COURT OF APPEALS OF VIRGINIA 

Present: Judges Baker, Elder and Fitzpatrick 

OWEN RILEY BOONE, M.D. 

 MEMORANDUM OPINION*

v. Record No. 0031-96-4 PER CURIAM 

 AUGUST 6, 1996 

LOUDOUN SURGICAL ASSOCIATES, LTD./ 

 THE VIRGINIA INSURANCE RECIPROCAL 

FROM THE VIRGINIA WORKERS' COMPENSATION COMMISSION 

 (Owen Riley Boone, pro se, on briefs). 

 (John E. McIntosh, Jr.; Crews & Hancock, on 

brief), for appellees. 

 Owen Riley Boone ("claimant") contends that the Workers' 

Compensation Commission ("commission") erred in finding that he 

failed to prove that his depression and post-traumatic stress 

syndrome were caused by either (1) an injury by accident arising 

out of and in the course of his employment; or (2) an ordinary 

disease of life related to conditions peculiar to his employment. 

 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. 

 I. Injury by Accident

 "To be compensable as an injury by accident, a purely 

psychological injury must be causally related to a physical 

injury or causally related to an obvious sudden shock or fright 

arising in the course of employment." Chesterfield County Fire 

 

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

designated for publication. 
 2 

Dept. v. Dunn, 9 Va. App. 475, 477, 389 S.E.2d 180, 182 (1990). 

Moreover, "purely psychological disability resulting from 

disagreements over managerial decisions and conflicts with 

supervisory personnel that cause stressful consequences . . . 

ordinarily are not compensable." Teasley v. Montgomery Ward & 

Co., 14 Va. App. 45, 49, 415 S.E.2d 596, 598 (1992). Unless we 

can say as a matter of law that claimant's evidence sustained his 

burden of proof, the commission's findings are binding and 

conclusive upon us. Tomko v. Michael's Plastering Co., 210 Va. 

697, 699, 173 S.E.2d 833, 835 (1970). 

 In holding that claimant failed to prove a compensable 

injury by accident, the commission found as follows: 

 [T]he notification of nonrenewal of a 

malpractice insurance policy, standing alone, 

or viewed in conjunction with a subsequent 

request for copies of medical records, is not 

the type of incident previously held by the 

Commission to engender a "sudden shock or 

fright . . ." Both of these incidents, which 

can be stressful, can reasonably be 

anticipated in the normal course of business 

and cannot be viewed as being so shocking as 

to rise to the level of compensability under 

§ 65.2-101. We further note that the 

claimant received the letter requesting 

copies of medical records at least one month 

after he received his insurance cancellation 

notice. These events cannot be viewed as a 

single specific incident. 

 It was undisputed that claimant's psychological condition 

was not the result of a physical injury. Moreover, the record 

supports the commission's factual findings which are binding upon 

appeal. These factual findings support the commission's 
 3 

conclusion that claimant's evidence did not rise to the level 

required to prove that his purely psychological injury was 

compensable as an injury by accident. 

 II. Occupational Disease

 A claimant must prove the existence of an occupational 

disease by a preponderance of the evidence. Virginia Dept. of 

State Police v. Talbert, 1 Va. App. 250, 253, 337 S.E.2d 307, 308 

(1985). Moreover, one seeking to establish that an ordinary 

disease of life is employment-related, and should be treated as 

an occupational disease, bears the burden of producing clear and 

convincing evidence in support of that claim. Code § 65.2-401. 

Claimant does not contest the commission's determination that the 

ordinary disease of life burden applied to his depression with 

post-traumatic stress disorder.1

 

 Code § 65.2-401 requires that for an ordinary disease of 

life to be treated as an occupational disease, a claimant must 

establish, by clear and convincing evidence, to a reasonable 

degree of medical certainty, that it arose out of and in the 

course of employment, as provided in Code § 65.2-400, and did not 

result from causes outside of the employment. Code § 65.2-400 

defines an occupational disease as one "arising out of and in the 

course of employment." Furthermore, the statute provides that 

 

 1The commission assumed, without deciding, that claimant's 

depression with post-traumatic stress disorder constituted a 

"disease" under the Workers' Compensation Act. Because employer 

did not appeal this finding, it is final and binding upon this 

Court on appeal. 
 4 

"[a] disease shall be deemed to arise out of the employment" when 

the evidence establishes six elements. Id. Element (3) requires 

that the disease "is characteristic of the employment and was 

caused by conditions peculiar to such employment." "Whether a 

disease is causally related to the employment and not causally 

related to other factors is . . . a finding of fact." Island 

Creek Coal Co. v. Breeding, 6 Va. App. 1, 12, 365 S.E.2d 782, 788 

(1988). 

 The commission found that claimant's evidence failed to 

prove the necessary causal link between his psychological 

condition and his employment. This finding is supported by the 

records and opinions of Drs. C. Gibson Dunn and Brian Schulman, 

psychiatrists. 

 Dr. Dunn's medical reports refer to numerous stressors in 

claimant's life, including long-standing personal conflicts with 

his partner, Dr. Thomas Gates, which would not lead to 

compensability, anxiety because of his wife's reaction to the 

prospect of his retiring, feelings of having been abused by the 

malpractice insurance system, anxiety because of his siblings' 

health problems, and claimant's own anxiety over whether he 

should retire or quit. The notations contained in these records 

support the commission's finding that claimant did not prove by 

clear and convincing evidence that his condition was primarily 

caused by his employment. The record showed that claimant had 

numerous sources of stress in his life that may have contributed 
 5 

to his condition. In fact, Dr. Dunn stated in his deposition 

that claimant's psychological condition was not characteristic of 

or peculiar to his work as a surgeon. 

 After performing a comprehensive psychiatric examination of 

claimant on May 23, 1995 and reviewing the records of Dr. Dunn, 

Dr. Schulman opined that "[t]here is no substantive medical 

evidence that Dr. Boone's depression was specifically caused by 

conditions of his employment or exposure to any specific 

psychosocial or occupational stressor." 

 Based upon this record, we cannot say as a matter of law 

that claimant's evidence sustained his burden of proving by clear 

and convincing evidence that his depression with post-traumatic 

stress syndrome arose out of and in the course of his employment 

pursuant to the requirements of Code § 65.2-401.For these 

reasons, we affirm the commission's decision. 

 Affirmed.