COURT OF APPEALS OF VIRGINIA 

Present: Judges Elder, Bumgardner and Lemons 

JERRY WAYNE COMBS 

 MEMORANDUM OPINION*

v. Record No. 1000-98-3 PER CURIAM 

 SEPTEMBER 15, 1998 

VALLEY HAULING, INC. AND 

 LIBERTY MUTUAL INSURANCE COMPANY 

 FROM THE VIRGINIA WORKERS' COMPENSATION COMMISSION 

 (D. Edward Wise, Jr.; Arrington, Schelin & 

Herrell, on brief), for appellant. 

 (John C. Johnson; Frith, Anderson & Peake, on 

brief), for appellees. 

 Jerry W. Combs ("claimant") contends that the Workers' 

Compensation Commission ("commission") erred in suspending his 

award of compensation benefits based on its finding that he 

unjustifiably refused reasonable and necessary medical treatment. 

 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. 

 "Code § 65.2-603(B) bars a claimant from receiving further 

compensation if the claimant unjustifiably refuses to accept 

medical services provided by the employer." Shawnee Management 

Corp. v. Hamilton, 25 Va. App. 672, 678-79, 492 S.E.2d 456, 459 

(1997) (en banc) (citations omitted). 

 In granting employer's application and holding that claimant 

 

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

designated for publication. 
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unjustifiably refused to undergo a reasonable and necessary 

diagnostic procedure, the commission made the following findings: 

 We note that the claimant's reported 

discomfort with Dr. [Matthew] Wood personally 

apparently did not arise until March 1997. 

Before then, the fact that the procedure was 

to be performed by Dr. Wood was not a factor. 

 We have carefully reviewed all the medical 

records filed with the Commission and find 

nothing inappropriate about the treatment by 

and recommendations of Dr. Wood in this case, 

and find no basis for the claimant's putative 

lack of trust. 

 We also conclude that the claimant's 

alleged "nerves" and mental attitude are 

raised in these proceedings only as a 

pretext. Combs was rejecting the cervical 

myelogram even before he manifested the 

psychological problems for which he was 

referred to Dr. [Robert W.] Hill and 

Dr. [Ronald W.] Brill. Moreover, even the 

early psychological reports do not suggest 

mental attitude as a basis for refusing the 

surgery, but anticipate that the procedures 

might be productive to reduce the claimant's 

chronic pain and help return him to gainful 

employment. Only much later were nerves and 

mental attitude raised as grounds to refuse 

the recommended procedure. 

 Claimant does not dispute that the cervical myelogram 

recommended by Dr. Wood constituted reasonable and necessary 

medical treatment and that claimant refused such treatment. 

Rather, claimant argues that the evidence proved that he was 

justified in refusing the procedure. We disagree. 

 "The matter of justification must be considered from the 

viewpoint of the patient and in light of the information which 

was available to him." Holland v. Virginia Bridge and 

Structures, Inc., 10 Va. 660, 662, 394 S.E.2d 867, 868 (1990). 
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The record supports the commission's finding that Drs. Wood and 

Melvin L. Heiman had fully explained to claimant the "benign and 

minimally invasive nature" of the cervical myelogram, which Dr. 

Wood had repeatedly recommended claimant undergo since April 

1994. 

 Moreover, the commission, as fact finder, was entitled to 

reject Dr. Brill's opinion and claimant's testimony that claimant 

was psychologically unable to undergo the procedure. Notably, 

during the same period of time that claimant alleged he was 

mentally unable to undergo the relatively "benign" myelogram 

procedure, he managed to have the mental capacity to undergo 

major shoulder surgery. In light of this fact, the lack of any 

credible evidence of personal friction or distrust by claimant 

with Dr. Wood, and the lack of any psychological basis for 

claimant's initial refusals to undergo the cervical myelogram, 

the commission could reasonably infer that "claimant's alleged 

'nerves' and mental attitude [were] raised . . . only as a 

pretext." Accordingly, the commission did not err in ruling that 

claimant unjustifiably refused to undergo the cervical myelogram. 

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

 Affirmed.