COURT OF APPEALS OF VIRGINIA 

Present: Judges Annunziata, Agee and Senior Judge Coleman 

QUEBECOR PRINTING, INC. AND 

 AMERICAN PROTECTION INSURANCE COMPANY 

 MEMORANDUM OPINION*

v. Record No. 3140-01-2 PER CURIAM 

 APRIL 9, 2002 

LESA W. SIMMS 

 FROM THE VIRGINIA WORKERS' COMPENSATION COMMISSION 

 (S. Vernon Priddy III; Patsy L. Mundy; Sands 

Anderson Marks & Miller, on briefs), for 

appellants. 

 (Thomas J. Schilling; Law Offices of Thomas 

J. Schilling, on brief), for appellee. 

 Quebecor Printing, Inc. and its insurer (hereinafter 

referred to as "employer") contend the Workers' Compensation 

Commission erred in (1) finding that Lesa W. Simms (claimant) 

proved that her right knee condition constituted a compensable 

consequence of her April 29, 1999 compensable left knee injury; 

(2) awarding benefits for claimant's right knee condition which 

resulted from a compensable consequence, a gait disturbance, of 

the left knee; and (3) relying upon medical histories alone to 

establish the cause of claimant's right knee condition. Upon 

reviewing the record and the parties' briefs, we conclude that 

 

* Pursuant to Code § 17.1-413, this opinion is not 

designated for publication. 
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this appeal is without merit. Accordingly, we summarily affirm 

the commission's decision. Rule 5A:27. 

I. 

 On appeal, we view the evidence in the light most favorable 

to the prevailing party below. R.G. Moore Bldg. Corp. v. 

Mullins, 10 Va. App. 211, 212, 390 S.E.2d 788, 788 (1990). "The 

actual determination of causation is a factual finding that will 

not be disturbed on appeal if there is credible evidence to 

support the finding." Ingersoll-Rand Co. v. Musick, 7 Va. App. 

684, 688, 376 S.E.2d 814, 817 (1989). Furthermore, "[q]uestions 

raised by conflicting medical opinions must be decided by the 

commission." Penley v. Island Creek Coal Co., 8 Va. App. 310, 

318, 381 S.E.2d 231, 236 (1989). 

 Claimant's treating orthopedic surgeon, Dr. Kenneth Zaslav, 

opined on December 8, 2000, as follows: 

Regarding your second question, I do believe 

that the current medical treatment to 

[claimant's] right knee is related to an 

industrial accident injury on 4/29/99 in the 

following way: 

Ms. Simms had to rely on her right knee more 

during the period of time when her left knee 

was being treated and during her post op 

course, and I believe this exacerbated an 

underlying patellar malalignment, causing a 

worsening of symptoms. 

 Dr. Herman Nachman, who reviewed claimant's medical records 

for employer, opined in a letter dated April 10, 2001 that 
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claimant's right knee problem was not causally related to the 

April 29, 1999 compensable left knee injury. 

 As fact finder, the commission was entitled to weigh the 

medical evidence. It did so, and accepted the opinion of the 

treating physician, Dr. Zaslav, while rejecting the opinion of 

Dr. Nachman, who had never examined or treated claimant. The 

commission concluded, "the weight of the evidence supports 

claimant's contention that her right knee problems are a 

compensable consequence of her April 29, 1999 left knee injury." 

"'[W]hen an attending physician is positive in his diagnosis 

. . . , great weight will be given by the courts to his 

opinion.'" Pilot Freight Carriers, Inc. v. Reeves, 1 Va. App. 

435, 439, 339 S.E.2d 570, 572 (1986) (citations omitted). 

 Dr. Zaslav's medical records and opinions constitute 

credible evidence to support the commission's finding. "The 

fact that there is contrary evidence in the record is of no 

consequence if there is credible evidence to support the 

commission's finding." Wagner Enters., Inc. v. Brooks, 12 Va. 

App. 890, 894, 407 S.E.2d 32, 35 (1991). 

II. and III. 

 On appeal, employer relies upon Amoco Foam Prods. Co. v. 

Johnson, 257 Va. 29, 510 S.E.2d 443 (1999), to argue that a 

compensable consequence of a compensable consequence is not an 

awardable condition. In doing so, employer contends claimant's 

right knee condition is not compensable because it resulted from 
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a compensable consequence of a gait disturbance, which was a 

compensable consequence of claimant's initial left knee injury. 

Employer also argues that the commission erred in relying upon 

the medical histories claimant supplied to her physicians to 

provide a credible account of how her right knee condition 

occurred, where claimant did not testify. Employer did not 

raise either of these arguments before the deputy commissioner 

or in its written statement filed on review before the full 

commission. 

 Any theory of recovery or argument not raised before the 

commission will not be considered by this Court for the first 

time on appeal. See Rule 5A:18; see also Kendrick v. Nationwide 

Homes, Inc., 4 Va. App. 189, 192, 355 S.E.2d 347, 349 (1987). 

Accordingly, we will not consider these arguments for the first 

time on appeal. Moreover, the record does not reflect any 

reason to invoke the good cause or ends of justice exceptions to 

Rule 5A:18. 

 For these reasons, we affirm the commission's decision. 

Affirmed.