COURT OF APPEALS OF VIRGINIA 

Present: Judges Elder, Bray and Senior Judge Overton 

B.A. MULLICAN LUMBER & MANUFACTURING 

 AND SECURITY INSURANCE COMPANY 

 OF HARTFORD 

 MEMORANDUM OPINION*

v. Record No. 1771-01-3 PER CURIAM 

 NOVEMBER 6, 2001 

LARRY HUBBARD 

 FROM THE VIRGINIA WORKERS' COMPENSATION COMMISSION 

 (Ramesh Murthy; Lisa Frisina Clement; Penn 

Stuart, on brief), for appellants. 

 (P. Heith Reynolds; Wolfe, Farmer, Williams & 

Rutherford, on brief), for appellee. 

 B.A. Mullican Lumber & Manufacturing and Security Insurance 

Company of Hartford (hereinafter referred to as "employer") 

contend that the Workers' Compensation Commission erred in 

finding that Larry Hubbard proved that his April 24, 2000 

surgery and subsequent disability were causally related to his 

compensable July 2, 1999 injury by accident. 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. Rule 5A:27. 

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

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

 

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

designated for publication. 
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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). 

 On July 2, 1999, claimant suffered a compensable injury by 

accident which caused a left inguinal hernia. Employer 

stipulated that claimant was disabled from September 10, 1999, 

the date of his surgery for ventral and left inguinal hernia 

repairs by Dr. William Garrett, through October 10, 1999. 

 On April 24, 2000, Dr. Garrett treated claimant at the 

Lonesome Pine Hospital. Dr. Garrett noted that appellant 

presented at the emergency room with an apparent recurrent and 

incarcerated ventral hernia. Dr. Garrett performed an 

exploratory laparotomy, an appendectomy, and an evacuation of 

abscess and repair of the ventral hernia. Dr. Garrett rendered 

a post-operative diagnosis of a functional bowel obstruction and 

recurrence of ventral hernia secondary to perforated vermiform 

appendix with intraperitoneal abscess and free feces in the 

peritoneal cavity. 

 In his May 2, 2000 discharge summary, Dr. Garrett noted a 

diagnosis of vermiform appendix with peritonitis and sepsis, a 

functional small bowel obstruction with recurrent ventral 

hernia, hypertension, and atrial fibrillation. Dr. Garrett 
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noted that during the surgery claimant had an appendectomy, 

evacuation of abscess and repair of ventral hernia. Dr. 

Garrett's findings included a functional bowel obstruction with 

recurrence of the ventral hernia secondary to a perforated 

vermiform appendix with intraperitoneal abscess and free feces 

in the peritoneal cavity. 

 Employer referred claimant's medical records to 

Dr. Andrew P. Kramer for review. Dr. Kramer concluded that 

claimant's hernia repair on September 10, 1999 was causally 

related to his work accident. Dr. Kramer concluded further that 

the "recurrence of [claimant's] ventral hernia is an unfortunate 

sequelae of his previous surgery, and most like[ly] exacerbated

by his bout with appendicitis." (Emphasis added.) 

 "Medical evidence is not necessarily conclusive, but is 

subject to the commission's consideration and weighing." 

Hungerford Mechanical Corp. v. Hobson, 11 Va. App. 675, 677, 401 

S.E.2d 213, 215 (1991). Based upon the medical evidence taken 

as a whole, the commission concluded that claimant's recurrent 

hernia was causally related to his initial work-related hernia. 

Credible evidence, including the medical records of Drs. Garrett 

and Kramer support the commission's findings. Based upon their 

medical records, the commission, as fact finder, could 

reasonably infer that "although the recurrent hernia was not a 

direct consequence of the initial accident, it is a sequelae of 
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the previous surgery." "'When the primary injury is shown to 

have arisen out of and in the course of employment, every 

natural consequence that flows from the injury likewise arises 

out of the employment, unless it is the result of an independent 

intervening cause attributable to claimant's own intentional 

conduct.'" Imperial Trash Serv. v. Dotson, 18 Va. App. 600, 

606-07, 445 S.E.2d 716, 720 (1994) (quoting Morris v. Badger 

Powhatan/Figgie Int'l, Inc., 3 Va. App. 276, 283, 348 S.E.2d 

876, 879 (1986)). 

 "If there is evidence, or reasonable inferences can be 

drawn from the evidence, to support the Commission's findings, 

they will not be disturbed on review, even though there is 

evidence in the record to support a contrary finding." Morris, 

3 Va. App. at 279, 348 S.E.2d at 877. Accordingly, we affirm 

the commission's decision. 

 Affirmed.