COURT OF APPEALS OF VIRGINIA 

Present: Judges Elder, Felton and Senior Judge Willis 

WELLMONT LONESOME PINE HOSPITAL AND 

 RECIPROCAL OF AMERICA 

 MEMORANDUM OPINION*

v. Record No. 0665-03-3 PER CURIAM 

 AUGUST 12, 2003 

CONNIE JO CANTOR 

 FROM THE VIRGINIA WORKERS' COMPENSATION COMMISSION 

 (Ramesh Murthy; Lisa Frisina Clement; 

PennStuart, on brief), for appellants. 

 (D. Allison Mullins; Lee & Phipps, P.C., on 

brief), for appellee. 

 Wellmont Lonesome Pine Hospital and its insurer 

(hereinafter referred to as "employer") contend the Workers' 

Compensation Commission erred in finding that (1) the doctrine 

of res judicata did not bar Connie Jo Cantor's (claimant) March 

11, 2002 change-in-condition application related to her left 

shoulder condition; and (2) claimant proved that her left 

shoulder condition was causally related to her compensable June 

18, 2001 injury by accident, entitling her to benefits beginning 

April 15, 2002 and continuing. Upon reviewing the record and 

the parties' briefs, we conclude that this appeal is without 

 

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

designated for publication. 
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merit. Accordingly, we summarily affirm the commission's 

decision. Rule 5A:27. 

Res Judicata

 On appeal, employer argues that the doctrine of res

judicata barred the commission from considering claimant's March 

11, 2002 change-in-condition application. Employer contends 

claimant previously presented a claim for a left shoulder injury 

to Deputy Commissioner Burchett, which was the subject of his 

January 24, 2002 decision from which claimant did not appeal. 

 Employer did not raise the doctrine of res judicata as a 

bar to claimant's March 11, 2002 application before the 

commission. Accordingly, we will not consider it for the first 

time on appeal. See Rule 5A:18. 

Causation

 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). 
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 The June 18, 2001 emergency room report indicates that 

claimant complained of a "neck, shoulder injury." On his June 

18, 2001 Attending Physician's Report, Dr. W. Zahnke, the 

emergency room physician, recorded that claimant "was pushing a 

box on top shelf in stock room – pulled off piece of tape from 

box [and] twisted [left] shoulder/neck." 

 Claimant began treatment with Dr. Ken Smith, a 

neurosurgeon, on August 13, 2001. At that time, she complained 

of left upper extremity numbness and tingling. Those complaints 

continued throughout Dr. Smith's treatment. Dr. Smith 

eventually referred claimant to Dr. S.K. Kotay, an orthopedist, 

for her left shoulder complaints. 

 Dr. Kotay began treating claimant on March 11, 2002. 

Dr. Kotay recorded a history of left shoulder pain with an onset 

of June 2001 when claimant was lifting some heavy boxes over her 

head and her shoulder popped, causing severe pain. Dr. Kotay 

indicated that claimant subsequently had some numbness in her 

hand and pain radiating down her arm. 

 In a March 13, 2002 Attending Physician's Report, Dr. Kotay 

indicated that claimant's left shoulder pain was due to an 

incident on June 18, 2001, when claimant was moving boxes above 

her head onto a wire cart and felt pain in her neck and left 

arm. As of April 15, 2002, Dr. Kotay excused claimant from all 

work at least until her next appointment on May 13, 2002. 

Dr. Kotay continued to treat claimant for left shoulder pain 
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with cortisone injections and issued another disability slip on 

May 30, 2002, stating "no work until return appointment of 

7/8/02." No evidence showed that Dr. Kotay ever subsequently 

released claimant to return to her pre-injury employment. 

 In finding that claimant proved that her left shoulder 

condition and disability commencing April 15, 2002 were causally 

related to her June 18, 2001 compensable injury by accident, the 

commission accepted Dr. Kotay's opinion, resolving any 

inconsistencies in his medical records in favor of claimant. 

Dr. Kotay's medical records and opinions, coupled with the 

records of Dr. Smith and Dr. Zahnke, provide credible evidence 

from which the commission could reasonably infer that claimant's 

left shoulder complaints were causally related to her 

compensable June 18, 2001 injury by accident and that she was 

totally disabled beginning April 15, 2002 as a result of that 

accident. "Where reasonable inferences may be drawn from the 

evidence in support of the commission's factual findings, they 

will not be disturbed by this Court on appeal." Hawks v. 

Henrico County Sch. Bd., 7 Va. App. 398, 404, 374 S.E.2d 695, 

698 (1988). As fact finder, the commission was entitled to 

weigh the medical evidence, to accept Dr. Kotay's opinion, and 

to reject the contrary opinions of Drs. William A. McIlwain and 

Jim C. Brasfield, who examined claimant upon employer's request. 

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

consequence if there is credible evidence to support the 
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commission's finding." Wagner Enters., Inc. v. Brooks, 12 

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

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

Affirmed.