COURT OF APPEALS OF VIRGINIA 

Present: Judges Benton, Elder and Overton 

Argued at Richmond, Virginia 

NORTHSIDE ELECTRIC COMPANY and 

 PENNSYLVANIA GENERAL INSURANCE 

 COMPANY 

 MEMORANDUM OPINION* BY 

v. Record No. 3105-96-2 JUDGE JAMES W. BENTON, JR. 

 JUNE 24, 1997 

NORBERT STEWART HICKS 

 FROM THE VIRGINIA WORKERS' COMPENSATION COMMISSION 

 Bradford C. Jacob (William C. Walker; Taylor & 

Walker, P.C., on brief), for appellants. 

 B. Mayes Marks, Jr., for appellee. 

 The Workers' Compensation Commission awarded Norbert S. 

Hicks disability benefits for various periods and the reasonable 

cost of his medical care. Northside Electric Company contends 

that the commission erred in finding (1) that Hicks' hearing loss 

was causally related to his injury by accident, and (2) that 

treatment by three physicians was authorized. We affirm the 

award. 

 I. 

 The principle is well established that the commission's 

factual findings are conclusive and binding on this Court if they 

are supported by credible evidence. See Code § 65.2-706; 

Manassas Ice & Fuel Co. v. Farrar, 13 Va. App. 227, 229, 409 

S.E.2d 824, 826 (1991). "The actual determination of causation 

 

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

designated for publication. 
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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). 

 "Following established principles, we review 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 proved that during Hicks' 

employment with Northside Hicks suffered an electrical shock 

while repairing a neon light. Hicks reached into an electrical 

box and was shocked with 15,000 volts of electricity. No 

controversy exists concerning the occurrence of this event. 

 Hicks testified that he immediately noticed a change in his 

hearing. Before the accident, Hicks owned hearing aids but only 

wore them when he went to church. He did not wear them to work 

and did not have them with him when the accident occurred. After 

the accident, Hicks had to turn the television up louder to hear 

it. Hicks also testified that he had to adjust his hearing aids 

to the highest volume setting to hear. 

 During the course of treatment for numbness and back pain 

caused by the shock, Hicks went to see Dr. Alvin Goldstone, an 

otolaryngologist who had been treating Hicks for approximately 20 

years for hearing problems. Dr. Goldstone had previously 

diagnosed Hicks with "sensory neural hearing loss." Dr. 

Goldstone opined that Hicks' hearing problems were "aggravated, 
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exacerbated, and/or accelerated when he was shocked with a high 

voltage of electricity on June 8, 1995." Dr. Goldstone reported 

"sensory neural loss of hearing, which has worsened." 

 Dr. Leslie S. Kreisler, a doctor hired by the employer, 

examined Hicks and disagreed with Dr. Goldstone's opinion. Dr. 

Kreisler stated that there was "no true documentation of sound 

levels or progression before or after the injury." Dr. Kreisler 

concluded that he could not "state with any reasonable degree of 

medical probability whether the electric shock injury increased 

. . . Hicks['] loss." 

 The commission found Dr. Goldstone's testimony and reports 

to be credible. In particular, the commission made the following 

findings: 

 It was initially Dr. Goldstone's opinion, as 

set forth in his narrative reports, that the 

increase in the loss of hearing was caused by 

the electrical shock. . . . The increase in 

the loss of hearing since [Hicks'] last visit 

on November 25, 1991, is documented. When 

Dr. Goldstone saw [Hicks] on January 5, 1996, 

some seven months after the industrial 

accident, he was not aware of the limited 

duck hunting with a shotgun in November or 

December 1995. 

 It remained Dr. Goldstone's opinion that 

the electrical shock caused the increase in 

the hearing loss, although he acknowledged, 

with refreshing candor, that he could not 

explain exactly how an electrical current 

passing through the body could cause this 

result. Repeated efforts to have him testify 

that [Hicks] was malingering was 

unsuccessful, and he did not waiver from his 

opinion on causation. Neither was Dr. 

Goldstone impressed with the limited hunting 

activities. Finally, it is clear that his 

opinion as to causation was based largely on 
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the history of hearing loss immediately 

following the shock. However, Dr. Goldstone 

also described [Hicks'] frankness and the 

reasons he felt that he was a reliable 

historian. The Deputy Commissioner's finding 

that the employer is responsible for the cost 

of this medical treatment for the increase in 

hearing loss, commencing with January 5, 

1996, is supported by the record and is 

affirmed upon Review. The finding, as to 

those issues raised by the employer upon 

Review, are, therefore, affirmed. 

 Northside argues that Dr. Kreisler's opinion was more 

credible. The principle is well established that "[a] question 

raised by conflicting medical opinion is a question of fact." 

Commonwealth v. Powell, 2 Va. App. 712, 714, 347 S.E.2d 532, 533 

(1986). Thus, "[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). 

 The commission was not required to accept Dr. Kreisler's 

opinion that he was unable to find that the shock increased 

Hicks' hearing loss. Although Dr. Kreisler noted that 

psychiatrists that perform electroshock therapy using 150 to 180 

volts have not documented cases of hearing loss, the evidence in 

this case is that Hicks came in contact with a 15,000 volt 

electrical line. The commission weighed the conflicting reports 

and provided a cogent reason for accepting Dr. Goldstone's 

opinion. Accordingly, we hold that Dr. Goldstone's opinion that 

the severe electrical shock aggravated Hicks' underlying 

condition is credible evidence that supports the award. Cf.

Farrar, 13 Va. App. at 233-34, 409 S.E.2d at 828. 
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 II. 

 After Hicks reported the incident to his supervisor, 

Northside did not give Hicks a panel of doctors to choose from. 

Hicks visited Dr. Martirosian, a cardiologist he had previously 

seen for an enlarged valve in his heart. Dr. Martirosian ordered 

tests and could not determine what was wrong with Hicks. Hicks 

then went to see Dr. Melhorn, an osteopath Hicks considered to be 

his family doctor. Dr. Melhorn sent Hicks to have an MRI, which 

indicated that nothing was wrong with Hicks' lower back. 

 Dr. Martirosian referred Hicks to Dr. Velo, a neurosurgeon. 

 Dr. Velo concluded that Hicks' "trouble was in [his] neck" and 

recommended surgery. Hicks' wife talked to Northside's insurance 

representative and told the representative that Hicks had seen 

Dr. Martirosian, Dr. Velo, and Dr. Melhorn. At that time, Hicks 

had not seen any other doctors. The representative did not tell 

Hicks' wife to take Hicks to a particular doctor or to continue 

seeing Dr. Velo. 

 Hicks talked to Dr. Velo about the possibility of a second 

opinion. Hicks mentioned to Dr. Velo that he wanted to see Dr. 

Isaacs, a doctor that had been treating Hicks' wife. Dr. Isaacs 

examined Hicks and noted in his report that he reviewed Dr. 

Velo's reports. Dr. Isaacs sent a copy of his report to Dr. 

Velo. After examining Hicks, Dr. Isaacs referred Hicks to Dr. 

Allen. 

 Hicks initially met with Dr. Allen and later was treated by 
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Dr. Allen's partner, Dr. Melisi, when Dr. Allen was out of the 

country. Northside's insurance carrier eventually referred 

Hicks' wife to a nurse who worked for the insurance carrier. 

Hicks' wife told the nurse that Hicks had seen Drs. Martirosian, 

Velo, Isaacs, and Allen. The nurse told Hicks' wife that Dr. 

Allen belonged to "a good group of doctors." Dr. Allen 

recommended, and Dr. Melisi ultimately performed, the same 

surgery Dr. Velo had originally recommended. 

 The commission made the following findings: 

 The initial course of treatment through 

Dr. Velo's last examination on October 3, 

1995, is not contested by [Northside] . . . . 

 We find that the course of treatment 

commencing with Dr. Isaacs was upon referral, 

rather than a change in physicians initiated 

by [Hicks], as argued by [Northside] upon 

Review. Surgery was recommended and he was 

clearly within his rights in requesting a 

second opinion. Dr. Velo acquiesced and 

referred [Hicks] for this purpose. However, 

Dr. Isaacs did not undertake treatment but 

only evaluated him as requested. He reported 

his findings to Dr. Velo and recommended 

against surgery, but at the same time, 

referred [Hicks] for further neurologic 

evaluation. At that point, surgery was 

recommended, and he came under the care of 

Dr. Allen and physicians in his medical 

group. Dr. Velo did not see [Hicks] after 

October 3, 1995, and there is no duplication 

of medical treatment. [Northside's] 

insurance carrier was clearly informed of 

this course of treatment commencing with Dr. 

Isaacs and offered no objection. The record 

establishes a clear chain of referrals by 

treating physicians for the industrial 

injury. The Deputy Commissioner's finding 

that [Northside] should be responsible for 

the cost of treatment by Drs. Allen, Melisi, 

and Isaacs, as well as the cost of surgery, 

is, therefore, affirmed. 
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 Credible evidence in the record supports the commission's 

finding that when Dr. Velo recommended surgery, Hicks 

appropriately requested a second opinion. That Hicks suggested 

to Dr. Velo that Dr. Isaacs be the physician to render a second 

opinion is of no moment. Dr. Isaacs examined Hicks, reviewed Dr. 

Velo's reports, and advised Dr. Velo of his findings. The 

commission's finding that Dr. Velo acquiesced in both the review 

by Dr. Isaacs and the later referral is supported by the record. 

 "If there is evidence or reasonable inference that can be drawn 

from the evidence to support the [c]ommission's findings, they 

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

Dan River Mills, Inc., 225 Va. 405, 411, 302 S.E.2d 507, 510-11 

(1983). We do not retry the facts or review the weight of the 

evidence. See id.

 In addition, the record is uncontradicted that Northside 

failed to provide Hicks with the opportunity to select a 

physician from a panel of at least three physicians as required 

by Code § 65.2-603(A)(1). Also uncontradicted is the evidence 

that Hicks' wife contacted Northside's insurance carrier when 

Hicks was seeking treatment from various doctors. The carrier's 

silence and the nurse's positive comments regarding Dr. Allen 

were reasonably interpreted by Hicks as authorization for the 

treatment. 

 For these reasons, we affirm the award. 

 Affirmed.