COURT OF APPEALS OF VIRGINIA 

Present: Judges Elder, Bumgardner and Lemons 

TOWN OF WASHINGTON WATER WORKS 

 AND VIRGINIA MUNICIPAL GROUP 

 SELF-INSURANCE ASSOCIATION 

 MEMORANDUM OPINION*

v. Record No. 1773-98-4 PER CURIAM 

 DECEMBER 15, 1998 

JOHNNY RAY PULLEN 

 FROM THE VIRGINIA WORKERS' COMPENSATION COMMISSION 

 (Ralph L. Whitt, Jr.; John T. Cornett; 

Williams, Lynch & Whitt, on briefs), for 

appellants. 

 (Lawrence J. Pascal; Ashcraft & Gerel, on 

brief), for appellee. 

 Town of Washington Water Works and its insurer (hereinafter 

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

Commission ("commission") erred in (1) finding that the trigger 

point injection therapy administered to Johnny Ray Pullen 

("claimant") by Dr. Larry L. Stephenson was reasonable and 

necessary medical treatment; (2) refusing to order a change in 

treating physicians; and (3) failing to appoint a disinterested 

physician to examine and evaluate claimant pursuant to Code 

§ 65.2-606. Upon reviewing the record and the briefs of the 

parties, we conclude that this appeal is without merit. 

Accordingly, we summarily affirm the commission's decision. See

Rule 5A:27. 

 

 *Pursuant to Code § 17.1-413, recodifying Code § 17-116.010, 

this opinion is not designated for publication. 
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 I. 

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

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

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

 In holding employer responsible for Dr. Stephenson's 

treatment, the commission found as follows: 

 [W]e concur with the Deputy Commissioner's 

opinion that trigger point injection therapy 

from Dr. Stephenson is reasonable and 

necessary under the circumstances. Further 

we concur with the conclusion that this was 

provided as a "stop-gap" measure. Dr. 

Stephenson had referred the claimant for 

numerous diagnostic tests and several 

referrals including to Dr. [David E.] Couk 

and Dr. [James N.] Campbell without 

alternative therapy being suggested. Dr. 

Stephenson's notes reflect that other modes 

of treatment, including physical therapy and 

acupuncture, were not productive and that the 

claimant suffered an intolerance to some 

medication prescribed. From his notes it is 

clear the doctor recognized the injections 

were not curative but also recognized they 

were providing the claimant relief. 

 In its role as fact finder, the commission was entitled to 

weigh the medical evidence and to accept the opinions of Dr. 

Stephenson, the treating physician. The commission was also 

entitled to reject the contrary opinions of Drs. Stuart R. Stark 

and Roger V. Gisolfi regarding the necessity and reasonableness 

of continuing trigger point injection therapy. "Questions 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). Dr. Stephenson's medical 
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records and opinions provide credible evidence to support the 

commission's findings. 

 Because the commission's findings are supported by credible 

evidence, they are binding and conclusive on appeal. See James 

v. Capitol Steel Constr. Co., 8 Va. App. 512, 515, 382 S.E.2d 

487, 488 (1989). 

 II. 

 Unless we can say as a matter of law that employer's 

evidence sustained its burden of proving that a change in 

treating physicians was warranted, the commission's findings are 

binding and conclusive upon us. See Tomko v. Michael's 

Plastering Co., 210 Va. 697, 699, 173 S.E.2d 833, 835 (1970). 

 In denying employer's request for a change in treating 

physicians, the commission found as follows: 

 Although there is some disagreement by other 

physicians with Dr. Stephenson's treatment, 

there is no evidence that adequate treatment 

is not being rendered. Dr. Stephenson 

recognized for approximately two years the 

desirability of a referral which has been 

routinely denied by the insurer. We concur 

with the Deputy Commissioner's finding that 

the claimant should be allowed to continue 

treating with Dr. Stephenson and should be 

referred to Johns Hopkins for continued 

evaluation by Dr. Campbell. 

 No evidence proved that Dr. Stephenson's treatment was 

inadequate. To the contrary, credible evidence established that 

his treatment was the only modality that relieved claimant's pain 

symptoms, albeit temporarily. Moreover, Dr. Stephenson's medical 

records provide credible evidence to support the commission's 
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finding that Dr. Stephenson's treatment plan did not move forward 

because employer repeatedly ignored Dr. Stephenson's 

recommendations that claimant be referred to Dr. Campbell at 

Johns Hopkins for evaluation and possible treatment. 

 Based upon this record, we cannot say as a matter of law 

that the commission erred in refusing to order a change in 

treating physicians. 

 III. 

 Because the commission did not err in holding that Dr. 

Stephenson's treatment was reasonable and necessary and in 

ordering that claimant be referred to Dr. Campbell for further 

evaluation, we cannot say that the commission abused its 

discretion in not appointing a disinterested physician to examine 

claimant pursuant to Code § 65.2-606. Under the circumstances of 

this case, no evidence established that such an examination was 

justified or necessary. 

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

 Affirmed.