COURT OF APPEALS OF VIRGINIA 

Present: Judges Elder, Bray and Fitzpatrick 

Argued at Richmond, Virginia 

LINDA WYTIAZ 

 MEMORANDUM OPINION* BY 

v. Record No. 1672-95-2 JUDGE RICHARD S. BRAY 

 APRIL 2, 1996 

EDISON BROTHERS STORES, INC. and 

 LUMBERMENS MUTUAL CASUALTY COMPANY 

 FROM THE VIRGINIA WORKERS' COMPENSATION COMMISSION 

 

 Laura Large Geller (Geoffrey R. McDonald; 

McDonald & Snesil, P.C., on brief), for 

appellant. 

 Timothy P. Murphy (William W. Nexsen; 

Stackhouse, Smith & Nexsen, on brief), for 

appellees. 

 Linda Wytiaz (claimant) appeals a ruling by the Workers' 

Compensation Commission (commission) that Edison Brothers Stores, 

Inc. and its insurer, Lumbermens Mutual Casualty Company 

(employer), were not responsible for the cost of certain 

unauthorized medical treatment provided claimant incidental to a 

compensable injury. Finding no error, we affirm the decision of 

the commission. 

 The parties are fully conversant with the record in this 

case and we recite only those facts necessary to a disposition of 

this appeal. 

 On appeal, we construe the evidence in the light most 

favorable to the party prevailing below, employer in this 

 

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

designated for publication. 
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instance. Crisp v. Brown's Tysons Corner Dodge, Inc., 1 Va. App. 

503, 504, 339 S.E.2d 916, 916 (1986). 

 From a panel of physicians provided by employer incidental 

to her compensable accidental injuries, claimant selected Dr. 

Frank G. Burns, Jr., an orthopedic surgeon, as treating 

physician. See Code § 65.2-603(A)(1). Dr. Burns referred 

claimant to Dr. Raymond Troiano, a neurologist, and Dr. Warren 

Foer, a neurosurgeon, and employer does not challenge the 

attendant costs. However, employer declined responsibility for 

treatment provided claimant by Dr. Raymond Iglecia, a 

psychiatrist and neurologist who had previously treated claimant 

for "major depression, chronic pain[,] and polysubstance abuse 

secondary to [an unrelated] work . . . injury." On March 

7, 1994, Dr. Troiano noted that he "referred [claimant] back to 

Dr. Iglecia for pain management because [she] requested continued 

treatment by him." (Emphasis added). In correspondence to Dr. 

Burns dated March 28, 1994, Dr. Troiano wrote: 

 [Claimant] would like to go back to Dr. Iglecia for 

further treatment, but she has been told to come to see 

me because of her continued pains for neurologic 

evaluation . . . . Mrs. Wytiaz has been treated 

previously by Dr. Iglecia . . . so she is referred back 

to Dr. Iglecia for his treatment of this problem, since 

this is where Mrs. Wytiaz wants to receive treatment. 

(Emphasis added). 

 In a March 8, 1994 office note, Dr. Burns recorded, "I 

advised [claimant] that I wanted her to see a neurologist - she 

states she sees Dr. Iglecia - my book lists him as a 
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psychologist. I told her I can only advise her what to do I can 

not [sic] make her do it." Dr. Burns' office advised employer on 

March 22, 1994, that "[claimant] said that she would make an 

appointment with Dr. Iglecia today . . . . Dr. Burns was not 

familiar with this doctor. He would not have referred her to him 

because he does not use his services." Dr. Burns wrote employer 

on May 20, 1994, that claimant "[f]or some reason . . . has a lot 

of confidence in Dr. Iglecia although . . . she states he treated 

her from 1988-90 for back problems with very little improvement. 

 Perhaps it is psychological support she wishes." 

 It is well established that "'[n]either the employer nor its 

insurance carrier may limit the treating physician in the medical 

specialist, or treating facilities to which claimant may be 

referred for treatment.'" Jensen Press v. Ale, 1 Va. App. 153, 

158, 336 S.E.2d 522, 525 (1985) (citation omitted). If an 

industrial accident is causally related to the complaints that 

give rise to a referral, "the employer is financially responsible 

for the medical attention which the attending physician deems 

necessary . . . ." Volvo White Truck Corp. v. Hedge, 1 Va. App. 

195, 200, 336 S.E.2d 903, 906 (1985). Whether a treating 

physician has made a compensable referral is a question of fact, 

and "[w]e are bound by the Commission's . . . finding if 

supported by credible evidence." Jensen Press, 1 Va. App. at 

158-59, 336 S.E.2d at 525. 

 Here, the commission concluded that "Dr. Burns and Dr. 
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Troiano referred . . . claimant to Dr. Iglecia only to 

accommodate her wishes." The referral was, therefore, prompted 

by claimant's insistence rather than medical necessity, and 

"employer [was] not responsible for treatment provided by Dr. 

Iglacia [sic]." This determination by the commission enjoys 

support in the evidence and will not be disturbed on appeal. 

 Accordingly, we affirm the decision. 

 Affirmed.