COURT OF APPEALS OF VIRGINIA 

Present: Chief Judge Moon, Judge Coleman and Senior Judge Cole 

Argued at Richmond, Virginia 

WAL-MART STORES, INC. AND 

 INSURANCE COMPANY OF THE STATE 

 OF PENNSYLVANIA 

 MEMORANDUM OPINION* BY 

v. Record No. 2196-96-2 JUDGE SAM W. COLEMAN III 

 APRIL 29, 1997 

CAROLYN R. RICHARDS 

 FROM THE VIRGINIA WORKERS' COMPENSATION COMMISSION 

 Monica L. Taylor (Christopher M. Kite; 

Gentry, Locke, Rakes & Moore, on brief), 

for appellants. 

 C. Waverly Parker for appellee. 

 Wal-Mart Stores, Inc. and its insurer (employer) contend 

that the Workers' Compensation Commission erred in finding that 

the claimant's somatoform pain disorder and anxiety disorder were 

causally related to her injury by accident. Finding no error, we 

affirm the commission's award. 

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

to the prevailing party. R.G. Moore Bldg. Corp. v. Mullins, 10 

Va. App. 211, 212, 390 S.E.2d 788, 788 (1990). So viewed, the 

evidence proves that, shortly after reporting to work on March 

28, 1995, the claimant slipped and fell on a heavily waxed floor, 

injuring her right shoulder and back. 

 Dr. Robert Brown, an internist and psychiatrist, diagnosed 

 

 * Pursuant to Code § 17-116.010 this opinion is not 

designated for publication. 
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the claimant as suffering from an anxiety disorder and a 

somatoform pain disorder, a condition in which the patient has 

more complaints of pain than can be accounted for by physiologic 

parameters. Dr. Brown opined that the claimant's anxiety 

disorder was caused by the March 1995 accident and that her 

somatoform pain disorder was a preexisting condition, but that it 

worsened as a result of the March 1995 accident and her physical 

injuries. Based on the claimant's reports of "passing out" and 

feeling "woozy-like," Dr. Brown assumed that the claimant had 

suffered a closed head injury as a result of her fall. However, 

he testified that "[e]ven if we take the head injury completely 

away, we've got a lady with a somatoform pain disorder . . . . I 

think she's disabled by A, which is the somatoform pain disorder. 

 I think she's disabled by B, which is the anxiety disorder." 

 Dr. James L. Levenson, who conducted an independent medical 

examination at the employer's request, agreed that the claimant 

suffered from a somatoform pain disorder and an anxiety disorder. 

 However, because he could not find any evidence of a head injury 

and because her disorders predated her accident, Dr. Levenson 

concluded that the March 1995 accident did not cause her 

psychological condition. 

 The commission held that the claimant's anxiety disorder and 

the aggravation of her somatoform pain disorder were caused by 

the injuries she sustained in the accident. The commission 

relied on Dr. Brown's opinion and held that whether the claimant 
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had a head injury was not significant because Dr. Brown's opinion 

regarding causation was not based on the claimant sustaining a 

head injury. Furthermore, Dr. Levenson's opinion did not address 

whether the claimant's physical injuries had aggravated her 

preexisting psychological problems. 

 In order to establish entitlement to workers' compensation 

benefits, a claimant must prove by a preponderance of the 

evidence a causal connection between a work-related accident and 

the injury. Classic Floors, Inc. v. Guy, 9 Va. App. 90, 95, 383 

S.E.2d 761, 764 (1989). "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." IngersollRand Co. v. Musick, 7 Va. App. 684, 688, 376 S.E.2d 814, 817 

(1989). However, "the standards required to prove causation and 

whether the evidence is sufficient to meet those standards are 

legal issues which [the appellate court] must determine." 

Hercules, Inc. v. Gunther, 13 Va. App. 357, 361, 412 S.E.2d 185, 

187 (1991). 

 Credible evidence in the record supports the commission's 

award. Dr. Brown's testimony that the claimant's anxiety 

disorder was caused by her March 1995 fall and that her 

preexisting somatoform pain disorder was aggravated by the fall 

and her physical injuries constitutes sufficient credible 

evidence to support the commission's decision. "Questions raised 

by conflicting medical opinions must be decided by the 
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commission." Penley v. Island Creek Coal Co., 8 Va. App. 310, 

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

 The employer contends that Dr. Brown's opinion as to 

causation should be disregarded because he based it on the faulty 

assumption that the claimant suffered a closed head injury as a 

result of her fall. See Sneed v. Morengo, Inc., 19 Va. App. 199, 

204, 450 S.E.2d 167, 171 (1994) ("Whenever a physician's 

diagnosis flows from an assumption that rests upon a faulty 

premise, such as misinformation provided by a claimant, the 

commission may refuse, and often will be required to refuse, to 

attribute any weight to that opinion."). However, the commission 

found that Dr. Brown's opinion regarding causation of the 

somatoform pain and anxiety disorders was not based upon the 

claimant sustaining a head injury. Although he stated that the 

head injury was significant, he testified that it was not the 

sole factor, or a necessary factor, in his finding that the 

claimant's March 1995 accident aggravated her psychological 

conditions. Therefore, Dr. Brown's opinion is not based upon a 

faulty premise and his opinion is credible evidence upon which 

the commission was entitled to base its decision. 

 Accordingly, we affirm the commission's award. 
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Affirmed.