COURT OF APPEALS OF VIRGINIA
Present: Judges Benton, Frank and Felton Argued at Chesapeake, Virginia

LITE-TECH, INC. AND GREAT AMERICAN INSURANCE COMPANY v. Record No. 2256-04-1
ANTONY ERIC CHARLES MEMORANDUM OPINION * BY JUDGE WALTER S. FELTON, JR. ANTONY ERIC CHARLE S MARCH 22, 2005 v. Record No. 2319-04-1 LITE-TECH, INC. AND GREAT AMERICAN INSURANCE COMPANY

FROM THE VIRGINIA WORKERS’ COMPENSATION COMMISSION Daniel E. Lynch (John T. Cornett, Jr.; Williams & Ly nch, on briefs), for Lite-Tech, Inc. and Great American Insurance Company. Alan P. Owens for Antony Eric Charles.

Lite-Tech, Inc. and its insure r (collectively referred to as “e mployer”) contend the Workers’ Compensation Commission (“ commission”) erred in determining: (1) that Antony Eric Charles’ (“claimant”) carpal tunnel syndrome constitute d a compensable conseque nce of his original compensable injury; (2) that his change -in-condition application was no t time-barred; and (3) that claimant had proven that he had reasonably mark eted his residual capaci ty. On cross-appeal, claimant contends the commission did not err in finding that his right carpal tunnel syndrome was a compensable consequence of his compensable right wrist injury; that hi s change in condition was timely filed under Code § 65.2-708 (A); that even if the commission erred in finding his right carpal

* Pursuant to Code § 17.1-413, this opin ion is not designated for publication.- 2 - tunnel syndrome was a compensable co nsequence, it was part of the compensable injury included in the initial compensation be nefits award; and that under Code § 65.2-708 (A), claimant had until September 15, 2003 to timely file a change-in-condition application. For the followi ng reasons, we affirm. 1
BACKGROUND On appeal, we view the evidence in the light most favorable to claimant, the prevailing party before the commission. Clinchfield Coal Co. v. Reed , 40 Va. App. 69, 72, 577 S.E.2d 538, 539 (2003); Greif Cos. v. Sipe , 16 Va. App. 709, 716, 434 S.E.2d 314, 318 (1993). On April 18, 1999, claimant, a cable splicer, wa s injured when he atte mpted to grab a heavy splicing box that fell from a cherry picker. He sprained his right shoulder and wrist and fractured the carpal bones in his ri ght wrist as he tried to grab the falling box. Following the accident, Dr. Meade, an orthopedic surgeon, treated cl aimant’s right shoulder inju ry. Dr. Krop, also an orthopedic surgeon, treated claimant’s right wrist inju ry. Initial treatm ents included ca sting the right wrist due to the carpal bone fractur e. Following treatment, claimant continued to have tenderness in his right hand and wrist. In November 1999, Dr. Krop performe d a scaphoid fusion of claimant’s right carpal bone. Post-o peratively, claimant continued to su ffer stiffness in his right wrist. On December 8, 1999, claimant filed a claim for be nefits stating that he injured his “right wrist, arm and shoulder,” in an April 18, 1999 work-related accident. Employer accepted claimant’s claim as compensable. Thereaf ter on February 1, 2001, the deputy commissioner awarded claimant disability compensation be nefits for 72 weeks beginning September 15, 2000, as well as medical benefits for his compensable injuries.

1 Claimant filed a cross-appeal to protect his interests in the event that employer prevailed on any of its questions presented. We do not sepa rately address claimant’s cross-appeal as our opinion affirms the commission’s aw ard in favor of claimant.- 3 - In April 2000, Dr. Krop examined claimant and found positive signs of carpal tunnel syndrome (CTS) in the injured right wrist and hand. He reported that cl aimant’s “right carpal tunnel syndrome is consistent with the edema of the surgery that [claimant] has been through.” On May 2, 2000, claimant underwent an EMG/nerv e conduction study read as being “suggestive of borderline or very mild carpal tunnel syndrom e.” After reviewing thes e test results, Dr. Krop informed claimant that he might require surger y to decompress the right CTS. In a July 6, 2000 letter, Dr. Krop repeated this as sessment of claimant’s right wr ist and hand, stating “there is a chance [claimant] will require CTS decompression surgery at some time in the future, also related to his injury.” Claimant continued to co mplain of pain in his right wrist and hand. As a result of his injuries and CTS, he con tinued to be placed on restrictive work duty. On December 12, 2002, claimant filed a change-in-condition application, seeking reinstatement of temporary total disability wage benefits based on his right CTS. From January 6, 2003 until May 2, 2003, claimant was an inpatient at the Martinsburg, West Virginia, VA hospital. There he was treate d for depression, for his right shoulder injury and for his bilateral CTS. Because he was homeless when he was admitted to the hospital, the inpatient program required claimant to work with a “treatment team” to continue his job search and job training as a condition of his hospital stay . On claimant’s release from the VA hospital, Dr. Lemperg instructed him to remain “off work” through June 20, 2003, because of his bilateral CTS. In August 2003, Dr. Kline, an associate of Dr. Krop, again placed claimant on restrictive work duty. He also recommended bilateral wrist splints because of claimant’s bilateral hand numbness and tingling resulting from his CTS. On November 18, 2003, the deputy commissi oner held a hearing on claimant’s change-in-condition application. He found that claimant’s medical records showed that he was treated for bilateral CTS, including his right CTS, and that the latter cond ition was a part of the- 4 - initial compensable injury incurred on Ap ril 18, 1999. The deputy commissioner further found that because the initial compensabl e injury included claimant’s right CTS, the two-year statute of limitations of Code § 65.2-601 did not apply. He also found that claimant had reasonably marketed his residual work capacity. In his March 2, 2004 opinion, the deputy commissioner stated: We had the opportunity to view his appearance and demeanor during the course of a lengthy evid entiary hearing. We find him to be extremely credible and we believe that he searched for work as set out in his various exhibits. * * * * * * * Based upon the law and the credibility of the claimant, we find that the claimant reasonably marketed his remaining work capacity. In fact, he made great efforts to find employment while still in the hospital and we applaud his efforts. The deputy commissioner ordered a supplemental award of compensa tion benefits for claimant’s temporary total disability, payable beginning September 11, 2002 and continuing until conditions justified modification. Employer appeal ed the award to the full commission. On August 31, 2004, the full commission found that, “for reasons different from those set forth by Deputy Commissione r,” claimant’s claim was not barre d by the statute of limitations. The commission found that claimant’s right CTS was a compensable consequence of his April 1999 accident. It concluded that, pursuant to Code § 65.2-708(A), claimant timely filed his change in condition within the 24 months from th e last date for which compensation was paid on the September 15, 2000 award. The commi ssion affirmed the deputy commissioner’s award, including his finding that claimant had reas onably marketed his residual work capacity.- 5 - ANALYSIS
I. On appeal, employer contends that the comm ission erred in finding that claimant’s right CTS was a compensable consequence of his April 16, 1999 injury. We disagree. “When a primary injury under the Workmen’s Compensation Act is shown to have arisen out of the course of employment, every natura l consequence that flow s from the injury is compensable if it is a direct and natural resu lt of a primary injury.” Leonard v. Arnold , 218 Va. 210, 214, 237 S.E.2d 97, 99 (1977). “In other words, where a causal connection between the initial compensable injury and the subsequent injury is established . . . th e subsequent injury is ‘treated as if it occurred in th e course of and arising out of the employee’s employment.’” Bartholow Drywall Co. v. Hill , 12 Va. App. 790, 794, 407 S.E.2d 1, 3 (1991) (quoting Leonard , 218 Va. at 214, 237 S.E.2d at 100). “The simplest application of this principle is the rule that all the medical consequences and se quelae that flow from the prim ary injury are compensable.” American Filtrona Co. v. Hanford , 16 Va. App. 159, 163, 428 S. E.2d 511, 513 (1993) (citation omitted). When the commission’s factual determinations are supported by credible evidence, they will not be disturbed on appeal. Wa ll St. Deli, In c. v. O’Brien , 32 Va. App. 217, 220-21, 527 S.E.2d 451, 453 (2000); Morris v. Badger Powhatan/Figgie Int’l, Inc. , 3 Va. App. 276, 279, 348 S.E.2d 876, 877 (1986). Claimant’s medical reco rds reflect that he suff ered a compensable injury when he attempted to grab a falling piece of equipm ent on April 16, 1999. Employer did not contest the medical and disability award for his ri ght shoulder, ar m, and wrist injuries resu lting from this workplace accident. Dr. Krop first diagnose d claimant’s right CTS in May 2002. Because of his right CTS, claimant required additional medi cal treatment and restrictions on his work activities. The medical- 6 - record reflects that claimant’s right CTS was “consistent with the edema of the surgery” that was necessitated by the compensa ble injury to his right wrist. In addition, Dr. Krop reported that claimant’s right CTS was “related to this injury ,” eliminating the possib ility it had anot her cause. The commission found that claimant clearly proved that his right CTS flowed from his initial compensable injuries and th at claimant’s right CTS was a compensable consequence of his April 16, 1999 right wrist injury. Claimant’s medical reco rds as well as his testimony, prov ide credible evid ence to support the commission’s finding that the scaphoid fusion, performed as a result of claimant’s initial right wrist injury, precipita ted the CTS in cl aimant’s right wrist. Accordingly, we will not disturb that finding on appeal.
II. Employer also contends that because claimant failed to file his change-in-condition application within two years of the date of the initial inju ry, it is time-barred un der Code § 65.2-601. We disagree. “Where the subsequent injury is a new in jury, the provisions of Code § [65.2-601] are applicable from the date of that new injury. When the subsequent injury is a change in condition, the provisions of Code § [65.2-708(A)] are applicable.” Berglund Chevrolet, Inc. v. Landrum , 43 Va. App. 742, 753-54, 601 S.E.2d 693, 699 (2004) (quoting Ba rtholow Drywall , 12 Va. App. at 797, 407 S.E.2d at 5). [I]f the consequent injury is a mere change in condition - some form of medical sequelae of the original in jury, though not of the accident itself - the claim falls within the limitations period of Code § 65.2-708(A), which requires filing within 24 months from the “last day for which compensa tion was paid, pursuant to an award” by the commission. Id. at 754, 601 S.E.2d at 699; see American Filtrona , 16 Va. App. at 163, 428 S.E.2d at 513.- 7 - On June 6, 2001, cl aimant was awarded perm anent partial disability benefits for 72 weeks beginning September 15, 2000. He filed a change-in-condition appl ication on December 12, 2002, alleging his right CTS was a compensable consequence of hi s initial right wrist injury. His claim was filed within 24 months from the last date for whic h compensation was pa id on the September 15, 2000 award. Because we conclude that the commis sion properly reviewed claimant’s change-in-condition application pursuant to Code § 65.2-708(A) and not Code § 65.2-601, we find no error in the commission’s ruling that the current claim is not time-barred.
III. Employer also argues that the commission erre d in finding that claima nt had proven that he made reasonable efforts to market his residual work capacity. A partially disabled employee is required to make reasonable efforts to market his residual earning capacity to maintain his eligibility to receive continuing compensation benefits.
See National Linen Service v. McGuinn , 8 Va. App. 267, 270, 380 S.E.2d 31, 33 (1989) (citation omitted). “What constitutes a reasonable marketing effort depends upon the facts and circumstances of each case.” Sipe , 16 Va. App. at 715, 434 S.E.2d at 318. To determine reasonableness, the commission should consider (1) the nature and extent of employee’s disability; (2) the employee’s training, age, experience, and education; (3) the nature and extent of employee’s job sear ch; (4) the employee’s intent in conducting his job search; (5) the ava ilability of jobs in the area suitable for the employee, consider ing his disability; and (6) any other matter affecting employ ee’s capacity to find suitable employment. McGuinn , 8 Va. App. at 272, 380 S.E .2d at 34 (footnotes omitted). Ultimately, “[t]he commission . . . determines which of these or other factors are mo re or less significant with regard to a particular case.” Id. at 272-73, 380 S.E.2d at 34-35.- 8 - Here, claimant worked in the fiber optics bus iness for some twenty-three years. While hospitalized in the VA hosp ital, following the initial award of compensa tion benefits, he maintained his job search, meeting regularly with his “treatment team” to coordinate his search efforts. He used two internet employment search websites where potential employers could review his job qualifications for available positions. He testified that he ha d spoken with potential employers and many “headhunters.” He testified that nearly 285 potential employers had viewed his resume on-line. He presented documents demonstrating that he sent resu mes to potential employers from June 2002 through February 2003. He testified that he had found his last two jobs through these websites. He also underwent job training wo rking toward a Microsoft Certified Engineering designation, and acquired software permitting him to pe rform computer work within his medical restrictions. He testifie d that he sought work outside his pr e-injury field of telecommunications work, looking for employ ment as an informatio n technology manager, co mputer programmer, and computer technician. The commission speci fically found that [C]laimant presented persuasive evidence that he diligently searched for alternative employment during his partial disability. He submitted paper documentation of his Internet search, contacts, and postings. The claimant also sought work with employers outside his pre-injury field of wo rk. . . . [B]ased on the extent and intent of his job search, disabi lity, experience, age, and other factors, this particular claimant put forth a sufficient effort to market his residual work capacity. Credible evidence in the record supports the commission’s finding that claimant reasonably marketed his residual work capacity. See Sipe , 16 Va. App. at 715, 434 S.E.2d at 318. For the foregoing reas ons, we affirm the award of the co mmission, finding that claimant’s right wrist CTS was a compensabl e consequence of his initial co mpensable injury; that his- 9 - change-in-condition application was timely filed; a nd that he reasonably mark eted his residual work capacity. Affirmed.