Present: All the Justices 

SOUTHERN EXPRESS, ET AL. 

v. Record No. 980453 OPINION BY JUSTICE CYNTHIA D. KINSER 

 January 8, 1999 

CLARA LOUISE GREEN 

FROM THE COURT OF APPEALS OF VIRGINIA 

 In this appeal, we decide whether chilblains that the 

claimant suffered as a result of being exposed to cold 

temperature in a walk-in cooler during a four-hour period 

constitute an “injury by accident” under the Virginia Workers’ 

Compensation Act (the Act). Because the claimant proved that 

she sustained the injury at a particular time and place and 

upon a particular occasion, that it was caused by an 

identifiable incident, and that it resulted in a structural 

change in her body, we will affirm the judgment of the Court 

of Appeals that the injury is compensable under the Act. 

I. 

Clara Louise Green was an employee at a Southern Express 

convenience store. When Green arrived at work on June 22, 

1996, John Patrick Vaillant, the store manager, asked a coworker to take Green inside the store’s walk-in cooler.1 He 

instructed the co-worker to show Green what tasks needed to be 

 1

 The cooler’s design included a series of glass doors on 

the front, shelving units behind the glass doors, and a walkin room behind the doors and shelves, which was also cold. 
completed in the cooler and how to perform those tasks. Green 

had never before worked in the cooler. The training session 

in the cooler lasted approximately 30 to 45 minutes. 

 Later, Vaillant assigned Green to work in the cooler 

stocking “beer” and “cokes.” When Green went back inside the 

cooler, she was wearing a short-sleeved shirt and an apron 

since she had not anticipated that she would be working in the 

cooler. When Green asked Vaillant for a pair of gloves, he 

authorized Green to use a pair out of the store’s inventory. 

However, Green chose not to do so. 

 Green testified that, in addition to the time spent in 

the cooler during the training session, she worked in the 

cooler stocking drinks from 2:00 o’clock a.m. until 6:00 

o’clock a.m. without taking a single break. She further 

stated that, at some point during this period of time, she 

tried to leave the cooler but was unable to open the door. 

She attempted to get someone’s attention by knocking on the 

window of the cooler, but no one responded. 

 Vaillant’s testimony conflicted with Green’s on this last 

point. He was present at the Southern Express store during 

Green’s shift of work on the morning in question and recalled 

Green coming out of the cooler to take at least one break and 

possibly more. He further testified that the cooler door had 

2
no locking device and that it could be opened from both inside 

and outside at all times. 

Green stated that, after finishing her work in the 

cooler, she was “cold and shivering” with her hands being “all 

balled up.” She testified that her face also had sores on it. 

Vaillant, however, testified that Green did not mention any 

injury to him when she left work at the end of her shift 

around 6:00 a.m. Green did not return to work at the Southern 

Express store after she left that morning.2

 The record reflects that Green received treatment from 

several doctors for her injury. On the morning of June 23, 

1996, Green saw Dr. Gary McGowan at Henrico Doctors’ Hospital 

for “an evaluation of pain in her hands, left forearm and left 

elbow” in connection with an injury sustained while “lift[ing] 

beer cases in the cold freezer for about 3-4 hours.” Dr. 

McGowan diagnosed a left hand/forearm strain and advised Green 

to wear gloves if she were exposed to cold temperatures at 

work again. Two days later, Dr. Lerla Joseph of the Charles 

 2

 The record contains conflicting evidence regarding 

Green’s period of employment at the Southern Express store. 

Green claims that she began working there in late May 1996 and 

worked until June 9, 1996. Vaillant, however, testified that 

Green’s period of employment ran from June 17 through 22, 

1996. In her claim for workers’ compensation benefits, Green 

originally listed her date of injury as June 22, 1996, but 

later changed it to June 9, 1996. 

3
City Medical Group, Inc., examined Green and recommended that 

Green limit her lifting, bending, or cold storage work. 

 On July 1, 1996, Dr. Marc Jay Pinsky treated Green. At 

that time, Green complained of “pain, burning, and stiffness 

in [her] hands and feet” as a result of having worked several 

hours in a cooler without “proper protection or a break for 

warm-up.” Dr. Pinsky diagnosed “chilbains [sic] [secondary] 

to longterm exposure to cold temperature.”3 He advised Green 

to avoid further exposure to the cold. 

 Next, on July 9, 1996, Green saw Dr. E.M. Hudgins of the 

Dermatology Associates of Virginia, P.C. In a letter to Dr. 

Pinsky, Dr. Hudgins opined that Green “has had a mold cold 

injury consistent with chilblains.” 

 Green filed a claim for workers’ compensation benefits on 

July 10, 1996. A deputy commissioner of the Virginia Workers’ 

Compensation Commission (Commission) denied Green’s claim on 

the basis that “there was no sudden precipitating event, no 

accident which arose out of and in the course of employment.” 

Instead, the deputy commissioner found that her injury 

 3

 Chilblains are “[a] form of cold injury characterized 

by localized erythema and sometimes blistering. The affected 

area itches, may be painful, and may progress to crusted 

ulcerations. The cause is thought to be prolonged 

constriction of arterioles in reaction to exposure to cold and 

dampness.” Taber’s Cyclopedic Medical Dictionary 367 (17th ed. 

1993). 

 

4
resulted from “continuous exposure over a period of time.” 

Upon Green’s request for review, the Commission reversed the 

deputy commissioner’s decision and awarded benefits to Green. 

Southern Express then appealed the Commission’s decision to 

the Court of Appeals of Virginia. A panel of the Court of 

Appeals affirmed the award of benefits on the basis that “a 

condition resulting from exposure to extreme temperatures may 

still constitute an ‘injury by accident.’” Southern Express 

v. Green, 26 Va. App. 439, 445, 495 S.E.2d 500, 503 (1998). 

We awarded Southern Express this appeal. 

II. 

When Green filed her claim for workers’ compensation 

benefits, she alleged an “injury by accident” under Code 

§ 65.2-101. This section states that “‘[i]njury’ means only 

injury by accident arising out of and in the course of the 

employment . . . .”4 The Act does not, however, specifically 

define the term “injury by accident.” Consequently, the 

phrase has been the subject of judicial interpretation. See 

Virginia Elec. & Power Co. v. Cogbill, 223 Va. 354, 288 S.E.2d 

485 (1982), and Badische Corp. v. Starks, 221 Va. 910, 275 

 4

 In the definition of “injury,” Code § 65.2-101 also 

includes “occupational disease as defined in Chapter 4 

(§ 65.2-400 et seq.).” Green does not, however, contend that 

her chilblains constitute an occupational disease under the 

Act. 

5
S.E.2d 605 (1981), for a survey of cases discussing the 

“injury by accident” requirement. 

“It is apparent from the language employed by the 

drafters of the Act that it was originally intended to provide 

coverage for the most frequently recurring kinds of industrial 

accidents, e.g., injuries immediately resulting from hazards 

of the workplace such as blows from falling objects . . . [or] 

falls from ladders . . . .” Morris v. Morris, 238 Va. 578, 

585, 385 S.E.2d 858, 862 (1989). The more difficult issue 

through the years has been “whether an injury resulting from 

repetitive trauma, continuing mental or physical stress, or 

other cumulative events, amounts to an ‘injury by accident’ 

within the meaning of [the Act] . . . .” Id. at 581, 385 

S.E.2d at 859-60. 

In Morris, a case relied upon by Southern Express, the 

Court addressed this issue and reiterated the parameters of an 

“injury by accident.” We considered the claims of three 

separate workers, two of whom had sustained myocardial 

infarctions and a third worker who had a ruptured cervical 

disc. One of the workers who had a myocardial infarction had 

been lifting cartons of fiberglass, weighing approximately 50 

pounds each, for about 45 minutes. The second employee with 

the same type of injury had been installing ceiling panels 

weighing 30 to 35 pounds each over a period of approximately 

6
two and one-half hours. The worker with the ruptured disc 

injury had been unloading steel doors for approximately an 

hour and a half. His injury was not diagnosed until several 

weeks later, but the two employees with myocardial infarctions 

were each taken to hospitals for treatment on the day of the 

injury. 

 We vacated all three awards of compensation on the basis 

that the claimants had not carried the burden of establishing 

an “injury by accident.” Although each respective injury 

“made its appearance suddenly ‘at a particular time and upon a 

particular occasion,’” we concluded that each claimant had 

failed to prove “that the cause of his injury was an 

identifiable incident or sudden precipitating event and that 

it resulted in an obvious sudden mechanical or structural 

change in the body.” Morris, 238 Va. at 589, 385 S.E.2d at 

864-65 (quoting The Lane Co., Inc. v. Saunders, 229 Va. 196, 

199, 326 S.E.2d 702, 703 (1985) (emphasis added)). We 

specifically held “that injuries resulting from repetitive 

trauma, continuing mental or physical stress, or other 

cumulative events, as well as injuries sustained at an unknown 

time, are not ‘injuries by accident.’” Morris, 238 Va. at 

589, 385 S.E.2d at 865. 

 In our analysis of the term “injury by accident” in 

Morris, we relied upon language from a law review article that 

7
we had previously quoted with approval in Aistrop v. Blue 

Diamond Coal Co., Inc., 181 Va. 287, 293, 24 S.E.2d 546, 548 

(1943) (citations omitted): 

‘The injury, to be regarded as “by accident,” must be 

received *** at a particular time and in a particular 

place and by a particular accident. And the accident 

must be something the date of which can be fixed. It is 

not enough that the injury shall make its appearance 

suddenly at a particular time and upon a particular 

occasion.’ In other words, the ‘incident,’ the act done 

or condition encountered, ‘must be shown to have occurred 

at some reasonably definite time’. 

On the other hand, as the author says, ‘*** injury 

of gradual growth, *** not the result of some particular 

piece of work done or condition encountered on a definite 

occasion, but caused by the cumulative effect of many 

acts done or many exposures to conditions prevalent in 

the work, no one of which can be identified as the cause 

of the harm, is definitely excluded from compensation.’ 

(quoting Francis H. Bohlen, A Problem in the Drafting of 

Workmen’s Compensation Acts, 25 Harv. L. Rev. 328, 342-43 

(1912)). 

 Thus, Morris and Aistrop teach that, to establish an 

“injury by accident,” a claimant must prove (1) that the 

injury appeared suddenly at a particular time and place and 

upon a particular occasion, (2) that it was caused by an 

identifiable incident or sudden precipitating event, and (3) 

that it resulted in an obvious mechanical or structural change 

in the human body. Accord Cogbill, 223 Va. 354, 288 S.E.2d 

485; Starks, 221 Va. 910, 275 S.E.2d 605. Measuring these 

elements of proof against the facts as recited in Morris, it 

8
is evident that those claimants failed to prove that an 

identifiable incident or event at work caused their injuries. 

The claimants asserted that the cause of their respective 

injuries was the particular piece of work that they were 

performing on the days when the injuries first manifested 

themselves, but evidence of causation, especially medical 

evidence, was noticeably absent. 

 The question of causation was also the critical issue in 

Byrd v. Stonega Coke & Coal Co., 182 Va. 212, 28 S.E.2d 725 

(1944), a case relied upon by the Court of Appeals. Contrary 

to Southern Express’s assertion that the Court of Appeals used 

the decision in Byrd to carve out an exception to the 

principles enunciated in Morris for all exposure cases, we 

find no such deviation from Morris. Nor do we perceive any 

tension between those two decisions as asserted by Southern 

Express. 

 In Byrd, the employee collapsed suddenly and died after 

having pulled coke out of a hot oven for more than ten hours. 

The employer conceded that the employee was exposed to heat of 

a much higher degree than that to which he otherwise would 

have been exposed, but denied that there was a causal 

connection between the hazards of the job and the employee’s 

death. The record contained medical evidence from five 

doctors, which we summarized by stating that all the doctors 

9
agreed that acute heart failure was the immediate cause of the 

employee’s death and that exposure to abnormal heat may affect 

the heart. However, we acknowledged that the employee had 

only some of the usual symptoms of heat stroke and that two of 

the doctors did not state whether the excessive heat 

contributed to the employee’s death. We concluded that the 

employee’s death “was the result of the conditions under which 

[he] was required to perform the duties of his employment.” 

Byrd, 182 Va. at 221, 28 S.E.2d at 729. We also stated that 

“if . . . injury or death results from, or is hastened by, 

conditions of employment exposing the employee to hazards to a 

degree beyond that of the public at large, the injury or death 

is construed to be accidental within the meaning of the 

[Act].” Id. at 216, 28 S.E.2d at 727. 

The Court in Byrd did not discuss whether injuries caused 

by repetitive trauma, continuing mental or physical stress, or 

other such cumulative occurrences satisfy the “injury by 

accident” requirement. Such an inquiry was not the focus of 

the parties or the Court for obvious reasons. The employee’s 

death occurred at a particular time and place and resulted in 

an obvious change in his body. Moreover, the fact that the 

identifiable event, the exposure to extreme heat, was not 

disputed is especially significant for the present case. The 

only contested issue was whether the exposure to the heat 

10
caused the employee’s collapse and death. Although the Court 

in Byrd did not specifically identify the elements of proof 

later enunciated in Morris, the evidence, nevertheless, 

satisfied those elements.5

Turning now to the facts of the present case and using 

the elements of proof outlined in Morris, we find that Green 

established an “injury by accident.” Green’s chilblains first 

appeared during the time that she spent in the cooler, thus at 

a particular time and place and upon a particular occasion, 

and resulted in a structural change in her body. She 

testified that her face had sores on it and her hands were 

“all balled up” after she finished her work in the cooler. In 

fact, she sought medical treatment on the morning of June 23, 

1996. At least two of the doctors who treated Green diagnosed 

chilblains resulting from Green’s exposure to cold 

temperature. Southern Express does not contest that Green 

suffered chilblains and that the cause of the chilblains was 

Green’s exposure to cold temperature during her work in the 

cooler. 

The only remaining question, the one that Southern 

Express does challenge, is whether exposure to cold 

temperature in a cooler for approximately four hours during a 

 5

 Notably, the Court in Byrd had the benefit of the 

decision in Aistrop, which discussed the same principles as 

11
shift of work constitutes an identifiable event or incident. 

Citing Morris, Southern Express argues that such a four-hour 

exposure to the cold is not an event “bounded by rigid 

temporal precision.” 238 Va. at 589, 385 S.E.2d at 864. 

Rather, Southern Express asserts that Green’s injury resulted 

from repetitive trauma, continuing physical stress, or a 

cumulative event. We do not agree. 

The evidence in this case shows that Green’s chilblains 

were not an “injury of gradual growth . . . caused by the 

cumulative effect of many acts done or many exposures to 

conditions prevalent in the work, no one of which can be 

identified as the cause of the harm . . . .” Aistrop, 181 Va. 

at 293, 24 S.E.2d at 548. (Emphasis added). Instead, the 

chilblains were “the result of some particular piece of work 

done or condition encountered on a definite occasion . . . .” 

Id. In other words, Green’s chilblains resulted from a single 

exposure to cold temperature on a definite occasion during the 

performance of a specific piece of work, i.e., an 

“identifiable incident.” Morris, 238 Va. at 589, 385 S.E.2d 

at 865. It was not caused by repeated exposures over a period 

of months or years. 

For these reasons, we will affirm the judgment of the 

Court of Appeals. 

_____________________ 

those set forth in Morris. 

12
Affirmed. 

13