COURT OF APPEALS OF VIRGINIA 

Present: Judges Benton, Bumgardner and Agee 

Argued at Alexandria, Virginia 

METROPOLITAN WASHINGTON AIRPORTS 

 AUTHORITY AND HARTFORD UNDERWRITERS 

 INSURANCE COMPANY 

 MEMORANDUM OPINION* BY 

v. Record No. 2790-01-4 JUDGE JAMES W. BENTON, JR. 

 AUGUST 13, 2002 

PATRICK J. BAILEY 

 FROM THE VIRGINIA WORKERS' COMPENSATION COMMISSION 

 Benjamin J. Trichilo (Trichilo, Bancroft, 

McGavin, Horvath & Judkins, P.C., on briefs), 

for appellants. 

 Michael A. Kernbach (Burgess, Locklin, 

Kernbach & Perigard, PLLC, on brief), for 

appellee. 

 The Workers' Compensation Commission entered an award on 

behalf of Patrick J. Bailey, based upon its findings that his 

employer, the Metropolitan Washington Airports Authority, failed 

to rebut the presumption under Code § 65.2-402 that Bailey's 

hypertension and heart disease were compensable as occupational 

diseases. We affirm the commission's award. 

 I. 

 The evidence proved that Bailey was employed as a 

firefighter for the Authority. On October 14, 1991, Bailey 

 

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

designated for publication. 
- 2 - 

visited his doctor and reported rapid heartbeats with 

palpitations. On October 19, 1991, after engaging in a disaster 

drill and then responding to an emergency medical call, Bailey 

began to experience chest tightness and an accelerated heart 

rate. He was taken to a hospital emergency room for treatment 

and later received a diagnosis of hypertension and heart 

disease. 

 We do not recite in minute detail the evidence because the 

commission's opinion extensively recites the evidence in the 

record and analyzes the reports of the physicians who treated 

Bailey and those who reviewed Bailey's medical records. 

Significantly, the commission noted "the deputy commissioner 

. . . found . . . that [Bailey] did suffer from both 

hypertension and supraventricular tachycardia and that he was 

entitled to the statutory presumption that his condition was 

causally related to his employment." The commission ruled that 

"[t]hese findings were not appealed, and they are now the law of 

the case." The record supports those findings and the 

commission's ruling. 

 II. 

 The Authority does not dispute that Bailey is within the 

category of employees entitled to the benefit of the statutory 

presumption of occupational disease for a disability resulting 

from hypertension and heart disease. Rather, the Authority 

contends it rebutted the statutory presumption, the commission 
- 3 - 

applied an erroneous legal standard, and the award is not 

supported by the evidence. 

 In pertinent part, Code § 65.2-402(B) provides as follows: 

Hypertension or heart disease causing . . . 

any health condition or impairment resulting 

in total or partial disability of . . . 

firefighters . . . shall be presumed to be 

occupational diseases, suffered in the line 

of duty, that are covered by this title 

unless such presumption is overcome by a 

preponderance of competent evidence to the 

contrary. 

"To overcome the presumption the employer must show, by a 

preponderance of the evidence, both that (1) the claimant's 

disease was not caused by his employment, and (2) there was a 

non-work-related cause of the disease." Bass v. City of 

Richmond Police Department, 258 Va. 103, 114, 515 S.E.2d 557, 

562-63 (1999). 

 Our review of the commission's decision is governed by well 

established principles. As a fundamental principle, the Act 

provides that "[t]he award of the Commission . . . shall be 

conclusive and binding as to all questions of fact." Code 

§ 65.2-706(A). Thus, we are guided by the following rules: 

 On appeal from [a] determination [that 

the employer has failed to overcome the 

statutory presumption], the reviewing court 

must assess whether there is credible 

evidence to support the Commission's award. 

Thus, unlike the Commission, the reviewing 

court is not charged with determining anew 

whether the employer's evidence of causation 

should be accorded sufficient weight to 

constitute a preponderance of the evidence 

on that issue. 
- 4 - 

Id. at 115, 515 S.E.2d at 563. These rules apply with equal 

force to questions raised by competing medical opinions because 

"a question raised by 'conflicting expert medical opinions' is 

'one of fact.'" Eccon Constr. Co. v. Lucas, 221 Va. 786, 790, 

273 S.E.2d 797, 799 (1981); Virginia Dep't of State Police v. 

Talbert, 1 Va. App. 250, 253, 337 S.E.2d 307, 308 (1985). "[A]s 

finder of fact . . . , the commission resolves all conflicts in 

the evidence and determines the weight to be accorded the 

various evidentiary submissions." Bass, 258 Va. at 114, 515 

S.E.2d at 563. 

 III. 

 In regard to Bailey's hypertension, the commission reviewed 

all the medical evidence and made findings concerning each of 

the physician's diagnoses and conclusions. For example, 

Dr. Holland reported Bailey's hypertension was "systemic 

hypertension of unknown cause." One of Dr. Israel's reports 

described it as "hypertension of uncertain cause." Analyzing 

the substance of each physician's report, the commission found 

"from this evidence that the etiology or cause of essential or 

systemic hypertension is unknown, and opinions suggesting a 

cause are conjectural at best." These findings are supported by 

credible evidence in the record. 

 The commission further "f[ou]nd that the 'conclusions' of 

these physicians identifying [Bailey's] family history, obesity, 

and high cholesterol as causative factors to be considered are 
- 5 - 

offered only as possible risk factors, and they are not 

probative to rebut the presumption as to a non-work-related 

cause." Indeed, the reports variously contain references to 

heritage, family history, and risk factors. We have previously 

held that "the showing of 'risk factors' alone does not rebut 

the statutory presumption and does not establish competent 

medical evidence of a non-work-related cause of the disabling 

disease." City of Norfolk v. Lillard, 15 Va. App. 424, 429, 424 

S.E.2d 243, 246 (1992). Thus, the evidence in the record 

supports the commission's findings that the Authority failed to 

establish a non-work-related cause for Bailey's hypertension. 

 In addition to finding the evidence did not establish a 

non-work-related cause of Bailey's hypertension, the commission 

also found the evidence failed to prove Bailey's hypertension 

was not caused by his employment. The commission specifically 

found unpersuasive the general conclusions of Dr. Seides, 

Dr. Holland, and Dr. Israel that work stress does not cause 

hypertension. In so finding, the commission relied in part upon 

Medlin v. County of Henrico Police, 34 Va. App. 396, 542 S.E.2d 

33 (2001). We hold that the commission did not err in doing so 

and in finding unpersuasive the physicians' general denials that 

employment can be related to stress and heart disease. See id.

at 407, 542 S.E.2d at 38. The commission also noted, however, 

that none of those physicians were aware of the extent to which 
- 6 - 

Bailey was exposed to stress in his occupation. These findings 

are supported by credible evidence. 

 Likewise, the commission reviewed each of the physician's 

reports concerning Bailey's tachycardia. The deputy 

commissioner found that the medical evidence was sufficient to 

prove superventricular tachycardia. Indeed, Dr. O'Brien clearly 

makes that diagnosis. Although the commission noted that the 

Authority did not appeal this finding, the commission reviewed 

the medical evidence and accorded greater weight to 

Dr. O'Brien's diagnosis and discounted entirely the reports of 

Dr. Seides, Dr. Holland, and Dr. Israel, which denied that 

Bailey had superventricular tachycardia. When the commission 

rejected the premise of the reports of these three doctors, 

i.e., that Bailey did not have superventricular tachycardia, the 

commission logically could find that those reports necessarily 

failed to prove a non-work-related cause for Bailey's 

superventricular tachycardia. Credible evidence supports that 

finding. 

 In addition, the commission logically could find and did 

find that the same medical reports, which denied even the 

existence of superventricular tachycardia, also failed to prove 

Bailey's superventricular tachycardia was not caused by his 

work. The record contains credible evidence to support this 

finding. 
- 7 - 

 In summary, the principle is well established that "[t]he 

probative weight to be accorded [medical] evidence is for the 

Commission to decide; and if it is in conflict with other 

medical evidence, the Commission is free to adopt that view 

'which is most consistent with reason and justice.'" C.D.S. 

Const. Services v. Petrock, 218 Va. 1064, 1071, 243 S.E.2d 236, 

241 (1978). The record contains credible evidence to support 

each of the commission's findings. Accordingly, we affirm the 

commission's award of benefits. 

 Affirmed.