself with her arm, this caused her
to wrench her back on the left side as well as twist her right
ankle and strain her right knee.
(Emphasis added.) Although Dr. Ragonesi’s summary does
indicate the direction of claimant’s fall and the movement of her
knee, ankle, and back, it does not indicate when claimant first
experienced pain. Claimant’s and Dr. Ragonesi’s accounts of the
slip merely provide information not contained in the other.
Because Dr. Ragonesi’s understanding of claimant’s slip is
consistent with and not contradicted by claimant’s testimony, the
commission’s reliance on Dr. Ragonesi’s medical opinion was not
Because credible evidence supports the commission’s finding
that claimant’s slip on March 13 caused her injuries, we cannot
say that the evidence was insufficient to prove that claimant
suffered an injury by accident.
For the foregoing reasons, we affirm the commission’s award of
 Pursuant to Code ? 17-116.010 this opinion is
not designated for publication.